NURS 3700 FINAL EXAM 2026 ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔10. A patient with an obstruction of the common bile duct has clay-colored fatty
stools among other manifestations. What is the pathophysiologic change that causes
this manifestation?
a.Water-soluble (conjugated) bilirubin in the blood excreted into the urine
b.Absence of bilirubin and bile salts in the small intestine prevents conversion to
urobilinogen and fat emulsion and digestion
c.Contraction of the inflamed gallbladder and obstructed ducts stimulated by
cholecystokinin when fats enter the duodenum
d.Obstruction of the common duct prevents bile drainage into the duodenum, resulting
in congestion of bile in the liver and subsequent absorption into the blood - ✔✔Answer:
B
Absence of bilirubin and bile salts in the intestine lead to clay-colored stools and
steatorrhea. Soluble bilirubin in the blood excreted into the urine leads to dark urine.
Contraction of the inflamed gallbladder leads to pain with fatty food intake. Obstruction
of the common bile duct prevents bile drainage into the duodenum, with congestion of
bile in the liver. Bilirubin absorption in the blood leads to jaundice
✔✔11. After a laparoscopic cholecystectomy, what should the nurse expect to be part of
the plan of care?
a.Return to work in 2-3 weeks
b.Be hospitalized for 3-5 days postoperatively
c.Have a T-tube placed in the common bile duct to provide bile drainage
d.Have up to 4 abdominal incisions covered with small dressings. - ✔✔Answer: D
A t-tube is placed in the common bile duct after exploration of the duct during an
incisional cholecystectomy
✔✔12. During discharge instructions for a patient following a laparoscopic
cholecystectomy, what should the nurse include in the discharge teaching?
a.Keep the incision area clean and dry for at least a week
b.Report the need to take pain medications for shoulder pain
c.Report any bile colored or purulent drainage from the incision
d.Expect some postoperative nausea and vomiting for several days - ✔✔Answer: C
This could indicate an infection.
b. Referred shoulder pain is a common and expected problem following lap procedures,
when carbon dioxide used to inflate the abdominal cavity is not readily absorbed by the
body. Nausea and vomiting are not expected postop and may indicate damage to other
abdominal organs
✔✔13. Which assessment finding would the nurse need to report most quickly to the
health care provider regarding a patient who has acute pancreatitis?
a.Nausea and vomiting
b.Hypotonic bowel sounds
,c.Muscle twitching and finger numbness
d.Upper abdominal tenderness and guarding - ✔✔c
Muscle twitching and finger numbness indicate hypocalcemia, which may lead to tetany
unless calcium gluconate is administered. Although the other findings also should be
reported to the health care provider, they do not indicate complications that require
rapid action.
✔✔14. Which response by the nurse best explains the purpose of ranitidine (Zantac) for
a patient who was admitted with bleeding esophageal varices?
a.The medication will reduce the risk for aspiration.
b.The medication will inhibit development of gastric ulcers.
c.The medication will prevent irritation of the enlarged veins.
d.The medication will decrease nausea and improve the appetite. - ✔✔c
✔✔15. Which assessment finding is of mostconcern for a patient with acute
pancreatitis?
a.Absent bowel sounds
b.Abdominal tenderness
c.Left upper quadrant pain
d.Palpable abdominal mass - ✔✔d
✔✔16. The nurse is planning care for a patient with acute severe pancreatitis. What is
the highest priority patient outcome?
a.Having fluid and electrolyte balance
b. Maintaining normal respiratory function
c. Expressing satisfaction with pain control
d. Developing no ongoing pancreatic disease - ✔✔b
✔✔17. A patient who has cirrhosis and esophageal varices is being treated with
propranolol (Inderal). Which finding is the best indicator to the nurse that the medication
has been effective?
a.The patient reports no chest pain.
b. Blood pressure is 130/80 mm Hg.
c. Stools test negative for occult blood.
d. The apical pulse rate is 68 beats/min. - ✔✔ANS: C
Because the purpose of -blocker therapy for patients with esophageal varices is to
decrease the risk for bleeding from esophageal varices, the best indicator of the
effectiveness for propranolol is the lack of blood in the stools. Although propranolol is
used to treat hypertension, angina, and tachycardia, the purpose for use in this patient
is to decrease the risk for bleeding from esophageal varices.
✔✔18. The nurse is caring for a patient who has cirrhosis. Which data obtained by the
nurse during the assessment will be of most concern?
a.The patient reports right upper-quadrant pain with palpation.
, b.The patient's hands flap back and forth when the arms are extended.
c. The patient has ascites and a 2-kg weight gain from the previous day.
d. The patient's abdominal skin has multiple spider-shaped blood vessels. - ✔✔b
✔✔19. A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with
cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide
(Lasix) due. Which action should the nurse take?
a.Withhold both drugs.
b. Administer both drugs.
c. Administer the furosemide.
d. Administer the spironolactone. - ✔✔d
✔✔20. A client admitted to the hospital with a suspected diagnosis of acute pancreatitis
is being assessed by the nurse. Which assessment findings would be consistent with
acute pancreatitis? Select all that apply
a.Diarrhea
b.Black, tarry stools
c.Hyperactive bowel sounds
d.Blue-grey color at the flank
e.Abdominal guarding and tenderness
f.Left upper quadrant pain with radiation the back. - ✔✔d e f
✔✔When guiding nursing in how to perform professionally, which describes a
competent level of nursing care based on the nursing process?
a. Standards of Professional Performance
b. Standards of Practice
c. Quality and Safety Education for Nurses
d. State Nurse Practice Act - ✔✔1. B: Standards of practice describe a competent level
of nursing based on the nursing process. Standards of Professional Performance
describe behavioral competencies expected of a nurse. Quality and Safety education for
nurses define specific competencies nurses need to possess to practice safely and
effectively. The state Nurse Practice Act defines nursing scope of practice in addition to
delegating patient care.
✔✔Two nurses are establishing a smoking cessation program to assist patients with
chronic lung disease to stop smoking. To offer the most effective program with the best
outcomes, the nurses should initially
a. search for an article that describes nursing interventions that are effective for
smoking cessation
b. develop a clinical question that will allow patients to compare different cessation
methods during the program
c. keep comprehensive records that detail each patient's progress and ultimate
outcomes from participation in the program
ANSWERS RATED A+
✔✔10. A patient with an obstruction of the common bile duct has clay-colored fatty
stools among other manifestations. What is the pathophysiologic change that causes
this manifestation?
a.Water-soluble (conjugated) bilirubin in the blood excreted into the urine
b.Absence of bilirubin and bile salts in the small intestine prevents conversion to
urobilinogen and fat emulsion and digestion
c.Contraction of the inflamed gallbladder and obstructed ducts stimulated by
cholecystokinin when fats enter the duodenum
d.Obstruction of the common duct prevents bile drainage into the duodenum, resulting
in congestion of bile in the liver and subsequent absorption into the blood - ✔✔Answer:
B
Absence of bilirubin and bile salts in the intestine lead to clay-colored stools and
steatorrhea. Soluble bilirubin in the blood excreted into the urine leads to dark urine.
Contraction of the inflamed gallbladder leads to pain with fatty food intake. Obstruction
of the common bile duct prevents bile drainage into the duodenum, with congestion of
bile in the liver. Bilirubin absorption in the blood leads to jaundice
✔✔11. After a laparoscopic cholecystectomy, what should the nurse expect to be part of
the plan of care?
a.Return to work in 2-3 weeks
b.Be hospitalized for 3-5 days postoperatively
c.Have a T-tube placed in the common bile duct to provide bile drainage
d.Have up to 4 abdominal incisions covered with small dressings. - ✔✔Answer: D
A t-tube is placed in the common bile duct after exploration of the duct during an
incisional cholecystectomy
✔✔12. During discharge instructions for a patient following a laparoscopic
cholecystectomy, what should the nurse include in the discharge teaching?
a.Keep the incision area clean and dry for at least a week
b.Report the need to take pain medications for shoulder pain
c.Report any bile colored or purulent drainage from the incision
d.Expect some postoperative nausea and vomiting for several days - ✔✔Answer: C
This could indicate an infection.
b. Referred shoulder pain is a common and expected problem following lap procedures,
when carbon dioxide used to inflate the abdominal cavity is not readily absorbed by the
body. Nausea and vomiting are not expected postop and may indicate damage to other
abdominal organs
✔✔13. Which assessment finding would the nurse need to report most quickly to the
health care provider regarding a patient who has acute pancreatitis?
a.Nausea and vomiting
b.Hypotonic bowel sounds
,c.Muscle twitching and finger numbness
d.Upper abdominal tenderness and guarding - ✔✔c
Muscle twitching and finger numbness indicate hypocalcemia, which may lead to tetany
unless calcium gluconate is administered. Although the other findings also should be
reported to the health care provider, they do not indicate complications that require
rapid action.
✔✔14. Which response by the nurse best explains the purpose of ranitidine (Zantac) for
a patient who was admitted with bleeding esophageal varices?
a.The medication will reduce the risk for aspiration.
b.The medication will inhibit development of gastric ulcers.
c.The medication will prevent irritation of the enlarged veins.
d.The medication will decrease nausea and improve the appetite. - ✔✔c
✔✔15. Which assessment finding is of mostconcern for a patient with acute
pancreatitis?
a.Absent bowel sounds
b.Abdominal tenderness
c.Left upper quadrant pain
d.Palpable abdominal mass - ✔✔d
✔✔16. The nurse is planning care for a patient with acute severe pancreatitis. What is
the highest priority patient outcome?
a.Having fluid and electrolyte balance
b. Maintaining normal respiratory function
c. Expressing satisfaction with pain control
d. Developing no ongoing pancreatic disease - ✔✔b
✔✔17. A patient who has cirrhosis and esophageal varices is being treated with
propranolol (Inderal). Which finding is the best indicator to the nurse that the medication
has been effective?
a.The patient reports no chest pain.
b. Blood pressure is 130/80 mm Hg.
c. Stools test negative for occult blood.
d. The apical pulse rate is 68 beats/min. - ✔✔ANS: C
Because the purpose of -blocker therapy for patients with esophageal varices is to
decrease the risk for bleeding from esophageal varices, the best indicator of the
effectiveness for propranolol is the lack of blood in the stools. Although propranolol is
used to treat hypertension, angina, and tachycardia, the purpose for use in this patient
is to decrease the risk for bleeding from esophageal varices.
✔✔18. The nurse is caring for a patient who has cirrhosis. Which data obtained by the
nurse during the assessment will be of most concern?
a.The patient reports right upper-quadrant pain with palpation.
, b.The patient's hands flap back and forth when the arms are extended.
c. The patient has ascites and a 2-kg weight gain from the previous day.
d. The patient's abdominal skin has multiple spider-shaped blood vessels. - ✔✔b
✔✔19. A serum potassium level of 3.2 mEq/L (3.2 mmol/L) is reported for a patient with
cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide
(Lasix) due. Which action should the nurse take?
a.Withhold both drugs.
b. Administer both drugs.
c. Administer the furosemide.
d. Administer the spironolactone. - ✔✔d
✔✔20. A client admitted to the hospital with a suspected diagnosis of acute pancreatitis
is being assessed by the nurse. Which assessment findings would be consistent with
acute pancreatitis? Select all that apply
a.Diarrhea
b.Black, tarry stools
c.Hyperactive bowel sounds
d.Blue-grey color at the flank
e.Abdominal guarding and tenderness
f.Left upper quadrant pain with radiation the back. - ✔✔d e f
✔✔When guiding nursing in how to perform professionally, which describes a
competent level of nursing care based on the nursing process?
a. Standards of Professional Performance
b. Standards of Practice
c. Quality and Safety Education for Nurses
d. State Nurse Practice Act - ✔✔1. B: Standards of practice describe a competent level
of nursing based on the nursing process. Standards of Professional Performance
describe behavioral competencies expected of a nurse. Quality and Safety education for
nurses define specific competencies nurses need to possess to practice safely and
effectively. The state Nurse Practice Act defines nursing scope of practice in addition to
delegating patient care.
✔✔Two nurses are establishing a smoking cessation program to assist patients with
chronic lung disease to stop smoking. To offer the most effective program with the best
outcomes, the nurses should initially
a. search for an article that describes nursing interventions that are effective for
smoking cessation
b. develop a clinical question that will allow patients to compare different cessation
methods during the program
c. keep comprehensive records that detail each patient's progress and ultimate
outcomes from participation in the program
