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2025 - 2026 NURS 618 ADVANCED
PATHOPHYSIOLOGY EXAM 2|ACTUAL QUESTIONS
AND ANSWERS|ALREADY GRADED A+
An older adult woman with a long history of COPD is admitted with progressive shortness of breath and a constant cough. she is anxious and is complaining of a dry mouth. Which intervention should the nurse implement? a. Administer a prescribed sedative b. Apply a high flow venturi mask c. Assist her to an upright position d. Encourage client to drink water c. Assist her to an upright position A client with history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened, tenacious mucus, and the inability to walk up a flight of stairs without experiencing breathlessness. What action is most important for the nurse to instruct the client about self-care? a. Increase the daily intake of oral fluids to liquefy secretions b. Avoid crowded enclosed areas to reduce pathogen exposure c. Teach anxiety reduction methods for feelings of suffocation d. Call the clinic if undesirable side effects of medications occur a. Increase the daily intake of oral fluids to liquefy secretions
A client who is newly diagnosed with emphysema is being discharged. What instruction is best for the nurse to provide to assist the client in self- management of dyspnea? a. Use a humidifier to increase home air quality humidity between 30% to 50% b. Practice inhaling through the mouth and exhaling slowly through pursed lips c. Strengthen abdominal muscles by alternating leg raises during exhalation d. Allow additional time to complete physical activities to reduce oxygen demand d. Allow additional time to complete physical activities to reduce oxygen demand The nurse is caring for a client with cor-pulmonale. The nurse should monitor the client for which expected finding. a. Ascites and hepatomegaly b. Elevated temperature and respiratory rate c. Complaints of chest pain and confusion d. Clubbing of the fingers and cyanosis of mucous membrane A. Ascites and hepatomegaly The nurse teaches pursed lip breathing to a client who is newly diagnosed with chronic obstructive pulmonary disease (COPD). The nurse reinforces that this technique will assist respiration by which mechanism?
c. assess respiratory rate and depth d. administer oxygen as prescribed c. assess respiratory rate and depth The nurse is caring for a client diagnosed with a pneumothorax who had chest tubes inserted four (4) hours ago. There is no fluctuating (tidaling) in the water- seal compartment of the closed chest drainage system. Which action should the nurse implement first? a. Check tubing for kinks b. Milk the chest tube c. Clamp the tubing to check for a link d. Instruct the client to cough a. Check tubing for kinks When collecting a sample from a disposable three-chamber water-seal drainage system, the nurse should obtain the sample from: a. The suction chamber b. The collection chamber that has a rubberized port with a one-way valve c. The water seal chamber d. The chest tube insertion site b. The collection chamber that has a rubberized port with a one-way valve
A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action? a. send the specimen to the lab for analysis immediately b. administer the first dose of prescribed antibiotic therapy c. observe the color, consistency, and amount of sputum d. encourage the client to drink plenty of warm fluids c. observe the color, consistency, and amount of sputum Ms. Gail is the charge nurse for the 7a-7p shift. The staff includes three RNs, one LPN, and two UAPs for a 16-bed unit. Ms. Gail and the UAP are caring for the following clients. Which information provided by the UAP requires immediate intervention by Ms. Gail? a. The client with a left-sided pneumothorax has 200 mL/hr of blood in the collection chamber of the Pleur-evac b. The client diagnosed with active tuberculosis who is in respiratory isolation and has orange urine int he urinary catheter c. The client diagnosed with bacterial pneumonia who has an elevated temperature and chills d. The client who has a right upper lobectomy on the patient-controlled analgesia (PCA) pump has level 4 pain on a scale of 1 to 10. a. The client with a left-sided pneumothorax has 200 mL/hr of blood in the collection chamber of the Pleur-evac The client's arterial blood gas (ABG) results are: pH 7.34, PaCO2 50, HCO3 24,
The nurse is monitoring the chest tube drainage system in a client with a chest tube. The nurse notes intermittent bubbling in the water seal chamber. Which is the most appropriate nursing action? a. change the chest tube drainage system b. check for an air leak c. notify the HCP d. document the findings d. document the findings The nurse is caring for a client diagnosed with diabetic ketoacidosis (DKA). Which statement best explains the scientific rationale for the client's Kussmaul's respirations? a. the respirations increase the amount of CO2 in the bloodstream b. the lungs speed up to release carbon dioxide and increase the pH c. the shallow and slow respirations will increase the HCO3 in the serum d. the kidneys produce excess urine and the lungs try to compensate b. the lungs speed up to release carbon dioxide and increase the pH A client with a history of hyperparathyroidism develops flank pain. Which of the following interventions would be appropriate by the nurse caring for this client?
a. strain all the urine to observe the passage of all the renal calculi b. decrease fluid intake c. call the HCP to ask for a prescription of antibiotics d. encourage the client to limit physical activity and maintain complete bedrest a. strain all the urine to observe the passage of all the renal calculi A female client is complaining of urinary frequency and burning with right lower back pain. Which intervention should the nurse implement first? a. evaluate the urine for a strong odor and insert an indwelling (Foley) catheter b. palpate the right flank for tenderness and check the client's SpO c. test her urine for the presence of hematuria and glucosuria d. measure her temperature and pulse rate d. measure her temperature and pulse rate A client undergoes intravenous pyelography (IVP). What should the nurse check as early signs of a reaction to the IV contrast (dye)? a. coughing and fever b. itching, rash, hives, tingling of the mouth/tongue c. shortness of breath d. nausea, vomiting, diarrhea
The home health nurse is planning to make a home visit to a client who has undergone surgical creation of an ileal conduit. The nurse should include which information on ostomy care in discussion with the client? a. cleanse the skin around the stoma, using gentle soap and water, and then rinse and dry well b. plan to do appliance changes in the late evening hours c. cut an opening that is slightly smaller than the stoma in the face plate of the appliance d. appliance odor from urine breakdown to ammonia can be minimized by limiting fluids a. cleanse the skin around the stoma, using gentle soap and water, and then rinse and dry well A client who is to have a cystectomy with creation of an ileal conduit asks the nurse why the bowel needs to be cleansed before surgery if the bladder is being removed. Which response by the nurse is the most appropriate? a. "usually all the bowel will be removed to create two conduits for urinary diversion" b. "this will decrease the chance of postoperative paralytic ileus" c. "all clients undergo bowel preparation with major surgery" d. "a portion of the bowel will be used to create the conduit for urinary diversion" d. "a portion of the bowel will be used to create the conduit for urinary diversion"
The nurse is providing dietary instructions to a client with an oxalate kidney stone. The nurse should instruct the client to avoid which food? a. poultry b. chocolate c. breads d. milk b. chocolate Following surgical repair of the bladder a female client is being discharged from the hospital to home with an indwelling urinary catheter. Which instruction is most important for the nurse to provide to this client? a. Drink 10,000mL of fluids daily to irrigate catheter b. Cleanse the perineal area with soap and water twice daily c. Keep the drainage bag lower than the level of the bladder d. Avoid coiling the tubing and keep it free of kinks c. Keep the drainage bag lower than the level of the bladder
e. 1,2,3, d. 1,2, The nurse is caring for a client with an ileal conduit. While assisting the client in removing the external pouch. the nurse observes that the stoma appears blueish grey. What is the nurses best action? a. Measure the stoma and apply a larger pouching device b. Report the findings to the health care provider (HCP) immediately c. Document the findings and continue to monitor for changes d. Administer an antibacterial agent and asses for further signs of infection b. Report the findings to the health care provider (HCP) immediately A client has been given instructions about collecting a urine specimen to test creatinine clearance. The client indicates correct understanding of the specimen collection procedure by making which statement? a. I must provide midstream sample in a sterile container b. I will need to collect all my urine in a container for 24 hours, discarding the start-time urine and containing the end time urine c. A catheter is placed temporarily and then removed after I void d. The first AM specimen is the best as it is more concentrated
b. I will need to collect all my urine in a container for 24 hours, discarding the start-time urine and containing the end time urine The nurse is caring for a client with multiple renal calculi. Which nursing interventions should be included in the plan of care?
- Administer analgesics at regularly scheduled intervals
- Encourage fluid intake of up to 3 L/dav
- Instruct client to stay on bed rest
- Provide massage to the client's flank
- Strain all urine for the presence of stones a. 1,2,3,4, b. 2,3, c. 2,3,4, d. 1,2,3, e. 1,2, e. 1,2, Following a transurethral resection of the prostate (TURP), a client is discharged from the hospital with an indwelling urinary catheter. Which instruction is most important for the nurse to include in the discharge teaching plan? a. Drink at least 2.5 to 3 liters of water each day
- "Clients who have HPV or Condylomata acuminate should have a pap smear regularly" a. 1,2, b. 1,2,3,4,5, c. 1,2,3,4, d. 3,4, e. 1,4,5, e. 1,4,5, The nurse is caring for a client who underwent suprapubic prostatectomv and is receiving continuous bladder irrigation. Which of the following should the nurse report to the provider first? a. Any leakage of urine around the meatus b. Any change in the color of the urine c. Nausea, vomiting, and anorexia d. Change in weight of 1 lb in one week a. Any leakage of urine around the meatus The nurse is caring for a client who sustained a spinal cord injury at the level of T4. During administration of morning care, the client who has a Foley catheter begins to exhibit severe throbbing headache, sweating, nasal congestion,
goosebumps, and flushing. BP is 195/85 and HR = 60. Which initial nursing action should the nurse take? a. Request a STAT computer tomography (CT) scan of the head b. Conduct a complete neurological assessment c. Notify the health care provider (HCP). d. Examine the rectum digitally and loosen tight clothing on the client. e. Place the client in a sitting position, and then check the urinary catheter tubing for kinks or obstruction. e. Place the client in a sitting position, and then check the urinary catheter tubing for kinks or obstruction. The nurse is caring for a client after a craniotomy and monitors the client for signs of increased intracranial pressure. Which finding, if noted in the client, would indicate an early sign of increased ICP? a. a widened pulse pressure b. fixed, dilated pupils that are non-reactive to light c. confusion d. bradycardia c. confusion
b. 1,2,3,4,5, c. 2,3,4, d. 2,4,5, e. 1,2, a. 1,2,3,5, The client with a head injury opens eyes to painful stimuli, responds to verbal stimuli by making incomprehensible sounds, and localizes to painful stimuli when applied to each extremity. How should the nurse document the Glasgow Coma Scale (GCS) score? a. GCS= b. GCS= c. GCS= d. GCS= b. GCS= A client with myasthenia gravis is having ineffective airway clearance and difficulty with maintaining an effective breathing pattern. The nurse should keep which most important items available at the client's bedside? a. Incentive spirometer and cough pillow b. Pulso oximeter and cardiac monitor
c. Oxygen and metered-dose inhaler d. Ambu bag and suction equipment d. Ambu bag and suction equipment A client with myasthenia gravis arrives at the hospital emergency department in suspected crisis. The health care provider plans is administer Edrophonium Chloride to differentiate between myasthenic and cholinergic crises. The nurse ensures that which mediation is available in the event that the client is in cholinergic crisis? a. Protamine sulfate b. Pyridostigmine bromide c. Atropine sulfate d. Morphine sulfate e. Vitamin K c. Atropine sulfate The nurse is caring for a client who has just been admitted to the hospital with a diagnosis of a hemorrhagic stroke. The nurse should place the client in which position? a. Prone
