Baton Rouge Community College NU335 Spring 2026 Final.
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Free Baton Rouge Community College NU335 Spring 2026 Final. Questions
The nurse receives a patient after hemodialysis is completed. Which action by the nurse prior to dialysis is most likely responsible for the patient’s current status?
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Missed dialysis appointments
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Administration of medications post-dialysis
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Decreased blood pressure monitoring
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Unresolved issues with client's acute exacerbation
Explanation
The correct answer is A) Missed dialysis appointments.
From the patient's nursing notes, it is indicated that the client missed two weeks of hemodialysis due to lack of transportation. This missed treatment could have led to the acute exacerbation of their condition, making this the most likely cause of the patient's current status.
Which laboratory result will the nurse expect if a patient develops heparin-induced thrombocytopenia (HIT)?
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Increased Hgb
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Decreased D-dimer
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Decreased Platelets
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Increased Activated partial thromboplastin time (aPTT)
Explanation
Correct Answer: C) Decreased Platelets
Heparin-induced thrombocytopenia (HIT) is an immune-mediated reaction to heparin in which antibodies form against the heparin-platelet factor 4 complex, leading to platelet destruction and a paradoxical increase in thrombosis risk. The hallmark laboratory finding is a significant drop in platelet count — typically a decrease of 50% or more from baseline, occurring 5–10 days after heparin initiation. D-dimer would be elevated (not decreased) due to clot formation, and hemoglobin is not directly affected by HIT.
Prescribed: Begin propofol IV infusion at 9 mL/hr Available: propofol 1000 mg/100 mL Patient's weight: 75 kg Calculate how many mcg/kg/min the patient is receiving? Record your answer to whole number.
Explanation
Correct Answer: 20 mcg/kg/min
Step 1 — Convert concentration: 1000 mg/100 mL = 10 mg/mL = 10,000 mcg/mL.
Step 2 — Calculate mcg/min: 9 mL/hr ÷ 60 min/hr = 0.15 mL/min × 10,000 mcg/mL = 1,500 mcg/min.
Step 3 — Calculate mcg/kg/min: 1,500 mcg/min ÷ 75 kg = 20 mcg/kg/min.
Four victims of an automobile accident are brought by the ambulance to the emergency department. Based on the principles of triage, the nurse determines that which patient has the highest priority for treatment?
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A sucking chest wound
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Absent pedal pulses
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Bleeding of head lacerations
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An open femur fracture
Explanation
Correct Answer: A) A sucking chest wound
In triage, priority is given to patients with life-threatening but survivable injuries. A sucking chest wound (open pneumothorax) directly compromises ventilation and oxygenation, as air enters the pleural space with each breath, collapsing the lung and potentially progressing to a tension pneumothorax — a rapidly fatal condition requiring immediate intervention.
This is the highest priority among the choices. Absent pedal pulses suggest vascular compromise but are not immediately life-threatening. Head lacerations bleed profusely but are rarely immediately fatal. An open femur fracture is serious but does not directly threaten airway or breathing as immediately as a sucking chest wound.
Prescribed: Heparin bolus 50 units/kg IV now then begin Heparin drip at 12 units/kg/hour. Available: Heparin 5000 units per mL. Patient weight: 70 kg. How many mL will the nurse administer for the prescribed bolus dose? Record your answer to the nearest tenth place.
Explanation
Correct Answer: 0.7 mL
Step 1 — Calculate the required bolus dose: 50 units/kg × 70 kg = 3,500 units
Step 2 — Calculate the volume to administer: 3,500 units ÷ 5,000 units/mL = 0.7 mL
The nurse will administer 0.7 mL for the heparin bolus dose.
A nurse is caring for a patient with a right radial arterial line. Which action should the nurse take?
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Ensure the pressure bag around the flush solution is inflated to 300 mm Hg
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Flush the line before administering antibiotics
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Instruct the patient to bear down when readings are obtained
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Position the patient in Trendelenburg to obtain readings
Explanation
Correct Answer: A) Ensure the pressure bag around the flush solution is inflated to 300 mm Hg
The pressure bag surrounding the flush solution of an arterial line must be maintained at 300 mm Hg to keep the flush solution flowing at approximately 3 mL/hour, which prevents backflow of blood into the tubing and maintains line patency. Arterial lines should never be used to administer medications such as antibiotics — they are for hemodynamic monitoring and blood sampling only. Instructing the patient to bear down (Valsalva maneuver) is used during central venous catheter insertion, not arterial line readings. Trendelenburg positioning is not required for accurate arterial line readings.
The nurse is caring for a patient with a chest tube status-post lobectomy. To ensure the chest tube drainage system is functioning correctly, as the patient breathes, the nurse will monitor which chamber of the drainage system for tidaling?
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Water-seal chamber
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Suction control chamber
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Collection chamber
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Window chamber
Explanation
Correct Answer: A) Water-seal chamber
Tidaling refers to the rise and fall of fluid in the water-seal chamber with each breath — rising during inspiration and falling during expiration. This fluctuation confirms that the chest tube is patent and the drainage system is functioning correctly. Absence of tidaling may indicate a kinked tube, clot, or lung re-expansion. The suction control chamber regulates suction pressure, the collection chamber collects drainage, and there is no "window chamber" in chest tube drainage systems.
The nurse assesses that a patient receiving warfarin is bleeding. What drug should the nurse prepare to administer to this patient?
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Protamine sulfate
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Vitamin K
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Calcium gluconate
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Vitamin E
Explanation
Correct Answer: B) Vitamin K
Vitamin K is the specific antidote for warfarin toxicity and warfarin-induced bleeding. Warfarin works by inhibiting Vitamin K-dependent clotting factors (II, VII, IX, X), so administering Vitamin K reverses this effect by restoring clotting factor synthesis. Protamine sulfate is the antidote for heparin overdose, not warfarin. Calcium gluconate is used for hypocalcemia or magnesium toxicity. Vitamin E has no role in reversing anticoagulation.
The patient with leukemia has acute disseminated intravascular coagulation (DIC) and is bleeding. What diagnostic finding supports this diagnosis?
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Reduced fibrin split products (FSPs)
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Elevated D-dimer
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Elevated fibrinogen
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Reduced prothrombin time (PT)
Explanation
Correct Answer: B) Elevated D-dimer
DIC involves simultaneous widespread clotting and bleeding, consuming clotting factors and activating fibrinolysis. Elevated D-dimer is a hallmark finding of DIC, reflecting extensive fibrin clot breakdown. FSPs would be elevated (not reduced) in DIC due to increased fibrinolysis. Fibrinogen would be decreased (consumed), not elevated. PT would be prolonged (not reduced) due to depletion of clotting factors. Elevated D-dimer, along with low platelets, prolonged PT/PTT, and decreased fibrinogen, confirms DIC.
A patient with electrical burns develops arrhythmias. What is the nurse's priority action?
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Maintain NPO status
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Administer morphine
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Apply cooling measures
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Initiate cardiac monitoring
Explanation
Correct Answer: D) Initiate cardiac monitoring
Electrical burns carry a high risk of life-threatening cardiac arrhythmias because electrical current travels through the body and directly disrupts the heart's electrical conduction system. The priority action when arrhythmias develop is to initiate continuous cardiac monitoring to identify the type of arrhythmia and guide treatment. Maintaining NPO status is appropriate for surgical preparation but is not the priority in this acute situation. Morphine addresses pain but does not treat arrhythmias. Cooling measures are used for thermal burns but are not indicated for electrical burn-induced arrhythmias.
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