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NR 452 Capstone Course: A Comprehensive Guide

Our NR 452 Final Exam Study Guide has the information you need to succeed in this course. This is the capstone experience of your nursing program, where you will apply what you’ve learned. The Capstone Course, NR 452, is designed to help students prepare for the challenges of working as registered nurses.

Fall 2018 Simulation Questions and Solutions

The simulation exercises play a significant role in the NR 452 Capstone Course. These drills are meant to mimic situations that nurses could face in actual practice. They offer a safe space for you to test out your talents and expertise. A bank of simulation questions and solutions was made available in the Fall 2018 semester.

You may improve your critical thinking, clinical reasoning, and decision making by working through these simulation problems. The purpose of these questions is to test your knowledge and encourage you to go further into specific areas of nursing. You may show off your skills in a variety of nursing specializations at these events.

The simulation activities and questions that follow them will help you hone your skills in patient assessment, clinical decision making, intervention delivery, and outcome assessment. These exercises are designed to help you transition smoothly from classroom learning to the working world of nursing.

The Capstone Course (NR 452) provides an ideal setting in which to integrate and perfect your nursing knowledge and skills in preparation for professional practice. You may improve your nursing skills and confidence by answering the simulation questions and actively participating in the course.

Finally, NR 452 Capstone Course offers a well-rounded education that readies you for the rigors of professional nursing. The Fall 2018 semester’s worth of simulation questions and solutions provides excellent practice applying what you’ve learned to real-world contexts. Take advantage of this test of your critical thinking and clinical reasoning skills to demonstrate that you’re prepared to enter the nursing profession.


Question 1: What key priority assessment findings are usually seen in left-sided heart failure? How do these findings differ from right-sided heart failure?

Left-sided heart failure priorities:

Respiratory symptoms comprise dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and coughing, generally with shades of pink frothy saliva (indicating pulmonary edema).

Heart failure on the left side causes fatigue, weakness, confusion and altered mental status due to decreased cardiac output.

Right-sided heart failure test outcomes include:

Venous congestion can cause upper extremes sacral, and reliant region swelling.

Central blood vessel pressure may distend the jugular veins.

Biventricular heart failure, which affects both sides of the heart, can manifest significantly depending on degree and cause.

Question 2: Identify two common medication classes used to treat left-sided heart failure. What are two nursing considerations for each identified classification of medication?

Left-sided heart failure medications include:

ACE inhibitors:

Nursing: a. Monitor blood pressure and heart rate routinely.

b. Report angioedema immediately.


Nursing: a. Monitor blood pressure and heart rate routinely.

a. Report signs of worsening heart failure to the doctor, such as shortness of breath or fluid retention.

These nursing concerns maintain patient safety and monitor medication efficacy and negative effects.

Question 3: How do cultural differences impact nurses in teaching diet and nutrition? What is cultural humility?

Cultural factors can affect how nurses teach diet and nutrition:

Dietary preferences and restrictions: Food attitudes and tastes vary by culture. To respect and meet cultural demands, nurses offering dietary instruction must be aware of certain cultural factors.

Health attitudes and practices: Traditional healing methods and cultural health beliefs may impact dietary choices. Nurses should work with patients to find culturally appropriate food suggestions.

Cultural humility respects cultural differences and provides care without judgment. Self-reflection, knowledge of biases and limits, and a willingness to learn from and adapt to diverse cultures are needed. Cultural humility in nursing promotes patient-centered care that respects and values cultural ideas and customs.

Question 4: What are two nursing considerations in prioritizing and deciding the placement location of a peripheral IV in heart failure?

In heart failure, two nursing considerations are:

Distal IV placement prioritizes venous access for medication and hydration control. This place the IV line closer to the extremities, improving blood flow and decreasing infiltration and extravasation.

Selecting a bigger gauge catheter: Heart failure patients may need intravenous diuretics or inotropes with viscosity or pH concerns. Using an 18 or 20-gauge catheter speeds up medicine administration and lowers the risk of catheter occlusion or phlebitis.

These factors maximize venous access and drug and hydration administration in heart failure patients.

Question 5: What are common signs and symptoms of acute infection in the elderly, and what two priority nursing interventions would you employ?

Elderly acute infection symptoms may include:

Hypothermia or fever

Mental confusion

Weakness or fatigue

Rapid heartbeat

Coughing and breathlessness are respiratory symptoms.

Urinary frequency, urgency, or discomfort

Infection-related skin changes include redness, warmth, and edema.

Two primary nursing strategies for elderly acute infection are:

Infection control:

Prevent infection by washing hands and wearing PPE.

If necessary, isolate the infectious agent or condition.

Vital signs and mental status:

Check temperature, heart rate, blood pressure, and respiration.

Older persons may show modest changes or confusion as the first sign of illness.

Due to age-related physiological changes and underlying health issues, elderly people are more susceptible to consequences from infections.

Question 6: Identify four different classifications of antibiotics. What priority nursing considerations should you review when a patient is on an antibiotic?

Four antibiotic classes:





Antibiotic patients have nursing priorities:

Allergy assessment: Antibiotic allergies can cause moderate rashes to life-threatening anaphylaxis, so examine the patient’s allergies.

Antibiotic dosage: Follow the antibiotic’s dose schedule and route. Some antibiotics must be taken before or after meals, and others cannot be taken with particular foods or drugs.

Monitoring for adverse effects: Check for antibiotic-related side effects include gastrointestinal issues, allergic reactions, and superinfections like oral thrush or vaginal yeast infection.

Patient education: Instruct patients on the need of finishing their antibiotics and the hazards of noncompliance, including antibiotic resistance.

These nursing principles assure antibiotic safety and optimal patient outcomes.

Question 7: What impact do Advanced Directives have on the nursing care of the patient? What resources are available to assist with completion and adherence to a patient’s end-of-life wishes?

Advanced Directives affect patient nursing, especially end-of-life care. They give legally enforceable medical and end-of-life care directives to patients who can’t speak or decide. Advanced Directives assist nurses respect patient autonomy and wants.

End-of-life resources include:

Patient and family education: Nurses can explain Advanced Directives, including living wills and durable power of attorney for healthcare choices, to patients and families. This aids patients and their families in decision-making and understanding their options.

Collaboration with healthcare team: Nurses collaborate with social workers, chaplains, and ethicists to promote end-of-life care talks, support Advanced Directives, and ensure interdisciplinary adherence to the patient’s desires.

Hospice and palliative care: These services serve terminally ill patients and their families. They can help patients complete Advanced Directives, discuss end-of-life care, and follow their wishes.

Legal and ethical resources: Nurses can consult legal and ethical resources inside their healthcare facility or professional associations to comply with Advanced Directives laws and ethics.

Nurses can help patients write Advanced Directives and deliver patient-centered care by increasing awareness, education, and teamwork.

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NR 452 Simulation Questions with Answers (Fall 2018)