1) A RN is teaching a student nurse about the reason for the development of natriuresis.

Which
statement made by the student nurse indicates effective teaching?
- Natriuresis develops as a result of the excretion of large amounts of sodium.
2) A nurse is caring for a client who is anxious and dizzy after a traumatic experience. The arterial
blood gas findings include pH level of 7.48, pO2 110, pCO2 25. Which initial intervention does
the nurse implement?
- Encourage the client to breathe into a paper bag.
3) The nurse suspects a client has pseudohypocalcemia. Which laboratory result does the nurse
monitor as a probable cause of this condition?
- hypoalbuminemia
4) A client’s laboratory test results show overproduction of aldosterone. Which is the best nursing
intervention to maintain serum electrolyte levels in the client?
- Provide spironolactone
5) The nurse is providing care of a client with cerebral edema. Which IV does the nurse expect to be
prescribed?
- Hypertonic solution
6) Which is an acidic pH of blood?
- 6.00
7) The nurse is providing care to a client admitted to the ICU after a severe accident. The client has
several fractured ribs and lost a considerable amount of blood due to lacerations. What is the
nurse’s primary concern when monitoring the client for acid-base imbalances?
- Decreased protein levels. (Proteins serve as the largest buffering system in the body. One of the
primary proteins that carries out this function is hgb. The concern is related to the considerable
loss of blood.)
8) The nurse is providing care for a client being treated for DKA. Assessment reveals the presence
of tremors, muscle spasms, a positive Babinski’s sign, and cardiac arrhythmias. Which condition
does the nurse recognize?
- hypomagnesemia
9) Which factor does hyperventilation of the lungs increase?
-Blood pH (hyperventilation decreased the amount of carbonic acid in the blood.)
10) The nurse is caring for a client who has been diagnosed with renal failure. Which mechanism of
compensation for the acid-base disturbance does the nurse recognize in the client?
-The client breathes rapidly to eliminate carbon dioxide.
11) A nurse is caring for a client who has undergone cardiac surgery. Which is the best method to
assess the client’s fluid loss or gain?
-Measuring body weight and VS every day.
12) A client is hospitalized for diarrhea. ABGs of the client are:
pH 7.50
pCO2 27
pO2 92
HCO3 17
O2 91%
Which statements are correct according to the interpretation of the ABG?
- The client has a lung problem.
13) Which is a physical assessment finding of respiratory acidosis?
- Cyanosis
14) Which nutritional advice should the nurse give to a hypokalemic client?
- Consume more orange juice.
- Add dried fruits to your diet.
- Consume more bananas and meat.
15) An adult client who has hypervolemia reports a headache, muscle cramps, and vomiting. The
nurse notices confusion. Which condition has the client developed?
-Hyponatremia.
16) Which is the compound that donates hydrogen ions in a solution?
- Acid
17) Which change in ABGs does the nurse expect to occur as a result of hypoventilation?
- pCO2 increases
18) The nurse is reviewing the lab results for a client:
pH 7.36
pCO2 48
pO2 96
HCO3 24
SaO2 98%
Which condition does the nurse recognize based on the displayed values?
- Hypercapnia
19) A client is running a high temperature and is found to have fluid volume deficit. Which signs and
symptoms are likely to appear in the client because of fluid volume deficit?
- Orthostatic hypotension
- Poor skin turgor
20) The nurse is providing care for a client experiencing respiratory acidosis. The health-care
provider prescribes that the client be placed on mechanical ventilation and be administered
sodium bicarbonate. Which understanding does the nurse have regarding the prescribed
treatment?
- Kidney compensation for acidosis is a slow process.
21) The nurse is providing care for a client in chemotherapy. The client is experiencing nausea and
vomiting and reports numbness and tingling around the mouth. Before notifying the health-care
provider, which is the most important assessment for the nurse to perform?
- Perform Chvostek’s and Trousseau’s test.
22) A client is on digitalis, and the laboratory results show that the client is hypokalemic. Which
effect does hypokalemia have o the drug administered?
- It can cause digitalis toxicity.
23) Which condition develops due to metabolic acidosis with an elevated anion gap?
- Ketoacidosis
24) The nurse is providing care to a patient with metabolic acidosis. For which reason does the nurse
note a laboratory result indicating hyperkalemia?
- The abundance of H+ ions moves into cells.
25) Changes in levels of which electrolyte can reduce the body’s response to cardiac drugs?
-Calcium
26) During evaluation of a client who has undergone a bariatric surgery, the nurse finds that the client
has an abnormally rapid heartbeat and hypotension. Which condition has the client developed?
- Dehydration
27) A health-care provider prescribes IV potassium infusion for a hypokalemic client who is NPO.
Which intervention by the nurse is correct when administering IV potassium?
- Validate the preparation of diluted IV potassium solution.
28) Which information is interpreted from ABG values?
- Presence of acidosis and alkalosis
- Disorders of the lungs
29) An older adult client is exhibiting lethargy, confusion and a respiratory rate of 8 breaths per
minute. The nurse sees that the last dose of medication administered through a PCA was within
the last 30 minutes. Which acid-base disorder might the client have developed?
-Respiratory acidosis
30) A client has hypertension and elevated serum calcium concentration. Which condition is likely to
occur in the client?
- Osteopenia
31) A client who is unconscious due to drug toxicity is brought to the ER. The VS include:
- Temp 97.8
- 90HR
-12RR
- 100/70 BP
The ABG values of the client are as shown:
-pH 7.29
-pCO2 32
-pO2 95
-HCO3 17
-saO2 98%
Which condition foes the ABGs indicate the client has developed?
- Uncompensated metabolic acidosis
32) The nurse is analyzing an ABG report of a client with COPD and respiratory acidosis. Which
compensation mechanism is likely to occur?
- the kidneys will retain bicarbonate.
33) A RN is teaching a student nurse about the effects of aldosterone. Which statement made by the
student nurse is correct?
- It increases blood volume and blood pressure.
34) Which condition is caused by an increase in the amount of potassium in the blood?
- Hyperkalemia
35) A comatose client’s blood pH is 7.1, pCO2 16, HCO3 5. Which acid-base imbalance has the
client developed?
- Metabolic acidosis
36) An unconscious client is brought to the hospital. The client’s ABG show pH greater than 7.45 and
a bicarbonate level of 37. Which acid-base imbalance has the client developed?
-Metabolic Alkalosis
37) A client who is taking a licensure examination is nervous and breathing rapidly in the
examination hall. Which acid-base imbalance is the client at risk for developing?
- Respiratory alkalosis
38) A client has N/V for 3 days due to a viral infection. ABGs are as shown:
- pH 7.61
-pCO2 49
-pO2 99
 -HCO3 18
- SaO2 99%
Which statement is incorrect according to the interpretation of the ABG values.
- The ABGs reflect the condition of dehydration.
39) A client has increased serum phosphorous levels. Which condition is related to hyperphophatemia
would the nurse expect to find?
- hypocalcemia
40) The nurse is providing care for a client with an undiagnosed illness. Calculations of the anion gap
indicate an elevation, and the client is identified as being positive for metabolic acidosis. Which
question does the nurse ask the client?
- Are you taking regular doses of aspirin?
41) A client has +3 pitting edema on the feet and ascites. Which is the most important lab value to be
monitored by the nurse given this condition?
- Serum albumin level
42) Which description of oncotic pressure is correct for the nurse to apply?
- The force exerted by albumin in the bloodstream

CH. 2.
1) Which defines translation in protein synthesis?
-Process of protein synthesis from RNA
2) A newborn exhibits the manifestations of a genetic disorder. A five-generation family history of
each parent does not indicate the presence of the disorder. Which type of mutation does the nurse
recognize?
- An alteration that likely occurred spontaneously
3) The human genome is estimated to be composed of between 20,000 and 25,000 genes and has a
specific arrangement of nucleotide bases, which carry a code for constructing proteins. Which
additional characteristic is present in genes?
-Genes have codons that signal when protein production should begin or should stop
4) Genomics is the study of the interactions of all the nucleotide sequences within an organism.
Which statement regarding genomics is correct?
- Genomics recognizes genes as the basic unit of heredity
5) Which definition applies to the term karyotype?
- All the chromosomal pairs In an individual
6) During fertilization each parent contributes to the DNA being passed onto the offspring. Which
genetic expression in the offspring is validation of the genetic contribution by a parent?
- The sex of the offspring
-
_____________________________________________________________________________________
_______
CH. 3.
1) The nurse is reviewing degenerative disc disease with a group of staff nurses. Which statement
made by an attending nurse indicates understanding?
- “Onset of lumbar DDD occurs most often between the ages of 30 and 50.”
2) A nursing instructor is teaching a group of nursing students the causes of spinal nerve
impingement. Which statement made by the student indicates the need for further teaching?
-Disc thickening may cause spinal nerve impingement.
3) The nurse is caring for a client with DDD. Which outcome indicates effective chiropractic
therapy?
- The client’s discs are realigned.
4) The nurse is providing care for a client with a lower extremity fracture immobilized by a cast.
Which complication does the nurse identify if assessment reveals tissue ischemia, functional
impairment, and pain level disproportionate to the injury?
- Compartment syndrome
5) The nurse is providing care for a client with nonunion at the site of a fracture in a lower
extremity. After 12 weeks of monitoring, the fracture site shows no signs of healing. Which
prescription does the nurse anticipate from the health-care provider?
- Placement of bone graft at the site
6) After assessing a client with a musculoskeletal disorder, the nurse concludes that the client has
skeletal injuries. Which characteristics observed in the client support the nurse’s conclusion?
- Numbness, crepitus, tingling sensation
7) The primary care provider recommends measuring the trabecular bone density in a client’s spine.
For which diagnostic test does the nurse prepare the client?
- Quantitative computerized tomography scan
8) What are signs and symptoms of musculoskeletal trauma?
- Joint swelling, joint clicking, paresthesia
9) The nurse is caring for a client whose bone mineral density is -2 on the T-score value, which
compares the client’s bone mineral density to the mean for a young adult woman. Which
condition does this score indicate?
- Osteopenia
10) Which of the following I a modifiable risk factor for vertebral compression fractures?
- Estrogen Deficiency
11) A client who is middle aged comes to a clinic and reports knee pain. The client states, “I don’t
understand. I walk to and from work every day and climb three flights of steps to my office.”
Besides age, the nurse’s assessment reveals the client is slightly overweight, and the knees are
warm to the touch and slightly edematous. Which contributing factor to the client’s
manifestations does the nurse suspect?
- Cartilage deterioration from excess weight bearing
12) A client is diagnosed with osteomalacia and undergoes therapy to correct the vitamin D
deficiency and normalize phosphate levels. Which outcome indicates the successful completion
of therapy?
- The client is able to walk up and down stairs comfortably.
13) The nurse observes that an older adult client has a hunched back. Which disorder does the nurse
suspect?
- osteoporosis
14) Which type of joint is the shoulder joint classified as?
- Synovial
15) Which diagnosis test does the nurse expect the health-care provider to prescribe to confirm a
diagnosis of osteoporosis?
- Dual energy x-ray absorptiometry (DEXA) Scan
16) A client with osteoporosis was prescribed teriparatide therapy? Which outcome indicates the
therapeutic effect of the medication has been achieved?
- Strengthening of bone
17) A client presents with a swollen left thigh and a lower extremity that appears shortened. Which is
the client’s most likely condition recognized by the nurse?
-Impacted femur shaft fracture
18) A nurse is discussing the various fluids of the musculoskeletal system with staff nurses. Which
statement made by an attending nurse indicates understanding?
- Edematous fluid makes the joint capsule less effective as a protector.
19) The nurse is obtaining a health history from a female client who is 70 years of age. The client has
experienced two bone fractures over the past 5 years, one from an auto accident and the other
from a fall on ice. Which information most strongly supports a concern about osteoporosis?
- Experienced a total hysterectomy at age 35
20) When assessing a client with a musculoskeletal disorder, the nurse finds lack of sensation in the
dermatome areas of the lower extremity L5. The nurse suspects lumbar strain/sprain. Which does
the nurse expect the health-care provider to prescribe in this situation?
- Anteroposterior and lateral x-rays of the lumbar spine
21) The nurse finds that a client with a musculoskeletal disorder has pain in the malleolar zone. The
client is also unable to bear weight for more than four steps. Which does the nurse expect the
health-care provider to prescribe?
- Ankle x-ray
22) When assessing a client’s muscle strength using the Lovett scare, the nurse finds the client has no
joint motion with palpable contraction of the muscle. Which grade does the nurse assign to the
client based on this finding?
- Trace
23) The nurse is caring for four clients diagnosed with different musculoskeletal disorders.
- Client 1: Hip Fx
- Client 2: Stress Fx
- Client 3: Femur shaft Fx
- Client 4: Vertebral compression Fx
Which client requires treatment with calcitonin, calcium or vitamin D supplements, analgesics,
and muscle relaxants?
- Client 4
24) The nurse in a pediatric clinic identifies an infant with rickets. The mother, who is from the
Middle Easter culture, has been exclusively breastfeeding the infant since birth. Which most
probably cause does the nurse recognize?
- Cultural practices contribute to the diagnosis
25) While reaching a group of student nurses about different types of fractures, the nursing instructor
says, “This fracture is characterized by the crushing of cancellous bone.” Which type of fracture
is the nursing instructor describing?
- Compression
26) A nurse is caring for a client whose lumbar spinal nerve 4 (L4) is affected by DDD. Which
assessment finding does the nurse anticipate in the client?
- Diminished patella reflex
27) A client is diagnosed with DDD. Which form of physical therapy does the nurse anticipate the
health-care provider will prescribe to reduce the movement of the spine and enhance the healing
 process?
- braces
28) Which disorders result from vitamin D deficiency?
- rickets
- Osteomalacia
29) The nurse is performing a physical examination on a client with a suspected musculoskeletal
disorder. Which is the first nursing intervention performed during the examination?
- Assessing general appearance, contour, and symmetry
30) The nurse is providing care for a client with suspected rickets. For which diagnostic testing does
the nurse prepare the client?
- Multiple view x-ray studies
31) For which reason is a dual energy x-ray absorptiometry scan used for a client with a
musculoskeletal disorder?
- It visualizes the bone mineral density of the hip and vertebrae.
32) Which physiological process takes place more rapidly after an individual is 30 years of age?
- Osteoclastic activity

Ch. 4
1) After an assessment, the nurse discovers a ringworm infection on the client’s hand. Which
terminology does the nurse use to document the finding I the client’s medical record?
-Tinea manus
2) The nurse is providing care for a client after a recent skin biopsy is positive for melanoma. The
health-care provider prescribes chest x-ray, CT, MRI scan of the brain, and ultrasound testing of
lymph nodes. Which explanation does the nurse give the client regarding the extensive testing?
- the tests are necessary to look for any evidence of metastases
3) The nurse is performing an assessment on a young adult client who presents with a skin infection
related to trauma. The nurse notices lineal scars in the location of the infection and reports the
finding to the health-care provider. Which initial prescription does the nurse expect?
- antibiotics
4) After assessing the burns on a client, the nurse documents the finding as “first-degree burns’ in
the client’s medical records. Which assessment finding supports the nurse’s documentation?
- Superficial burns
5) The nurse is preparing teaching material for a community presentation about the prevention of
skin cancer. Which factor presents a dilemma for the nurse regarding conflicting information?
- vitamin D Production
6) The nurse is obtaining a history from a client with a skin disorder. The client states, “I have tried
to remove the scales on my skin, but then they bleed.” Which terminology does the nurse
associate with the client’s comment?
- Auspitz sign
7) The nurse is providing care for a toddler admitted to the burn unit for scalding urns to both legs.
During assessment, the nurse notices diminished pedal pulses and cyanotic skin color to the left
leg. The toddler cries without provocation. For which reason does the nurse contact the health-
care provider immediately?
- Evidence indicates development of compartment syndrome
8) Which symptoms are associated with exposure to the highest levels of radiation?
- Diarrhea
 -Vomiting
-Nausea
9) While caring for a client after a thermal injury, the nurse finds that the client is showing signs and
symptoms of hyperkalemia. Which is the most important nursing intervention for this client?
- Monitoring cardiac function through electrocardiogram
10) The nurse is teaching a client preventative measure for scalds. Which statement does the nurse
include in the teaching plan to ensure safety?
- you should set the temperature of the water heater below 140 degrees.
11) The nurse is performing an assessment on a client, who states, “I had a rash a few weeks ago but
it is gone now.” Which assessment information is most important for the nurse to obtain next?
- Determine if the client has developed any open sores on the body
12) Parents bring a child to the ER because of the ingestion of a corrosive cleaner. Which physical
manifestation does the nurse specifically expect to find during assessment?
-Gray coloring of the skin
13) The nurse is reviewing terminologies used to describe skin lesions with a group of staff nurses.
Which statement made by an attending nurse indicates a need for further review?
-The loss of epidermal and dermal tissue is called telangiectasia
14) Which client is at high risk for psoriasis?
- This client who has a history of skin trauma
- The client who uses the medication Plaquenil
-The client who uses the medication lithium
15) While caring for a client with full-thickness burns, the nurse finds the client is exhibiting
manifestations of Curling’s ulcer. Which classification of medication does the nurse anticipate
being described for the client.
- Proton pump inhibitors
16) While caring for a client with thermal injury of approximately 50% of the total body surface, the
nurse assesses stridor in the client. Which is the priority nursing intervention for this client?
- Intubating the client
17) Which disorders are precursors to malignant melanoma?
- Lentigo maligna
- Dysplastic nevus
18) A school-aged client diagnosed with Stevens-Johnson syndrome is admitted to the hospital.
Which symptom does the nurse find in this client?
-A bull-s eye lesion
19) The nurse is assessing a client with a spider bite. The client is seeking medical care because of
recent development of cramping, pain, weakness, fever, sweating, nausea and vomiting. Which
conclusion foes the nurse draw based on the clients manifestations?
-A systemic reaction is occuring
20) A nurse in an emergency department is caring for a client with thermal burns on 30% of the body.
Which nursing intervention prevents the risk of burn shock in the client?
- Ensuring adequate fluid resuscitation
21) While caring for the client with an autoimmune skin disorder, the nurse observes a red butterfly-
patterned lesion over the client’s nose and cheeks. After reviewing the skin biopsy reports, the
nurse also finds deposits of immunoglobulin M in the lesions. Which skin disorder does the nurse
expect to find I the medical record of this client?
- Systemic lupus erythematosus
22) After reviewing the medical record of a client with a skin disorder, the nurse finds the term
“lichenification” in the record. Which symptom does the nurse anticipate assessing in this client?
- A hardening or thickening of the skin with markings
23) Which physiological changes occur in the body after a thermal injury?
- Increased systemic vascular resistance
- Increased potassium ion flow into the extracellular fluid
- Decreased intravascular fluid volume
24) While assessing a client, a nurse finds the skin on the wrist appears pearl-pink, wet, and blistered
and the client’s dermis is exposed. The client reports exposure to nearly boiling water. Which
diagnosis does the nurse make?
- the client has superficial partial-thickness burns
25) The nurse is providing care to a client admitted to the intensive care burn unit with serious
thermal burns. Which finding is indicative of improvement of this client?
-Minimal tissue edema is present at the injury sites
26) The nurse finds the medication betamethasone in the prescription of a client with a skin disorder.
Which skin disorder does the nurse suspect in the client?
- Eczema
27) A client with partial-thickness burns is hemodynamically unstable. By which route does the nurse
administer analgesics to the client?
- IV
28) A new nurse on a burn unit is assisting the regular nurse in caring for a client I the emergent
phase with deep partial-thickness burns on almost 60% of the body. Which action by the new
nurse requires correction by the regular nurse?
- Encouraging a low-liquid diet for the client
29) While caring for a client with a skin disorder, the nurse observes a cherry-red, dome-shaped
papule over the abdomen of the client. Which skin disorder does the nurse anticipate in this client,
based on this finding?
- Senile angiomas
30) Which physiological change can be observed in the prodromal stage of radiation burns in a client
who has been exposed to 200 rads?
- Pruritis
31) Which zone exhibits the greatest degree of thermal injury within the skin?
- Zone of coagulation
32) While assessing a client, the nurse finds the client’s cheek epidermal skin is dry, redness, and
warm. The client reports pain and tenderness at the area. Which cause does the nurse suspect for
the condition?
- Overexposure to the sun
33) While assessing a client, the nurse finds evidence of superficial burns. Which treatment does the
nurse anticipate to be beneficial for this client?
- Analgesics
34) A nurse is caring for a client with severe bleeding from the right hand due to an injury acquired
while working in a uranium mine. Which is a priority nursing intervention for the client?
- removing and bagging the client’s clothes and shoes
35) A patient with an electrical burn to one hand and arm is admitted to the ICU. Entrance and exit
wounds of electricity exhibit full-thickness burns, with partial-thickness and superficial burns to
the remaining area. Which nursing intervention is appropriate before the first prescribed dressing
 change?
- Medicate with an IV opioid before changing the dressing.
36) A client arrives I the ER with burns. After assessing a client, the nurse determines there is no need
for a diagnostic evaluation of the nurse. Which type of burns does the nurse identify on the client?
- Superficial burns
37) While caring for a client with a skin disorder, the nurse finds wheals on the skin, as well as
swelling of the eyes, face, lips, and mucous membranes of the client. Which reason does the nurse
attribute this disorder?
- Release of histamine from mast cells
38) While treating a silent diagnosed with melanoma, the health-care provider also finds tumors in
the liver. Which is the stage of melanoma for the client based on the health-care provider’s
finding?
- Stage IV

Ch 5
1) The nurse is providing care for a client admitted with a stroke. Which information and
manifestation support the presence of an ischemic stroke?
- Manifestations occurred over a period of hours
2) The nurse finds accumulation of yellow-brown-colored earwax in the client’s ear canal while
assessing a client who reports hearing difficulty. Which is an appropriate nursing intervention?
- Irrigate or use a curette to remove the earwax
3) The nurse is assessing an older adult client who has a history of a previous TIA. The nurse finds
elevated BP and suspects injury to the trigeminal nerve. Which findings enable the nurse to
suspect cranial nerve injury?
- No facial expressions
- Impaired Chewing
4) After multiple follow-up visits, the nurse finds that a client with persistent otitis media for 12
weeks is not improved using the initial treatment regimen. Which intervention is the nurse most
likely expecting to be prescribed?
- Tympanostomy
5) The nurse is reviewing subdural hematomas with a group of staff nurses. Which statement made
by an attending staff nurse indicates understanding?
- Subdural hematomas cause tearing of the cerebral and meningeal vessels within the
subarachnoid space of the brain
6) The nurse is providing care for multiple clients who are reporting headaches. The nurse’s goal is
to provide preventative care for the development of a migraine. Which client does the nurse
prioritize as the first needing preventative therapy?
- A female client who is on therapy with vasodilators
7) A nurse is caring for four clients diagnosed with different cerebrovascular disorders. Which client
is most likely to require an endarterectomy surgical procedure to prevent the recurrence of the
condition?
- The client with ischemic stroke
8) Which finding indicates the client has acute angle closure glaucoma?
- Cup-to-disc ratio of 1.0
9) A client reports to a health-care provider a decrease in the ability to see faces and to read over a
period of several months. Medical history reveals treatment for high cholesterol and a smoking
habit of one pack of cigarettes daily. Which diagnosis is the health-care provider most likely to
 associate with the client’s condition?
- Exudative AMD
10) Which cranial nerves are associated with extraocular movements?
-Trochlear
-Oculomotor
- Abducens
11) During assessment of a client, the nurse finds the client has blurred vision and swelling of the
optic disc. Which condition does the nurse interpret from the findings?
- the client has papilledema
12) In a client with Guillain-Barre syndrome, the health-care provider finds the possibility of
performing plasmapheresis is low. Which other alternative treatment is recommended to produce
the same effect as that of plasmapheresis?
- CSF Filtration
13) The nurse is performing a physical assessment on a school-aged client. When assessing the
client’s eyes, the nurse notes strabismus, eye redness, white spots in the pupil, and an absence of
red reflex in both eyes. Which treatment strategy does the nurse expect will be beneficial for the
client?
- Enucleation surgery
14) The nurse is teaching care measures to be followed by a client who has otitis externa. Which
instruction by the nurse is most beneficial to the client?
- You should use ear plugs while you are bathing.
15) While assessing a client with glaucoma, the nurse uses a tonometry instrument. Which clinical
information does the nurse document from this instrument?
- Measurement of intraocular pressure
16) The nurse is preparing review material for staff nurses about cranial nerves and their functions.
Which cranial nerves does the nurse plan to refer to as mixed cranial nerves?
-VII
- IX
-X
17) The nurse is providing care for a client with a perforated tympanic membrane after a scuba diving
event. Which treatment is best for the health-care provider to recommend?
- Tympanic membrane surgery
18) The nurse educator is teaching a family about athetosis movements in clients with Huntington’s
disease. Which statement made by a family member indicates understanding?
- Athetosis refers to twisting and writhing movements
19) Which instruction does the nurse provide to a client who is prescribed an anticholinergic drug for
symptomatic relief of Parkinson’s disease?
- Watch out for side effects such as dry mouth and double vision after taking the medication.
20) While examining a client’s ear through a pneumatic otoscope, the nurse notes decreased
movement of the tympanic membrane in the client. Additional assessment reveals pharyngeal
erythema and rhinorrhea in the client. Which is an appropriate nursing intervention for the client?
- Obtaining a specimen for a throat culture.
21) The nurse is using an Amsler grid to assess the vision of a client. The client tells the nurse, “I am
noticing black spots while looking through the grid.” Which interpretation does the nurse
associate with the assessment finding?
- The client has age-related macular degeneration
22) The nurse reviews a culture report on a client’s ear secretions, which identified the presence of
staphylococcus aureus and Pseudomonas bacterial strains. The client initially presented with pain,
tenderness, and itching on the auricle. Which conclusion does the nurse conclude from these
findings?
- The client has otitis externa
23) A parent of a child reports the child is irritable, tugs the ear, and has poor feeding behaviors. On
assessment, the nurse finds the child has a red and bulged tympanic membrane. Which other
findings in the child is the nurse most likely observing?
- vomiting
- Ear Drainage
- Runny Nose
24) The nurse is reviewing the medical record of a client admitted with the diagnosis of an ischemic
stroke involving the middle cerebral artery. For which reason does the nurse consider the client’s
condition to be serious?
- A large area of brain tissue is involved.
25) A client comes to the clinic and asks for a test to determine the possibility of developing
Huntington’s disease. Which preparation does the nurse make to fulfill the request?
- Obtains a small sample of blood from the client
26) A client reports symptoms of severe headache, vomiting, and double vision. After assessing the
client, the nurse determines the client has swelling of the optic nerve. Which interpretation does
the nurse associate with these findings?
- The client has papilledema
27) The nurse is assessing a child who exhibits the manifestations of otitis media. Which additional
finding does the nurse associate with otitis media?
- Upper respiratory tract infection
28) The health-care provider is monitoring a client who is unconscious. Which assessments does the
nurse expect the health-care provider to prescribe?
- GCS
- Pupil Response
- VS
29) The nurse is reviewing the most important intervention for clients with myasthenic crisis with
staff nurses. Which statement by an attending nurse indicates understanding?
- The forced vital capacity and negative inspiratory force are monitored every 2 to 4 hours.
30) Which eye disorder is associated with irregular clumping of proteinaceous substances within the
lens?
- Cataract
31) After a theoretical session about edrophonium (tensilon) testing, the nurse educator asks a staff
nurse to select a client from a group with different neurological disorders on which to perform the
test. Which client is the nurse expected to select?
- A client with myasthenia gravis
32) Which characteristic does the nurse associate with the secondary polycythemia?
- High erythropoietin level
33) Which supportive care is provided to a client diagnosed with Guillain-Barre syndrome?
- Provide physical and occupational therapy
- Provide mechanical ventilation
- Monitor hemodynamics continuously
 34) The nurse is providing care for a client recently diagnosed with a CVA. For which reason does the
nurse check the function of cranial nerve XII before advancing the client’s prescribed diet from
full liquid to soft?
- Confirm ability for tongue movement
35) Which neurotransmitter is depleted in clients with Parkinson’s disease?
- Dopamine
36) While reviewing the medication prescribed for a client, the nurse finds the client is on a therapy
to decrease the release of the excitatory neurotransmitter glutamate. Which disorder does the
nurse recognize in the client?
- Amyotrophic lateral sclerosis

Ch 6
1) In which way does the nurse define oncotic pressure?
- A force that attempts to pull fluid from the interstitial and intracellular spaces.

2) The nurse is administering an anticoagulant to a client after lower extremity surgery. The client
states, “I have never had a clotting problem before.” Which reason does the nurse provide to the
client about the prescribed drug?
- The percentage of clots becoming emboli is unknown.

3) The nurse is recording the blood pressure of four clients. Which client’s blood pressure indicates
that the client has orthostatic hypotension?
- The client with 140/90 while lying and 130/80 upon standing

4) A nurse is reviewing the prescription records of four clients being treated for DVT. Which client
needs a prothrombin time lab test to monitor the therapeutic effects of the drug?
- The client receiving warfarin.

5) A left ventricular impulse is seen through the chest wall of a client. On palpation, a diastolic thrill
is palpated along the left sternal border, and a systolic thrill is palpable under the jugular notch.
To which pathological condition are these symptoms attributed?
- Aortic valve insufficiency.

6) The nurse is performing a physical assessment on a new client. The nurse notes diminished
pulses, palpable coolness, and pallor in the lower extremities. The client reports numbness,
tingling, and pain with ambulation. Which question by the nurse helps identify possible
complications?
- Do you have pain when you rest your legs?

7) A client comes to the clinic with dark red edema on the lower leg, with irregular margins of skin
breakdown especially in the medial ankle region. The primary health-care provider diagnoses
necrosis and tissue damage surrounding the affected area. Which treatment does the nurse expect
to be prescribed for this client?
- Topical medications
8) Which is a clinical manifestation in clients with infective endocarditis?
- Petechiae

9) Which condition is likely to be the cause of a new heart murmur in an older adult client?
- Aortic valve sclerosis

10) A nurse is caring for a client with infective endocarditis. Which is the specific nursing
intervention for this client?
- Administering ampicillin

11) The registered nurse is teaching staff nurses the relationship between cardiac output, blood
pressure, and peripheral vascular resistance. A nurse is asked to recap the mathematical equation
that relates the three factors. Which equation provided by the nurse indicates the need for further
teaching?
- PVR / CO = BP

12) The nurse is responsible for caring for a variety of clients in a hospital setting. Using Virchow’s
Triad, which clients does the nurse recognize as being at most risk for developing venous
insufficiency?
- A pregnant client at 30 weeks gestation

13) A client reports pain in the calf muscle while walking and exercising but also reports that the pain
is relieved by resting. Which medication does the nurse expect the health-care provider to
prescribe the client?
- Pentoxifylline

14) The nurse is providing care to a client diagnosed with hypertension and scheduled for testing
related to the diagnosis. The client states, “I don’t know why I need to have kidney tests.” Which
client teaching does the nurse provide?
- Circulation to the kidneys regulates sodium and water levels

15) Which clinical manifestation is observed in a client who has abdominal aortic aneurysm rupture?
- Cool extremities

16) Which symptoms does the nurse assess for in a client who has peripheral artery disease?
- Paresthesia in the lower extremities
- Coolness in the lower extremities
- Absence of pulsation in the lower extremities

17) The nurse is preparing to explain the anatomical cause of venous insufficiency to a client. Which
factor does the nurse include about the tunica media?
- It is the smooth muscle layer that moves blood toward the heart.

18) Which pathology is a cause specifically for right ventricular failure?

- Pulmonary emboli
19) The nurse is providing care for an older adult client after a left knee joint replacement. The client
is resisting offers for frequent assisted ambulation. Which manifestation during assessment causes
the nurse to suspect the formation of DVT?
- Palpable warmth over a leg vein

20) Which specific sign or symptom indicates that a client is experiencing varicose veins?
- Itching and aching in the lower leg muscles

21) A nurse hears a bruit while assessing the carotid artery of a client. Which is the most probable
reason behind the bruit?
- Turbulent blood flow in the artery.

22) In which manner does the nurse document a clients heart murmur that begins just before S2 and
ends at S2?
- Late systolic

23) A client works as a sales associate in a garment outlet and stands for the duration of each work
shift. Clinical examination reveals a presence of a dusky coloration around the ankle, instep, and
lower leg. What condition do these findings indicate?
- Chronic venous insufficiency

24) At which intercostal space does the nurse place the stethoscope for auscultation of the pulmonic
valve?
- The second intercostal space in the left sternal border

25) The nurse is providing care to a client diagnosed with a deep vein thrombosis who is prescribed
anticoagulant therapy. The client asks the nurse about the reason for the medication. Which
condition does the nurse address as being a risk if the DCT is not treated appropriately?
- PE

26) The registered nurse is teaching nursing staff about ischemic cardiomyopathy. Which statement
made by one of the attending nurses indicates effective learning?
- There is scarring of the heart muscle caused by coronary artery insufficiency

27) Which is a risk factor for hypertension?

- Insufficient vitamin D in the diet

28) The nurse is providing care for a client with chronic hypertension who presents with chest pain.
The client is diagnosed with left ventricular hypertrophy. Which manifestation of the condition
accounts for the client’s symptoms?
- An extra supply of coronary artery blood flow is unavailable.

29) A RN is preparing an in-service education session for nursing staff about the diagnostic tests for
cardiovascular diseases. Which information does the nurse correctly include?
- Hypothyroidism is a risk factor for atherosclerosis
30) Which condition is characterized by the deposition of immune complexes, causing inflammation
and fluid accumulation in the pericardial sac?
- Dressler’s syndrome

31) A client reports myalgia and fever. On physical examination, an S3 gallop rhythm was heard
through the stethoscope, and the client is diagnosed with myocarditis. For which reason is the
client prescribed angiotensin-converting enzyme inhibitors?
- To treat heart failure

32) The nurse is reviewing pathological heart murmurs with the nursing staff. Which statements made
by an attending nurse indicate effective learning?
- They are sounds caused by heart wall defects.

33) The nurse is teaching a client who has cardiovascular disease about the dietary sources of
cholesterol and the effects on the body. Which statement made by the client indicates the need for
further teaching?
- I should try to use peanut and canola oil more.

34) The nurse is providing teaching to a client diagnosed with hypertension. When the nurse presents
information about smoking cessation, the client states, “I don’t plan to quit unless someone
convinces me of the connection between smoking and high blood pressure.” Which information
does the nurse present?
- Nicotine increases blood pressure by causing vasoconstriction.

35) The nurse is caring for four clients with chest pain. Which client is treated for infective
endocarditis?
- The client with a dental implant.

36) A registered nurse is teaching a nursing student the effects of medications that are used to treat
hyperlipidemia. Which statement of the student nurse indicates effective learning?
- Cholestyramine blocks the bile acid absorption in the GI tract.

37) The registered nurse is teaching a nursing student about the effects of glucose on the arteries.
Which statement made by the student nurse indicates effective learning?
- Increased serum glucose causes endothelial injury, which would lead to atherosclerosis.

38) In which way is chronic heart failure different from acute heart failure?
- Chronic heart failure gradually develops over a long period.

39) Various test results for a middle-aged client indicate right ventricular backward failure, jugular
venous distention, and ascites. The client also has hepatomegaly and splenomegaly. Which other
S/S of right ventricular failure would the nurse expect to see with this client?
- Cough
- Orthopnea
- Dyspnea
 40) A client visits the hospital with chest pain, and the VS are 101.5 degrees, 125.85 BP, The EKG of
the client shows valve perforation, and a new regurgitant murmur is heard during chest
auscultation. Which condition has the client developed?
- Infective endocarditis

41) A client whose neck vein has bilged presents with a sharp pain in the chest. The EKG shows an
elevated ST segment, and the lab report shows an increase in the serum creatinine and blood urea
nitrogen. Which condition has the client developed?
- Pericarditis

42) Which risk factors from Virchow’s triad?

- Vascular damage
- Venous stasis
- Hypercoagulability

43) While evaluating a client for a heart murmur, the nurse auscultates the murmur with the bell of a
stethoscope. For which type of heart murmur is the nurse assessing?
- A low-pitched murmur

CH 7
1) The nurse is reviewing the complete blood count of a client who presents with fever. The which
blood cell count of the client is 15,000. Which condition has the client developed?
- Leukocytosis
2) A registered nurse is teaching nursing staff about interpreting blood test reports and urinalysis
reports of clients with SLE. Which statements made by attending nurses indicate effective
teaching?
- Erythrocyte sedimentation rate is high in clients with SLE
- Leukopenia and thrombocytopenia are often observed in clients with SLE.

3) A client reports persistent cough. The nurse suspects the client may have developed TB. Which
diagnostic test does the nurse expect the primary health-care provider to prescribe to confirm this
condition?
-Xray of the Lungs

4) Which component of the blood does the nurse associate with surrounding and consuming foreign
material?
- WBC

5) The nurse is providing care for a client who is recovering from hepatitis A. the nurse is aware that
which immunity is developed by the client after experiencing this illness?
- Active acquired adaptive immunity

6) Which are the inflammatory mediators that are released from white blood cells?
- Leukotrienes
-TNF-alpha
 - Interleukins

7) The nurse is providing care for an older adult female diagnosed with vaginal candidiasis. The
client expresses dismay about having a sexually transmitted infection. Which knowledge does the
nurse use to assure the client that vaginal candidiasis is a side effect of long-term antibiotic use?
-It eradicates lactobacillus I the vagina.

8) Which is the predominant immunoglobulin produced after a host’s re-exposure to an antigen?

-Immunoglobulin G (predominant immunoglobulin produced after a host’s re-exposure to an
antigen. IgG comprises 75%-80% of the total serum immunoglobulins.)

9) An adult client worked I the radiation department of a hospital for 6 years. The client reports
weakness and fatigue. The complete blood count report of the client shows a white blood cell
count of 25.6, RBC 3.11, hgb 8.9, platelet 130, the white blood cell differential shows 75% blasts,
20% lymphocytes, and 2% segs. Based on these findings, which condition should the nurse
suspect?
- Chronic myelogenous leukemia

10) Which cells are known as granular lymphocytes?

-Natural killer cells

11) A client comes to an acute facility with reports of pain from unilateral, swollen cervical lymph
nodes. The client is diagnosed with lymphoma. In which manner is the client’s lymphoma
classified?
- Stage 1 lymphoma

12) A client develops an infection after dental implant surgery. Which condition is the client likely to
develop if the infection is left untreated?
- Septicemia

13) A nurse is analyzing the report of a school-age client with leukemia who is receiving
chemotherapy. The platelet count is 20. What would be the best intervention for the nurse to
include in the client’s plan of care?
- Use a soft toothbrush for oral care.

14) In which location does maturation of T lymphocytes occur?

- Thymus gland

15) A nurse is assessing four clients who are suspected of having SLE. Which client does the nurse
recognize as having developed the disease?
- Client 1: Fever, butterfly rash on face, and joint inflammation.
- Client 2: Fever, Swollen joints, and general malaise.
- Client 3: Erythema nodosum, weight loss, and fever.
- Client 4: Hypothermia, elevated red blood cell count, and weight gain.
-ANSWER – Client 1
16) Which components of the blood attract platelets to the site of the injury in the form of a chemical
signal?
- Microbial agents

17) During an inflammatory response, which components are involved in a respiratory burst from the
mitochondria?
- Free radicals

18) The nurse recognizes which physiologic manifestation of Acute inflammation?

- The predominance of neutrophils

19) A nurse is formulating a nursing diagnosis for a client with stage IV chronic lymphoid leukemia.
Which observed activity does the nurse interrupt immediately?
- Delivering of flowers, plants, or fruit

20) A client reports fever and shortness of breath and is diagnosed with pneumonia. A complete blood
count with differential shows a white blood count of 16 with 90% neutrophils, 2% eosinophils,
and 1% basophils. Which specific condition has the client developed?
- Bacterial pneumonia

21) The nurse identifies which as the cause of lymphomas?

- They arise from abnormal proliferation of T lymphocytes.

22) A nurse demonstrates understanding of predisposing factors to pseudomonas aeruginosa by

selecting which option?
- Urinary tract catheterization.

23) Which component enables the blood vessels to dilate and become more permeable during the
vascular phase of inflammation?
- Inflammatory mediators

24) A 27-year-old client is pregnant. The blood group of the client and the fetus are incompatible.
Which antibodies produced by the mother against the fetus’s blood cells do not affect the fetus?
-IgM (IgM antibodies will be developed by the mother against the fetus’s blood cells.)

25) Which is an example of passive acquired adaptive immunity?

- Newborns receiving immunity through breast milk.

26) The registered nurse is teaching a student nurse about C-reactive proteins.
- It prevents WBC adhesion to endothelium and stimulates other inflammatory cytokines.

27) A nurse is reviewing the prescriptions of four clients in the hospital. Comparing the effects of the
medications prescribed to the clients, the nurse identifies which client is most likely being treated
for SLE?
- Client 1: Amoxicillin, vancomycin, Imodium.
-Client2: Hydrocortisone, hydroxychloroquine, methotrexate.
-Client 3: Cyclophosphamide, mycophenolate, infliximab
 - Client 4: Codeine, ibuprofen, naproxen.
-ANSWER- Client 2

28) The nurse is aware that both a reservoir and a vector may be involved in infection transmission.
Which does the nurse recognize as a vector?
- A living being not infected

29) The nurse is notified that a client has a bacterial infection. The health-care provider prescribed
diagnostic testing. For which diagnostic procedure does the nurse prepare the client?
-Serological test

30) A registered nurse is teaching nursing students about passive acquired adaptive immunity. Which
statement made by a student nurse indicates the need for additional learning?
-It is activated after the administration of a vaccine.

31) A registered nurse is teaching a student about the common side effects of methotrexate therapy,
which is used to treat clients with rheumatoid arthritis. Which statement made by the student
nurse indicates effective learning?
- The client’s WBC will be below 4.5

32) The nurse is providing care for an older adult client diagnosed with multiple myeloma. The
client’s laboratory report indicates anemia along with white blood cell and red blood cell
abnormalities. Radiographic studies indicate rounded, punched-out areas in the bones. Which
early treatment does the nurse expect?
- Bisphosphonate therapy (Reduces osteoclastic activity, which in turn limits bone disease,
fractures, and skeletal complications, improving survival.)

33) The nurse in an acute care facility is assigned to care for a client diagnosed with community-
acquired Staphylococcus aureus manifested as osteomyelitis. Which nursing intervention is most
important?
- Perform diligent handwashing (S. aureus is a major cause of skin and soft tissue infections,
osteomyelitis, respiratory infections and even endocarditis)

34) The nurse is aware immunoglobulin A is mostly found in which body fluid?
- Tears (found more in saliva, nasal secretions, breast milk, etc.)

35) The human body includes two mechanisms for defending the body against infection. Which
factors does the nurse NOT accredit to the function of innate immunity?
- Sensitized T and B lymphocytes. (memory for specific antigens, comprise the adaptive
immunity)

36) The nurse is reviewing the role of CD4 cells I the diagnosis of HIV. She notes that HIV attack
CD4 cells. Which conclusion made by the nurse is correct?
- The CD4 cells take part in cell-mediated immunity.

37) The nurse is viewing the complete blood count report of a middle-aged client who reports
unintended weight loss. The report shows:
 - Hgb 9.5
- WBC 15
- Albumin 3
- Lymphocyte 500
Which condition has the client developed?
- Hodgkin’s lymphoma

38) A toddler is brought to the hospital with fever. Reports reveal the client has developed an acute
infection. Which nursing intervention does the nurse implement for the client?
- Administer the prescribed antibiotic therapy (Do not administer salicylates because the client is
at risk for developing Reye’s syndrome. Reye’s syndrome is a life threatening disease that
damages mitochondria and leads to liver failure.)

39) While assessing the vital signs of an adult client, the nurse records a blood pressure of 130/85 and
temperature of 103. The client’s CBC value indicates the presence of an acute infection. Which is
the best nursing intervention for the nurse to implement first?
- Administer aspirin to reduce fever.

Ch. 8
1) Which term refers to the process of coughing up sputum?
- Expectoration

2) Which lung condition is common in clients with a genetic disorder such as Marfan syndrome, as
well as frequent smokers?
- Primary spontaneous pneumothorax

3) A client is being examined by the health-care provider because of a report of “always feeling like
I am holding air in my lungs.” Which specific measurement from a pulmonary function test does
the nurse expect to be most informative?
- Functional residual capacity

4) The nurse is assisting with a client who has pharyngeal erythema, a persistent cough, and
rhinorrhea. An inspiratory stridor is indicative of mucus obstruction within the trachea. Which
treatments does the nurse expect the health-care provider to prescribe?
-Symptomatology

5) A client presents with dyspnea, chest pain, and a cough producing yellow sputum. Which
presenting manifestation specifically causes the nurse to look beyond respiratory cause for the
clients condition?
- Chest pain

6) While examining a client, the primary health-care provider finds the client has symptoms that
include cough, fever, sore throat, and general malaise. Physical assessment findings include
mucus production and rhonchi. Which treatment does the primary health-care provider administer
to the client?
 - Bronchodilators and antibiotics

7) The nurse is assigned to care for a client diagnosed with a lung abscess. Which information does
the nurse understand about the origin and risk factors leading to lung abscess?
- Staphylococcal endocarditis is a source of lung abscesses

8) The heath-care provider finds that a client is producing foul-smelling sputum with a cough, which
is accompanied by the health-care provider?
- Bronchoscopy
- Surgical intervention
- Antibiotic therapy

9) The health-care provider is attending a client experiencing chest pain, dyspnea, and an increased
respiratory rate. During physical assessment, the chest expansion is found to be asymmetrical,
and hyper resonance is noted with percussion. Which condition is interpreted from the gathered
date?
- Pneumothorax or collapsed lung

10) When assessing a client with asthma, which questions does the nurse ask?
- What kinds of materials do you handle on your job?
-Does exposure to certain environmental allergens trigger attacks?
- Are symptoms worse at night or after exercise?

11) While studying the vocal resonance in the client’s physical assessment report, the nurse observes
that the egophony, bronchophony, and whispered pectoriloquy are bringing out a crackle in the
client’s voice. Which condition does the nurse identify from the readings?
- The client is suffering from pneumonia.

12) When viewing the recent chest x-rays of a client, the nurse finds nodules and honeycomb lung
patterns. The health-care provider points out the client’s previous chest x-ray report identifying
diffused “ground glass” markings in the lower lung fields. Which condition does the nurse
conclude from this information?
- Idiopathic pulmonary fibrosis

13) The nurse is assessing a client diagnosed with secondary pulmonary hypertension. The increase in
the pulmonary artery pressure has led to the client’s elevated pulmonary venous pressure. Which
existing condition may be identified as the cause of the client’s condition?
- Collagen vascular disease.

14) A middle-aged client presents with a cough producing large amounts of mucus. The client tells
the nurse, “I get this and keep it all winter. My wife says I cough until I turn blue.” With a
suspicion of chronic bronchitis, which question does the nurse ask first?
- So how many years have you had this problem?

15) Which part of the respiratory system assists with the management of particles from the outside
environment?
 - Mucociliary apparatus

16) Which bacterium is responsible for pneumonia in a client with HIV infection?
- Pneumocystis jirovecii

17) A victim of a motor vehicle accident comes to a medical facility with a rib fracture that has
punctured the pleural membrane. The open wound allows the pleural cavity to pull air into the
opening of the wound, thus building a pleural space. Which treatment can a nurse expect from the
primary health-care provider?
- A chest tube with suction to be applied on the affected side

18) The nurse educator is teaching staff nurses about pneumonia. Which statement shows proper
learning about pneumonia by an attending nurse?
- Pneumonia causes more death in the US than any other infection.

19) Which diseases are identified as pulmonary restrictive diseases?

- Diseases that reduce the total lung capacity
- Diseases that prevent complete ventilation
- Diseases that act as an impediment to alveoli

20) Which pulmonary condition is caused by infiltration of bacteria, resulting in a localized area of
purulent inflammation, tissue necrosis, and a central area of liquefaction?
- Lung abscess

21) Which unique respiratory infection is caused by a resilient bacterial organism that can remain
dormant in the body?
- TB

22) A client admitted with a lung abscess has developed an area of pulmonary tissue necrosis. Which
is the most appropriate treatment to manage this complication?
- Surgical treatment

23) Which condition results in lung tissue filling up with fluid or pus, inflammatory cells, and fibrin?
- Pneumonia

24) The nurse is teaching a client about obstructive sleep apnea. Which treatment, according to the
nurse, is most appropriate to keep the airways from closing?
-CPAP

25) The nurse is reviewing the administration for asthma medication with a group of staff nurses.
Which statement by a nurse indicates understanding?
- An oral corticosteroid is added to the regimen of rescue medications when short-acting
bronchodilators are not working against asthma attacks.

26) The nurse is assessing a client who has been a butcher for an extensive period, making the client
subject to a prolonged and intense exposure to inhaled organic dust in the form of animal protein.
Which disorder, according to the nurse, is a probable cause of the client’s respiratory problem?
 - Hypersensitivity pneumonitis

27) The nurse is assessing a young adult client who has a history of smoking and Marfan syndrome.
Previous medical reports do not suggest evidence of underlying lung disease. For which condition
is the client at risk?
- Primary spontaneous pneumothorax

28) A health-care provider determines that a client is experiencing symptoms such as jugular venous
distension, ascites, hepatomegaly, and ankle and sacral edema. Which condition does the health-
care provider identify?
- Cor pulmonale

29) The nurse educator is reviewing the pathophysiology of TB with staff nurses. Which statement
confirms understanding by an attending nurse?
- The cheese-like necrotic lung tissue is called the caseous necrosis

30) The nurse is assessing a child with chronic asthma. Which microorganism, according to the nurse,
may be responsible for causing asthma in the child?
- RSV

CH 9
1) The nurse is caring for multiple clients in an acute care setting. Which client does the nurse
identify as being at risk for nonalcoholic fatty liver disease?
- The client who is a strict vegetarian.

2) The client with alcoholic liver disease is experiencing bruising, nosebleeds, and hematemesis.
Which treatment option does the nurse suspect to be effective in this client?
- Vitamin K

3) The nurse is providing care for a client with renal disease and notices a slight yellowish color of
the skin. The client reports recent symptoms of the flu. Which contributing factor does the nurse
identify as increasing the client’s possibility of hepatitis B?
- Renal disease is treated with hemodialysis.

4) Which gastrointestinal disorder occurs after bariatric surgery involving removal of part of the
stomach?
- Dumping syndrome.

5) Which is a characteristic feature of ulcerative colitis?

- Continuous areas of inflammation in the large intestine.

6) The staff nurses are reviewing precautions to be taken while caring for a client with suspected
need of surgery for appendicitis. Which statement made by a nurse indicates understanding?
- The client is not given pre-diagnosis pain medications.

7) The nurse is reviewing portal hypertension with a group of staff nurses. Which statement by an
attending nurse indicates the need for further review?
 - Portal hypertension causes coagulation abnormalities. (Liver cirrhosis leads to coagulation
abnormalities because of impaired clotting factor synthesis. However, portal hypertension does
not specifically cause any coagulation abnormalities.)

8) The health-care provider prescribes a fasting serum gastrin level test and a magnetic resonance
imaging scan for symptoms of peptic ulcer. On reviewing the test reports, the nurse finds a
diagnosis of hypergastrinemia and a tumor. The nurse administers the prescribed PPI. Which
condition does the nurse identify?
- Zollinger-Ellison syndrome (Characterized by severe symptoms of a peptic ulcer. PPIs are used
to inhibit the activity of parietal cells and neutralize HCl acid.)

9) The nurse is orienting a group of staff nurses to the laparoscopic cholecystectomy procedure.
Which statement by an attending nurse indicates effective learning?
- The client is discharged less than 24 hours after surgery.

10) The nurse is reviewing anatomy and physiology with staff nurses. Which structure does the nurse
identify as being at risk for choledocholithiasis?
- Common bile duct

11) The nurse is providing care for an older adult client who presents with abdominal cramping,
abdominal distention, and the inability to have a bowel movement. An abdominal x-ray reveals a
distended colon, with loops of dilated bowel superior to an obstruction. which treatment does the
nurse expect to be prescribed?
- Placement of a NG tube

12) Which is the largest serous membrane in the body?

- Peritoneal serosa (peritoneum is the loosely attached outermost layer of the intestine. It is the
largest serous membrane in the body.)

13) The nurse is preparing a client for laparoscopic fundoplication. Reports on previously performed
endoscopy and barium tests are not yet available. On reviewing the medical history, the nurse
noted the client complains of dysphagia, substernal burning, and belching. Which condition does
the nurse expect to be identified in the client?
-Hiatal Hernia

14) For which reason does the nurse identify the change of urine color in a client with liver disease?
- Accumulation of bilirubin in the bloodstream.

15) Which virus helper function is needed for the replication of hepatitis D?
- Hep B

16) Th nurse concludes that an obese client is manifesting symptoms from a rare type of hernia.
Which finding confirms the condition?
- Acute chest pain
17) Which part of the GI tract is involved in the production of protective mucus?
- Goblet cells

18) The nurse is counseling a client about high doses of NSAIDs taken to “keep aches and pains
away.” The nurse shares that the liver is at risk for damage. The client asks, “What does the liver
do, anyway?” Which is the best answer by the nurse?
- The liver plays multiple important roles in digestion.

19) The nurse is reviewing with a group of staff nurses the use of antibiotics in a client diagnosed
with appendicitis. Which statement made by a nurse indicates understanding?
- Antibiotics are administered before an operation and continued until 48hrs after the operation.

20) The nurse is reviewing anatomical information about the pancreas. Which conclusion about the
anatomy and function of the pancreas is incorrect?
-It stimulates the secretion of cholecystokinin
- It is a hollow organ that sits just beneath the liver.

21) Which client benefits from early endoscopic retrograde cholangiopancreatography?

- A client with severe gallstone pancreatitis.

22) What characteristic feature of dumping syndrome does the nurse recognize in a client after
bariatric surgery?
- Diaphoresis

23) Which diagnostic procedure does the health-care provider use to confirm advanced chronic
pancreatitis with exocrine insufficiency in a client?
- Fecal chymotrypsin (Used to confirm advanced chronic pancreatitis with exocrine insufficiency
in a client.)

24) The nurse is caring for a client with glucuronyl transferase enzyme deficiency. The laboratory
reports show elevated serum bilirubin levels. Which treatment does the nurse suspect to be
effective in the client?
- Phototherapy (Glucuronyl transferase enzyme deficiency is associated with Crigler-Najjar
syndrome. Glucose transferase enzyme is used to conjugate bilirubin in the liver. Therefore, its
deficiency causes increased bilirubin in the blood. Phototherapy aids in the breakdown and
excretion of bilirubin in clients who are diagnosed with Crigler-Najjar syndrome.)

25) The nurse is providing care for a client admitted with an obstruction of the common bile duct.
Which additional condition does the nurse associate with the admitting diagnosis?
- Jaundice

26) Which suggestion does the nurse provide to a client with chronic pancreatitis?
- You need to eliminate you alcohol intake.

27) Which complications does the nurse suspect in a client when bile is obstructed from flowing into
the intestine?
- Pruritis
 - Jaundice
- Steatorrhea

28) Which part of the stomach most commonly harbors H. pylori?

- Fundus

29) The nurse teaches a group of staff nurses about the diagnosis of irritable bowel syndrome. After
the teaching session, an attending nurse is asked to determine the presence of lactose intolerance
in a client with irritable bowel syndrome. Which intervention by the nurse indicates effective
learning?
- The nurse performs a hydrogen breath test on the client.

30) Which findings can the nurse observe in the laboratory reports of a client after 4 weeks of
hepatitis A infection?
- A rise in liver enzymes

31) Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds
accompanied by signs of borborygmi, abdominal distention, and tympany on percussion. Which
diagnostic test distinguishes Chron’s disease from ulcerative colitis in the client?
- Colonoscopy

32) The laboratory reports of a client with gastritis reveal H. pylori is the causative organism. Which
pathophysiological changes can result from this infection?
- increased production of gastrin
- Decreased production pepsin
- Decreased production of HCl acid

33) Which pathophysiological changes are responsible for pain in a client with acute gastritis?
- Increased blood supply at the inflammatory area
- Eradication of prostaglandins by medications
Increased pressure within the layers of the stomach

34) The nurse instructor is teaching a group of nursing students about the pathophysiology of
cholecystitis. The nursing instructor asks, “What happens during chronic cholecystitis?” Which
statement by a student nurse indicates effective learning?
- The gallbladder becomes thickened and functions poorly.

35) While assessing a client with liver cirrhosis, the nurse examines the client for indication of
encephalopathy. Which manifestation indicates the development of encephalopathy?
- Asterixis (Failure of the liver to remove nitrogenous waste results in the accumulation of toxins
and causes encephalopathy. Hepatic encephalopathy may cause neurologic disturbances,
including asterixis, which is characterized by flapping tremors of the hands.)

36) The nurse reviews the coloscopy report on a client. The nurse concludes that which disorder is
diagnosed by the presence of a “cobblestoning” appearance?
- Crohn’s Disease
37) The nurse is providing care for a client with suspected gallbladder disease. Assessment by the
nurse reveals jaundice, dark-colored urine, and upper R quadrant abd pain. Based on the
assessment findings, which is the most likely cause of the client’s condition?
- A gallstone lodged in the common bile duct

38) The nurse is providing care for a client with a recent spinal cord injury resulting in paralysis from
the midthoracic region downward. The client is unable to initiate or control bowel function, but
states to the nurse, “I am going to get bowel training later.” Which factor does the nurse consider
in response to the client?
- Neural control of the large intestine is likely lost

39) The parent of an adolescent client tells the nurse, “My child complains of burning sensation in the
throat and refuses to eat food.” On assessment, the nurse finds the client also has a dry cough.
Which teaching does the nurse provide if the client is diagnosed with GERD?
- Provide small, frequent meals to the client
- Elevate the client’s head at 70 degrees for eating
- Administer PPIs to the client

40) The nurse suspects hepatic encephalopathy in a client with severe liver dysfunction. Which
symptom supports the nurse’s suspicion?
- Stupor (The accumulation of toxins in the brain result in hepatic encephalopathy and leads to
decreased mental function and decreased level of consciousness.)

41) The laboratory reports of a client with alcoholic liver disease reveal low Hgb levels. For which
reason does the nurse recognize this condition?
- Hypersplenism (occurs due to portal hypertension in clients with alcoholic liver disease. It is a
disorder that causes the spleen to prematurely destroy the red blood cells leading to anemia.)

42) The nurse is preparing information for a client newly diagnosed with ulcerative colitis. Which
information is more likely associated with Crohn’s disease that with ulcerative colitis?
-The patient is prone to anal fistula and fissure formation.

43) A client is admitted into the emergency room with hematemesis; dark urine; and black, tarry
feces. On examination, the nurse finds that the client has weight loss and distended abdomen.
Which condition does the nurse suspect in the client?
- Esophageal varices

44) A female client is admitted to the hospital with abdominal pain that originates in the umbilical
region and radiates to the right lower quadrant. The health-care provider prescribes a urinalysis.
In which manner does this help the health-care provider diagnose the client’s condition?
- Rules out the possibility of a kidney stone or pyelonephritis.

45) The healthcare provider asks a client to lie down facing upwards and flex the right thigh at the
hip. The client says, “I cannot do this. This position is hurting my abdomen.” Which signs of
appendicitis does the nurse recognize in this client?
- Psoas sign
46) The nurse is preparing teaching material to present to a community group about the common risk
factors for cholecystitis. Which factor does the nurse include for female attendees?
- Incidence of multiple pregnancies

47) The nurse is reviewing both the functions and dysfunctions of the pancreas. Which diagnosis
related to pancreatic dysfunction is the greatest risk to the client with chronic pancreatitis?
- Gland destruction.

48) The nurse is assessing a client in the emergency department. The client states, “I have been really
sick with an infection and now I have this awful diarrhea.” Which type of gastroenteritis does the
nurse suspect?
- C. Diff

49) While reviewing the medical file of a client with cirrhosis, the nurse finds that the client has
steatorrhea. Which reason does the nurse identify for this condition in the client?
- Diminished synthesis of bile

50) Which diagnostic test does the health-care provider order to get the most accurate information
related to appendicitis?
- CT scan

51) Which side effect does the nurse expect to observe in a client who is on epinephrine therapy?
- Suppression of the urge to defecate

52) The nurse is assessing a client with pain in the right upper quadrant for 4 hours. The client reports
the pain is radiating to the upper thoracic region. A laboratory report suggests elevated liver
enzymes and serum bilirubin. Which condition does the nurse suspect from the findings?
- Biliary colic

53) The nurse is reviewing the pathophysiology of nonalcoholic fatty liver disease with staff nurses.
Which statement made by an attending nurse indicates understanding?
- NAFLD is linked to metabolic syndrome (characterized by insulin resistance, obesity,
hyperlipidemia. It can lead to excess fat accumulation in the liver.)

54) The nurse educator is teaching a group of staff nurses about the importance of inserting a NG
tube in clients with large bowel obstruction. Which statement made by an attending nurse
indicates effective learning?
- A NG tube relieves pressure caused by bowel obstruction.

55) The client reports nausea, vomiting, abdominal cramping, and diarrhea. On assessment, the nurse
finds high-pitched bowel sounds. Which nursing interventions help the client improve the
manifestations of the condition?
- Administer antiemetic medications
- Administer IV fluids
- Administer antibiotics
 56) A client was brought to the hospital because of severe abdominal pain, nausea, and vomiting. The
client reports increased pain in the abdomen and in the epigastric region radiating to the back
when lying supine. During physical assessment, the nurse finds the client has a fever and
hypotension. Which condition does the nurse suspect from these findings?
- the client has acute pancreatitis

57) A client tells the nurse, “I have intense stomach pain for 3 hours after eating.” On assessment the
nurse finds abdominal pain and tenderness. The nurse suspects the client has peptic ulcers. Which
diagnostic procedure does the nurse expect the health-care provider to prescribe?
- blood test for H. pylori antibodies

58) A physical examination of a client elicits the Cullen sign and Grey-Turner sign. Which condition
does the nurse suspect in the client?
- Acute pancreatitis

59) The radiographic diagnostic reports for a client show the presence of stones in the common bile
duct. Which complications does the nurse expect in the client?
- Increase in bilirubin levels

60) The laboratory reports of a client diagnosed with alcoholism show hepatic encephalopathy and
portal hypertension. Which nursing intervention will be beneficial for the client?
- Encourage the use of thiamine supplements

61) The healthcare provider suspects the presence of esophageal varices in a client diagnosed with
cirrhosis of the liver. An ultrasound is prescribed and verifies the suspected condition. Which
medication does the healthcare provider prescribe to prevent esophageal variceal bleeding?
- Propranolol (Adrenergic betablocker. It decreases blood pressure and thereby reduces portal
hypertension, helping to prevent the rupture or hemorrhage.)

62) The nurse is providing care for a client in the emergency room with an initial presence of pain in
the abdomen. Assessment elicits the presence of rebound pain at McBurney’s point, an ultrasound
is positive for an inflamed appendix, and WBC are moderately elevated. The patient does not
have an appendicolith and is concerned about the cost of surgery and the time away from work.
Which prescription does the nurse anticipate from the healthcare provider?
- Administer oral antibiotics and explain continued use at home.

63) The nurse is reviewing the functions of the liver with a group of staff nurses. Which response by
one of the attending nurses indicates the need for additional review?
- The liver synthesizes glucagon.

64) The nurse is assessing a client with an episodic abdominal pain, constipation, and flatulence.
Upon physical assessment and review of the laboratory findings, the nurse concludes the client
has jaundice and elevated serum amylase. Which condition does the nurse suspect in the client?
- Chronic pancreatitis

Ch 10
1) Which type of stone, in the case of urolithiasis, is associated with indwelling catheters?
- Struvite (Calcium stones are formed due to excess dietary calcium and excess resorption of
calcium from the bone.)

2) The nurse notices the GFR of a client has decreased. Which are the possible reasons for this
change?
- A decrease in the client’s renal perfusion.
- A part of the normal aging process.
- A decrease in the client’s blood pressure.

3) An older adult male client reports difficulty with urination. Which does the nurse identify as the
most common cause of urinary obstruction in men older than 60 years of age?
- BPH

4) The nurse is providing care for a client with a history of insulin-dependent type 2 diabetes
mellitus. Currently, the client is diagnosed with renal failure. Which effect does the client’s
condition have on the insulin administered by the nurse?
- The degradation of insulin is decreased. (Higher levels of insulin are not administered because
of the decreased insulin clearance related to kidney failure.)

5) Which is a risk factor for both bacterial and fungal urinary tract infections?
- Urinary catheters

6) Which statement made by a nurse demonstrates understanding of the secretory functions of the
kidney?
- Clients with impaired renal function have disrupted calcium balance in the bloodstream due to
inactive vitamin D. (The kidneys synthesize components that comprise vitamin D. Calcium is
absorbed by the facilitation of vitamin D, so a lack disrupts calcium balance in the bloodstream.)

7) Which factors does a nurse identify as associated with the formation of struvite stones after
comparing struvite stones with calcium stones?
- Anatomical abnormalities in the urinary tract
- Presence of urease-producing organism
- Neurological disorders of the bladder

8) Which statement does the nurse identify as correct after contrasting peritoneal dialysis with
hemodialysis and continuous renal replacement therapy?
- The process of draining and filling in PD takes about 30-40 minutes.

9) Which statement made by a nurse demonstrates understanding of the basic pathology of renal
disorders?
- Postrenal dysfunction can be accompanied by an increased risk of infection.

10) The nurse is taking the history of a female client suspected of having urolithiasis. Which question
would not be helpful to facilitate the diagnosis?
- Have you been diagnosed with endometriosis?
11) The nurse provides teaching to a client about lower urinary tract infections. Which statement
made by the client demonstrate an understanding of the clinical presentation related to UTIs?
- Severe pain in the glans penis is common.

12) The nurse is counseling a female client who is experiencing urinary incontinence. Which
intervention does the nurse initiate for this client?
- Explanation and directions for Kegel’s exercises.

13) Which statement is true regarding the bacteria that frequently causes lower urinary tract
infections?
- In hospital-acquired infections, multidrug resistant bacterial organisms often cause UTIs.
(Proteus mirabilis secretes urease, which decreases the acidity of urine, changing it’s pH. This
enhances formations of struvite staghorn calculi in the kidney. E. Coli does not change the acidic
nature of urine, the outer capsule can resist the acid.)

14) The nurse is reviewing the pathology report on a kidney stone passed by a client. If the client’s
stone is identified as a cysteine stone, which type of client teaching does the nurse perform?
- A genetic disorder

15) A client presents with a specific type of renal calculi that is not widely prevalent. The nurse
knows this client has been undergoing chemotherapy for the treatment of cancer. Which is an
associated characteristic of the type of renal calculi that is most likely to be present in this client?
- High purine levels in the bloodstream (High purine levels in the bloodstream occur with high
ingestion of meats or whenever there is a high rate of cellular breakdown, as in the treatment of
malignancy. High purine levels cause uric acid stones.)

16) The nurse is preparing a client for urodynamic studies. Which information does the nurse tell the
client the study will provide?
- Observes the actual process of voiding. (Urodynamic studies help evaluate the bladder’s
neuromuscular status. Studies are done during both bladder filling and emptying. This testing can
determine if the bladder can fully expand and the actual process of voiding to determine if the
bladder can contract properly.)

17) The nurse is assessing a client with suspected nephrolithiasis. Which factor does the nurse
identify as possible causes for the disease?
- The client suffers from hyperparathyroidism. (metabolic risk factor for nephrolithiasis.)

18) A nurse is reviewing the treatment of nephrolithiasis with staff nurses. Which statements made by
an attending nurse indicate the need for additional review?
- Most renal stones are treated with lithotripsy.

19) Which statement about the pathophysiology of the lower urinary tract infections is true?
- Any obstruction of urinary outflow decreases the bladder’s resistance to bacterial infection.

20) The nurse is teaching an in-service to nurses about the epidemiology of lower UTIs. Which
statement made by an attending nurse indicates a need for clarification?
 - Up to 40% of men in the US, aged 20-40 years, has suffered a lower UTI.

21) The nurse is reviewing the difference between acute kidney injury and chronic renal failure.
Which client does the nurse identify as having chronic renal failure?
- diagnosis of SLE

22) The nurse in the urology unit is comparing treatment methods for urolithiasis and urinary
incontinence. Which statement made by the nurse indicates proper understanding of the treatment
methods?
- HCTZ is the drug of choice for the treatment of calcium stones.

23) Which statement made by a nurse pertains to the theory of protein deficiency as a possible cause
of the formation of renal calculi?
- There is a deficiency of the protein nephrocalcin, which inhibits stone formation.

24) During a health screening a client’s urine culture shows a colony count of 110,000 bacteria. A
second culture confirms the initial finding. The client does not exhibit manifestations of a UTI.
Which nursing intervention does the nurse initiate?
- Teaching the reasons to wipe from front to back.

25) The nurse is providing care for an adult female client who states, “I think I have a urinary
infection.” The client presents with frequency, pain on urination, urgency, and fever. Which is the
most important action for the nurse to perform?
- Reports a possibility of pyelonephritis

26) Which observation is associated with the nonulcerative type of interstitial cystitis?
- Hemorrhages when the bladder is distended.

27) A client presents with a colicky type of flank pain that radiates into the groin. Assessment reveals
edema and distention of the renal pelvis caused by a buildup of urine. Which condition is the
client at risk for developing if the edema and distention continue for a prolonged period?
- Ischemia (Ischemia is caused by prolonged hydronephrosis. The symptom of colicky flank pain
radiating into the groin indicates that the client is suffering from renal calculi. The edema and
distention of the renal pelvis indicate that the stone has caused obstruction of urine and put
backpressure into the renal pelvis.)
28) Which constitute an effect of the RAAS of the kidneys?
- Water reabsorption.

29) The nurse is providing care for a client admitted to the ICU after surgery for multiple accident-
related injuries. The client’s spouse asks why the nurse is measuring the client’s urine every hour.
What is the reason for the assessment?
- Blood loss from surgery and injuries can cause prerenal dysfunction. (Because the client is
likely to have blood loss from both injuries and surgery there is a high risk for prerenal
dysfunction related to hypovolemia.)

30) Which diagnostic procedures are used for the detection of interstitial cystitis in females?
-Hysteroscopy
 -Urodynamic studies
-Laparoscopy

31) The nurse is providing care for a client with a spinal cord injury who is having difficulty
urinating. If the client is diagnosed with a calculi in the ureter, which type of stone does the nurse
expect to be present?
- Struvite

32) A client has a history of kidney stones and states, “My whole family has kidney stones.” Which is
the most likely reason for the client’s formation of renal calculi?
- A genetic disposition

33) The nurse is caring for an older adult client with a history of spinal injury that is necessitated the
long-term use of an indwelling urinary catheter. A routing urine culture reveals the presence of
proteus mirabilis. For which complication does the nurse carefully monitor?
- Urosepsis (Urosepsis is a likely complication because proteus mirabilis, a bacterium found from
the bowel, secretes urease, which decreases the acidity of the urine and enhances its ability to
invade the bladder. Proteus-related UTIs is most commonly associated with the use of urinary
instrumentation or catheterization.)

Ch 11

1) A client is being scheduled for thyroid testing. For which diagnostic test does the nurse prepare
the client for detecting hyperactivity of the thyroid gland?
- Radioactive iodine scan.

2) Which electrolyte disturbance occurs due to low levels of aldosterone?

- Hyperkalemia

3) The caregiver of a client tells the nurse, “The client has coarsening of facial features and enlarged
bones in the face.” On assessment of the client, the nurse finds that the client has high blood
pressure and visual impairment. Which diagnostic test does the nurse expect the health care
provider to prescribe?
- Blood studies of tropic hormones

4) The nurse finds the symptoms of thyroid dysfunction in a client are due to abnormal pituitary
activity. The client’s laboratory tests show a low TSH level, which supports the nurse’s finding.
Which type of endocrine disorder is likely present in the client?
- Secondary hypothyroidism

5) Which congenital condition does the nurse recognize as being due to thyroid hormone deficiency
during embryonic development and early neonatal life?
- Cretinism (A congenital condition caused by hypothyroidism during embryonic development
and early neonatal life.)
6) After reviewing the laboratory results of a client with diabetes, the nurse finds that the client had
DKA. Which finding supports the nurse’s conclusion?
- Blood glucose of 300mg.dL (Clients with DKA will have an arterial pH of less than 7.3.)

7) The nurse reviews the laboratory results of a client and concludes that the client has diabetes.
Which finding helped the nurse to reach this conclusion?
- HgbA1c of 7

8) A client is diagnosed with multiple endocrine neoplasia. Which sign or symptom observed in the
client indicates the presence of pituitary tumors?
- Visual disturbances (Characteristic feature of large tumors due to their proximity to the optic
nerve chiasm.)

9) Which symptom does the nurse observe in a client with hyperosmolar hyperglycemic syndrome?
- Confusion
- Polydipsia
- Pulyuria

10) The nurse reviews the lab results of a client with DM and concludes that the client has diabetic
nephropathy. Which finding supports the nurse’s conclusion?
- Albumin in the urine

11) The nurse is providing care for a client with DM. The nurse obtains a glucose lever of 55mg/dL.
For which complication does the nurse prepare the client?
- Seizure

12) The nurse assesses the blood glucose levels of a client at regular intervals. The nurse finds
55mg/dL at 0200 and 150mg/dL at 0700. Which mechanism does the nurse suspect behind the
change in the glucose levels in the client?
- Somogyi effect

13) The nurse is teaching a group of staff nurses about managing hyper osmolar hyperglycemic
syndrome. Which response by an attending nurse indicates effective learning?
- Fluids are administered before administering IV insulin to the client.

14) Which endocrine disorder involves treatment using antithyroid hormone medication such as
propylthiouracil?
- Grace’s disease

15) A clint tells a nurse, “I’ve been feeling excessively thirsty for the last 2 days.” On examination,
the nurse finds the client has poor skin turgor, low BP, and dry skin. A CT of the client’s head
shows a pituitary tumor. Which treatment does the nurse expect to be prescribed by the health
care provider?
- Arginine vasopressin

16) A client is experiencing issues with abnormal blood glucose levels and infertility. The health care
provider prescribes a MRI of the clients head. If asked, which explanation for the test does the
 nurse provide?
- Your issues may be related to your pituitary gland.

17) The nurse observes the final diagnosis for four clients in their case reports. In which client does
the nurse notice the presence of Chvostek’s sign and Trousseaus sign?
- The client diagnosed with hypoparathyroidism

18) Which is the most common complication expected in clients with type 1 Diabetes?
- DKA

19) The nurse educator is reviewing treatment strategies that are beneficial to a client with
hyperparathyroidism with a group of staff nurses. Which statement by an attending nurse does the
nurse educator correct?
- The client is prescribed bisphosphonates to increase osteoclast activity.

20) A client who underwent laryngotomy presented with depression, increased sensitivity to cold,
and constipation. On assessment, the nurse identifies the client with a puffy face and periorbital
edema. The blood report shows a high thyroid-stimulating hormone level. Which does the nurse
interpret from the findings?
- The client has hypothyroidism.

21) The nurse is caring for a client with immune-mediated type 1 diabetes. Which does the nurse
expect to be the cause of this condition in the client?
- The client has destruction of beta cells.

22) Which disorder is described as the complete loss of all of the pituitary hormones?
- Panhypopituitarism

23) A male adolescent client with an age of 13 years is assessed at a height of 4 feet 2 inches. The
manifestation is related to abnormal growth hormone levels. Which treatment does the nurse
expect to be prescribed?
- Growth hormone replacement therapy

24) Which disorder does the nurse recognize as being caused by an increase in the hormones that are
secreted from the adrenal gland?
- Cushing’s syndrome

25) Which diagnostic test is appropriate to rule out ectopic adrenocorticotropic hormone-secreting
tumors in the body?
- Ocreotide scintigraphy

26) Which signs or symptoms does the nurse observe while assessing a client with diabetes insipidus?
- Poor skin turgor

27) The nurse observes sweating, dizziness, and disorientation in the client with a known history of
diabetes mellitus. Finger-stick blood glucose level is 40mg/dL. When consulting the health care
provider, which treatment option does the nurse anticipate being most beneficial to the client?
 - Administering 50mL of 50% dextrose IV

28) Which medication does the healthcare provider prescribe for the treatment of prolactinoma in a
client with hyperpituitarism?
- Bromocriptine (Dopamine agonist that blocks secretion of prolactin and can shrink tumors.)

29) The lab report of a client shows arterial blood pH of 7.6, blood glucose level of 650mg/dL, and
serum bicarbonate level of 17mEq/L. Which conclusion does the nurse draw from these lab
findings?
- The client has hyperosmolar hyperglycemic syndrome.

30) The nurse suspects nocturnal hypoglycemia in a diabetic client. Which symptom does the nurse
NOT expect to observe in this client?
- severe dehydration

31) Which condition exhibits “moon face” as a characteristic symptom?

- Cushing’s syndrome

Ch 12
1) A nurse is caring for a female client at 19 years of age who never had a menstrual cycle. Physical
assessment reveals a webbed neck, short stature, and a broad, shield-like chest. Which is the most
probable cause od the client’s condition?
- Turner syndrome

2) Which physical finding in a client will lead a nurse to suspect paraphimosis?

- Permanent retraction of the foreskin behind the tip of the penis.

3) While assessing a female client at 7 years of age, the health care provider finds the client has
enlargement of the breasts, erection of the nipples, and pubic hair. Which hormonal levels are
found to be high in the client?
- Estrogen.

4) The medical records of a client indicate the client has Reiter’s syndrome. Which microorganism
is most likely to cause this infection?
- Chlamydia trachomatis (It’s a reactive arthritis that is an autoimmune-mediated inflammatory
disorder occurring 1 week to 1 month after genitourinary chlamydia infection.)

5) While teaching health promotion measures to a group of football players, the nurse instructs the
players to wear protective gear while on the field. Which complication is the nurse trying to avoid
in the players?
- Hydrocele
6) Which hormone stimulates the Leydig cells of the testes to secrete testosterone?
- Luteinizing hormone

7) Which artery provides engorgement of the glans during erection?

- Dorsal

8) In a client with a uterine disorder, a nurse observes that the endometrial tissue grown inside the
muscular layer of the uterus. Which complication is NOT specifically associated with this uterine
disorder?
- Infertility

9) The nurse is caring for a neonate immediately after birth. The mother has genital warts. Which
intervention by the nurse is initiated?
- Examine the pharynx of the neonate

10) A female client reports missed menstrual periods after discontinuing hormonal contraceptives.
Which reason does the nurse recognize as the cause for the missed menstrual periods?
- Hypothalamic-pituitary-ovarian dysfunction

11) While assessing a female client for anomalies of the genital tract, the health care provider
observes that the uterus is absent and the vagina is foreshortened. However, the client’s breast is
normal in shape and contour. Which menstrual disorder would the nurse suspect in the client?
- Mayer-Rokitansky-Hauser syndrome

12) The registered nurse is teaching about medications for benign prostatic hyperplasia to a group of
staff nurses. Which statement made by a nurse indicates the need for additional teaching?
- Alpha-blockers reduce the size of the prostate.

13) The nurse counsels a male client about healthy spermatogenesis. During a follow-up visit, the
nurse learns the client is still experiencing diminished sperm production. Which statement by the
client indicates a need for additional teaching?
- I sit in a hot tub daily after exercising.

14) The registered nurse is teaching a client with dysmenorrhea about her treatment plan. Which
statement made by the client indicates the need for additional teaching?
- I should avoid the use of oral contraceptives.

15) While performing the genital assessment of a male client, the nurse observes that the client has a
curvature of the penis. Which condition does the nurse suspect in the client?
- Peyronie’s disease

16) A digital rectal examination in a client reveals the enlargement of the prostate land that is firm,
painless, and generalized. Which medication does the nurse anticipate the health care provider
will prescribe?
- Extracts of saw palmetto
17) A client tells a nurse, “My new medication has helped with my erectile dysfunction.” Which
medication prescribed for the client is likely responsible?
- Sildenafil

18) While assessing a male client, a nurse observes that the client has a small penis and testicles, long
legs, short trunk, enlarged breast tissue and a history of sexual dysfunction. Which condition does
the nurse suspect?
- Presence of an extra X Chromosome

19) Which complication does the nurse expect in a female client diagnosed with atrophic vaginitis
during the perimenopausal stage?
- Vaginal yeast infection (Due to decreased secretions)

20) A female client at 14 years of age is identified with constitutional growth delay. The client tells a
nurse, “I’m not getting any taller! I am the same height I was last year!” In which manner does
the nurse respond?
- You will reach full height by adulthood.

21) A client with OMD is prescribed SSRIs and nutritional supplements. Which symptom in the
client indicates the effectiveness of the therapy?
- The client has decreased irritability and mood swings

22) A client infected with Neisseria gonorrhoeae develops sepsis. Which symptoms does the nurse
expect to observe in the client?
- Meningitis

23) When reviewing a pathology report, the nurse associates an identified pathogen with a certain
condition. Which microorganism does the nurse associate with inclusion conjunctivitis?
- Chlamydia trachomatis

24) The registered nurse is teaching a group of adolescents about sexually transmitted diseases and
makes the following statement, “This disease spreads through close skin contact and cannot be
prevented by using condoms.” Which sexually transmitted disease si the nurse referring to in the
teaching?
- HSV

25) After reviewing the medical records of a client, the nurse finds that the client was previously
diagnosed with mild salpingitis and later had tubal dysfunction. The nurse also finds strains of
Chlamydia in the client’s blood specimen. Which does the nurse interpret from these findings?
- the client has silent PID

26) A client is exposed to Neisseria gonorrhoeae organism and becomes infected. Which symptom is
noted in the client immediately after the infection?
- Dysuria

27) Upon reviewing a female client’s lab reports, the nurse finds that the client tested positive for a
STI. With which infection is the client likely to remain fertile?
 -HPV

28) The nurse is reviewing the causes and manifestations of perimenopause with a group of staff
nurses. Which comment by an attending staff nurse indicates understanding of the difference
between perimenopause and menopause?
- Perimenopause is confirmed by high levels of follicle-stimulating hormone.

29) The nurse reviews a client’s medical record and learns the endometrial lining is absent in a client
who underwent a D&C abortion. Which syndrome does the nurse recognize in the client?
-Asherman’s syndrome

30) During an assessment, the nurse observes the signs of diminished secondary sexual characteristics
in an adult male client. Which is the appropriate nursing action?
- Measure the morning serum testosterone levels.

31) After assessing a client who has chlamydia trachomatis infection, the nurse finds fibrotic
adhesions around the liver and a tender abdomen. Which condition does the nurse identify in the
client?
- Fits-Hugh-Curtis syndrome

32) A client visits the gynecologist because of pelvic pain and the inability to conceive after one year
of trying. After reading the results of a pelvic ultrasound, the gynecologist suspects
endometriosis. Which prescribed treatment will both confirm and treat the client’s condition?
- Performance of laparoscopy

33) The nurse is providing care for a neonate immediately after a spontaneous vaginal birth to a
mother who tested positive for gonorrhea. Which prescription foes the nurse anticipate to be most
beneficial to the neonate?
- Tetracycline ophthalmic ointment

34) A female client tells a nurse, “I have excessive bleeding that lasts for more than 7 days every time
I menstruate.” Which menstrual disorder does the nurse suspect in the client?
- Menorrhagia

35) The nurse is aware of multiple methods of testing to identify microorganisms causing STIs.
Which lab test is used In order to detect microorganisms in the sample of tissue, blood, or body
fluid?
-Polymerase chain reaction (PCR)

36) A client diagnosed with dysmenorrhea is prescribed ibuprofen and hormonal contraceptives.
Which outcome is the client indicates the effectiveness of the therapy?
- No painful experience during the first 2 days of the menstrual period.

37) After reviewing the lab reports for a client, the nurse finds the client has chronic pelvic
inflammatory disorder. Which condition does the nurse recognize as a risk to the client?
- Inflammation of the fallopian tubes.
38) Which gland secretes a lubricating fluid that coats the urethra during sexual arousal?
- Bulbourethral gland

39) The nurse is teaching adolescent girls about the menstrual cycle. Which comment by an attendee
expresses understanding about ovulation?
- The actual stimulus for ovulation comes from the brain.

40) The nurse is reviewing the medical records of a client who is pregnant and finds the client has a
chlamydia infection. Which complication is the nurse aware of in the newborn if the client is not
treated?
- Conjunctivitis

41) In the male client, which hormone stimulates Sertoli cells to synthesize spermatozoa?
-Follicle-stimulating hormone.