| Course | NUR 673 Producing and Evaluating Programs for Academic and Practice Settings |
|---|---|
| Module | Module 5 |
| Paper type | Test item set with keys, rationales and blueprint mapping |
| Length | About 1,020 words, 6 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | MS in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 673 Module 5
Fifteen Items, One Blueprint: Final Questions for an Electrolyte and Acid-Base Unit Quiz
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 673: Producing and Evaluating Programs for Academic and Practice Settings
Instructor Name
Month Day, Year
Fifteen Items, One Blueprint: Final Questions for an Electrolyte and Acid-Base Unit Quiz
Item Set
Format notes: Single-best-answer items have four options. Select-all-that-apply items are scored with partial credit. Each item lists its content area (CA), cognitive level (L) and, for analysis items, the clinical judgment step (CJ).
Item 1 (CA: fluid volume; L: understand)
Which assessment finding is most consistent with fluid volume deficit? A. Bounding pulse. B. Heart rate of 112 with a weak pulse. C. Crackles in both lung bases. D. Jugular venous distension.
Key: B. A low circulating volume produces a fast, weak pulse; the other options indicate excess volume.
Item 2 (CA: fluid volume; L: apply)
An 84-year-old with vomiting for two days has orthostatic hypotension. Which action is most important before the client gets out of bed? A. Encourage oral fluids. B. Help the client dangle at the bedside before standing. C. Obtain a daily weight. D. Review the intake and output record.
Key: B. Dangling first and preventing a fall from orthostatic hypotension is the immediate safety priority.
Item 3 (CA: fluid volume; L: analyze; CJ: recognize cues)
A client with heart failure receiving IV fluids has these findings. Select all that indicate fluid volume excess. A. Weight gain of 2 kg in 24 hours. B. New crackles in both bases. C. Urine specific gravity of 1.030. D. Pitting edema of both ankles. E. Distended neck veins at 45 degrees.
Key: A, B, D, E. A high specific gravity suggests concentrated urine and deficit, not excess.
Item 4 (CA: fluid volume; L: analyze; CJ: evaluate outcomes)
After furosemide, which finding best shows that treatment of fluid volume excess is effective? A. Urine output of 900 mL over 4 hours with fewer crackles. B. Potassium of 3.4 mEq/L. C. Blood pressure of 150/90. D. Client reports thirst.
Key: A. Diuresis with improved lung sounds shows the intended outcome; B is an adverse effect.
Item 5 (CA: sodium; L: understand)
Which condition is most likely to cause hyponatremia from water retention? A. Diabetes insipidus. B. Syndrome of inappropriate antidiuretic hormone. C. Excess sodium intake. D. Profuse sweating with free water replacement withheld.
Key: B. Excess antidiuretic hormone causes water retention and dilutional hyponatremia.
Item 6 (CA: sodium; L: apply)
A client with a serum sodium of 121 mEq/L becomes confused. What is the nurse's first action? A. Institute seizure and fall precautions. B. Offer a high-sodium snack. C. Encourage 2 liters of water. D. Prepare to give hypertonic saline by rapid bolus.
Key: A. Safety comes first; rapid correction risks osmotic demyelination, and water worsens hyponatremia.
Item 7 (CA: sodium; L: analyze; CJ: analyze cues)
An 80-year-old started hydrochlorothiazide two weeks ago and now has a sodium of 124 mEq/L, new confusion and moist mucous membranes. Which explanation best fits the data? A. Dehydration from poor intake. B. Diuretic-induced sodium loss. C. Hypernatremia from fluid loss. D. Laboratory error.
Key: B. Thiazides commonly cause hyponatremia in older adults; moist membranes argue against dehydration.
Item 8 (CA: potassium; L: apply)
A client is prescribed 20 mEq of potassium chloride IV. Which nursing action is correct? A. Give it by IV push over 2 minutes. B. Dilute it and infuse with a pump at the prescribed rate. C. Add it to a hanging IV bag without mixing. D. Give it intramuscularly if the IV is infiltrated.
Key: B. Potassium must be diluted and infused by pump; IV push can cause fatal arrhythmias.
Item 9 (CA: potassium; L: apply)
Select all actions appropriate for a client with a potassium of 6.4 mEq/L. A. Place on a cardiac monitor. B. Hold potassium supplements. C. Encourage bananas and orange juice. D. Prepare to give calcium gluconate as prescribed. E. Recheck the level if the sample was hemolyzed.
Key: A, B, D, E. High-potassium foods are contraindicated.
Item 10 (CA: potassium; L: analyze; CJ: recognize cues)
Which ECG change most suggests hyperkalemia? A. Peaked T waves. B. U waves. C. Prolonged QT interval. D. ST depression with flat T waves.
Key: A. U waves and flat T waves suggest hypokalemia.
Item 11 (CA: calcium and magnesium; L: understand)
Which finding indicates hypocalcemia? A. Positive Trousseau sign. B. Kidney stones. C. Decreased deep tendon reflexes. D. Constipation.
Key: A. The others are associated with hypercalcemia.
Item 12 (CA: calcium and magnesium; L: apply)
A client's potassium remains low despite replacement. Which laboratory value should the nurse review? A. Sodium. B. Magnesium. C. Chloride. D. Phosphorus.
Key: B. Low magnesium makes hypokalemia difficult to correct.
Item 13 (CA: acid-base; L: apply)
A client with prolonged vomiting is at risk for which acid-base imbalance? A. Metabolic acidosis. B. Metabolic alkalosis. C. Respiratory acidosis. D. Respiratory alkalosis.
Key: B. Loss of gastric acid raises bicarbonate.
Item 14 (CA: acid-base; L: analyze; CJ: analyze cues)
Arterial blood gas: pH 7.30, PaCO2 56 mm Hg, HCO3 25 mEq/L. Which interpretation is correct? A. Uncompensated respiratory acidosis. B. Compensated metabolic acidosis. C. Uncompensated metabolic alkalosis. D. Partially compensated respiratory alkalosis.
Key: A. Low pH with high PaCO2 and normal bicarbonate indicates uncompensated respiratory acidosis.
Item 15 (CA: acid-base; L: analyze; CJ: evaluate outcomes; extended case)
A client in diabetic ketoacidosis had deep, rapid respirations and a pH of 7.18 on admission. After four hours of insulin and fluids, select all findings that show improvement. A. Respirations of 18 and regular. B. pH of 7.31. C. Potassium of 3.1 mEq/L. D. Anion gap narrowing from 26 to 16. E. New confusion.
Key: A, B, D. Low potassium needs action and new confusion is a warning sign.
Revisions After Peer Review
Following peer feedback, I removed the word "always" from a distractor in item 5, rewrote item 14 so the stem no longer names the type of imbalance, and added two incorrect options to item 9 so that not every option was correct. Each single-best-answer item was checked for a clear first or best answer, plausible distractors drawn from common student errors and options of similar length, following item-writing guidelines (Haladyna et al., 2002; Oermann et al., 2024). The clinical judgment tags follow the NCSBN model (Dickison et al., 2019).
References
Dickison, P., Haerling, K. A., & Lasater, K. (2019). Integrating the National Council of State Boards of Nursing Clinical Judgment Model into nursing educational frameworks. Journal of Nursing Education, 58(2), 72-78. https://doi.org/10.3928/01484834-20190122-03
Haladyna, T. M., Downing, S. M., & Rodriguez, M. C. (2002). A review of multiple-choice item-writing guidelines for classroom assessment. Applied Measurement in Education, 15(3), 309-333. https://doi.org/10.1207/S15324818AME1503_5
Oermann, M. H., Gaberson, K. B., & De Gagne, J. C. (Eds.). (2024). Evaluation and testing in nursing education (7th ed.). Springer Publishing.
What the NUR 673 Module 5 instructions ask for
Part 2 of the Assessment Portfolio, the test questions, is the largest graded item in NUR 673 at 25 points. It is developed in two stages: draft questions are posted in Week 3 for the peer review in Part 4, and the final questions are due at the end of Week 5, when the module turns to assembling, administering and scoring tests and to item analysis. The syllabus asks for test questions developed in alignment with your test blueprint that follow best practices in item writing. That means the number of items in each content area and level should match your Part 1 grid exactly, and each item should reflect the guidelines covered in Weeks 2 and 3 for multiple-choice, multiple-response and higher-level items.
How this NUR 673 Module 5 example is built
Built as a submission-ready item set, the sample opens with format notes on option counts and scoring. Fifteen items follow, each labeled with its content area, cognitive level and, for analysis items, the clinical judgment step, then the stem, options, key and a brief rationale that explains why distractors are wrong. Items move from understanding to analysis within each content area and include eleven single-best-answer items, three select-all-that-apply items and one extended case that evaluates outcomes after treatment. A margin note shows the counts that match the blueprint. A closing section lists the specific revisions made after peer review and the item-writing checks applied, with sources.
NUR 673 Module 5 rubric: what earns full marks
Part 2 carries 25 points under the Canvas rubric. Item sets are generally evaluated on alignment with the blueprint by content and level, adherence to item-writing best practices, clinical accuracy, plausible distractors drawn from real misconceptions, correct keys and rationales and evidence that peer feedback was used. Higher-level items should require use of data rather than recall dressed in a scenario. Points are commonly lost for counts that do not match the blueprint, for items with more than one defensible answer, for cues such as length or grammatical agreement and for select-all-that-apply items where every option is correct. Including rationales also prepares you for the Week 5 item analysis quiz.
NUR 673 Module 5 help: mistakes that cost marks
The most common problem is drifting from the blueprint while writing; count your items by cell before submitting. Another is writing application items that are really recall with a patient name added. Ask whether the student must use the data in the stem to answer. Draw distractors from errors students actually make. Avoid absolute terms, all-of-the-above and negative stems. Write a rationale for every item, including why the distractors are wrong. Show what you changed after peer review. Check clinical accuracy against current references. If you send the desk your blueprint and draft items, it can check the counts and construction. A final read of every stem for clues that give away the answer is worth the time before you submit.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 673 Module 5 questions, answered
Where can I find a free NUR 673 Module 5 sample paper?
This page has a full NUR 673 Module 5 sample: fifteen final test questions on fluid, electrolyte and acid-base imbalances, each with a key, rationale and blueprint mapping.
How should test questions align with a blueprint?
The number of items in each content area and cognitive level should match the blueprint, and each item should be labeled with the cell it fills.
What makes a good distractor in a nursing test item?
A plausible wrong answer based on a common misconception or error, similar in length and grammar to the correct answer.
How are select-all-that-apply items scored?
Often with partial credit, such as plus/minus scoring, which awards points for correct choices and subtracts for incorrect ones, mirroring current licensure exam practice.
How much is NUR 673 Part 2 worth?
The final test questions are worth 25 of the course's 100 points, the largest single assignment, due at the end of Week 5.