Foundation Exam #5 Summer 2025 at Denver College of Nursing

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Free Foundation Exam #5 Summer 2025 at Denver College of Nursing Questions

1. A nurse is planning a community health class about herbal remedies for a group of older adults. Which information about herbal remedies should the nurse include in the class?
  • Herbal supplements can be taken in larger quantities than pharmacological medications.
  • Herbal remedies are always safe and can be used without worries.
  • Herbal supplements can cause serious herbal-drug interactions with prescribed medications.
  • All herbal supplements are approved by the FDA and can be used regularly.

Explanation

Many herbal supplements can interact with prescription or over-the-counter medications, altering their effectiveness or causing harmful side effects. For example, St. John’s Wort can reduce the effectiveness of antidepressants and oral contraceptives, while Ginkgo biloba can increase bleeding risk when taken with anticoagulants. Older adults are especially vulnerable due to polypharmacy. Nurses should emphasize discussing all supplements with healthcare providers before use.
2. A nurse is taking care of a 24-year-old client. The client exhibits signs of muscle weakness and paralysis through the day. The nurse suspects which complication?
  • Drowsiness
  • Narcolepsy
  • Sleep apnea
  • Cataplexy

Explanation

Cataplexy is a sudden and temporary episode of muscle weakness or paralysis triggered by strong emotions such as laughter, anger, or surprise. It is often associated with narcolepsy, a sleep disorder that causes excessive daytime sleepiness. During cataplexy, the client remains conscious but unable to move, and muscle tone is suddenly lost. The nurse should assess for additional symptoms of narcolepsy and ensure safety during these episodes.
3. During a morning assessment, the nurse notes agitation in the client. When asked, the client states that they woke up suddenly and was unable to move. The nurse knows that this is referred to as:
  • Congestive Heart Failure
  • Sleep Paralysis
  • Cataplexy
  • Narcolepsy

Explanation

Sleep paralysis occurs when a person wakes up or is about to fall asleep and is temporarily unable to move or speak. It happens when the brain awakens from REM sleep, but the body’s muscle atonia (paralysis during REM) persists briefly. This can cause significant fear or agitation, though it is typically harmless and resolves within seconds to minutes.
4. A client in a LTC facility is preparing for bed. The nurse knows that which sleep/bedtime hygiene actions can be delegated to the UAP? Select all that apply. One, some, or all options may be correct.
  • Providing warm tea to the client after verifying their diet orders.
  • Assessing the client for side effects of a sleeping pill given by the nurse.
  • Helping the client into their pajamas.
  • Assisting the client to brush their teeth.
  • Turning on music for the client to listen to.

Explanation

C. Helping the client into their pajamas: This is an activity of daily living (ADL) that can safely be delegated to the UAP. It helps prepare the client physically for rest and promotes comfort before sleep. D. Assisting the client to brush their teeth: This is another basic care activity appropriate for delegation. Oral hygiene before bed supports comfort and health, promoting good sleep hygiene. E. Turning on music for the client to listen to: Providing relaxing background music as part of the bedtime routine is a non-invasive comfort measure that UAPs can assist with to promote relaxation and sleep.
5. The nurse administers 0.9% Normal Saline intravenous (IV) to a client. In which direction will the fluid shift?
  • Hypertonic to Homeostatic
  • Extracellular to Intracellular
  • No net movement
  • Intracellular to Extracellular

Explanation

0.9% Normal Saline (NS) is an isotonic solution, meaning it has the same osmolarity as plasma. Because the solute concentration is equal inside and outside the body’s cells, there is no osmotic gradient to cause fluid to shift between compartments. This maintains the balance between the intracellular and extracellular fluid volumes. Isotonic fluids are commonly used for fluid resuscitation and volume replacement without altering cell size.
6. The nurse is caring for a client with hyperkalemia. The nurse knows that which body system assessment is a priority?
  • Neurological
  • Cardiac
  • Respiratory
  • Gastrointestinal

Explanation

Hyperkalemia (elevated serum potassium) primarily affects the cardiac system because potassium plays a critical role in the electrical conduction of the heart. High potassium levels can lead to life-threatening dysrhythmias, including bradycardia, ventricular fibrillation, or cardiac arrest. The nurse should prioritize continuous cardiac monitoring and assess for ECG changes such as peaked T waves, widened QRS complexes, and prolonged PR intervals.
7. A student nurse is working on a busy medical/surgical floor. When asked by the client how much fluid the client should be taking daily, the student nurse knows the correct answer would be:
  • 3000 mL daily
  • 2300 mL daily
  • 1800 mL daily
  • 1000 mL daily

Explanation

The average adult requires about 2300 mL (2.3 liters) of fluid per day to maintain proper hydration and support normal physiological functions such as circulation, temperature regulation, and waste elimination. Fluid needs may vary depending on age, activity level, and health status, but 2 to 3 liters daily is the general guideline for healthy adults without fluid restrictions.
8. The nurse prepares an 80-year-old client with type 2 diabetes for hip replacement surgery. The client weighs 400 pounds and is 5 feet 2 inches tall and smokes 2 packs of cigarettes per day. Which factors increase this client's risk for surgical complications? Select all that apply. One, some, or all options may be correct.
  • Delayed wound healing
  • Obesity
  • No family history of anesthesia complications
  • Good clotting times are shown in the client's labs
  • Age

Explanation

A. Delayed wound healing: This client has type 2 diabetes and smokes heavily, both of which impair circulation and oxygenation to tissues, resulting in delayed wound healing and increased risk for infection after surgery. B. Obesity: The client’s extreme obesity (400 lbs, 5'2") increases the risk for respiratory compromise, wound dehiscence, poor circulation, and difficulty with anesthesia and postoperative mobility, making recovery more challenging. E. Age: At 80 years old, the client’s decreased physiological reserve, slower metabolism, and reduced organ function increase the likelihood of postoperative complications such as pneumonia, infection, or delayed healing.
9. A nurse is aware of several of her clients using complementary medicine. In the United States, there are approximately what percent of clients using some type of complementary or alternative medicine?
  • One-half
  • Two-thirds
  • One-tenth
  • One-fourth

Explanation

Approximately one-half (about 50%) of adults in the United States report using some form of complementary or alternative medicine (CAM), such as herbal remedies, acupuncture, yoga, meditation, or massage therapy. Many people use CAM alongside conventional medical treatments to promote wellness, manage chronic conditions, or relieve stress. Nurses must be aware of these practices to assess for potential interactions and ensure safe, coordinated care.
10. The nurse administers an intravenous (IV) hypertonic solution to a client. In which direction will the fluid shift?
  • Intracellular to Extracellular
  • Extracellular to Intracellular
  • Hypercellular to Interstitial
  • Hypertonic to Homeostatic

Explanation

A hypertonic IV solution has a higher solute concentration than the fluid inside the cells. This causes water to move out of the cells (intracellular space) and into the extracellular space (intravascular and interstitial compartments) to balance osmotic pressure. The result is cell shrinkage and increased extracellular fluid volume, which can be beneficial for treating conditions like severe hyponatremia or cerebral edema.

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