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. 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.
2. The 72-year-old adult is at increased risk for respiratory complication following surgery. The nurse knows that which of the following is the priority?
- Encourage the client to cough and deep breathe.
- Check on cardiac function every 2 hours while ambulating the client.
- Frequently orient the client to person, place, and time.
- Withhold pain medication until the client requests it.
Explanation
Older adults are at increased risk for respiratory complications such as atelectasis and pneumonia following surgery due to decreased lung expansion, weakened cough reflex, and prolonged immobility. The nurse’s priority intervention is to encourage coughing and deep breathing exercises to promote lung expansion, clear secretions, and maintain adequate oxygenation. This prevents hypoxia and post-operative pulmonary infections.
3. During a dressing change, the client tells the nurse that he closes his eyes and thinks about waves coming up on the beach. He states this helps with pain and anxiety associated with dressing changes. The nurse recognizes this client is using which CAM practice?
- Tai Chi
- Reiki Therapy
- Guided Imagery
- Prayer
Explanation
Guided imagery is a complementary and alternative medicine (CAM) practice that uses mental visualization to promote relaxation and reduce pain or anxiety. By imagining soothing scenes, such as ocean waves or peaceful landscapes, the client can calm the mind, reduce stress responses, and lower pain perception. It is often used during medical procedures, wound care, or anxiety-provoking situations to enhance comfort.
4. A client who is admitted shares that they have had trouble sleeping for many years. The nurse knows that lack of sleep over long periods of time can cause many signs and symptoms. Which of the following are adverse effects related to sleep disturbances? Select all that apply. One, some, or all options may be correct.
- Increased energy
- Death
- Cardiac issues
- A positive outlook on life
- Decreased thinking and learning
Explanation
B. Death: Severe, prolonged sleep deprivation can be life-threatening. It impairs immune and cardiovascular function, increases stress hormone levels, and may lead to fatal complications such as heart failure or accidents due to exhaustion. C. Cardiac issues: Chronic sleep disturbances contribute to hypertension, heart disease, and arrhythmias due to elevated stress hormone levels, inflammation, and poor oxygenation during sleep. E. Decreased thinking and learning: Sleep is essential for cognitive processing and memory consolidation. Lack of sleep results in poor concentration, reduced alertness, and slower reaction times, increasing the risk of mistakes and impaired judgment.
5. A client has a fluid volume deficit; the nurse anticipates a decrease in which vital sign when the client changes position?
- Temperature
- Respiratory rate
- Pulse rate
- Blood pressure
Explanation
In fluid volume deficit (hypovolemia), the circulating blood volume is reduced, leading to a drop in blood pressure, especially when the client changes positions from lying to sitting or standing. This is known as orthostatic (postural) hypotension. The decreased vascular volume causes less venous return to the heart, lowering cardiac output and resulting in dizziness or lightheadedness upon standing.
6. A client in the postoperative area is receiving some education. The nurse knows that which postoperative intervention best prevents atelectasis?
- Incentive Spirometer (IS)
- Sequential Device
- Compression Stockings
- Active Range of Motion (ROM)
Explanation
Atelectasis is the partial or complete collapse of lung tissue caused by shallow breathing, mucus accumulation, or immobility after surgery. The incentive spirometer (IS) encourages the client to take slow, deep breaths, promoting alveolar expansion, improving oxygenation, and preventing lung collapse. Regular use postoperatively is the most effective noninvasive intervention for preventing atelectasis.
7. A nurse is teaching a postoperative client how to perform deep breathing and coughing exercises. The nurse knows that which method of instruction is most appropriate in this situation?
- Explanations with time for questions
- Internet research conducted by the client
- Return demonstration
- A pamphlet from the American Lung Association
Explanation
A return demonstration allows the nurse to assess the client’s understanding and technique in performing deep breathing and coughing exercises, which are essential to prevent postoperative complications such as atelectasis and pneumonia. This method ensures that the client can perform the skill correctly and safely while giving the nurse an opportunity to correct any mistakes immediately.
8. 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.
9. A nurse is caring for a client who expresses overwhelming stress due to a number of life stressors all occurring at once. Which of the following would be the least helpful for stress reduction for this client?
- Music Therapy
- Receiving a massage
- Medication
- Probiotics
Explanation
Probiotics are beneficial for gut health and digestion but have no direct, proven effect on reducing psychological stress. While some studies suggest a connection between gut health and mood regulation, probiotics are not considered an evidence-based intervention for managing acute or overwhelming stress.
10. 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.
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