ADULT HEALTH REAL FINAL EXAM QUESTIONS AND 100% CORRECT ANSWERS / ADULT HEALTH lll EXAM 1-4 & FINAL EXAM 2023/2024 LATEST UPDATE
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ADULT HEALTH REAL FINAL EXAM QUESTIONS AND 100% CORRECT ANSWERS / ADULT HEALTH lll EXAM 1-4 & FINAL
EXAM 2023/2024 LATEST UPDATE ADULT HEALTH REAL FINAL EXAM QUESTIONS AND 100% CORRECT ANSWERS / ADULT HEALTH lll EXAM 1-4 & FINAL
EXAM 2023/2024 LATEST UPDATE
ADULT HEALTH REAL FINAL EXAM QUESTIONS
AND 100% CORRECT ANSWERS / ADULT HEALTH lll
EXAM 1-4 & FINAL
EXAM 2023/2024 LATEST UPDATE
Adult Health lll Exam 1
1. The nurse should interpret the arterial blood gas results shown below as which of the
following?
pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L
a. respiratory alkalosis
b. metabolic acidosis
c. metabolic alkalosis
d. respiratory acidosis
Feedback: The ABGs shown indicate the pH is high which would mean alkalosis. The PaCO2 is
low which is the opposite of the pH and indicates that the respiratory system is the primary
problem. The HCO3 is within normal levels. Remember the acronym ROME when interpreting
ABGs.Lewis 2017, pgs 290-291abcK
2. The nurse is caring for a client who is receiving prescribed intravenous (IV) fluids at 50
ml/hr, has voided 300 ml in 24-hours and reports having a headache. The nurse notes the
client's laboratory results show a low urine specific gravity level. Which of the following
actions should the nurse take?
a. Encourage the client to increase their fluid intake.
b. Decrease the intravenous fluids.
c. Administer prescribed antibiotics.
d. Assist the client to ambulate to increase their metabolic rate.
,Feedback: Acute renal failure manifests as oliguria, anuria, or normal urine volume. Oliguria
(less than 400 mL/d of urine) is the most common clinical situation seen in acute renal failure
along with a low urine specific gravity; anuria (less than 50 mL/d of urine) and normal urine
output are not as common. In acute renal failure you want to encourage the client to increase
their fluid intake to prevent dehydration. Administering antibiotics will not increase the client's
decreased urine output. Decreasing IV fluids will be putting the client at risk for dehydration.
Increasing the metabolic rate will not assist the client in their urine output deficit. Lewis 2017,
pgs. 1071-1072abkd
3. The plan of care for a client with a low potassium level includes providing information
about the effects of medications and the dietary intake of foods high in potassium. Which of
the following information should the nurse use to evaluate if the outcome for the plan was
met? a. laboratory data
b. physical assessment
c. health history
d. client statements
Feedback: The interventions are aimed at increasing the potassium level of the client, and
achievement would be measured by evaluating laboratory data. Potassium levels cannot be
measured by physical assessment, health history information, or client statements. Lewis 2017,
pgs. 282-283
4. The nurse caring for a client experiencing acute hypoxemic respiratory failure due to V/Q
mismatch is evaluating the client’s plan of care. Which of the following interventions
would be appropriate for the client’s care plan?
a. Initiate 24% to 32% oxygen via face mask.
b. Provide high flow supplemental oxygen via nasal cannula.
c. Provide oxygen via noninvasive positive pressure ventilation (NIPPV).
d. Initiate invasive positive pressure ventilation (PPV) via endotracheal tube for SaO2
below 90%.
,Feedback: The nurse should understand that acute hypoxemic respiratory failure due to V/Q
mismatch requires low levels of oxygen either via nasal cannula or using a face mask at 24% to
32% oxygen. This helps improve the PaO2 and SaO2 levels. Without knowing the client’s
baseline SaO2 an intervention to initiate PPV vie ET tube for SaO2 would be inappropriate.
NIPPV is typically the treatment of choice for hypoxemia secondary to an intrapulmonary shunt,
not V/Q mismatch.Lewis 2017, pgs. 1615-1616
5. The nurse is caring for a client with right sided pneumonia (PN) and helps position the
client in the left Sims position. The nurse should evaluate the client’s response to the
position by doing which of the following?
a. Compare the client’s PaO2 level with the previous level.
b. Assessing the client’s pain level.
c. Ask the client to perform coughing and deep breathing.
d. Compare the client’s pH and HCO3 levels with the baseline levels.
Feedback: Clients with unilateral lung disease should be positioned with the healthy lung in a
dependent position. This helps to mobilize the secretions which makes it easier to expectorate.
The client’s PaO2 level compared to the previous level would give the nurse a good indication if
the client’s ventilation has increased. Lewis 2017, pgs. 1610-1611k, 1624-1625k, acd by
omission
6. The nurse is caring for a client with acute respiratory distress syndrome (ARDS) who is
mechanically ventilated with positive end-expiratory pressure (PEEP). Which of the
following should alert the nurse that the client is having complications from PEEP?
Select all that apply. a. tachycardia
b. hypopnea
c. decreased urine output
d. diminished lung sounds
e. hypertension
Feedback: PEEP is indicated in clients with ARDS. PEEP provides positive pressure at the end
of expiration to keep the alveoli open. This positive pressure can increase the intrathoracic
, pressure. When intrathoracic pressure increases, the client will have a decrease in preload, which
can decrease cardiac output. When there is a decrease in cardiac output, the client can have
tachycardia, hypotension, and decreased perfusion to the kidneys. With increased intrathoracic
pressure, barotrauma or pneumothorax can occur. A client on mechanical ventilation should have
equal and bilateral breath sounds, diminished breath sounds may indicate a pneumothorax.Lewis
2017, pg. 1577Kbe
7. The nurse received report from the previous shift for a client who was intubated for acute
respiratory failure (ARF) less than one hour ago. Which of the following test results
would be a priority for the nurse to follow-up?
a. end-tidal CO2 (ETCO2)
b. complete blood count (CBC)
c. electrocardiogram (ECG)
d. mixed venous O2 saturation (SvO2)
Feedback: After a client is intubated the ETCO2 should be evaluated because this confirms
proper tube placement within the airway immediately after intubation. A CBC, ECG and SvO2
are also done after intubation but would not be a priority over correct tube placement.Lewis
2017, p. 1614
8. A nurse is caring for a client in the emergency department (ED) who had a radiograph (x-
ray) that reveals rib fractures, and the client is diagnosed with a small flail chest injury.
Which of the following interventions should the nurse include in the client's plan of care?
a. suction the client's airway secretions
b. strict fluid intake and fluid replacement restriction
c. prepare the client for surgery
d. immediately sedate and intubate the client
Feedback: As with rib fracture, treatment of flail chest is usually supportive. Management
includes ventilatory support, clearing secretions from the lungs, and controlling pain. If only a
small segment of the chest is involved, it is important to clear the airway through positioning,
coughing, deep breathing, and suctioning. Clients should have adequate fluid intake and
replacement to mobilize secretions and underlining pulmonary contusion. Intubation is required
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