Download 2025-2026 NURS 618 ADVANCED PATHOPHYSIOLOGY EXAM 3|50 QUESTIONS AND ANSWERS|GRADED A+ and more Exams Pathophysiology in PDF only on Docsity!
2025 - 2026 NURS 618 ADVANCED
PATHOPHYSIOLOGY EXAM 3|50 QUESTIONS AND
ANSWERS|ALREADY GRADED A+
The nurse administers levothyroxine to a client with hypothyroidism. Which data indicate(s) that the drug is effective?
- Increase in T3 and T
- Decrease in heart rate
- Increase in TSH
- Decrease in urine output
- Decrease in periorbital edema a. 1,2,3,4, b. 1,2, c. 2,3, d. 1,2,3, e. 1, e. 1, A client with hyperparathyroidism presented to the hospital with flank pain. Which should be included in the client's plan of care? a. Strain all urine to see if kidney stones will pass in the urine b. Assess vital signs and call the respiratory therapist to draw blood for arterial blood gases c. Check blood for T3, T4, and TSH
d. Draw blood to check for serum sodium and potassium a. Strain all urine to see if kidney stones will pass in the urine The nurse prepares to administer 3 units of insulin subcutaneously to a client with a blood glucose level of 250 mg/dL. Which procedure is correct? a. Using one syringe, add the regular insulin into the syringe and then add the NPH insulin. b. Using one syringe, first insert air into the regular vial and then insert air into the NPH vial c. Avoid combining the two insulins because incompatibility could cause an adverse reaction d. Administer regular insulin subcutaneously and then give the NPH IV to prevent a separate stick a. Using one syringe, add the regular insulin into the syringe and then add the NPH insulin. An elderly client with long-term type 2 diabetes mellitus is seen in the clinic for a routine health assessment. To determine if the client is experiencing any long- term complications of diabetes, which assessments should the nurse obtain?
- Sensation in feet and legs
- Serum creatinine and blood urea nitrogen
- Visual acuity
- Signs of respiratory tract infection
- Skin condition of lower extremities
d. Assess radial pulse volume b. Collect the blood sample A client with type 1 diabetes mellitus is admitted with osteomyelitis for management with antibiotic right before the surgical procedure after controlling his infection. Considering the client's risk for developing diabetic ketoacidosis (DKA), which intervention is most important for the nurse to Include in the plan of care? a. Check finger stick glucose Q 4-6 hours b. Ensure IV fluids are infusing continuously c. Teach the client how to manage sick days by increasing Metformin dose when he is ill or having an infection d. Use dipstick to measure urine for ketone a. Check finger stick glucose Q 4-6 hours An elderly client with diabetes mellitus is transferred from the hospital to a rehabilitation facility following treatment for a stroke. He tells the nurse that his feet are always uncomfortably cool at night preventing him from falling asleep. What action should the nurse implement? a. Place warm blankets next to the client's feet b. Provide a heating pad to be applied to the feet throughout the night c. Medicate the client with a prescribed sedative to help him sleep well at night d. Ignore the client's complaint because feet of all elderly are always cold at night a. Place warm blankets next to the client's feet
The nurse in the emergency department is caring for a client with type 1 diabetes mellitus in diabetic ketoacidosis (DKA). Which action should the nurse take first? a. Give a potassium supplement b. Check serum electrolyte levels c. Administer NPH insulin IV d. Administer sodium bicarbonate e. Start an IV infusion of normal saline e. Start an IV infusion of normal saline The nurse administers regular insulin (human), 8 units subcutaneously, to a client at 8.00 am, 30 minutes before his breakfast. At what time is the client most at risk for a hypoglycemic reaction? a. 9:00am b. 4:00pm c. 10:30am d. 1:00pm e. 11:00pm c. 10:30am When is the most important time to check blood glucose level? a. at HS (hours sleep=bedtime) b. after food
d. Mix dextrose 50% in 50mL of IV normal saline to piggyback for a volume of 100mL and infuse it into the client as secondary IV using an IV pump e. Ask the pharmacy to add Dextrose 50% to the TPN and infuse it into the client using an IV pump c. Push undiluted dextrose 50% slowly through the current infusing IV The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse should ensure that which piece of medical equipment is most important to be kept at the client's bedside? a. intermittent gastric suction device b. cardiac monitor c. tracheotomy set d. underwater seal chest drainage system c. tracheotomy set A client with type 2 diabetes mellitus has a blood glucose level of 680 mg/dL and is complaining of polydipsia, polyuria, polyphagia, weight loss, and weakness. The nurse reviews the health care provider's documentation and most likely expects to note which diagnosis? a. Diabetic ketcacidoss (DKA) b. Diabetes insipidus (DI)
c. Insulin shock d. Hypoglycemia e. Hyperosmolar hyperglycemic syndrome (HHS) e. Hyperosmolar hyperglycemic syndrome (HHS) A hospitalized client is experiencing an episode of hypoglycemia. The client is lethargic and has no available intravenous (IV) access. Which medication should the nurse anticipate administering? a. Hydrocortisone b. Regular insulin c. Glucagon d. Epinephrine e. NPH Insulin c. Glucagon The nurse teaches a client with diabetes mellitus about differentiating between insulin shock (hypoglycemia) and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop?
- Polyuria
a. 1,4, b. 1,2,3, c. 2,3, d. 2,3,4, e. 1,2,3,4, a. 1,4, The nurse is administering Ranitidine to a client diagnosed with peptic ulcer disease. Which statement supports the rationale for administering this medication? a. It prevents the final transport of hydrogen ions into the gastric lumen b. It protects the ulcer from the destructive action of the digestive enzyme pepsin c. It blocks histamine 2 receptors controlling hydrochloric acid secretion by the parietal cells. d. It neutralizes the hydrochloric acid secreted by the stomach c. It blocks histamine 2 receptors controlling hydrochloric acid secretion by the parietal cells. A client returns to the nursing unit after undergoing an esophagogastroduodenoscopy (EGD). Which is the appropriate nursing intervention?
a. Tell the client to report a sore throat immediately because it is a serious complication b. Withhold oral fluids until the client's sag reflex has returned c. Allow the client to have bathroom privileges d. Keep the client lying flat in bed in the supine position b. Withhold oral fluids until the client's sag reflex has returned A nurse is teaching clients with gastroesophageal reflux disease (GERD). Which should the nurse include in the teaching?
- Minimize avoid wearing tight clothing to decrease pressure/compression on the stomach
- Take fluids with rather than between meals
- Avoid milk products at night
- Take small frequent meals and snacks
- Avoid late-night snacking or meals
- Avoid chocolate, peppermint, coffee, tomato juice, orange juice a. 3,4,5, b. 1,2,3,4,5, c. 1,3,4,5, d. 1,2,3, e. 1,2,3,4,
a. Positive rebound tenderness b. Recurring flatus c. Frequent: watery stools d. Abdominal cramping a. Positive rebound tenderness A client is receiving an infusion of total parenteral nutrition (TPN) through a central line at 75ml/hr. The nurse responds to the client's IV pump alarm, which indicates that the bag is empty. The new TPN bag is not expected to arrive from the pharmacy for an hour. What is the most appropriate nursing action? a. Hang 0.9% normal saline until the new TPN bag arrives, then increase TPN to 150 ml/hr for 1 hour b. Hang 10% dextrose in water until new TPN bag arrives, then resume TPN at 75 ml/hr c. Hang lactated ringers until the new TPN bag arrives then resume TPN at 75ml/hr d. Hang Dextran in normal saline until the new TPN bag arrives, then resume TPN at 150 ml/hr b. Hang 10% dextrose in water until new TPN bag arrives, then resume TPN at 75 ml/hr
The nurse is providing discharge teaching to a client newly diagnosed with ulcerative colitis. Which of the following statements by the client indicate that teaching has been effective?
- I need to avoid eating anything during exacerbation to rest my bowel
- I should ask my provider to prescribe a high dose of an antidiarrheal medication to treat my disease, manage the inflammation, and induce remission
- I should increase the consumption of fresh fruits and vegetables as they are very high in fiber, and avoid roast Turkey and canned veggies
- should take my Sulfasalazine "Asulfidine" after meals and take it with a full glass of water, and increase my fluid intake throughout the day.
- I should avoid consuming alcoholic beverages, caffeine, and tobacco because these are gastric irritants that stimulate the intestine. a. 1,2, 3 b. 1,2,3,4, c. 1,4, d. 2,3,4, e. 1,2,3, c. 1,4, The nurse will implement which nursing actions when caring for an overweight client recently diagnosed with a hiatal hernia?
- Elevate the head of the hospital bed to approximately 30 degrees
A client with ulcerative colitis (UC) reports abdominal pain (9/10), 10 bloody stools per day, and decreased appetite. The client states, "What's the point of taking medication? I have been taking my medication, but it doesn't help anyway." Which nursing diagnoses are appropriate to include in the client's plan of care?
- Acute pain
- Altered nutritional status
- Hopelessness
- Noncompliance
- Risk of deficient fluid volume a. 1,2,3, b. 1,2, c. 3,4, d. 2,3,4, a. 1,2,3, The nurse is preparing a client for discharge from the hospital. The client has had a Roux-en-Y gastric (RYGB) procedure using a small proximal portion of the stomach to create a gastric pouch that is anastomosed to the Roux limb of the small intestine, bypassing most of the stomach and a portion of the duodenum. What information should the nurse plan to include in the discharge teaching related to the prevention of dumping syndrome?
a. Fluids should be encouraged with each meal b. Meals should be small and low in carbohydrate content c. Take a multivitamin with ton and calcium supplements daily d. You will need to take your cobalamin (vitamin B12) injection monthly b. Meals should be small and low in carbohydrate content A client calls the primary care clinic reporting diarrhea for 4 days and a low- grade fever and bloody stool. What instruction is most important for the nurse to give to the client? a. Instruct the client to take 2 tablets of Loperamide (Imodium) followed by 1 tablet after each loose stool b. Encourage the client to eat bulk forming foods such as whole grain bread c. Make an appointment for the client with the health care provider today d. Encourage rest, fluids, and acetaminophen for the fever c. Make an appointment for the client with the health care provider today The nurse assessing a client's pain would expect the client to make which statement when describing the abdominal pain associated with appendicitis? a. My pain is acute and excruciating in my right lower abdomen above my night hip
- Report black tarry stools to your health care provider immediately
- Take your amoxicillin, clarithromycin, and omeprazole for the next 14 days
- You may take over the counter drugs such as aspirin if you have mild epigastric pain a. 1,2,3, b. 2,4, c. 1,2,3,4, d. 2,3,4, e. 1,3, a. 1,2,3, A client with a history of diverticular disease is being discharged home after being treated for an episode of acute diverticulitis. Which instructions should be included in the discharge teaching plan to reduce the risk of future episodes of acute exacerbation of diverticulosis?
- Drink plenty of fluids
- Exercise regularly
- Follow a low residue diet
- Include whole grains, fruits, and vegetables in the diet
- Increase intake of red meat and take opioids when complaining of abdominal pain a. 1,2,3,
b. 2,3,4, c. 1,2, d. 2,3, e. 1,2,3,4, c. 1,2, A graduate nurse is caring for a client who was diagnosed with acute appendicitis and is awaiting surgery. Which action by the graduate nurse would require the precepting nurse to intervene? a. Administer morphine IV PRN for pain b. Provides a heating pad for abdominal discomfort c. Teaches the client about prescribed strict NPO status d. Teach the client to report any projectile vomiting after appendectomy e. Initiates continuous normal saline IV b. Provides a heating pad for abdominal discomfort The nurse receives new prescriptions for a client with acute abdominal pain associated with vomiting and suspected acute appendicitis. Which prescription should the nurse implement first? a. Obtain urine specimen for urinalysis b. Administer 0.25mg Hydromorphone PO with a full glass of water
