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NUR 667 FINAL EXAM 2025 QUESTIONS AND
VERIFIED ANSWERS (SOLVED)
A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis?
A. Gastroenteritis
B. Recent use of Imodium
C. Lack of dietary fiber
D. Decreased physical activity
A. Gastroenteritis
A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis?
A. Endometriosis
B. Yersinia enterocolitica infection
C. Appendicitis
D. GERD
A. Endometriosis
A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point?
A. Stool culture
B. Liver enzymes
C. Antihepatitis D virusD
Thyroid-stimulating hormone test
C. Antihepatitis D virus
A pt is seen with c/o diarrhea. Which of the following should be included in the pt's differentials?
a. Gastroenteritis
b. Inflammatory bowel disease
c. Lactase deficiency
d. All of the above
D. Iodine preparations
E. Glucocorticoids
Rationale: Thyroid storm or thyrotoxicosis may develop with poorly managed hyperthyroidism. Clinical manifestations include tachycardia, fever, systolic hypertension, abdominal pain, tremors, and changes in level of consciousness. Airway management and fluid resuscitation are priorities. Antithyroid medications may be administered along with iodine preparations. For management of tachycardia, beta-adrenergic blockers may be administered. Glucocorticoids may also be administered because in high doses these medications decrease the conversion of T4 to the more active T3, as well as decreasing the release of TSH from the anterior pituitary gland.
Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions?
A. Myxedema
B. Thyrotoxicosis
C. Cushing's syndrome
D. Pan-hypopituitarism
B. Thyrotoxicosis
The nurse is caring for a client with exophthalmos. What is the anticipated cause?
A. Hypothyroidism
B. Hyperthyroidism
C. Thyrotoxicosis
D. Hypoparathyroidism
B. Hyperthyroidism
The patient experiencing thyroid storm (thyrotoxicosis) is ordered to receive beta- adrenergic agents. The nurse monitors which therapeutic effect of these medications?
A. Increased respiratory rate
B. Increased appetite
C. Decreased heart rate
D. Decreased bowel sounds
C. Decreased heart rate
A 45yo pt presents with a CC of generalized abd pain. Her physical exam is remarkable for LLQ tenderness. At this time, which of the following should be considered in the differential dx?
a. Endometriosis
Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to reflect?
A. Thrombocytopenia and elevated transaminase
B. Elevated WBCs
C. Decreased WBCs
D. Decreased serum globulins
A. Thrombocytopenia and elevated transaminase
The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should the clinician order on the initial visit?
A. Sensitive thyroid-stimulating hormone (TSH) assay and T
B. Free T4 and serum calcium
C. Nuclear scintigraphy with radiolabeled iodine (123I)
D. Magnetic resonance imaging
A. Sensitive thyroid-stimulating hormone (TSH) assay and T
Which of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease? Select all that apply
A. Low TSH
B. Elevated T
C. Elevated thyrotropin-releasing hormone (TRH)
D. All of the above
D. All of the above
Graves Disease, a form or HYPERTHYROIDISM.
Labs:- 2nd most prevalent from of autoimmune thyroid disease- Suppressed TSH- detectable TSH antibodies- high thyroid uptake of radioactive Iodine
Polydipsia occurs in diabetes as a result of a high serum glucose level, which:
A. interferes with the release of antidiuretic hormones
B. has an osmotic effect on fluids and eventually triggers the thirst mechanism for compensation
C. causes a dry mouth, increasing the client's thirst to the point of drinking compulsively
D. disrupts fluid and electrolyte imbalance, increasing the thirst mechanism to compensate for fluid gain or loss
B. has an osmotic effect on fluids and eventually triggers the thirst mechanism for compensation
Which medication for type 2 diabetes mellitus would be contraindicated during pregnancy?
A. Insulin
B. Metformin (Glucophage)
C. Glipizide (Glucotrol)
D. Acarbose (Precose)
C. Glipizide (Glucotrol)
A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which condition that the patient also has would be a contraindication to taking metformin?
A. Ulcerative colitis
B. Inflammatory bowel disease
C. Chronic obstructive pulmonary disease
D. Renal disease
D. Renal disease
A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test should the clinician order?
A. Viral load
B. Hemoglobin A1c
C. Western blot assay
D. Heterophile antibody test
D. Heterophile antibody test
Which cognitive behavioral finding would the nurse anticipate finding in a patient with cirrhosis who has hepatic encephalopathy?
A. Intact short-term memory
B. Intact long-term memory
C. Personality changes
D. Clear speech articulation
C. Personality changes
In cirrhosis, alterations in blood and lymph flow can lead to what end organ effect of the liver?
A. Increased perfusion as a result of ascites
B. Increased pressure leading to increased vascularity
C. Cellular changes leading to malignancy
D. Spontaneous bacterial peritonitis
B. Hepatic encephalopathy
The nurse is caring for a client with an elevated thyroid stimulating hormone (TSH) level. Which assessments are consistent with this finding? Select all that apply.
A. Constipation
B. Weight gain
C. Edema
D. Tachycardia
E. Restlessness and anxiety
a. Constipation
b. Weight gain
c. Edema
Rationale: The diagnosis of hypothyroidism is confirmed through analysis of laboratory data, including T3, T4, and TSH. If the etiology is primary hypothyroidism, the TSH level is elevated as a result of the feedback system to the hypothalamus and anterior pituitary gland caused by low circulating levels of thyroid hormones (T3 and T4). The hypometabolic state is characterized by decreased energy, increased sleep, fatigue, weight gain, decreased appetite, and
susceptibility to cold temperatures. Decreased gastrointestinal activity results in constipation and abdominal distention.
What does a low level of thyroid-stimulating hormone indicate?
A. Hypothyroidism
B. Myxedema
C. Hyperthyroidism
D. Thyroid nodule
C. Hyperthyroidism
Minnie is pregnant. She has hypothyroidism and has been on the same levothyroxine medication for years. What might you expect to do with her levothyroxine medication?
A. Increase the dosage
B. Maintain her established dose
C. Decrease her dosage
D. Increase the dose during the first trimester, then decrease it during the second and third trimesters
A. Increase the dosage
A. Adjust her morning dose of rapid-acting insulin.
B. Increase her midafternoon snack.
C. Add physical activity between lunch and dinner.
D. Reduce the amount of carbohydrates at dinner.
C. Add physical activity between lunch and dinner.
T/F
Metformin is the first line of pharm treatment for T2DM.
True
A patient is 66 inches in height, weighs 200 pounds, and is newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?
A. No treatment at this time
B. Diet and exercise for 6-week trial
C. Diet, exercise, and oral medication
D. Diet, exercise, and exogenous insulin
B. Diet and exercise for 6-week trial
The nurse is caring for a client with cirrhosis. Which clinical manifestations should the nurse expect to observe? Select all that apply.
a. Altered mental status
b. Metabolic alkalosis
c. Altered respiratory status
d. Jaundice. Petechiae
a. Altered mental status
c. Altered respiratory status
d. Jaundice
e. Petechiae
Which action performed by a nurse while taking care of a patient with cirrhosis puts the patient at increased risk of complication?
A. Providing electrolyte replacements such as potassium
B. Administering diuretics.
C. Increasing amounts of protein in the diet.
D. Restricting sodium and fluid intake as ordered.
C. Increasing amounts of protein in the diet.
A. .Iron
B. Aspirin
C. Opioids
D. Laxatives
E. Antibiotics
A. .Iron
C. Opioids
The nurse is providing teaching to a client with constipation. Which statement made by the client indicates an understanding of the teaching?
A. "I need to limit physical activity when constipated."
B. "I will reduce my fluid intake to 8 oz of water daily."
C. "I need to avoid the urge to defecate to strengthen muscles."
D. "I can take psyllium to help with bowel movements."
D. "I can take psyllium to help with bowel movements."
You are working with a client who claims to be constipated and who uses laxatives and enemas daily to ensure that she has a bowel movement. Which of the following nursing diagnoses would be most appropriate for this client?
A) Constipation
B) Risk for Constipation
C) Perceived Constipation
D) Dysfunctional Gastrointestinal Motility
C) Perceived Constipation is an appropriate diagnosis for a client who makes a self-diagnosis of constipation and uses laxatives, suppositories, or enemas to ensure a daily bowel movement.
Which of the following patients is at risk for developing urinary tract cancer?
A. The 45-year-old woman who is 100 lbs overweight
B. The 78-year-old man who smokes three packs of cigarettes a day
C. The 84-year-old man who worked in the asbestos mines
D. All of the above
D. All of the above
Obesity; exposure to asbestos, cadmium, and/or gasoline; the use of phenacetin- and aspirin-containing analgesics; and chronic hemodialysis for acquired polycystic kidney disease are all risk factors for renal cell carcinoma. Cigarette smoking has a 25% to 30% correlation with the development of renal cell carcinoma.
Dunphy, Lynne M; Winland-Brown, Jill E; Porter, Brian; Thomas, Debera. Primary Care Art and Science of Advanced Practice Nursing (Page 622). F.A. Davis Company. Kindle Edition.
