NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College.
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Free NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College. Questions
1. The new graduate nurse is developing a teaching care plan for a 72-year-old patient. What should the new graduate nurse keep in mind when educating this client?
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Increase the environmental stimuli.
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Always stick to strict deadlines.
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Speak softly and quickly.
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Accommodate for any sensory deficits.
Explanation
Explanation
Correct Answer: D) Accommodate for any sensory deficits.
Older adults commonly experience age-related sensory changes including decreased hearing acuity (presbycusis), reduced visual acuity, and slower cognitive processing. Effective teaching for elderly clients requires acknowledging and accommodating these deficits — such as speaking clearly and at a moderate pace, using large-print materials, ensuring adequate lighting, and using hearing aids if needed — to ensure the information is received and understood.
Increasing environmental stimuli is counterproductive for older adults, as excess noise and distraction impair concentration and the ability to process new information. Strict teaching deadlines do not account for the slower pace at which many older adults process and retain information. Speaking softly and quickly is inappropriate — the nurse should speak at a normal to slightly elevated volume, clearly and slowly, to ensure comprehension.
Correct Answer: D) Accommodate for any sensory deficits.
Older adults commonly experience age-related sensory changes including decreased hearing acuity (presbycusis), reduced visual acuity, and slower cognitive processing. Effective teaching for elderly clients requires acknowledging and accommodating these deficits — such as speaking clearly and at a moderate pace, using large-print materials, ensuring adequate lighting, and using hearing aids if needed — to ensure the information is received and understood.
Increasing environmental stimuli is counterproductive for older adults, as excess noise and distraction impair concentration and the ability to process new information. Strict teaching deadlines do not account for the slower pace at which many older adults process and retain information. Speaking softly and quickly is inappropriate — the nurse should speak at a normal to slightly elevated volume, clearly and slowly, to ensure comprehension.
2. After a teaching session with a nurse, a client learns that a normal adult heartbeat is 60 to 100 beats/min. In which domain did learning take place?
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Affective
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Kinesthetic
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Cognitive
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Psychomotor
Explanation
Explanation
Correct Answer: C) Cognitive
The cognitive domain involves knowledge acquisition and understanding of information. Learning factual information, such as normal heart rate ranges, reflects cognitive learning rather than emotional (affective) or skill-based (psychomotor) learning.
Correct Answer: C) Cognitive
The cognitive domain involves knowledge acquisition and understanding of information. Learning factual information, such as normal heart rate ranges, reflects cognitive learning rather than emotional (affective) or skill-based (psychomotor) learning.
3. What assessments does a nurse make before hanging an IV fluid that contains potassium?
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ABGs
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Bilateral neck veins
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Serum potassium laboratory value in EHR
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Level of consciousness
Explanation
Explanation
Correct Answer: C) Serum potassium laboratory value in EHR
Before administering any IV fluid containing potassium, the nurse must verify the client's current serum potassium level in the electronic health record. Potassium is a high-alert electrolyte — administering it to a patient who already has a normal or elevated potassium level can cause dangerous hyperkalemia, leading to life-threatening cardiac dysrhythmias including ventricular fibrillation and cardiac arrest.
ABGs reflect acid-base and oxygenation status and are not the priority assessment before potassium-containing fluids. Bilateral neck vein assessment is relevant for fluid volume status but is not specific to potassium administration safety. Level of consciousness is a general neurological assessment and is not the critical check required before hanging potassium-containing IV fluids.
Correct Answer: C) Serum potassium laboratory value in EHR
Before administering any IV fluid containing potassium, the nurse must verify the client's current serum potassium level in the electronic health record. Potassium is a high-alert electrolyte — administering it to a patient who already has a normal or elevated potassium level can cause dangerous hyperkalemia, leading to life-threatening cardiac dysrhythmias including ventricular fibrillation and cardiac arrest.
ABGs reflect acid-base and oxygenation status and are not the priority assessment before potassium-containing fluids. Bilateral neck vein assessment is relevant for fluid volume status but is not specific to potassium administration safety. Level of consciousness is a general neurological assessment and is not the critical check required before hanging potassium-containing IV fluids.
4. A nursing student has been written up several times for being late with providing patient care and for omitting aspects of patient care and not knowing basic procedures that were taught in the skills course one term earlier. The nursing student says, "I don't understand what the big deal is. As my instructor, you are there to protect me and make sure I don't make mistakes." What is the best response from the nursing instructor?
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"You are practicing under the license of the hospital's insurance."
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"You are practicing under the license of the nurse assigned to the patient."
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"You are expected to perform at the level of a prudent nursing student."
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"You are expected to perform at the level of a professional nurse."
Explanation
Explanation
Correct Answer: C) "You are expected to perform at the level of a prudent nursing student."
The legal standard of care for a nursing student is that they are held to the same standard as a reasonably prudent nursing student with similar education and training. This means the student is personally accountable for their own actions and omissions in patient care. The instructor's role is to supervise and facilitate learning, not to absorb the student's legal and professional responsibility. Ignorance of previously taught skills does not excuse substandard care.
Stating the student is practicing under the hospital's insurance is legally inaccurate and does not reflect the standard of care framework. Saying the student is practicing under the assigned nurse's license is also incorrect — each individual is accountable for their own practice. Holding the student to the standard of a professional nurse would be unfair, as that is a higher bar than what is legally expected of a student.
Correct Answer: C) "You are expected to perform at the level of a prudent nursing student."
The legal standard of care for a nursing student is that they are held to the same standard as a reasonably prudent nursing student with similar education and training. This means the student is personally accountable for their own actions and omissions in patient care. The instructor's role is to supervise and facilitate learning, not to absorb the student's legal and professional responsibility. Ignorance of previously taught skills does not excuse substandard care.
Stating the student is practicing under the hospital's insurance is legally inaccurate and does not reflect the standard of care framework. Saying the student is practicing under the assigned nurse's license is also incorrect — each individual is accountable for their own practice. Holding the student to the standard of a professional nurse would be unfair, as that is a higher bar than what is legally expected of a student.
5. A nurse provides client care within a philosophy of ethical decision-making and professional expectations. What framework is the nurse using for practice?
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Code of ethics
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Standards of care
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Definition of nursing
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Values clarification
Explanation
Explanation
Correct Answer: A) Code of ethics
The code of ethics provides a framework for ethical decision-making and guides professional behavior in nursing practice. It outlines responsibilities, values, and expectations for nurses in delivering care.
Standards of care define clinical expectations, the definition of nursing describes the profession, and values clarification is a personal process rather than a professional framework.
Correct Answer: A) Code of ethics
The code of ethics provides a framework for ethical decision-making and guides professional behavior in nursing practice. It outlines responsibilities, values, and expectations for nurses in delivering care.
Standards of care define clinical expectations, the definition of nursing describes the profession, and values clarification is a personal process rather than a professional framework.
6. 500 mL of dextrose 5% in water (D5W) is prescribed to infuse over 6 hours by gravity. The drop factor is 15 gtt/mL. How many drops per minute are given to infuse the total amount of D5W over 6 hours? Round to the nearest whole number. __gtt/min.
Explanation
Explanation
Correct Answer: 21 gtt/min
Using the IV flow rate formula:
Drops per minute = (Volume in mL × Drop factor) ÷ Time in minutes
=(500 mL × 15 gtt/mL) ÷ (6 hours × 60 minutes)
= 7,500 ÷ 360
= 20.83 → rounded to 21 gtt/min
This formula is the standard method for calculating gravity IV flow rates. The drop factor converts volume into drops, and dividing by total minutes gives the rate per minute needed to deliver the full prescribed volume on time.
Correct Answer: 21 gtt/min
Using the IV flow rate formula:
Drops per minute = (Volume in mL × Drop factor) ÷ Time in minutes
=(500 mL × 15 gtt/mL) ÷ (6 hours × 60 minutes)
= 7,500 ÷ 360
= 20.83 → rounded to 21 gtt/min
This formula is the standard method for calculating gravity IV flow rates. The drop factor converts volume into drops, and dividing by total minutes gives the rate per minute needed to deliver the full prescribed volume on time.
7. Which fluid type is considered the same tonicity as normal blood?
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Hypotonic
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Isotonic
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Colloids
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Hypertonic
Explanation
Explanation
Correct Answer: B) Isotonic
Isotonic fluids have the same osmolarity as normal blood plasma, approximately 275–295 mOsm/L. Because their concentration matches that of blood, isotonic fluids do not cause fluid to shift in or out of cells when infused — they remain in the extracellular space and expand intravascular volume. Common examples include Normal Saline (0.9% NaCl) and Lactated Ringer's solution.
Hypotonic fluids have a lower osmolarity than blood, causing water to shift into cells, which can lead to cellular swelling. Colloids are large-molecule solutions such as albumin that exert oncotic pressure and pull fluid into the vascular space — they are not classified by tonicity in the same way as crystalloids. Hypertonic fluids have a higher osmolarity than blood, drawing water out of cells and into the extracellular space, and are used in specific clinical situations such as severe hyponatremia or cerebral edema.
Correct Answer: B) Isotonic
Isotonic fluids have the same osmolarity as normal blood plasma, approximately 275–295 mOsm/L. Because their concentration matches that of blood, isotonic fluids do not cause fluid to shift in or out of cells when infused — they remain in the extracellular space and expand intravascular volume. Common examples include Normal Saline (0.9% NaCl) and Lactated Ringer's solution.
Hypotonic fluids have a lower osmolarity than blood, causing water to shift into cells, which can lead to cellular swelling. Colloids are large-molecule solutions such as albumin that exert oncotic pressure and pull fluid into the vascular space — they are not classified by tonicity in the same way as crystalloids. Hypertonic fluids have a higher osmolarity than blood, drawing water out of cells and into the extracellular space, and are used in specific clinical situations such as severe hyponatremia or cerebral edema.
8. A client is reported to be hypernatremic. Choose the laboratory information that best demonstrates this condition.
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A potassium level of 2.3 mEq/L
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A sodium level of 160 mEq/L
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A sodium level of 130 mEq/L
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A potassium level of 6.0 mEq/L
Explanation
Explanation
Correct Answer: B) A sodium level of 160 mEq/L
Hypernatremia is defined as a serum sodium level above 145 mEq/L. A sodium level of 160 mEq/L clearly exceeds this threshold and directly confirms the hypernatremic state. Hypernatremia causes water to shift out of cells due to increased extracellular osmolarity, leading to cellular dehydration with symptoms such as thirst, confusion, and in severe cases, seizures.
A potassium level of 2.3 mEq/L indicates hypokalemia, not hypernatremia — these are separate electrolyte imbalances. A sodium level of 130 mEq/L is below the normal range of 135–145 mEq/L, indicating hyponatremia, which is the opposite condition. A potassium level of 6.0 mEq/L indicates hyperkalemia and is unrelated to sodium levels or hypernatremia.
Correct Answer: B) A sodium level of 160 mEq/L
Hypernatremia is defined as a serum sodium level above 145 mEq/L. A sodium level of 160 mEq/L clearly exceeds this threshold and directly confirms the hypernatremic state. Hypernatremia causes water to shift out of cells due to increased extracellular osmolarity, leading to cellular dehydration with symptoms such as thirst, confusion, and in severe cases, seizures.
A potassium level of 2.3 mEq/L indicates hypokalemia, not hypernatremia — these are separate electrolyte imbalances. A sodium level of 130 mEq/L is below the normal range of 135–145 mEq/L, indicating hyponatremia, which is the opposite condition. A potassium level of 6.0 mEq/L indicates hyperkalemia and is unrelated to sodium levels or hypernatremia.
9. A client has a potassium level of 6.5 mEq/L. Which of the following physician orders should the nurse implement first?
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Apply a cardiac monitor
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Monitor intake and output
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Provide a glass of orange juice
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Obtain a chest x-ray
Explanation
Explanation
Correct Answer: A) Apply a cardiac monitor
A potassium level of 6.5 mEq/L indicates severe hyperkalemia (normal range 3.5–5.0 mEq/L). Hyperkalemia is a life-threatening emergency because elevated potassium disrupts the cardiac membrane potential, leading to dangerous dysrhythmias including ventricular fibrillation and cardiac arrest. Applying a cardiac monitor is the immediate priority to continuously assess for potentially fatal cardiac changes and allow for rapid intervention.
Monitoring intake and output is important in managing hyperkalemia but is not the immediate life-saving priority. Providing orange juice is contraindicated in hyperkalemia as orange juice is high in potassium and would worsen the condition. Obtaining a chest x-ray is not relevant to the acute management of hyperkalemia.
Correct Answer: A) Apply a cardiac monitor
A potassium level of 6.5 mEq/L indicates severe hyperkalemia (normal range 3.5–5.0 mEq/L). Hyperkalemia is a life-threatening emergency because elevated potassium disrupts the cardiac membrane potential, leading to dangerous dysrhythmias including ventricular fibrillation and cardiac arrest. Applying a cardiac monitor is the immediate priority to continuously assess for potentially fatal cardiac changes and allow for rapid intervention.
Monitoring intake and output is important in managing hyperkalemia but is not the immediate life-saving priority. Providing orange juice is contraindicated in hyperkalemia as orange juice is high in potassium and would worsen the condition. Obtaining a chest x-ray is not relevant to the acute management of hyperkalemia.
10. The nurse is assessing arterial blood gas results and recalls the acceptable range. Choose the correct range for the pH laboratory test.
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7.00–7.50
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7.25–7.40
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7.35–7.45
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7.55–7.65
Explanation
Explanation
Correct Answer: C) 7.35–7.45
The normal arterial blood pH range is 7.35 to 7.45. Values below 7.35 indicate acidosis, while values above 7.45 indicate alkalosis. Maintaining this narrow range is essential for proper cellular function and enzyme activity.
Correct Answer: C) 7.35–7.45
The normal arterial blood pH range is 7.35 to 7.45. Values below 7.35 indicate acidosis, while values above 7.45 indicate alkalosis. Maintaining this narrow range is essential for proper cellular function and enzyme activity.
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