NU216 Fall 25 Final
NU 216: Fall 25
Boost your exam performance with Ulosca’s NU 216 Exam review. This guide is tailored for nursing students preparing to master core medical-surgical concepts, patient safety, and clinical judgment skills essential for adult health nursing practice.
Everything you need to answer with confidence:
- Covers all key NU 216 exam topics including cardiovascular, respiratory, renal, endocrine, musculoskeletal, neurological, and gastrointestinal disorders; fluid and electrolyte balance; infection control; perioperative nursing; pain management; and evidence-based interventions for chronic and acute conditions.
- Features timed practice sets with case-based, multiple-choice, and NCLEX-style questions modeled after the actual NU 216 exam format.
- Strengthens your ability to recognize priority nursing interventions, apply the nursing process, manage complex patient scenarios, and use clinical judgment in medical-surgical settings.
- Fully aligned with NU 216 course objectives and program outcomes for safe and effective adult health nursing care.
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- Learn from mistakes with detailed answer explanations.
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Free NU216 Fall 25 Final Questions
The nurse is providing discharge teaching to a patient with a new leg cast. Which instructions should be included? Select all that apply.
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Elevate the limb above heart level to reduce swelling.
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Wrap the cast tightly with plastic when bathing.
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Keep the cast dry at all times.
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Use a pen or stick to relieve itching inside the cast.
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Report increased pain or numbness in the affected limb.
Explanation
Correct Answers:
Elevate the limb above heart level to reduce swelling
Keep the cast dry at all times
Report increased pain or numbness in the affected limb
Explanation of Correct Answers:
Elevate the limb above heart level to reduce swelling
Elevation reduces edema, promotes venous return, and decreases discomfort during the first 48 hours after cast application. It is a standard teaching point to minimize swelling and complications.
Keep the cast dry at all times
Moisture weakens plaster and can damage fiberglass casts, increasing the risk of infection and skin breakdown. Patients should be taught to protect the cast from getting wet at all times.
Report increased pain or numbness in the affected limb
This instruction is vital because worsening pain, tingling, or numbness may indicate complications such as compartment syndrome or impaired circulation. Patients must be told to report these findings immediately.
Why Other Options Are Wrong:
Wrap the cast tightly with plastic when bathing
This is incorrect because wrapping tightly can trap moisture, leading to skin breakdown. Instead, the patient should cover the cast with a waterproof shield or keep the cast out of the water entirely.
Use a pen or stick to relieve itching inside the cast
This is incorrect because inserting objects into the cast can injure the skin, introduce infection, or damage the cast structure. Instead, patients should use safe alternatives like cool air from a hair dryer on a low setting to relieve itching.
Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed as the bowel prep for a patient scheduled for a colonoscopy. The patient begins to experience diarrhea following the administration of the solution. What action by the nurse is appropriate?
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Administer a PRN antidiarrheal agent
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Start an IV infusion to prevent dehydration
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Explain that diarrhea is expected
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Request that the diagnostic test be postponed
Explanation
Correct Answer:
Explain that diarrhea is expected
Explanation:
GoLYTELY is prescribed as a bowel-cleansing solution before colonoscopy. The expected therapeutic effect is profuse watery diarrhea, which clears the bowel of stool for accurate visualization during the procedure. The appropriate nursing response is to reassure the patient that diarrhea is expected and is a sign the medication is working.
Why Other Options Are Wrong:
Administer a PRN antidiarrheal agent
This is incorrect because giving an antidiarrheal would counteract the purpose of the bowel prep, preventing effective colon cleansing.
Start an IV infusion to prevent dehydration
This is incorrect because mild diarrhea with GoLYTELY is anticipated and not usually severe enough to require IV hydration. Patients are typically instructed to drink fluids as part of the prep.
Request that the diagnostic test be postponed
This is incorrect because diarrhea indicates the prep is working as intended, not a complication that requires postponing the test.
A patient scheduled to receive an influenza vaccination asks the nurse, "How do those things work anyway?" What is the nurse's best response?
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"Immunizations work to keep you from getting blood diseases. So, you need one!"
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"Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
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"Immunizations work by activating unstimulated internal proteins which are part of the immune response."
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"Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
Explanation
Correct Answer:
"Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
Explanation of Correct Answer:
Vaccinations introduce a weakened or inactivated form of a pathogen, or parts of it, to the immune system. This triggers the production of antibodies and memory cells without causing illness. When the body encounters the real pathogen later, it can mount a rapid and effective immune response, preventing or reducing illness severity.
Why Other Options Are Incorrect:
"Immunizations work to keep you from getting blood diseases. So, you need one!"
This statement is vague, inaccurate, and misleading, as vaccines prevent many types of infectious diseases, not just bloodborne ones.
"Immunizations work by activating unstimulated internal proteins which are part of the immune response."
This is unclear and does not accurately explain the immune mechanism of vaccines.
"Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
This describes passive immunity (e.g., immune globulin), not active immunity provided by most vaccines like the influenza vaccine.
The nurse will be starting a new intravenous infusion and needs to select the site for the insertion. In selection of a site, the nurse should adhere to which principle?
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Use the dominant arm
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Look for hard, cordlike veins
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Start with the most distal site
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No restrictions on an extremity with a dialysis graft
Explanation
Correct Answer:
Start with the most distal site
Explanation:
The principle of IV therapy is to begin with the most distal site, such as the veins in the hand, and progress proximally if needed. This approach preserves proximal sites for future use in case the distal site becomes unusable. It also helps protect the larger, more accessible veins for long-term therapy and avoids unnecessary complications.
Why Other Options Are Wrong:
Use the dominant arm
This is incorrect because using the dominant arm for IV access can interfere with the patient’s mobility and daily activities. Nurses should prioritize the non-dominant arm whenever possible to minimize discomfort and disruption.
Look for hard, cordlike veins
This is incorrect because hard, cordlike veins may indicate thrombosed or sclerosed veins, which are unsuitable for IV insertion. Using such veins increases the risk of infiltration, phlebitis, and ineffective infusion. Healthy, soft, and palpable veins are preferred.
No restrictions on an extremity with a dialysis graft
This is incorrect because an extremity with a dialysis graft or fistula should never be used for IV access. Inserting an IV in these sites increases the risk of infection, clot formation, and loss of vascular access critical for dialysis patients.
The nurse reviews lab results and transfusion orders for a patient diagnosed with chronic anemia. The patient will receive two units of packed red blood cells. How often should the tubing be changed?
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After four hours.
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After two units have transfused.
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Between each unit of blood.
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Every six hours.
Explanation
Correct Answer:
B. After two units have transfused.
Why this is the correct answer:
Blood transfusion administration sets with filters should be changed after every two units of packed red blood cells or after 4 hours of use, whichever comes first. This reduces the risk of bacterial contamination and prevents filter occlusion. Since the order is for two units, the tubing can safely be used for both units before changing.
Why the other options are incorrect:
A. After four hours
The four-hour rule applies only if transfusions extend beyond that time. If two units are given within four hours, tubing can be used for both before changing.
C. Between each unit of blood
Changing tubing between each unit is unnecessary unless the tubing becomes occluded or contaminated. This would waste supplies and is not required by guidelines.
D. Every six hours
Six hours exceeds the safe limit for blood tubing use. Bacterial growth risk increases after 4 hours, making this unsafe.
The nurse monitors the patient with an acute myocardial infarction (AMI) closely. Which complication does the nurse know is the most common with an AMI?
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Dysrhythmias
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Pericarditis
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Congestive heart failure
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Cardiogenic shock
Explanation
Correct Answer:
Dysrhythmias
Explanation:
The most common complication of an acute myocardial infarction is dysrhythmias. Ischemia and infarction of heart muscle disrupt the normal conduction pathways, leading to abnormal rhythms such as premature ventricular contractions, ventricular tachycardia, or ventricular fibrillation. Dysrhythmias can occur in over 80–90% of AMI patients, making them the most frequent complication and a leading cause of sudden cardiac death post-MI.
Why Other Options Are Wrong:
Pericarditis
This is incorrect because while pericarditis (inflammation of the pericardial sac) can occur after an AMI, particularly in the days following, it is not the most common complication. It is relatively rare compared to dysrhythmias.
Congestive heart failure
This is incorrect because heart failure can develop if the infarcted area is large and impairs the heart’s pumping ability. While serious, it is less common than dysrhythmias in the immediate phase following an AMI.
Cardiogenic shock
This is incorrect because cardiogenic shock is a severe but uncommon complication of massive MI where the heart cannot pump enough blood to meet body demands. It is less frequent than dysrhythmias and typically associated with extensive myocardial damage.
A nurse is caring for a patient with leukemia. Which nursing intervention is most effective to reduce the spread of harmful pathogens?
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Wearing an N-95 respiratory mask when caring for the patient.
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Strict and frequent handwashing by all persons having contact with the patient.
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Maintaining a strict administration schedule of prophylactic antibiotics.
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Creation of a sterile environment and use of a negative pressure room.
Explanation
Correct Answer:
B. Strict and frequent handwashing by all persons having contact with the patient.
Explanation:
Patients with leukemia are immunocompromised and highly vulnerable to infection. The single most effective nursing intervention to reduce pathogen spread is strict and frequent hand hygiene by anyone who comes in contact with the patient. This is the cornerstone of infection prevention and control.
Why Other Options Are Wrong:
A. Wearing an N-95 respiratory mask when caring for the patient
This is required for airborne infections (like TB), but leukemia patients are not typically placed on airborne precautions.
C. Maintaining a strict administration schedule of prophylactic antibiotics
While antibiotics may be prescribed, they do not prevent the introduction of pathogens and are not the most effective infection control method.
D. Creation of a sterile environment and use of a negative pressure room
Negative pressure rooms are used for patients with airborne illnesses to protect others, not to protect immunocompromised patients. Leukemia patients may require protective isolation, but routine sterile environments and negative pressure are not standard.
The nurse is providing patient teaching on a peak flow meter. Which of the following are appropriate uses of a peak flow meter? Select all that apply.
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Detect early signs of asthma exacerbation.
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Diagnoses pneumonia.
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Measures oxygen saturation.
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Determines need for emergency interventions.
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Evaluates effectiveness of asthma medications.
Explanation
Correct Answers:
A. Detect early signs of asthma exacerbation
D. Determines need for emergency interventions
E. Evaluates effectiveness of asthma medications
Explanation:
A peak flow meter measures peak expiratory flow rate (PEFR), which reflects how well air moves out of the lungs. This tool helps patients with asthma monitor airway narrowing before symptoms appear (early exacerbation detection), decide if urgent intervention is needed, and evaluate how well asthma medications are working.
Why Other Options Are Wrong:
B. Diagnoses pneumonia
A peak flow meter does not diagnose infections such as pneumonia. Diagnosis requires clinical assessment and imaging.
C. Measures oxygen saturation
Oxygen saturation is measured by pulse oximetry, not a peak flow meter.
A patient undergoing chemotherapy has a platelet count of 15,000/µl. Which of the following is the most appropriate nursing action?
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“I will take the iron tablets with orange juice about an hour before meals.”
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“I will increase my fiber and fluids if the iron tablets make me constipated.”
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“I will call the doctor if the tablets cause a lot of stomach upset.”
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“I will notify my physician if my stools turn dark.”
Explanation
Correct Answer:
“I will notify my physician if my stools turn dark.”
Explanation:
A platelet count of 15,000/µl indicates severe thrombocytopenia, placing the patient at high risk for spontaneous bleeding. Black or tarry stools may indicate GI bleeding, which is a medical emergency for patients with low platelet counts. Prompt physician notification is crucial to prevent life-threatening hemorrhage.
Why Other Options Are Wrong:
“I will take the iron tablets with orange juice about an hour before meals.”
This is incorrect because while this is good teaching for iron absorption, it is unrelated to the patient’s critical risk of bleeding from thrombocytopenia.
“I will increase my fiber and fluids if the iron tablets make me constipated.”
This is incorrect because while constipation management is appropriate for iron use, it does not address the urgent bleeding risk in a thrombocytopenic patient.
“I will call the doctor if the tablets cause a lot of stomach upset.”
This is incorrect because stomach upset is a common side effect of medications like iron but is not life-threatening. The priority with platelets at 15,000/µl is recognizing and reporting bleeding signs.
A patient arrives to the emergency department with complaints of a rash that "appeared about two days after doing yard work." The nurse knows that the patient is experiencing which type of hypersensitivity reaction?
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Type III Immune-Complex Reaction
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Type II Cytotoxic / Cytolytic Reaction
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Type I Immediate Hypersensitivity Reaction
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Type IV Delayed Hypersensitivity Reaction
Explanation
Correct Answer:
Type IV Delayed Hypersensitivity Reaction
Explanation:
Type IV hypersensitivity is cell-mediated, involving T lymphocytes rather than antibodies. It is characterized by a delayed onset, typically 24 to 72 hours after exposure to an allergen such as poison ivy, nickel, or latex. The patient’s presentation of a rash appearing two days after yard work matches this delayed mechanism. This is why it is often referred to as “delayed-type hypersensitivity.”
Why Other Options Are Wrong:
Type III Immune-Complex Reaction
This is incorrect because type III hypersensitivity involves immune complex deposition, leading to conditions like serum sickness, systemic lupus erythematosus, and some forms of vasculitis. It usually manifests with systemic symptoms such as fever, arthralgia, or nephritis, not a localized rash after contact exposure.
Type II Cytotoxic / Cytolytic Reaction
This is incorrect because type II hypersensitivity involves antibody-mediated destruction of specific cells, such as in hemolytic anemia, transfusion reactions, or Goodpasture’s syndrome. It does not present as a contact dermatitis rash days after exposure.
Type I Immediate Hypersensitivity Reaction
This is incorrect because type I hypersensitivity is mediated by IgE antibodies and occurs within minutes of exposure. Examples include anaphylaxis, asthma, or urticaria. The delayed rash occurring two days after exposure rules out type I hypersensitivity.
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NU 216: Comprehensive Study Notes
This exam evaluates nursing students’ knowledge and clinical judgment in caring for adult patients across a range of medical-surgical conditions. Candidates will demonstrate the ability to apply the nursing process, prioritize care, and implement evidence-based interventions to manage acute and chronic health problems.
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Endocrine System
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Pathophysiology and nursing management of hypo- and hyperthyroidism, thyroidectomy complications, and parathyroid disorders.
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Recognition and emergency response for thyroid storm and myxedema coma.
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Diabetes mellitus management including insulin therapy, complications, and patient education.
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Respiratory System
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Assessment and management of asthma, COPD, pulmonary embolism, pneumonia, and status asthmaticus.
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Oxygen therapy, airway management, and ventilatory support.
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Diagnostic procedures such as peak flow monitoring, arterial blood gases, CT scans, and V/Q scans.
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Immune System
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Hypersensitivity reactions (Types I–IV) and appropriate nursing interventions.
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Autoimmune disorders and immunosuppressive therapy precautions.
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Principles of vaccination, active vs. passive immunity, and patient teaching.
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Perioperative and Critical Care
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Postoperative assessments and priorities (airway, bleeding, circulation, neuro checks).
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Central line and IV therapy safety (infection prevention, infiltration, blood transfusions).
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Recognition and management of emergencies such as compartment syndrome and transfusion reactions.
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Hematology and Oncology
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Anemia types (iron deficiency, pernicious, aplastic) and priority nursing diagnoses.
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Blood transfusion safety protocols and prevention of hemolytic reactions.
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Common cancers (e.g., Hodgkin’s disease) and related diagnostic findings.
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The NU 216 exam emphasizes application of knowledge to clinical scenarios, prioritizing airway, breathing, circulation (ABCs), recognizing early warning signs of complications, and ensuring safe, patient-centered care in medical-surgical nursing practice.