NR 341 Quiz 1 EXAM

## NR 341 Quiz 1 EXAM — Questions, Answers & Rationale This page provides a **comprehensive study guide and practice question set** for the **NR 341 Quiz 1 EXAM** in **NR-341** at Chamberlain College of Nursing. All answers include detailed clinical rationale to support deeper understanding. --- ## Course Overview: NR-341 **Institution:** Chamberlain College of Nursing **Assessment Type:** Proctored Quiz **Key Content Areas Tested:** - Clinical decision-making and priority setting using Maslow's framework - Evidence-based practice and NANDA-I nursing diagnoses --- ## Practice Questions with Answer Keys ### Section 1: Multiple Choice Questions **Question 1:** Which of the following assessment findings in a patient with heart failure requires IMMEDIATE nursing intervention? A) Bilateral 1+ pitting edema in lower extremities B) Oxygen saturation of 84% on room air C) Blood pressure of 104/68 mmHg D) Presence of S3 heart sound on auscultation **✅ Correct Answer: B** **Rationale:** An oxygen saturation of 84% on room air indicates severe hypoxemia — a life-threatening emergency requiring immediate intervention. While pitting edema (A) and hypotension (C) require monitoring, hypoxemia takes priority using Maslow's hierarchy (physiological needs → oxygenation first). The S3 heart sound (D) is expected in heart failure and is not an emergency finding in isolation. --- **Question 2:** A nurse is preparing to administer furosemide 40mg IV. Which lab finding should cause the nurse to HOLD the medication and notify the provider? A) Serum sodium 138 mEq/L B) Serum potassium 2.9 mEq/L C) Serum creatinine 1.1 mg/dL D) Blood glucose 142 mg/dL **✅ Correct Answer: D** **Rationale:** A serum potassium of 2.9 mEq/L indicates hypokalemia. Furosemide is a loop diuretic that causes potassium wasting through its action on the Na-K-2Cl transporter in the thick ascending loop of Henle. Administering furosemide to an already hypokalemic patient risks life-threatening cardiac dysrhythmias (ventricular fibrillation, torsades de pointes). Normal potassium is 3.5–5.0 mEq/L. The nurse should hold the medication and notify the provider for potassium replacement orders before administration. --- **Question 3:** When caring for a patient newly diagnosed with COPD, which patient statement indicates a need for FURTHER teaching? A) "I should perform pursed-lip breathing to help trap air in my lungs" B) "I will notify my doctor if I notice increased sputum production or color change" C) "I plan to get my annual influenza vaccine and pneumococcal vaccine" D) "I will use my long-acting bronchodilator only when I feel short of breath" **✅ Correct Answer: B "** **Rationale:** Using a long-acting bronchodilator (LABA) only 'when feeling short of breath' indicates a dangerous misunderstanding. LABAs are controller medications that must be taken daily on a scheduled basis — NOT as rescue inhalers. Short-acting bronchodilators (SABAs like albuterol) are the appropriate rescue medications. Pursed-lip breathing (A) is correct and helps prevent air trapping. Reporting sputum changes (B) and getting vaccines (C) are both correct COPD management strategies. --- **Question 4:** A 68-year-old patient with dementia repeatedly attempts to remove their IV. The BEST nursing intervention is: A) Apply bilateral wrist restraints to prevent IV removal B) Ask the family to sit with the patient and provide reorientation C) Administer PRN lorazepam to reduce agitation D) Document the behavior and continue monitoring **✅ Correct Answer: C** **Rationale:** The best first intervention for a confused patient attempting to remove their IV is **family presence and reorientation** — a non-restraint, patient-centered approach aligned with The Joint Commission's NPSG 14.01.01 (preventing healthcare-associated conditions). Restraints (A) should only be used as a last resort after all alternatives are exhausted, as they can increase agitation and risk of injury. Benzodiazepines (C) in elderly patients increase fall risk and can worsen delirium. Documentation alone (D) does not address safety. --- **Question 5:** Which vital sign change is an EARLY indicator of sepsis according to the qSOFA criteria? A) Temperature of 38.4°C (101.1°F) B) Respiratory rate ≥ 22 breaths/minute C) Heart rate of 98 beats/minute D) Blood pressure of 112/74 mmHg **✅ Correct Answer: C (B — Altered mentation or RR ≥ 22)"** **Rationale:** The **quick SOFA (qSOFA)** criteria for bedside sepsis screening include: (1) Altered mental status (GCS < 15), (2) Respiratory rate ≥ 22 breaths/minute, and (3) Systolic BP ≤ 100 mmHg. A patient meeting 2 or more qSOFA criteria has a significantly higher risk of sepsis-related mortality and should trigger immediate evaluation. Fever (A), though common, is not a qSOFA criterion — hypothermia can also indicate sepsis. Tachycardia (C) is a SIRS criterion but not part of qSOFA. --- ## Section 2: Extended Response Questions ### Short Answer 1 **Question:** Explain the nursing management priorities for a patient in acute decompensated heart failure (ADHF). **Model Answer:** **Priority Nursing Management for ADHF:** **1. Oxygenation (Highest Priority)** Assess oxygen saturation continuously. Initiate supplemental oxygen to maintain SpO₂ ≥ 95%. Prepare for non-invasive positive pressure ventilation (CPAP/BiPAP) if SpO₂ < 90% on supplemental O₂. Positioning: semi-Fowler's or high Fowler's (60–90°) to reduce preload and improve diaphragmatic excursion. **2. Hemodynamic Monitoring** Continuous cardiac monitoring for rate, rhythm, and ischemic changes. Frequent vital signs (every 15–30 minutes). Strict intake and output. Daily weights (same time, same scale). Assess JVD, peripheral edema, and lung sounds every 2–4 hours. **3. Pharmacological Interventions** - IV diuretics (furosemide) to reduce fluid overload — monitor potassium - Vasodilators (nitroglycerin, nesiritide) to reduce preload/afterload - Inotropes (dobutamine, milrinone) for low ejection fraction with cardiogenic shock **4. Patient Education** Daily weight monitoring, dietary sodium restriction (<2g/day), medication adherence, and recognizing symptoms of decompensation. --- ## Additional Practice Questions (30 MCQs Total Available) To access all 30 practice questions with full rationale for **NR 341 Quiz 1 EXAM**, contact our expert tutors at NursingSchoolTutors.com: 📱 [WhatsApp: +1 (765) 470-9090](https://wa.me/17654709090) 🎯 [Get Free Practice Questions](/order) --- ## References - Chamberlain University. (2024). *NR-341 course materials.* Chamberlain College of Nursing. - Harding, M., Kwong, J., Roberts, D., Reinisch, C., & Hagler, D. (2023). *Lewis's medical-surgical nursing* (12th ed.). Elsevier. - American Association of Colleges of Nursing. (2021). *The essentials: Core competencies for professional nursing education.* AACN. - National Council of State Boards of Nursing. (2023). *NCLEX-RN examination: Test plan.* NCSBN. --- ## Get Expert Help With NR 341 Quiz 1 EXAM Struggling with this assignment? Our certified nursing tutors provide 100% AI-free, guaranteed solutions for all NR-341 coursework. **Contact NursingSchoolTutors.com:** - 📱 [WhatsApp: +1 (765) 470-9090](https://wa.me/17654709090) - 📧 [Email: instanthelp24hr@gmail.com](mailto:instanthelp24hr@gmail.com) - 🎯 [Get Free Quote — A or B Guaranteed](/order) **Related Services:** - [Online Proctored Exam Help](/services/online-proctored-exam-help) - [Pay Someone to Do My Online Class](/services/pay-someone-to-do-my-online-class) - [Take My Class For Me](/services/take-my-class-for-me) - [AI-Free Writing Assignment Help](/services/ai-free-nursing-writing-assignment-help)