NR 325 EXAM 1,2,3 AND FINAL NEWEST ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
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NRS 325 FINAL EXAM NEWEST 2024-2025 ACTUAL
EXAM COMPLETE 150 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
The nurse should include which instructions when teaching a patient
about sulfamethoxazole therapy? SATA
A. “Use sunscreen when you are outside”
B. “If you have diarrhea more than five times a day, notify your
healthcare provider”
C. “Avoid using this drug if you are pregnant”
D. “Stop taking the drug if you experience nausea”
E. “Stop taking the drug if you experience vomiting” – ANSWERAnswers: A, B, C
Rationale: A – sulfamethoxazole has a side effect of photosensitivity
therefore the patient should cover up and use sunscreen when in
direct sunlight. B – This is a symptom of a superinfection (such as c.
diff) and the provider should be notified. C – sulfamethoxazole is
contraindicated in pregnancy (and in newborns). D & E – These can
be expected side effects of antibiotic use.
You are ordered to take a peak and trough for a patient on vancomycin.
The student nurse shadowing you asks why this is important. Which
statement by the nurse would be the best response?
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A. “It’s to show how well the medication is metabolizing in the body.”
B. “These tests help identify what kind of infection the body is fighting.”
C. ” These tests help determine if a medication is in therapeutic range.”
D. ” Using these tests will help us decide if we need to switch to another
drug.” – ANSWER- Answer: C
Rationale: A peak and trough is obtained to help determine whether
a drug is in therapeutic range for it to be effective. If the peak is too
high, the drug becomes toxic, and if it becomes too low, then the
drug is not as effective.
You are treating a patient with vancomycin and begin to see redness
around the IV site and the patient reports that, “my throat feels a little
tight”. Which is a priority intervention that the nurse can do.
A. Call the provider
B. Stop the infusion
C. Give the patient epinephrine
D. This is a normal reaction to the drug – ANSWER- Answer: B
Rationale: This is an adverse reaction and the drug should be
stopped immediately. Calling the provider is also important, but not
the priority action. Epinephrine may be indicated, but it is still not
the priority action in this scenario.
A patient comes in feeling fatigued and has redness in different areas of
their skin. The doctor concludes that they have a fungal infection and
prescribed amphotericin B as a medication. The nurse notes the patient
has adequate understanding of the drug with which statement?
A. “I should watch my teeth for any yellowing while on this medication”
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B. ” I will be more prone to bleeding and infections.”
C. ” I should decrease my activity and exercise less.”
D. ” I will feel sleepy when I take this medication.” – ANSWERAnswer: B
Rationale: Amphotericin B causes bone marrow suppression, which
decreases WBC, Platelets, and RBC. The patient will be more prone
to bleeding and infections.
*Side note: amphotericin B is typically only used for life-threatening
fungal infections and requires pre-medicating for adverse effects and
close monitoring of the patient after administration. It is likely not being
used outpatient for mild skin/fungal infections.
A nurse is helping a patient who was ordered gentamicin for a bacterial
infection. What is a priority step that the nurse must do when giving
gentamicin?
A. Avoid giving the patient zinc, calcium, and other vitamins with this
medication
B. Teach the patient to avoid long exposure to sunlight
C. Take the peak and trough for this medication
D. Watch for signs of seizure and neuropathy – ANSWER- Answer: C
Rationale: Gentamicin is an aminoglycoside and they have a narrow
therapeutic range. Drawing a peak and trough would be a priority
to make sure the drug will be most effective.
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A patient with myasthenia gravis was recently diagnosed with a bacterial
infection in a left foot wound. The doctor prescribed gentamicin q8 hrs
via IV. Which is the priority nursing action?
A. Administer the medication and educate the patient about the risk of cdiff infections.
B. Hold the medication and call the provider because of the risk of
causing respiratory suppression.
C. Take a peak and trough because of gentamicin’s narrow therapeutic
range.
D. Monitor closely for tinnitus and vertigo. – ANSWER- Answer: B
Rationale: MG is an autoimmune disorder that results in muscle
weakness. When combined with aminoglycosides, it can result in
life-threatening respiratory paralysis.
A patient with a history of asthma is prescribed IV prednisone to
manage their airway inflammation and acute exacerbations. Which
nursing education does not require further teaching?
A. Recommend foods high in calcium and vitamin D
B. Advise the patient to increase fluid intake
C. Promote a low-potassium diet
D. Advise the patient to immediately stop taking prednisone if s/sx of
infection occur – ANSWER- Answer: A
Rationale: A – Long-term corticosteroid use is associated with bone
loss → vitamin D foods can help prevent osteoporosis. B –
Corticosteroids cause fluid retention → should not recommend
increase in fluid intake. C – Corticosteroids cause K+ loss → may
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NR 325 EXAM 3 NEWEST 2024-2025 ACTUAL EXAM
COMPLETE 200 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
- The nurse is performing an assessment of an 80-year-old patient.
Which information obtained by the nurse will be of most concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion – ANSWER- ANS: C
Rationale: Unintentional weight loss is not a normal finding in older
patients and may indicate a problem such as cancer or depression.
Poor appetite, difficulty in chewing, and complaints of indigestion
are common in older patients. These will need to be addressed, but
are not of as much concern as the weight loss - To promote bowel evacuation in a patient with chronic complaints of
constipation, the nurse will suggest that the patient should attempt
defecation
a. in the mid-afternoon.
b. after eating breakfast.
c. right after getting up in the morning.
d. immediately before the first daily meal. – ANSWER- ANS: B
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Rationale: These reflexes are most active after the first daily meal.
Arising in the morning, the anticipation of eating, and physical
exercise do not stimulate these reflexes.
- When a patient has a history of a total gastrectomy, the nurse will
monitor for clinical manifestations of
a. constipation.
b. dehydration.
c. elevated total cholesterol.
d. cobalamin (vitamin B12) deficiency. – ANSWER- ANS: D
Rationale: The patient with a total gastrectomy does not secrete
intrinsic factor, which is needed for cobalamin (vitamin B12)
absorption. Because the stomach absorbs only small amounts of
water and nutrients, the patient is not at higher risk for
dehydration, elevated cholesterol, or constipation. - The nurse will monitor a patient who has an obstruction of the
common bile duct for
a. melena.
b. steatorrhea.
c. decreased serum cholesterol levels.
d. increased serum indirect bilirubin levels. – ANSWER- ANS: B
Rationale: A common bile duct obstruction will reduce the
absorption of fat in the small intestine, leading to fatty stools.
Gastrointestinal (GI) bleeding is not caused by common bile duct
obstruction. Serum cholesterol levels are increased with biliary
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obstruction. Direct bilirubin level is increased with biliary
obstruction.
- During change-of-shift report, the nurse receives the following
information about a patient who is scheduled for a colonoscopy. Which
information should be communicated to the health care provider before
sending the patient for the procedure?
a. The patient has a permanent pacemaker to prevent bradycardia.
b. The patient is worried about discomfort during the examination.
c. The patient has had an allergic reaction to shellfish and iodine in the
past.
d. The patient refused to drink the ordered polyethylene glycol
(GoLYTELY). – ANSWER- ANS: D
Rationale: If the patient has had inadequate bowel preparation, the
colon cannot be visualized and the procedure should be rescheduled.
Because contrast solution is not used during colonoscopy, the iodine
allergy is not pertinent. A pacemaker is a contraindication to
magnetic resonance imaging (MRI), but not to colonoscopy. The
nurse should instruct the patient about the sedation used during the
examination to decrease the patient’s anxiety about discomfort. - When the nurse is obtaining a history from a patient who is admitted
with jaundice, which statement is most indicative of a need for patient
teaching?
a. “I used cough syrup several times a day last week.”
b. “I take a baby aspirin every day to prevent strokes.”
c. “I need to take an antacid for indigestion several times a week”
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d. “I use acetaminophen (Tylenol) every 4 hours for chronic pain.” –
ANSWER- ANS: D
Rationale: Chronic use of high doses of acetaminophen can be
hepatotoxic and may have caused the patient’s jaundice. The other
patient statements require further assessment by the nurse, but do
not indicate a need for patient education.
When the nurse is listening to a patient’s abdomen, which finding
indicates a need for a focused abdominal assessment?
a. Loud gurgles
b. High-pitched gurgles
c. Absent bowel sounds
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To palpate the liver, the nurse
a. places one hand on the patient’s back and presses upward and inward
with the other hand below the patient’s right costal margin.
b. places one hand on top of the other and uses the upper fingers to apply
pressure and the bottom fingers to feel for the liver edge.
c. presses slowly and firmly over the right costal margin with one hand
and withdraws the fingers quickly after the liver edge is felt.
d. places one hand under the patient’s lower ribs and presses the left
lower rib cage forward, palpating below the costal margin with the other
hand. – ANSWER- ANS: A
Rationale: The liver is normally not palpable below the costal
margin, the nurse needs to push inward below the right costal
margin while lifting the patient’s back slightly with the left hand.
The other methods will not allow palpation of the liver.
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NR 325 EXAM 2 NEWEST 2024-2025 ACTUAL EXAM
COMPLETE 100 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
_ is used to assess soft tissue injury, neurologic changes, unexplained neurologic deficits, or worsening neurologic condition in SCI. – ANSWER- MRI Goals immediately after include maintaining a patent
airway, adequate ventilation/breathing, and adequate circulating
blood volume (ABCs) and preventing extension of spinal cord
damage (secondary injury). – ANSWER- SCI
allows the patient to move and ambulate while cervical
bones fuse – ANSWER- Halo fixation device
One of the physically demonstrable symptoms of meningitis is
__. Severe neck stiffness causes a patient’s hips and
knees to flex when the neck is flexed. – ANSWER- Brudzinski’s
sign
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Positive _ sign is involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges) – ANSWER- Brudzinski’s sign is a neuropsychiatric manifestation of liver
disease. The pathogenesis is multifactorial. It includes the
neurotoxic effects of ammonia, abnormal neurotransmission,
astrocyte swelling, and inflammatory cytokines. – ANSWERHepatic encephalopathy
A characteristic manifestation of hepatic encephalopathy is
, or flapping tremors, with the most common involving the
arms and hands. – ANSWER- asterixis
If the common bile duct is obstructed due to , no bilirubin
will reach the small intestine to be converted to urobilinogen.
Thus the kidneys will excrete bilirubin, causing dark amber to
brown urine. – ANSWER- cholelithiasis
Complications of _ and cholecystitis include gangrenous
cholecystitis, subphrenic abscess, pancreatitis, cholangitis
(inflammation of biliary ducts), biliary cirrhosis, fistulas, and
rupture of the gallbladder, which can cause bile peritonitis. –
ANSWER- cholelithiasis
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Manifestations of _ vary from indigestion to moderate to severe pain, fever, chills, and jaundice. – ANSWERcholecystitis When a stone is lodged in the ducts or when stones are moving through the ducts, spasms may result in response to the stone. This sometimes causes severe pain, which is termed
. – ANSWER- biliary colic
results in the replacement of liver tissue by fibrosis (scar
tissue) and regenerative nodules that occur from the liver’s
attempt to repair itself – ANSWER- cirrhosis
Hepatic encephalopathy caused by cirrhosis is treated with
, to prevent breakdown of blood and the release of
ammonia in the intestine. – ANSWER- lactulose
Increased levels of alkaline phosphatase, ALT, and AST are the
notable labs present with . – ANSWER- cholecystitis
After an _, tell the patient to avoid heavy lifting for
4 to 6 weeks. Usual sexual activities, including intercourse, can
be resumed as soon as the patient feels ready, unless otherwise
instructed by the HCP. – ANSWER- incisional cholecystectomy
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- Remove the bandages on the puncture sites the day after
surgery and you can shower. - Notify your HCP if any of the following signs and symptoms
occurs:
- Redness, swelling, bile-colored drainage or pus from any
incision - Severe abdominal pain, nausea, vomiting, fever, chills
- You can gradually resume normal activities.
- Return to work within 1 wk of surgery.
- You can resume your usual diet, but a low-fat diet is usually
better tolerated for several weeks after surgery. – ANSWER- PT
education for lap cholecystectomy
_ is a blood-borne pathogen that can cause either acute or chronic hepatitis. – ANSWER- Hepatitis B (HBV) pain has a sudden onset. It is described as severe, deep,
piercing, and continuous or steady. Eating worsens the pain. –
ANSWER- Pancreatitis
The most common cause of __ is drugs,
usually acetaminophen. Other drugs that can cause acute liver
failure include isoniazid, sulfa-containing drugs, and
anticonvulsants. – ANSWER- acute liver failure
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NR 325 EXAM 1 NEWEST 2024-2025 ACTUAL EXAM
COMPLETE 100 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
A female patient with a suspected urinary tract infection (UTI) is to
provide a clean-catch urine specimen for culture and sensitivity testing.
To obtain the specimen, the nurse will
a. have the patient empty the bladder completely, then obtain the next
urine specimen that the patient is able to void.
b. teach the patient to clean the urethral area, void a small amount into
the toilet, and then void into a sterile specimen cup.
c. insert a short sterile “mini” catheter attached to a collecting container
into the urethra and bladder to obtain the specimen.
d. clean the area around the meatus with a povidone-iodine (Betadine)
swab, and then have the patient void into a sterile container. –
ANSWER- ANS: B
Rationale: This answer describes the technique for obtaining a
clean-catch specimen.clean the area around the meatus with a
povidone-iodine (Betadine) swab, and then have the patient void
into a sterile container
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The nurse is caring for a 68-year-old hospitalized patient with a
decreased glomerular filtration rate who is scheduled for an intravenous
pyelogram (IVP). Which action will be included in the plan of care?
a. Monitor the urine output after the procedure.
b. Assist with monitored anesthesia care (MAC).
c. Give oral contrast solution before the procedure.
d. Insert a large size urinary catheter before the IVP. – ANSWER- ANS:
A
Rationale: Patients with impaired renal function are at risk for
decreased renal function after IVP because the contrast medium
used is nephrotoxic, so the nurse should monitor the patient’s urine
output.
Which nursing action is essential for a patient immediately after a renal
biopsy?
a. Check blood glucose to assess for hyperglycemia or hypoglycemia.
b. Insert a urinary catheter and test urine for gross or microscopic
hematuria.
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c. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal
function.
d. Apply a pressure dressing and keep the patient on the affected side for
30 minutes. – ANSWER- ANS: D
Rationale: A pressure dressing is applied and the patient is kept on
the affected side for 30 to 60 minutes to put pressure on the biopsy
side and decrease the risk for bleeding.
A male patient in the clinic provides a urine sample that is red-orange in
color. Which action should the nurse take first?
a. Notify the patient’s health care provider.
b. Teach correct midstream urine collection.
c. Ask the patient about current medications.
d. Question the patient about urinary tract infection (UTI) risk factors. –
ANSWER- ANS: C
Rationale: A red-orange color in the urine is normal with some
over-the-counter (OTC) medications such as phenazopyridine
(Pyridium).
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A female patient being admitted with pneumonia has a history of
neurogenic bladder as a result of a spinal cord injury. Which action will
the nurse plan to take first?
a. Ask about the usual urinary pattern and any measures used for bladder
control.
b. Assist the patient to the toilet at scheduled times to help ensure
bladder emptying.
c. Check the patient for urinary incontinence every 2 hours to maintain
skin integrity.
d. Use intermittent catheterization on a regular schedule to avoid the risk
of infection. – ANSWER- ANS: A
Rationale: Before planning any interventions, the nurse should
complete the assessment and determine the patient’s normal bladder
pattern and the usual measures used by the patient at home.
Which information from a patient’s urinalysis requires that the nurse
notify the health care provider?
a. pH 6.2
b. Trace protein
c. WBC 20 to 26/hpf
d. Specific gravity 1.021 – ANSWER- ANS: C
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