Download NEIEP 200 Final Exam | Actual Questions and Answers | 2025 Update | 100% Correct and more Exams Nursing in PDF only on Docsity!
NEIEP 200 Final Exam | Actual Questions and
Answers | 2025 Update | 100% Correct
- A nurse is preparing to administer the first dose of intravenous ceftriaxone to a patient with a documented penicillin allergy. What is the priority nursing action? A. Administer the medication slowly over 60 minutes B. Verify the allergy history and consult the provider for an alternative antibiotic C. Premedicate with diphenhydramine D. Monitor for signs of anaphylaxis after administration Correct Answer: B. Verify the allergy history and consult the provider for an alternative antibiotic Rationale: Cross-reactivity between penicillins and cephalosporins exists, and administering a cephalosporin without provider clarification risks a severe allergic reaction. Safety protocols require verification and alternative selection before administration.
- Which assessment finding in a postoperative patient indicates the highest risk for venous thromboembolism? A. Temperature of 37.8°C B. Unilateral calf swelling and warmth C. Mild incisional pain D. Heart rate of 88 beats per minute Correct Answer: B. Unilateral calf swelling and warmth Rationale: Unilateral leg swelling, warmth, and pain are classic signs of deep vein thrombosis, a precursor to pulmonary embolism. Early recognition prevents life-threatening complications through prompt diagnostic imaging and anticoagulation.
- A patient with chronic heart failure is prescribed furosemide 40 mg orally daily. Which laboratory value requires immediate notification of the provider? A. Sodium 138 mEq/L B. Potassium 3.0 mEq/L C. Blood urea nitrogen 22 mg/dL D. Creatinine 1.1 mg/dL Correct Answer: B. Potassium 3.0 mEq/L Rationale: Loop
diuretics like furosemide cause potassium wasting, and a level of 3.0 mEq/L indicates hypokalemia, which increases the risk of cardiac arrhythmias. Prompt replacement and dose adjustment are clinically indicated.
- During a code blue, which team member is responsible for maintaining the airway and providing ventilation? A. Team leader B. Medication nurse C. Airway manager D. Compressor Correct Answer: C. Airway manager Rationale: Role clarity during cardiac arrest improves resuscitation outcomes. The airway manager focuses exclusively on bag-valve-mask ventilation, advanced airway placement, and ensuring adequate oxygenation and CO2 clearance.
- A nurse is teaching a patient about sublingual nitroglycerin for angina. Which statement indicates a need for further teaching? A. I will sit down before taking the medication B. I can take up to three tablets five minutes apart if pain persists C. I will store the tablets in my bathroom medicine cabinet D. I should call emergency services if pain does not resolve after three doses Correct Answer: C. I will store the tablets in my bathroom medicine cabinet Rationale: Nitroglycerin is highly sensitive to heat, moisture, and light, which degrade its potency. It must be stored in its original dark glass container at room temperature, away from humidity and sunlight.
- Which intervention best demonstrates culturally competent care in a pediatric oncology setting? A. Assuming all families prefer direct, factual communication B. Asking the family about their beliefs regarding illness, treatment, and decision-making C. Limiting visitor access to reduce infection risk regardless of family structure D. Providing educational materials only in English Correct Answer: B. Asking the family about their beliefs regarding illness, treatment, and decision-making Rationale: Cultural competence requires active inquiry
and prevents drug interactions or clogging. Auscultation alone is unreliable for placement verification; radiographic confirmation or pH testing is required. 10.Which finding in a patient with pneumonia indicates clinical improvement? A. Increased respiratory rate from 24 to 28 breaths per minute B. Oxygen saturation improving from 89% to 94% on room air C. Persistent crackles bilaterally D. Elevated white blood cell count Correct Answer: B. Oxygen saturation improving from 89% to 94% on room air Rationale: Improved oxygenation reflects resolving alveolar consolidation and adequate gas exchange, signaling therapeutic response to antibiotics and supportive care. 11.A nurse is caring for a patient with a suspected opioid overdose. Which intervention takes priority? A. Administer naloxone intravenously B. Obtain a urine toxicology screen C. Place the patient in a supine position D. Start intravenous fluid resuscitation Correct Answer: A. Administer naloxone intravenously Rationale: Reversing respiratory depression is the immediate priority in opioid overdose. Naloxone rapidly restores airway patency and ventilation while other assessments can follow. 12.Which principle of infection control is most effective in preventing healthcare- associated infections? A. Wearing gowns for all patient contact B. Performing hand hygiene before and after every patient interaction C. Using alcohol-based hand rubs only when gloves are worn D. Isolating patients with fever Correct Answer: B. Performing hand hygiene before and after every patient interaction Rationale: Hand hygiene is the single most evidence-based intervention for reducing pathogen transmission. It breaks the chain of infection regardless of visible contamination or glove use.
13.A patient with a history of asthma is prescribed a beta-blocker for hypertension. What is the nurse’s primary concern? A. Increased risk of bronchospasm B. Decreased heart rate C. Orthostatic hypotension D. Hyperkalemia Correct Answer: A. Increased risk of bronchospasm Rationale: Nonselective beta-blockers can antagonize beta-2 receptors in the lungs, triggering airway constriction in asthmatic patients. Cardioselective alternatives or alternative antihypertensives are preferred. 14.Which assessment tool is most appropriate for evaluating pain in a nonverbal adult with advanced dementia? A. Numeric Rating Scale B. Visual Analog Scale C. PAINAD Scale D. FLACC Scale Correct Answer: C. PAINAD Scale Rationale: The PAINAD (Pain Assessment in Advanced Dementia) tool evaluates breathing, vocalization, facial expression, body language, and consolability, making it valid for nonverbal cognitive impairment. 15.A nurse discovers a medication error that resulted in no patient harm. What is the required action? A. Document the error in the patient’s chart only B. Report the event through the facility’s incident reporting system C. Inform the patient’s family before the provider D. Correct the record and continue the shift Correct Answer: B. Report the event through the facility’s incident reporting system Rationale: Just culture principles require transparent reporting of near misses and errors to identify system vulnerabilities, implement corrective actions, and prevent future harm. 16.Which laboratory parameter best reflects long-term glycemic control over the past 2-3 months? A. Fasting blood glucose B. Postprandial glucose C. Glycated hemoglobin (HbA1c) D. Fructosamine Correct Answer: C. Glycated hemoglobin (HbA1c) Rationale: HbA1c measures the percentage of hemoglobin bound to
hyperphosphatemia and fluid overload. Restricting phosphorus prevents bone demineralization and vascular calcification, while fluid control prevents hypertension and pulmonary edema. 20.Which finding indicates effective fluid resuscitation in a patient with hypovolemic shock? A. Urine output of 35 mL/hour B. Capillary refill of 5 seconds C. Mean arterial pressure of 58 mmHg D. Heart rate of 120 beats per minute Correct Answer: A. Urine output of 35 mL/hour Rationale: Adequate renal perfusion is a reliable indicator of restored intravascular volume. Urine output ≥30 mL/hour suggests improved cardiac output and tissue perfusion. 21.A nurse is preparing to administer subcutaneous enoxaparin. Which technique minimizes bruising? A. Massage the injection site vigorously B. Inject slowly and release the skin fold after needle removal C. Use a 22-gauge needle D. Aspirate before injection Correct Answer: B. Inject slowly and release the skin fold after needle removal Rationale: Slow injection reduces tissue trauma, and maintaining the skin fold until needle withdrawal prevents medication leakage into subcutaneous tissue, decreasing bruising risk. Aspiration is contraindicated for LMWH. 22.Which patient statement demonstrates understanding of warfarin therapy? A. I will take ibuprofen for headaches instead of acetaminophen B. I will maintain a consistent intake of vitamin K-rich foods C. I can stop the medication once my INR is normal D. I will avoid brushing my teeth to prevent bleeding Correct Answer: B. I will maintain a consistent intake of vitamin K-rich foods Rationale: Warfarin antagonizes vitamin K-dependent clotting factors. Consistent dietary vitamin K intake stabilizes INR values, preventing dangerous fluctuations that increase thromboembolic or bleeding risk.
23.A patient presents with chest pain radiating to the left arm, diaphoresis, and shortness of breath. Which diagnostic test should be obtained first? A. Chest X- ray B. 12-lead electrocardiogram C. Troponin level D. Echocardiogram Correct Answer: B. 12-lead electrocardiogram Rationale: An ECG within 10 minutes of presentation is critical for identifying ST-elevation myocardial infarction, which requires immediate reperfusion therapy to salvage myocardial tissue. 24.Which intervention best reduces the risk of catheter-associated urinary tract infections? A. Changing the catheter every three days B. Using antiseptic solutions daily at the meatus C. Maintaining a closed drainage system and removing the catheter as soon as clinically indicated D. Elevating the drainage bag above the bladder level Correct Answer: C. Maintaining a closed drainage system and removing the catheter as soon as clinically indicated Rationale: Prolonged catheterization is the primary risk factor for CAUTI. Aseptic insertion, closed system maintenance, and early removal significantly reduce bacterial colonization and ascending infection. 25.A nurse is caring for a patient with diabetic ketoacidosis. Which laboratory finding is expected? A. Blood pH 7.45 B. Serum bicarbonate 24 mEq/L C. Anion gap of 18 mEq/L D. Blood glucose 95 mg/dL Correct Answer: C. Anion gap of 18 mEq/L Rationale: DKA causes metabolic acidosis with an elevated anion gap due to accumulation of ketone bodies. Normal anion gap is 8-12 mEq/L; values >16 indicate significant acid accumulation requiring insulin and fluid therapy. 26.Which communication strategy is most effective when de-escalating an agitated patient? A. Using authoritative tone and direct commands B. Maintaining eye contact, speaking calmly, and offering choices C. Isolating the patient in a secure room immediately D. Confronting the patient about their
ambulation and return of bowel function Rationale: Functional mobility and gastrointestinal recovery indicate physiological readiness for home care. Complete wound healing and lab normalization are not required for safe discharge. 30.Which principle guides the ethical allocation of scarce medical resources? A. First-come, first-served basis B. Maximizing benefit and minimizing harm using objective clinical criteria C. Prioritizing patients with higher insurance coverage D. Distributing resources equally regardless of prognosis Correct Answer: B. Maximizing benefit and minimizing harm using objective clinical criteria Rationale: Utilitarian and justice-based ethical frameworks require transparent, evidence-based triage criteria that prioritize survival likelihood and equitable resource distribution during shortages. 31.A patient with hypertension is prescribed a calcium channel blocker. Which side effect requires patient education? A. Dry cough B. Peripheral edema C. Hyperkalemia D. Photosensitivity Correct Answer: B. Peripheral edema Rationale: Dihydropyridine calcium channel blockers cause arteriolar dilation without venous dilation, leading to capillary hydrostatic pressure increase and fluid leakage into interstitial spaces, commonly presenting as ankle edema. 32.Which intervention is most appropriate for a patient experiencing acute anxiety before a procedure? A. Administering a benzodiazepine without provider order B. Using guided imagery and controlled breathing techniques C. Leaving the patient alone to reduce stimulation D. Dismissing concerns as normal Correct Answer: B. Using guided imagery and controlled breathing techniques Rationale: Nonpharmacological interventions activate the
parasympathetic nervous system, reduce sympathetic overdrive, and empower patients to self-regulate physiological stress responses. 33.A nurse is monitoring a patient on a continuous cardiac monitor. Which rhythm requires immediate intervention? A. Normal sinus rhythm B. Sinus bradycardia at 58 bpm C. Ventricular tachycardia with pulse D. Atrial fibrillation at 110 bpm Correct Answer: C. Ventricular tachycardia with pulse Rationale: Pulseless VT is a cardiac arrest rhythm, but even with a pulse, VT compromises cardiac output and rapidly deteriorates to ventricular fibrillation. Immediate antiarrhythmic therapy and provider notification are critical. 34.Which finding in a patient with chronic obstructive pulmonary disease indicates CO2 retention? A. Hyperventilation B. Bounding pulses C. Morning headache and confusion D. Elevated oxygen saturation Correct Answer: C. Morning headache and confusion Rationale: Hypercapnia causes cerebral vasodilation and altered mental status. Chronic CO2 retention shifts the respiratory drive from hypoxic to hypercapnic, making unmonitored high-flow oxygen potentially dangerous. 35.A nurse is teaching a patient about osteoporosis prevention. Which recommendation is evidence-based? A. Limit weight-bearing exercises B. Ensure adequate calcium and vitamin D intake C. Increase caffeine consumption D. Avoid all sunlight exposure Correct Answer: B. Ensure adequate calcium and vitamin D intake Rationale: Calcium supports bone matrix mineralization while vitamin D enhances intestinal calcium absorption and regulates bone remodeling, directly reducing fracture risk. 36.Which assessment technique is used to detect ascites in a patient with liver cirrhosis? A. Percussion for tympany B. Fluid wave test and shifting dullness C.
compression from rising ICP. Late signs require immediate intervention such as osmotic therapy, hyperventilation, or surgical decompression. 40.Which intervention prevents deep vein thrombosis in postoperative patients? A. Prolonged bed rest B. Sequential compression devices and early ambulation C. Restricting fluid intake D. Applying heating pads to lower extremities Correct Answer: B. Sequential compression devices and early ambulation Rationale: Mechanical compression and muscle contraction from ambulation enhance venous return, reduce stasis, and decrease thrombus formation in high-risk surgical patients. 41.A patient with a history of peptic ulcer disease is prescribed naproxen. What is the nurse’s priority concern? A. Increased risk of gastrointestinal bleeding B. Renal toxicity C. Hepatic enzyme elevation D. Bone marrow suppression Correct Answer: A. Increased risk of gastrointestinal bleeding Rationale: NSAIDs inhibit prostaglandin synthesis, reducing gastric mucosal protection. In patients with ulcer history, this significantly increases perforation and hemorrhage risk, warranting proton pump inhibitor co-administration or alternative analgesics. 42.Which principle underlies informed consent in clinical practice? A. Provider determines best treatment regardless of patient preference B. Patient receives comprehensive information, demonstrates understanding, and voluntarily agrees C. Family members sign consent when patients are competent D. Consent is implied for all routine procedures Correct Answer: B. Patient receives comprehensive information, demonstrates understanding, and voluntarily agrees Rationale: Informed consent is a legal and ethical
requirement ensuring autonomy, disclosure of risks/benefits/alternatives, and voluntary participation without coercion. 43.A nurse is assessing a patient with suspected hypoglycemia. Which symptom is most specific? A. Diaphoresis and tremors B. Polyuria and polydipsia C. Weight loss D. Dry skin Correct Answer: A. Diaphoresis and tremors Rationale: These are autonomic nervous system responses to low blood glucose, triggering catecholamine release. Neuroglycopenic symptoms like confusion follow if untreated. 44.Which intervention best supports wound healing in a diabetic foot ulcer? A. Applying topical hydrogen peroxide daily B. Maintaining a moist wound environment with appropriate dressings C. Keeping the wound dry and exposed to air D. Using adhesive tape directly on fragile skin Correct Answer: B. Maintaining a moist wound environment with appropriate dressings Rationale: Moist wound healing promotes cellular migration, angiogenesis, and autolytic debridement. Dry environments impair epithelialization and increase scab formation. 45.A patient with atrial fibrillation is prescribed apixaban. Which statement indicates correct understanding? A. I will take this medication with warfarin for better effect B. I should report any unusual bruising or dark stools immediately C. I can stop taking it once my heart rhythm normalizes D. I will double the dose if I miss a day Correct Answer: B. I should report any unusual bruising or dark stools immediately Rationale: Direct oral anticoagulants increase bleeding risk. Patients must recognize signs of hemorrhage and avoid dose adjustments without provider guidance.
Progression to widened QRS and sine wave patterns precedes cardiac arrest, requiring immediate calcium gluconate and potassium-lowering therapies. 50.Which intervention best prevents aspiration in a patient with dysphagia? A. Placing the patient in supine position during meals B. Thickening liquids and elevating the head of bed to 90 degrees C. Feeding rapidly to reduce fatigue D. Offering large bites of food Correct Answer: B. Thickening liquids and elevating the head of bed to 90 degrees Rationale: Postural alignment and viscosity modification improve swallowing mechanics, reduce laryngeal penetration, and minimize pulmonary aspiration risk. 51.A nurse is monitoring a patient on a continuous heparin infusion. Which laboratory test guides dosing? A. PT/INR B. aPTT C. D-dimer D. Platelet count Correct Answer: B. aPTT Rationale: Activated partial thromboplastin time measures the intrinsic coagulation pathway and is used to titrate unfractionated heparin to therapeutic ranges, typically 1.5-2.5 times control. 52.Which finding in a patient with sepsis indicates systemic inflammatory response? A. Temperature 38.5°C and heart rate 110 bpm B. Blood pressure 130/80 mmHg C. Respiratory rate 14 breaths per minute D. Normal lactate level Correct Answer: A. Temperature 38.5°C and heart rate 110 bpm Rationale: SIRS criteria include temperature >38°C, heart rate >90, respiratory rate >20, or abnormal white blood cell count. These reflect systemic cytokine release and early sepsis physiology. 53.A patient with a spinal cord injury develops autonomic dysreflexia. What is the priority intervention? A. Administer antihypertensives immediately B. Identify and remove the triggering stimulus C. Place the patient in Trendelenburg position D. Restrict fluid intake Correct Answer: B. Identify and remove the
triggering stimulus Rationale: Autonomic dysreflexia is a life-threatening hypertensive crisis triggered by noxious stimuli below the injury level, commonly a distended bladder or bowel. Removing the stimulus resolves the sympathetic surge. 54.Which principle guides safe medication administration in pediatric patients? A. Using adult dosing scaled by age B. Calculating doses by weight and using standardized concentration protocols C. Administering all medications intravenously D. Avoiding liquid formulations Correct Answer: B. Calculating doses by weight and using standardized concentration protocols Rationale: Children have variable pharmacokinetics. Weight-based dosing with double- check verification and standardized concentrations prevents overdose and underdose errors. 55.A nurse is evaluating a patient’s pain using the PQRST mnemonic. What does the “Q” represent? A. Quality of pain B. Quantity of medication C. Quick response time D. Quotient of relief Correct Answer: A. Quality of pain Rationale: PQRST stands for Provocation, Quality, Region/Radiation, Severity, and Timing. Quality describes the pain character (e.g., sharp, dull, burning), guiding differential diagnosis and treatment. 56.Which intervention reduces the risk of ventilator-associated pneumonia? A. Keeping the head of bed flat B. Daily sedation vacations and oral care with chlorhexidine C. Using continuous subglottic suctioning only when secretions are visible D. Changing ventilator circuits every 24 hours Correct Answer: B. Daily sedation vacations and oral care with chlorhexidine Rationale: Bundled VAP prevention strategies include oral hygiene, sedation interruption to
60.Which intervention best supports breastfeeding initiation in the first hour postpartum? A. Separating mother and infant for routine procedures B. Skin- to-skin contact and early latch assistance C. Administering formula before breastfeeding D. Delaying feeding until maternal rest Correct Answer: B. Skin- to-skin contact and early latch assistance Rationale: Immediate skin-to-skin promotes thermoregulation, stimulates prolactin and oxytocin release, and establishes effective latch, improving long-term breastfeeding success. 61.A patient with a history of depression is prescribed sertraline. Which teaching point is essential? A. Therapeutic effects occur within 24 hours B. Do not discontinue abruptly due to withdrawal syndrome C. Take with grapefruit juice to enhance absorption D. Avoid all physical activity Correct Answer: B. Do not discontinue abruptly due to withdrawal syndrome Rationale: SSRIs require gradual tapering to prevent discontinuation syndrome, including dizziness, irritability, and flu-like symptoms. Full therapeutic benefit typically takes 4- weeks. 62.Which finding indicates dehydration in an older adult? A. Skin turgor returning immediately B. Dry mucous membranes and decreased urine output C. Bounding peripheral pulses D. Moist oral mucosa Correct Answer: B. Dry mucous membranes and decreased urine output Rationale: Age-related skin elasticity changes make turgor unreliable. Mucous membrane dryness, concentrated urine, and orthostatic changes are more accurate indicators of volume depletion. 63.A nurse is caring for a patient with a chest tube. Which observation requires immediate intervention? A. Continuous bubbling in the water seal chamber B. Intermittent bubbling during exhalation C. Tidaling with respiration D. 50 mL
drainage in the collection chamber Correct Answer: A. Continuous bubbling in the water seal chamber Rationale: Continuous bubbling indicates an air leak in the system or patient, requiring assessment for disconnection, tube malposition, or bronchopleural fistula. Intermittent bubbling and tidaling are expected. 64.Which principle underlies trauma-informed care? A. Assuming all patients have experienced trauma B. Recognizing trauma prevalence, avoiding re- traumatization, and promoting safety and empowerment C. Focusing solely on physical injuries D. Delaying emotional support until discharge Correct Answer: B. Recognizing trauma prevalence, avoiding re-traumatization, and promoting safety and empowerment Rationale: Trauma-informed care integrates universal precautions for psychological safety, validates patient experiences, and adjusts interactions to prevent triggering distress. 65.A patient with hyperthyroidism is prescribed propranolol. What is the primary therapeutic goal? A. Reducing thyroid hormone production B. Controlling sympathetic symptoms like tachycardia and tremors C. Increasing metabolic rate D. Promoting weight gain Correct Answer: B. Controlling sympathetic symptoms like tachycardia and tremors Rationale: Beta-blockers do not alter thyroid hormone levels but rapidly alleviate adrenergic symptoms, improving patient comfort and reducing cardiac strain until antithyroid medications take effect. 66.Which assessment tool is validated for fall risk in hospitalized adults? A. Glasgow Coma Scale B. Morse Fall Scale C. Braden Scale D. APGAR Score Correct Answer: B. Morse Fall Scale Rationale: The Morse Fall Scale evaluates history of falling, secondary diagnosis, ambulatory aid, IV therapy, gait, and
