Circulatory System
Atrial fibrillation increases risk for:
A. Stroke
B. Hypoglycemia
C. Liver failure
D. Pneumothorax
A — AFib causes atrial clot formation → embolic stroke.
A client with COPD is receiving oxygen at 4 L/min NC. What complication must the nurse monitor for?
A. Decreased respiratory drive
B. Hypoglycemia
C. Increased intracranial pressure
D. Hyperkalemia
A — High O₂ in COPD may reduce hypoxic drive in some patients.
A client with CKD has crackles and weight gain of 2.5 kg in 2 days. Best interpretation?
A. Dehydration
B. Fluid overload
C. Hyperglycemia
D. Improved kidney function
B — Rapid weight gain + crackles indicates overload.
A client with sickle cell crisis reports severe pain. What is the priority nursing intervention? Select ALL that apply.
C. + D. Crisis care: oxygenation, hydration, and pain control (opioids).
The nurse notes a pressure injury with full-thickness skin loss and visible adipose tissue, but no bone/tendon exposed. Stage?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
C — Stage III = full-thickness loss with visible fat, no bone/tendon.
A client has signs of shock: cool clammy skin, weak pulse, confusion. Priority?
A. Place in upright position and restrict fluids
B. Encourage walking
C. Give antihistamine first
D. Support airway/oxygenation and start IV fluids per protocol
D— Shock priorities: airway/oxygen + restore circulation.
A client in severe asthma exacerbation should receive first:
A. Inhaled short-acting bronchodilator (albuterol)
B. Long-acting beta agonist
C. Antibiotics
D. Mucolytic
A — Rescue inhaler (SABA) is first for acute bronchospasm.
A client with UTI now has fever, chills, and flank pain. The nurse suspects:
A. Cystitis
B. Renal cancer
C. Pyelonephritis
D. SIADH
C — Fever + flank pain suggests kidney involvement (pyelonephritis).
A client with leukemia is most at risk for which complication?
A. Hypertension
B. Infection
C. Hyperthyroidism
D. Kidney stones
B — Leukemia compromises immune function → infection risk.
Which intervention best prevents pressure injuries in a bedbound client?
A. Massage reddened bony areas
B. Turn and reposition at least every 2 hours
C. Use donut-shaped cushions under the sacrum
D. Limit fluids to decrease incontinence
B — Repositioning reduces pressure duration (prevention priority).
A client with hypertension should be taught to:
A. Stop meds once BP normal
B. Reduce sodium intake and follow medication regimen
C. Increase alcohol for vasodilation
D. Avoid exercise forever
B — Lifestyle + adherence prevents complications (stroke, MI, CKD).
A client has a chest tube. The nurse notes continuous bubbling in the water-seal chamber. This suggests:
A. Air leak in the system
B. Normal finding
C. Tube obstruction
D. Fluid overload
A — Continuous bubbling in water seal = air leak.
A client has post-op urinary retention. The nurse scans bladder and finds 700 mL. Priority?
A. Encourage oral fluids only
B. Catheterize per protocol/provider order
C. Wait 8 hours and reassess
D. Give diuretic
B — 700 mL retained: relieve retention to prevent bladder injury.
A client has suspected internal bleeding. Which is the earliest clue?
A. Bounding pulses
B. Hypertension
C. Jaundice
D. Tachycardia
D — Early shock signs: restlessness + tachycardia (compensation).
A client with herpes zoster reports severe pain. The nurse understands this pain occurs because the virus affects the:
A. Sweat glands
B. Dermal capillaries
C. Sensory nerve roots
D. Sebaceous glands
C — Shingles affects sensory nerve roots → neuropathic pain.
A — Troponin is most specific for myocardial damage.
Which lab is most specific for myocardial injury?
A. Troponin
B. BNP
C. WBC
D. Potassium
Which finding is most consistent with tuberculosis?
A. Sudden fever and green sputum for 2 days
B. Chronic cough, night sweats, weight loss
C. Wheezing after exercise only
D. Pink frothy sputum
B — TB classic: chronic cough, night sweats, weight loss.
A client has renal calculi. Which instruction helps stone passage?
A. Restrict fluids
B. Encourage ambulation and fluids (if not contraindicated)
C. Apply ice to flank
D. Avoid all pain medication
B — Fluids + movement help pass stones (unless contraindicated).
Which lab finding is most consistent with iron-deficiency anemia?
A. High hemoglobin, high hematocrit
B. Low hemoglobin, low hematocrit
C. High platelets, high potassium
D. High WBC, high calcium
B — Iron-deficiency = low Hgb/Hct.
A client with cellulitis has a marked border around erythema. Which finding is most concerning?
A. Warmth at site
B. Redness extending beyond border
C. Mild edema
D. Pain rated 4/10
B — Spreading erythema suggests worsening infection/sepsis risk.
A heart failure client has crackles and +3 edema. Which med is priority?
A. Antitussive
B. Beta Blocker
C. Loop Diuretic
D. Albuterol
C — Diuretics relieve fluid overload (crackles/edema).
Critical thinking question... What electrolyte do I need to monitor and Why?
Which ABG indicates respiratory acidosis?
A. pH 7.28, HCO₃20
B. pH 7.30, CO₂ 55
C. pH 7.50, HCO₃ 30
D. pH 7.48, CO₂ 40
B — Low pH + high CO₂ = respiratory acidosis.
Critical thinking question...If the HCO₃ was 24, would it be uncompensated, partially compensated, or fully compensated?
Which AKI finding is most life-threatening?
A. BUN 35 mg/dL
B. Creatinine 2.1 mg/dL
C. Potassium 6.2 mEq/L
D. Mild peripheral edema
C — Hyperkalemia can cause lethal dysrhythmias.
Critical Thinking... How do I fix it?
A client has DVT and is started on warfarin. Teaching should include:
A. Increase vitamin K foods
B. Keep vitamin K intake consistent
C. Avoid all green vegetables permanently
D. Stop monitoring INR once stable
B — Consistency of vitamin K helps stable INR.
Critical thinking... What is a therapeutic INR for a patient taking Warfarin?
A client with psoriasis asks about the cause of the condition. The nurse explains it is primarily:
A. A bacterial infection
B. An autoimmune disorder
C. A fungal infection
D. A vitamin deficiency
B Psoriasis is autoimmune.