N3661 Care of the Adult SU25
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Free N3661 Care of the Adult SU25 Questions
A nurse instructs a preoperative client on how to perform deep-breathing exercises and cough effectively after surgery. Which of the following statements by the client indicates an understanding of the teaching
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I'll breathe deeply and cough every 4 hours.
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I'll splint my incision with a pillow to cough.
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I'll ask for pain medication after I do the exercises.
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I'll use the incentive spirometer when I can get out of bed
Explanation
Correct Answer B: I'll splint my incision with a pillow to cough.
Explanation:
Splinting the incision with a pillow provides support to the surgical site and helps reduce pain during coughing, making it easier and safer to clear secretions from the lungs. This technique is essential to prevent postoperative complications such as pneumonia and atelectasis.
Why the Other Options Are Incorrect:
A. I'll breathe deeply and cough every 4 hours.
This is not frequent enough. Deep breathing and coughing should be performed every 1 to 2 hours while awake.
C. I'll ask for pain medication after I do the exercises.
Pain medication should be taken before exercises, not after, to optimize comfort and encourage effective participation.
D. I'll use the incentive spirometer when I can get out of bed.
Incentive spirometry should begin while in bed, ideally as soon as the client is awake and able to follow instructions — not delayed until ambulation.
The client is admitted to the medical unit with suspected acute pancreatitis. Which laboratory values should the nurse monitor to confirm this diagnosis
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Creatinine and BUN
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Troponin and CK-MB
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Serum bilirubin and calcium
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Serum amylase and lipase
Explanation
Correct Answer D: Serum amylase and lipase
Explanation:
Serum amylase and lipase are the primary diagnostic enzymes used to confirm acute pancreatitis. These enzymes are released into the bloodstream when the pancreas becomes inflamed or injured. Lipase is more specific to pancreatitis and tends to remain elevated longer than amylase.
Why the Other Options Are Incorrect:
A. Creatinine and BUN
These measure kidney function, not pancreatic inflammation. They may be monitored for complications but are not diagnostic of pancreatitis.
B. Troponin and CK-MB
These are cardiac markers used to diagnose myocardial infarction, not pancreatitis.
C. Serum bilirubin and calcium
While bilirubin may be elevated if pancreatitis is related to biliary obstruction and calcium may be low in severe cases, these are supportive findings, not confirmatory.
While hospitalized and recovering from an episode of diabetic ketoacidosis, the client calls the nurse and reports feeling anxious, nervous, and sweaty. What is the nurse's priority action based on the client's report
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Administer a glucose tablet.
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Administer 1 mg of glucagon subcutaneously.
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Obtain a glucose reading using a finger stick.
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Have the client drink 8 ounces of Coca-Cola.
Explanation
Correct Answer C: Obtain a glucose reading using a finger stick.
Explanation:
The client is showing early symptoms of hypoglycemia (anxious, nervous, sweaty), which can occur during DKA recovery due to insulin administration. The nurse’s priority is to confirm the blood glucose level with a finger stick reading before taking further action. This ensures the symptoms are due to hypoglycemia and guides the next appropriate intervention.
Why the Other Options Are Incorrect:
A. Administer a glucose tablet.
While appropriate if hypoglycemia is confirmed, the nurse must first check the glucose level to ensure this is the correct action.
B. Administer 1 mg of glucagon subcutaneously.
Glucagon is used for severe hypoglycemia, especially when the client is unconscious or unable to swallow — not appropriate for mild symptoms.
D. Have the client drink 8 ounces of Coca-Cola.
This can be effective treatment for hypoglycemia, but again, it should only be given after confirming low blood glucose. Administering sugar without confirmation may cause unnecessary hyperglycemia.
A nurse is assessing a client who has developed atelectasis postoperatively. Which of the following findings should the nurse expect
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Decreasing respiratory rate
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Facial flushing
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Increasing dyspnea
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Friction rub
Explanation
Correct Answer C: Increasing dyspnea
Explanation:
Atelectasis is the collapse of alveoli, often occurring postoperatively due to shallow breathing, pain, or immobility. A common clinical sign is increasing dyspnea (shortness of breath) as oxygenation becomes impaired. Other signs may include decreased breath sounds, crackles, and low oxygen saturation.
Why the Other Options Are Incorrect:
A. Decreasing respiratory rate
This is not expected. The respiratory rate typically increases in response to hypoxia caused by atelectasis.
B. Facial flushing
Facial flushing is not associated with atelectasis. Cyanosis or pallor may occur in severe cases due to oxygen deficiency.
D. Friction rub
A friction rub is associated with pleuritis or pericarditis, not atelectasis. Atelectasis causes reduced or absent breath sounds in the affected area.
Which assessment finding would alert the nurse to the possibility of worsening hyponatremia
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A client with elevated blood pressure.
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A client complaining of shortness of breath upon exertion.
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A client who states, "I am so tired and restless."
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A client with an altered mental status.
Explanation
Correct Answer D: A client with an altered mental status.
Explanation:
Altered mental status is a key indicator of worsening hyponatremia, especially when sodium levels fall significantly. Symptoms such as confusion, disorientation, lethargy, seizures, or coma may develop as cerebral edema progresses. This is a medical emergency and requires immediate intervention.
Why the Other Options Are Incorrect:
A. A client with elevated blood pressure
This is not directly indicative of worsening hyponatremia. Hyponatremia typically does not present with hypertension.
B. A client complaining of shortness of breath upon exertion
While important, this is more associated with cardiac or pulmonary issues, not typically a symptom of hyponatremia.
C. A client who states, "I am so tired and restless."
These are early nonspecific signs and could be caused by many factors. However, altered mental status is a more significant red flag for severe or worsening hyponatremia.
A nurse is providing preoperative teaching to a client who is to undergo an open bowel resection at 1300 next week. Which of the following statements by the client indicates the need for further teaching
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I understand what risks I can expect with this surgery.
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I can eat solid food right when I wake up from anesthesia
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I will take time to relax if I get nervous the night before surgery.
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I will have a glass of juice the morning of my surgery.
Explanation
Correct Answer B: I can eat solid food right when I wake up from anesthesia.
Explanation:
After abdominal surgery like an open bowel resection, clients are not permitted to eat solid food immediately post-op. Return to oral intake depends on bowel function recovery (e.g., presence of bowel sounds, passing gas). Starting solid foods too early can risk nausea, vomiting, or ileus.
Why the Other Options Are Incorrect
A. I understand what risks I can expect with this surgery.
This shows appropriate understanding of informed consent and surgical risks.
C. I will take time to relax if I get nervous the night before surgery.
This reflects good emotional preparation and coping, which is encouraged preoperatively.
D. I will have a glass of juice the morning of my surgery.
Clear liquids may be allowed up to 2 hours before surgery, depending on the surgeon’s and facility’s protocol. However, this may still be acceptable if cleared by the provider.
A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L (range: 135–145). Which of the following assessment findings should the nurse anticipate
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Thirst
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Muscle cramps and weakness
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Swollen, dry tongue
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Hallucinations
Explanation
Correct Answer B: Muscle cramps and weakness
Explanation:
SIADH causes water retention and dilutional hyponatremia. A sodium level of 123 mEq/L is significantly low and can lead to symptoms such as muscle cramps, weakness, nausea, headache, and lethargy. These are common early signs of moderate hyponatremia.
Why the Other Options Are Incorrect:
A. Thirst
Thirst is not a prominent feature of SIADH due to fluid retention and euvolemia or hypervolemia, not dehydration.
C. Swollen, dry tongue
A dry tongue is associated with dehydration, which is not characteristic of SIADH, as the body retains too much water.
D. Hallucinations
Hallucinations can occur in severe hyponatremia, typically when sodium levels fall below 120 mEq/L. This client’s level, while low, is more likely to produce neuromuscular symptoms first.
Which assessment finding would the nurse expect from a client with chronic peripheral arterial disease (PAD
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Ulceration around the medial malleolus
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Pallor on elevation of limbs and rubor when limbs are dependent
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Scaling eczema of the lower legs with stasis dermatitis
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Significant edema around the ankles and feet
Explanation
Correct Answer B: Pallor on elevation of limbs and rubor when limbs are dependent
Explanation:
Clients with chronic peripheral arterial disease (PAD) often exhibit color changes due to impaired blood flow. Elevating the legs may cause pallor (paleness) because of reduced arterial perfusion, while lowering the legs (dependent position) may lead to rubor (a reddish-blue discoloration) as gravity helps bring blood back to the extremities. These findings are classic signs of arterial insufficiency.
Why the Other Options Are Incorrect:
A. Ulceration around the medial malleolus
This is more typical of venous ulcers, not arterial disease. Arterial ulcers tend to occur on bony prominences or pressure points like the toes or lateral malleolus.
C. Scaling eczema of the lower legs with stasis dermatitis
Stasis dermatitis and skin changes like eczema are associated with chronic venous insufficiency, not PAD.
D. Significant edema around the ankles and feet
Edema is more commonly associated with venous disorders, heart failure, or kidney disease. PAD usually involves minimal or no edema unless the condition is very advanced or mixed with venous insufficiency
In preparation for ambulation, the nurse plans to assist a postoperative client in transitioning from a lying to a sitting position. Which nursing action is most appropriate to maintain the client's safety
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Assist the client to move quickly from the lying position to the sitting position
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Allow the client to rise from the bed to a standing position unassisted
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Elevate the head of the bed quickly to assist the client to a sitting position
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Assess the client for signs of dizziness and hypotension
Explanation
Correct Answer D: Assess the client for signs of dizziness and hypotension
Explanation:
Postoperative clients are at risk for orthostatic hypotension due to anesthesia, immobility, and fluid shifts. The nurse should always assess for dizziness, lightheadedness, and changes in blood pressure before assisting the client to sit or stand. This helps prevent falls and ensure safety during early ambulation.
Why the Other Options Are Incorrect:
A. Assist the client to move quickly from the lying position to the sitting position
This can lead to sudden drops in blood pressure and increase the risk of fainting or falling.
B. Allow the client to rise from the bed to a standing position unassisted
This is unsafe, especially in the immediate postoperative period when the client may be weak or unstable.
C. Elevate the head of the bed quickly to assist the client to a sitting position
Changes in position should be done slowly to allow the body time to adjust and prevent orthostatic hypotension.
A nurse is caring for a client who had a total thyroidectomy and a serum calcium level of 7.6 mg/dL (range 8.8–10.5). Which of the following findings should the nurse expect
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Constipation
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Hypoactive deep tendon reflexes
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Shortened QT intervals
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Tingling of the extremities
Explanation
Correct Answer D: Tingling of the extremities
Explanation:
A serum calcium level of 7.6 mg/dL indicates hypocalcemia, a common complication after total thyroidectomy due to accidental removal or damage to the parathyroid glands, which regulate calcium levels. Tingling (paresthesia) of the fingers, toes, and around the mouth is an early sign of hypocalcemia.
Why the Other Options Are Incorrect:
A. Constipation
Constipation is associated with hypercalcemia, not hypocalcemia.
B. Hypoactive deep tendon reflexes
Hypocalcemia causes hyperactive, not hypoactive, deep tendon reflexes.
C. Shortened QT intervals
Hypocalcemia is associated with a prolonged QT interval, while shortened QT is seen in hypercalcemia.
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The package offers over 150 practice questions tailored specifically for the N3661 Care of the Adult SU25 Exam 4. These questions cover key nursing topics such as peripheral vascular conditions, anticoagulant therapy, peripheral artery disease (PAD), venous ulcers, and patient education. Each question comes with clear, step-by-step explanations to help deepen your understanding.
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