NCM 118 Semi Finals BSN-C

1. 1.
A 58-year-old male presents with hematemesis and melena. His blood pressure is 90/60 mmHg, and pulse is 120 bpm. What is the nurse’s priority action?

A) Administer proton pump inhibitor
B) Prepare for endoscopy
C) Insert a nasogastric tube
D) Start IV fluid resuscitation

2. 2.
The nurse is caring for a patient with an upper GI bleed. The nasogastric tube returns bright red blood. What does this finding indicate?

A) Normal NG output
B) Bleeding from lower GI
C) Ongoing active bleeding
D) Bleeding has stopped

3. 3.
After endoscopy for bleeding ulcers, the patient reports black tarry stools. What is the nurse’s interpretation?

A) New onset of lower GI bleed
B) Rebleeding from ulcer site
C) Normal finding post-endoscopy
D) Upper GI bleeding is resolving

4. 4.
A patient with GI bleeding is scheduled for blood transfusion. Which assessment finding requires immediate attention?

A) BP 110/70 mmHg
B) Temperature 37°C
C) Crackles in lungs after transfusion
D) Pulse 88 bpm

5. 5.
During octreotide infusion for variceal bleeding, the nurse observes bradycardia. What is the best nursing action?

A) Stop infusion and notify physician
B) Continue infusion
C) Decrease IV fluids
D) Give atropine

6. 6.
A trauma patient with massive fluid resuscitation has tense abdomen and decreased urine output. What is the nurse’s priority?

A) Measure bladder pressure
B) Provide pain relief
C) Elevate the head of the bed
D) Administer diuretics

7. 7.
What parameter best reflects intra-abdominal pressure?

A) Gastric residual volume
B) Central venous pressure
C) Mean arterial pressure
D) Bladder pressure

8. 8.
A patient with intra-abdominal hypertension has decreased cardiac output. What is the underlying cause?

A) Compression of inferior vena cava
B) Vasodilation
C) Increased intrathoracic pressure
D) Increased venous return

9. 9.
What is the initial management of mild intra-abdominal hypertension?

A) Start vasopressors
B) Immediate surgical decompression
C) Optimize fluid balance and positioning
D) insert chest tube

10. 10.
In abdominal compartment syndrome, which nursing assessment finding is most alarming?

A) Urine output 15 mL/hr
B) Soft abdomen
C) Heart rate 90 bpm
D) Respiratory rate 18/min

11. 11.
A patient with liver failure has confusion and flapping tremor (asterixis). What should the nurse suspect?

A) Hypokalemia
B) Hypoglycemia
C) Hypocalcemia
D) Hepatic encephalopathy

12. 12.
Which lab result is consistent with liver failure?

A) Decreased ammonia
B) Decreased bilirubin
C) Increased albumin
D) Elevated ALT and AST

13. 13.
A patient with liver failure has ascites. Which intervention is most appropriate?

A) Encourage deep breathing
B) Encourage high-sodium diet
C) Restrict fluids
D) Position in high Fowler’s

14. 14.
After paracentesis, what is the most important nursing action?

A) Record urine output
B) Monitor blood pressure
C) Document color of fluid
D) Check bowel sounds

15. 15.
The nurse should withhold lactulose if the patient exhibits which symptom?

A) Mild abdominal pain
B) Drowsiness
C) Severe diarrhea
D) Two soft stools per day

16. 16.
A patient with severe epigastric pain radiating to the back is diagnosed with acute pancreatitis. Which finding indicates a serious complication?

A) Fever
B) Nausea
C) Vomiting
D) Grey-Turner’s sign

17. 17.
Which lab result supports the diagnosis of acute pancreatitis?

A) Decreased lipase
B) Low WBC count
C) Elevated amylase and lipase
D) Low bilirubin

18. 18.
What is the priority nursing intervention in acute pancreatitis?

A) Maintain NPO status
B) Administer insulin
C) Provide low-fat diet
D) Encourage oral fluids

19. 19.
Which electrolyte imbalance is common in pancreatitis?

A) Hypomagnesemia
B) Hyperkalemia
C) Hypernatremia
D) Hypocalcemia

20. 20.
Which position best relieves pain in acute pancreatitis?

A) Trendelenburg
B) Supine
C) Left side-lying with knees flexed
D) Prone

21. 21.
A diabetic patient arrives with fruity odor breath and Kussmaul respirations. What is the priority action?

A) Start insulin drip
B) Administer bicarbonate
C) Prepare for dialysis
D) Begin IV fluids

22. 22.
Which lab result confirms DKA?

A) Blood glucose 180 mg/dL
B) pH 7.45
C) Serum ketones positive
D) HCO₃ 24 mEq/L

23. 23.
Which electrolyte must be monitored closely during insulin therapy in DKA?

A) Potassium
B) Magnesium
C) Calcium
D) Sodium

24. 24.
Which sign indicates effective management of DKA?

A) Decreasing ketones and glucose
B) Dry mucous membranes
C) Fruity odor persists
D) Increased urine output

25. 25.
The nurse should administer insulin infusion until:

A) C. pH returns to normal
B) D. IV fluids completed
C) A. Ketones disappear
D) B. Glucose < 200 mg/dL and patient can eat

26. 26.
An elderly type 2 diabetic is admitted with dehydration and glucose of 700 mg/dL, no ketones. What is the likely diagnosis?

A) B. HHNK
B) D. SIADH
C) C. Hypoglycemia
D) A. DKA

27. 27.
What is the primary cause of HHNK?

A) C. Excess carbohydrate intake
B) A. Infection or dehydration
C) B. Insulin overdose
D) D. Hypokalemia

28. 28.
Which intervention is most important in initial management of HHNK?

A) D. Provide potassium supplements
B) A. Administer IV insulin bolus
C) B. Rehydrate with IV fluids
D) C. Start antibiotics

29. 29.
What differentiates HHNK from DKA?

A) A. Presence of ketones
B) B. Level of glucose
C) D. All of the above
D) C. pH value

30. 30.
A nurse identifies decreased skin turgor and dry mucous membranes in a HHNK patient. What should the nurse expect?

A) D. Acidosis
B) B. Fluid overload
C) A. Fluid volume deficit
D) C. Hypoglycemia

31. 31.
A patient with acute renal failure has urine output of 200 mL/24 hrs. What phase is this?

A) B. Oliguric
B) A. Diuretic
C) C. Recovery
D) D. Initial

32. 32.
Which lab finding indicates renal failure?

A) A. Decreased creatinine
B) D. High GFR
C) B. Increased BUN and creatinine
D) C. Low potassium

33. 33.
In chronic renal failure, which diet is most appropriate?

A) A. High protein
B) B. Low potassium and phosphorus
C) C. High sodium
D) D. High fluid intake

34. 34.
The nurse monitors which ECG change for hyperkalemia in renal failure?

A) B. Peaked T waves
B) D. Flat P waves
C) A. ST depression
D) C. U waves

35. 35.
Which medication helps remove potassium in renal failure?

A) A. Kayexalate
B) D. Mannitol
C) B. Lasix
D) C. Spironolactone

36. 36.
A trauma patient presents with BP 80/50 mmHg, pulse 130 bpm, cool clammy skin. What type of shock is this?

A) D. Anaphylactic
B) C. Neurogenic
C) A. Cardiogenic
D) B. Hypovolemic

37. 37.
What is the first nursing action in hypovolemic shock?

A) B. Start IV fluids
B) C. Give oxygen
C) D. Draw labs
D) A. Administer vasopressors

38. 38.
In septic shock, which finding indicates early stage?

A) D. Hypothermia
B) C. Bradycardia
C) A. Cold clammy skin
D) B. Bounding pulse

39. 39.
Which lab test confirms septic shock?

A) A. Blood culture positive
B) B. Increased sodium
C) C. Decreased BUN
D) D. Elevated calcium

40. 40.
The most reliable indicator of adequate tissue perfusion in shock is:

A) D. Capillary refill
B) B. Urine output
C) C. Blood pressure
D) A. Skin color

41. 41.
Which of the following meets SIRS criteria?

A) C. RR 14, WBC 5,000
B) A. Temp 38.5°C, HR 100, WBC 15,000
C) D. BP 120/80
D) B. Temp 36°C, HR 70

42. 42.
What is the primary trigger for SIRS?

A) A. Infection or tissue injury
B) C. Hypoglycemia
C) D. Hypertension
D) B. Dehydration

43. 43.
MODS is characterized by:

A) C. Mild infection
B) B. Single organ failure
C) A. Dysfunction of two or more organ systems
D) D. Local inflammation only

44. 44.
A patient with MODS develops jaundice, oliguria, and confusion. What does this indicate?

A) C. Dehydration
B) D. Stable condition
C) A. Improvement
D) B. Multisystem involvement

45. 45.
Nursing priority in SIRS management is:

A) B. Fluid restriction
B) C. Oxygen removal
C) A. Early identification and treatment of infection
D) D. High-protein diet

46. 46.
In MODS, which intervention prevents further organ injury?

A) A. Maintain oxygenation and perfusion
B) B. Limit IV fluids
C) D. Withhold nutrition
D) C. Stop antibiotics

47. 47.
Which assessment finding indicates progression from SIRS to MODS?

A) B. Decreasing LOC and urine output
B) C. Warm, dry skin
C) D. Mild fever
D) A. Stable BP and urine output

48. 48.
Which laboratory marker is typically elevated in SIRS/MODS?

A) A. C-reactive protein (CRP)
B) D. Glucose
C) C. Sodium
D) B. Hematocrit

49. 49.
The nurse monitors for which complication in MODS?

A) D. Hypoglycemia
B) B. Hyperthyroidism
C) C. Dehydration
D) A. Disseminated intravascular coagulation (DIC)

50. 50.
What is the ultimate goal in managing SIRS and MODS?

A) D. Lower WBC count
B) C. Decrease urine output
C) B. Restrict fluids
D) A. Prevent sepsis and maintain organ perfusion

Created with That Quiz — where a math practice test is always one click away.