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
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Auscultation of all 4 quads.
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Percussion in the upper quads.
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Palpate the patient's painful area first.
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Observe the contour of the abdomen.
Explanation
Correct Answer: D) Observe the contour of the abdomen.
The correct sequence for abdominal assessment is inspection, auscultation, percussion, then palpation — which differs from the standard assessment order used for other body systems. Inspection (observation) is always performed first, allowing the nurse to visually assess the contour, symmetry, distension, visible masses, skin changes, and movement of the abdomen before any physical contact is made.
Auscultation comes second in abdominal assessment, before percussion and palpation, because manipulating the abdomen first can artificially alter bowel sounds. Percussion is performed third to assess organ size and detect fluid or air. Palpating the painful area last — or avoiding it initially — is critical to prevent guarding, rigidity, and patient discomfort that could interfere with the rest of the examination.
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Read the laboratory results for high cholesterol and other data.
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Perform nursing care therapies to address hypertension.
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Identify that teaching is the same for every client with high blood pressure.
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Focus on the client's individual learning needs and objectives.
Explanation
Correct Answer: D) Focus on the client's individual learning needs and objectives.
Effective patient education begins with assessing the individual client's learning needs, readiness, preferences, and objectives. Teaching must be tailored to the specific client rather than using a one-size-fits-all approach. Identifying what the client already knows, what they need to learn, and how they learn best ensures that the education is relevant, meaningful, and more likely to result in behavior change.
Reading laboratory results for cholesterol provides background data but is not the priority action before teaching about sodium reduction. Performing nursing care therapies addresses the clinical management of hypertension but is separate from the educational process. Assuming teaching is the same for every hypertensive client ignores individual differences in literacy, culture, motivation, and learning style, which undermines effective education.
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
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.
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At bedtime, while the client is relaxed.
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At medication time when the nurse is administering patient medication.
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At lunchtime, while the nurse is preparing the food tray.
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At bath time when the nurse is cleaning the client.
Explanation
Correct Answer: C) At lunchtime, while the nurse is preparing the food tray.
Teaching about dietary sodium reduction is most effective and meaningful when it occurs in context — that is, at mealtime when actual food is present. This allows the nurse to use the food tray as a concrete teaching tool, pointing out high- and low-sodium foods in real time. Contextual teaching reinforces learning, improves retention, and helps the client make immediate, practical connections between the information and their daily life.
At bedtime, the client may be drowsy or fatigued, which reduces the ability to concentrate and retain new information. At medication time, the nurse's focus and the client's attention are on medications, not dietary habits, making it a suboptimal learning opportunity. Bath time is an uncomfortable and distracting environment that does not support focused patient education.
The nurse has instructed the patient to take 20 mL of a medication. How many teaspoons should the patient be instructed to take at home?
Explanation
Correct Answer: 4 teaspoons
One teaspoon equals 5 mL. To convert 20 mL to teaspoons, divide 20 by 5, which equals 4 teaspoons.
The nurse follows the "rights" and "checks" of medication administration to do no harm. By following this process, which moral principle is the nurse demonstrating?
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Fidelity
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Morals
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Autonomy
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Nonmaleficence
Explanation
Correct Answer: D) Nonmaleficence
Nonmaleficence is the ethical principle meaning "do no harm." By carefully following the rights of medication administration (right patient, right drug, right dose, right route, right time) and performing the required checks, the nurse is actively working to prevent medication errors and protect the client from harm — a direct demonstration of nonmaleficence in practice.
Fidelity refers to keeping promises and maintaining loyalty and trustworthiness in the nurse-client relationship, not specifically to harm prevention protocols. Morals refer to personal values and beliefs about right and wrong but are not a formal ethical principle applied in clinical practice. Autonomy refers to respecting the client's right to make their own informed decisions, which is unrelated to medication safety checks.
A graduate nurse is teaching a new diabetic client how to correctly administer insulin. Which statement by the graduate nurse indicates understanding of the importance of client demonstration and teach back?
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It is an effective strategy in teaching psychomotor skills.
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It allows for standardized information to be presented to each client.
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It is learner-centered and effective for teaching in the affective and cognitive domains.
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It is an efficient and cost-effective way to impart information, particularly for large groups.
Explanation
Correct Answer: A) It is an effective strategy in teaching psychomotor skills.
Teach-back and demonstration are essential for psychomotor learning, which involves performing physical skills such as insulin administration. This method ensures the client can correctly perform the task and allows the nurse to correct errors immediately.
A nurse is reviewing fluid movement across cell membranes. Which statement about the water is correct?
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Osmosis requires active energy expenditure by the cell to move water across membranes.
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Water moves from areas of low solute concentration to areas of high solute concentration during osmosis.
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When a cell is placed in a hypotonic solution, water moves out of the cell, causing it to shrink.
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Osmotic pressure has no impact on fluid balance.
Explanation
Correct Answer: B) Water moves from areas of low solute concentration to areas of high solute concentration during osmosis.
Osmosis is the passive movement of water across a semipermeable membrane from an area of lower solute concentration (higher water concentration) to an area of higher solute concentration (lower water concentration). This movement continues until equilibrium is achieved and requires no energy expenditure by the cell.
Osmosis is a passive process and does not require active energy — active transport is what requires ATP. When a cell is placed in a hypotonic solution, water moves INTO the cell (not out), causing it to swell and potentially lyse. Osmotic pressure is a fundamental regulator of fluid distribution between compartments and has a direct and significant impact on fluid balance.
An older patient has been vomiting for 2 days and has been unable to eat or drink anything during that time. Which health problem should the nurse realize this client is experiencing?
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Hypovolemia
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Hypervolemia
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Hypernatremia
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Hypokalemia
Explanation
Correct Answer: A) Hypovolemia
Prolonged vomiting and inability to intake fluids lead to significant fluid loss, resulting in decreased circulating volume. This places the client at risk for hypovolemia, which can cause hypotension, tachycardia, and decreased organ perfusion.
Hypervolemia involves fluid excess, which is not consistent with fluid loss. While electrolyte imbalances such as hypokalemia or hypernatremia may occur with vomiting, the most immediate and primary problem is fluid volume deficit.
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.
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