ADULT 2 ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ CMP.
Answer: Liver function test (LFT) ALTAST AmylaseLipase Albumin
◍ Ulcerative Colitis.
Answer: Pathophys: Often starts in teens, peaks in 30s, affects ONLY colon
and rectum, affects mucus layer - inner lining only, bowel wall narrows,
thickens, fibrotic. Varies in severityClinical manifestations: Frequent
diarrhea with blood and mucous, abd pain LLQ/cramping, anorexia, weight
loss, vomiting, electrolyte imbalances, fatigue, weakness, fever,
anemiaDiagnosis: Colonoscopy (best), abd xray, stool sample - blood to rule
out other causes. Labs: Low H&H, high WBC, electrolytesTreatment: Goal
to reduce exacerbations, aminosalicylates - sulfasalazine for local effect to
decrease inflammation (AE - HA, N/D), corticosteroids, Immunomodulators
to alter immune response, monitor for pancytopenia, infections due to
suppression of bone marrow, liver toxic!!!Treat nutritional deficiencies,
avoid aggravating foods.
◍ What labs should be monitored for warfarin?.
Answer: PT/INR (have to get blood work done once or twice a week to
monitor levels and adjust dosing)
◍ What is sudden cardiac death?.
Answer: - Death from a cardiac cause- Majority of SCDs result from
ventricular dysrhythmias (ventricular tachycardia, ventricular fibrillation)
◍ What education should be given to patients on warfarin?.
Answer: Education on vitamin K and diet modification: watch for
consumption of foods high in vitamin K
◍ What is the medical and nursing management of septic shock?.
, Answer: - Assess risk factors and signs of infection- Assessment tools:
SOFA and MEWSTreat promptly to correct underlying causes:- Fluid
replacement- Pharmacologic treatment (ex: norepinephrine to increase organ
perfusion)- Nutritional therapy: early enteral feeding with increased protein
◍ What is the medical management for tumor lysis syndrome?.
Answer: - Adequate hydration (IV fluids; need to be hydrated so they can
break down and pass the pieces)- Life-threatening complications-
Medication: Kayexalate, which lowers potassium
◍ What needle size is used for prefilled sub-q heparin?.
Answer: 27 g
◍ What is type 2 heparin-induced thrombocytopenia (HIT)?.
Answer: Less common and more severe
◍ Menopause.
Answer: Clinical manifestations: Systemic effects: increase in overall body
fat, cholesterol increase, hot flashes, mood swings, fatigue,
irritabilityMedical management: Hormone therapy: estrogen or
estrogen/progestin comboNursing management: Prevent complications
◍ What is the nursing management for heparin-induced thrombocytopenia
(HIT)?.
Answer: - Decrease the incidence of heparin exposure- Maintain
surveillance for complications- Provide comfort and emotional support-
Educate the patient and family
◍ What is anaphylactic shock?.
Answer: Body's immune reaction causes low BP and narrowing airway
◍ What is the pathophysiology of anaphylactic shock?.
Answer: - Previously produced antibodies are exposed to an antigen and
develop a systemic reaction (immunoglobulin E-mediated response)- Mast
cells release potent vasoactive substances (histamine, bradykinin causing
vasodilation, increased HR)- Inflammation with significant vasodilation and
capillary permeability
, ◍ Absolute neutrophile count.
Answer: Less than 1,500 would be neutropenia
◍ Female common reproductive infections.
Answer: Genital herpes (HSV2): Lifelong viral infection from direct
contact, intercourse during a partner outbreak increases the risk of
contracting. Sx: Recurrent painful blisters or asymptomatic. Prevention
(abstinence during outbreaks, protection, self-infection prevention), consider
painHuman papillomavirus (HPV): Most common STI in US, Sx (wart
growths on vulva, vagina, cervix, and anus). Prevention is key (Gardasil 9) 3
IM injections, education for those at riskOther: Candidiasis (yeast infection),
bacterial vaginosis (multiple sex partners, high risk in smokers, with STIs,
female same-sex partners), trichomoniasis (a common STI from parasite,
70-85% are asymptomatic, but can contribute to PID, infertility, adverse
pregnancy outcomes. Atrophic vaginitis: Caused lack of estrogen
◍ Endoscopic procedures.
Answer: EGD: NPO 8H prior, moderate sedation, local anesthetic, left
lateral position, gag reflex, perforation Colonoscopy: Adequate colonic
cleansing, left lateral with knees drawn up; may have to reposition during
test, risk for perforation
◍ Small Bowel Obstruction.
Answer: Clinical Manifestations: Initially crampy and colicky pain, possible
visible peristaltic waves, vomiting profuse/projectile (w/ stomach contents
-> bile-stained contents -> fecal matter, upper abd distention, hyperactive
bowel sounds proximally, and hypoactive sounds distallyDiagnostic
findings & medical management: ABD x-ray and CT (large quantities of gas
and/or fluid in the intestines, may see collapsed bowel. Labs: Electrolytes,
CBC: possible infection, loss of plasma volume. Decompression with NG
tube (typically to 3 days), surgical intervention. Prevent complications:
Profound dehydration, severe electrolyte disturbances, ischemia/necrosis,
rupture/perforation, sepsis/peritonitis
◍ Hiatal Hernia.
QUESTIONS WITH ANSWERS GRADED A+
◍ CMP.
Answer: Liver function test (LFT) ALTAST AmylaseLipase Albumin
◍ Ulcerative Colitis.
Answer: Pathophys: Often starts in teens, peaks in 30s, affects ONLY colon
and rectum, affects mucus layer - inner lining only, bowel wall narrows,
thickens, fibrotic. Varies in severityClinical manifestations: Frequent
diarrhea with blood and mucous, abd pain LLQ/cramping, anorexia, weight
loss, vomiting, electrolyte imbalances, fatigue, weakness, fever,
anemiaDiagnosis: Colonoscopy (best), abd xray, stool sample - blood to rule
out other causes. Labs: Low H&H, high WBC, electrolytesTreatment: Goal
to reduce exacerbations, aminosalicylates - sulfasalazine for local effect to
decrease inflammation (AE - HA, N/D), corticosteroids, Immunomodulators
to alter immune response, monitor for pancytopenia, infections due to
suppression of bone marrow, liver toxic!!!Treat nutritional deficiencies,
avoid aggravating foods.
◍ What labs should be monitored for warfarin?.
Answer: PT/INR (have to get blood work done once or twice a week to
monitor levels and adjust dosing)
◍ What is sudden cardiac death?.
Answer: - Death from a cardiac cause- Majority of SCDs result from
ventricular dysrhythmias (ventricular tachycardia, ventricular fibrillation)
◍ What education should be given to patients on warfarin?.
Answer: Education on vitamin K and diet modification: watch for
consumption of foods high in vitamin K
◍ What is the medical and nursing management of septic shock?.
, Answer: - Assess risk factors and signs of infection- Assessment tools:
SOFA and MEWSTreat promptly to correct underlying causes:- Fluid
replacement- Pharmacologic treatment (ex: norepinephrine to increase organ
perfusion)- Nutritional therapy: early enteral feeding with increased protein
◍ What is the medical management for tumor lysis syndrome?.
Answer: - Adequate hydration (IV fluids; need to be hydrated so they can
break down and pass the pieces)- Life-threatening complications-
Medication: Kayexalate, which lowers potassium
◍ What needle size is used for prefilled sub-q heparin?.
Answer: 27 g
◍ What is type 2 heparin-induced thrombocytopenia (HIT)?.
Answer: Less common and more severe
◍ Menopause.
Answer: Clinical manifestations: Systemic effects: increase in overall body
fat, cholesterol increase, hot flashes, mood swings, fatigue,
irritabilityMedical management: Hormone therapy: estrogen or
estrogen/progestin comboNursing management: Prevent complications
◍ What is the nursing management for heparin-induced thrombocytopenia
(HIT)?.
Answer: - Decrease the incidence of heparin exposure- Maintain
surveillance for complications- Provide comfort and emotional support-
Educate the patient and family
◍ What is anaphylactic shock?.
Answer: Body's immune reaction causes low BP and narrowing airway
◍ What is the pathophysiology of anaphylactic shock?.
Answer: - Previously produced antibodies are exposed to an antigen and
develop a systemic reaction (immunoglobulin E-mediated response)- Mast
cells release potent vasoactive substances (histamine, bradykinin causing
vasodilation, increased HR)- Inflammation with significant vasodilation and
capillary permeability
, ◍ Absolute neutrophile count.
Answer: Less than 1,500 would be neutropenia
◍ Female common reproductive infections.
Answer: Genital herpes (HSV2): Lifelong viral infection from direct
contact, intercourse during a partner outbreak increases the risk of
contracting. Sx: Recurrent painful blisters or asymptomatic. Prevention
(abstinence during outbreaks, protection, self-infection prevention), consider
painHuman papillomavirus (HPV): Most common STI in US, Sx (wart
growths on vulva, vagina, cervix, and anus). Prevention is key (Gardasil 9) 3
IM injections, education for those at riskOther: Candidiasis (yeast infection),
bacterial vaginosis (multiple sex partners, high risk in smokers, with STIs,
female same-sex partners), trichomoniasis (a common STI from parasite,
70-85% are asymptomatic, but can contribute to PID, infertility, adverse
pregnancy outcomes. Atrophic vaginitis: Caused lack of estrogen
◍ Endoscopic procedures.
Answer: EGD: NPO 8H prior, moderate sedation, local anesthetic, left
lateral position, gag reflex, perforation Colonoscopy: Adequate colonic
cleansing, left lateral with knees drawn up; may have to reposition during
test, risk for perforation
◍ Small Bowel Obstruction.
Answer: Clinical Manifestations: Initially crampy and colicky pain, possible
visible peristaltic waves, vomiting profuse/projectile (w/ stomach contents
-> bile-stained contents -> fecal matter, upper abd distention, hyperactive
bowel sounds proximally, and hypoactive sounds distallyDiagnostic
findings & medical management: ABD x-ray and CT (large quantities of gas
and/or fluid in the intestines, may see collapsed bowel. Labs: Electrolytes,
CBC: possible infection, loss of plasma volume. Decompression with NG
tube (typically to 3 days), surgical intervention. Prevent complications:
Profound dehydration, severe electrolyte disturbances, ischemia/necrosis,
rupture/perforation, sepsis/peritonitis
◍ Hiatal Hernia.
