NR302 Quiz 3 Las Vegas 2026 V2 - Chamberlain University
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Free NR302 Quiz 3 Las Vegas 2026 V2 - Chamberlain University Questions
A nurse is caring for a client with right-sided heart failure. Which assessment finding should the nurse expect?
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Productive cough
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Hemoptysis
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Acute dyspnea
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Peripheral edema
Explanation
Explanation:
Correct Answer: (D) Peripheral edema
Right-sided heart failure causes the right ventricle to pump ineffectively, leading to a backup of blood in the systemic venous circulation. This results in increased hydrostatic pressure in peripheral vessels, causing fluid to shift into the interstitial spaces and producing peripheral edema, particularly in the lower extremities, as well as jugular vein distension, hepatomegaly, and ascites.
Why Other Options are Incorrect:
A. Productive cough — A productive cough is more commonly associated with respiratory infections or left-sided heart failure causing pulmonary congestion, not right-sided failure.
B. Hemoptysis — Coughing up blood is associated with pulmonary conditions such as tuberculosis, pulmonary embolism, or severe left-sided heart failure, not right-sided failure.
C. Acute dyspnea — Dyspnea and pulmonary congestion are hallmark findings of left-sided heart failure, where blood backs up into the pulmonary circulation. Right-sided failure primarily causes systemic venous congestion.
Which assessment finding is most concerning during a skin assessment?
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Small scar on the knee
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Freckles on the arms
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Dark purple discoloration on the coccyx
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Intact skin over pressure points
Explanation
Explanation:
Correct Answer: (C) Dark purple discoloration on the coccyx. Dark purple discoloration over a bony prominence like the coccyx is a concerning sign of a deep tissue pressure injury, indicating significant underlying tissue damage that requires prompt intervention to prevent further skin breakdown.
Why Other Options are Incorrect:
A. Small scar on the knee. A scar represents healed tissue from a previous injury and is not an acute or concerning finding.
B. Freckles on the arms. Freckles are a normal, benign variation in skin pigmentation and are not a concerning finding.
D. Intact skin over pressure points. Intact skin over pressure points is a positive, reassuring finding indicating no current breakdown or injury.
A client reports itching and redness after using a new lotion. Which question is most appropriate for the nurse to ask next?
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"Have you traveled recently?"
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"Do you have any medication allergies?"
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"When did you first notice the reaction?"
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"What did you eat today?"
Explanation
Explanation:
Correct Answer: (C) "When did you first notice the reaction?" Establishing the onset timing of the reaction in relation to the lotion use is the most directly relevant follow-up question, helping the nurse confirm a likely cause-and-effect relationship and gather essential information about the current problem.
Why Other Options are Incorrect:
A. "Have you traveled recently?" This question is not directly relevant to a localized skin reaction following new lotion use.
B. "Do you have any medication allergies?" While allergy history can be useful background information, it is not the most immediately relevant next question regarding this specific new topical reaction.
D. "What did you eat today?" Diet is not directly relevant to a topical skin reaction caused by a new lotion applied to the skin.
Which finding would the nurse expect in a healthy nail assessment?
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Curved clubbed nails
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Thick yellow nails
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Smooth texture with pink nail beds
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Delayed capillary refill
Explanation
Explanation:
Correct Answer: (C) Smooth texture with pink nail beds. Healthy nails are expected to have a smooth texture and pink nail beds, reflecting normal tissue structure and adequate oxygenation and perfusion.
Why Other Options are Incorrect:
A. Curved clubbed nails. Clubbing is an abnormal finding associated with chronic hypoxia, not a healthy nail assessment.
B. Thick yellow nails. Thickened, yellow nails are often associated with fungal infection and are not a normal, healthy finding.
D. Delayed capillary refill. Delayed capillary refill indicates poor peripheral perfusion, which is an abnormal finding, not an expected healthy result.
The nurse is preparing to measure orthostatic vital signs. Which positions should the client be placed in?
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Side-lying and sitting
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Sitting and prone
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Standing only
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Supine, sitting, and standing
Explanation
Explanation:
Correct Answer: (D) Supine, sitting, and standing. Orthostatic vital sign measurement requires assessing blood pressure and heart rate in three sequential positions, supine, sitting, and standing, to evaluate the body's cardiovascular response to positional changes and detect orthostatic hypotension.
Why Other Options are Incorrect:
A. Side-lying and sitting. This combination does not include the standard supine and standing positions required for a complete and accurate orthostatic vital sign assessment.
B. Sitting and prone. Prone positioning is not part of the standard orthostatic vital sign protocol.
C. Standing only. A single position cannot capture the necessary comparative data; orthostatic assessment requires multiple position changes to evaluate the cardiovascular response.
Which factor can falsely lower an oxygen saturation reading?
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Adequate circulation
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Warm fingers
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Proper sensor placement
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Nail polish
Explanation
Explanation:
Correct Answer: (D) Nail polish. Nail polish, particularly dark colors like blue, green, black, or purple, can interfere with the light absorption used by pulse oximetry sensors, leading to a falsely low oxygen saturation reading.
Why Other Options are Incorrect:
A. Adequate circulation. Good circulation supports accurate pulse oximetry readings rather than causing a false low result.
B. Warm fingers. Warm extremities promote good peripheral perfusion, which supports accurate, not falsely lowered, oxygen saturation readings.
C. Proper sensor placement. Correct sensor placement ensures an accurate reading rather than causing an inaccurate falsely low result.
The nurse identifies redness over a bony prominence that does not blanch. This finding suggests:
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Jaundice
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Normal circulation
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Cyanosis
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Stage 1 pressure injury
Explanation
Explanation:
Correct Answer: (D) Stage 1 pressure injury. Non-blanchable redness over a bony prominence is the defining characteristic of a stage 1 pressure injury, indicating localized tissue damage from sustained pressure before any skin breakdown has occurred.
Why Other Options are Incorrect:
A. Jaundice. Jaundice refers to a yellowish discoloration of the skin and sclera due to elevated bilirubin, not localized non-blanchable redness.
B. Normal circulation. Normal skin typically blanches, temporarily turns white, when pressed and then returns to its original color; non-blanchable redness indicates a problem, not normal circulation.
C. Cyanosis. Cyanosis refers to a bluish discoloration of the skin due to poor oxygenation, not redness over a bony prominence.
During nail assessment, capillary refill time greater than 3 seconds may indicate:
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Normal finding in adults
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Adequate circulation
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Nail infection
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Poor peripheral perfusion
Explanation
Explanation:
Correct Answer: (D) Poor peripheral perfusion. A capillary refill time greater than 3 seconds indicates delayed blood flow return to the nail bed, suggesting poor peripheral perfusion, which can result from conditions such as hypovolemia, hypothermia, or peripheral vascular disease.
Why Other Options are Incorrect:
A. Normal finding in adults. A normal capillary refill time is generally 2 to 3 seconds or less; a time greater than 3 seconds is considered abnormal, not a normal finding.
B. Adequate circulation. Adequate circulation would result in a prompt capillary refill time, not a delayed one greater than 3 seconds.
C. Nail infection. Nail infection is assessed through signs such as discoloration, thickening, or odor, not through capillary refill time.
The nurse is teaching a client about skin cancer prevention. Which statement indicates understanding?
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"A mole that changes is usually harmless."
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"I should use sunscreen when outdoors."
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"I only need sunscreen in summer."
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"Tanning beds are safer than sunlight."
Explanation
Explanation:
Correct Answer: (B) "I should use sunscreen when outdoors." Consistent sunscreen use during outdoor activities is a fundamental and evidence-based strategy for protecting the skin from harmful UV radiation and reducing the risk of skin cancer, indicating correct understanding of prevention teaching.
Why Other Options are Incorrect:
A. "A mole that changes is usually harmless." This is inaccurate; a changing mole is a warning sign that should be evaluated promptly, as it can indicate skin cancer such as melanoma.
C. "I only need sunscreen in summer." This is incorrect, as UV exposure occurs year-round, and sunscreen should be used regardless of season.
D. "Tanning beds are safer than sunlight." This is false; tanning beds emit concentrated UV radiation and are not a safer alternative to natural sunlight, both increase skin cancer risk.
Which respiratory assessment finding is normal?
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Absent tactile fremitus and hyperresonant percussion tones
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Increased tactile fremitus and dull percussion tones
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Adventitious sounds and limited chest expansion
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Vesicular breath sounds and symmetric tactile fremitus
Explanation
Explanation:
Correct Answer: (D) Vesicular breath sounds and symmetric tactile fremitus
Normal respiratory assessment findings include vesicular breath sounds — soft, low-pitched sounds heard over most lung fields — and symmetric tactile fremitus, meaning vibrations are felt equally on both sides of the chest during spoken words. These indicate healthy, unobstructed lung tissue.
Why Other Options are Incorrect:
A. Absent tactile fremitus and hyperresonant percussion tones — These findings suggest air trapping or pneumothorax, not a normal respiratory assessment.
B. Increased tactile fremitus and dull percussion tones — These findings are associated with consolidation such as pneumonia, where fluid or solid material replaces air in the lungs.
C. Adventitious sounds and limited chest expansion — Adventitious sounds such as crackles, wheezes, and rhonchi are abnormal breath sounds indicating underlying pathology such as asthma, pulmonary edema, or infection.
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