417 FINAL EXAM QUESTIONS WITH CORRECT
ANSWERS 2025/2026
Which finding indicates to the nurse that demeclocycline has been effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. Weight has increased.
2. Urinary output has increased.
3. Peripheral edema has increased.
4. Urine specific gravity has increased. - CORRECT ANSWER -2. Urinary output has increased.
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and
increases urine output, producing more dilute urine. An increase in weight or an increase in
urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur
with SIADH. A sudden weight gain without edema is a common clinical manifestation of this
disorder.
Which patient statement indicates to the nurse that further instruction is needed about chronic
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. "I should weigh myself daily and report sudden weight loss or gain."
2. "I need to shop for foods low in sodium and avoid adding salt to food."
3. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
4. "I should eat foods high in potassium because diuretics cause potassium loss." - CORRECT
ANSWER -2. "I need to shop for foods low in sodium and avoid adding salt to food."
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed.
The other patient statements are correct and indicate successful teaching has occurred.
,A patient who is disoriented and reports a headache and muscle cramps is hospitalized with
syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would
the nurse expect?
1. Elevated hematocrit
2. Decreased serum sodium
3. Increased serum chloride
4. Low urine specific gravity - CORRECT ANSWER -2. Decreased serum sodium
When water is retained, the serum sodium level will drop below normal, causing the clinical
manifestations reported by the patient. The hematocrit will decrease because of the dilution
caused by water retention. Urine will be more concentrated with a higher specific gravity. The
serum chloride level will usually decrease along with the sodium level.
Which intervention will the nurse include in the plan of care for a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
1. Encourage fluids to 2 to 3 L/day.
2.cKeepcheadcofcbedcelevatedctoc30cdegrees.
3.cMonitorcforcincreasingcperipheralcedema.
4.cOffercthecpatientcsugarlesscgumctocchew.c-cCORRECTcANSWERc-4.cOffercthecpatientcsugarless
gumctocchew.
Chewingconcsugarlesscgumcdecreasescthirstcforcacpatientconcfluidcrestriction.cPatientscwithcSIADH
areconcfluidcrestrictionscofc800ctoc1000cmL/day.cPeripheralcedemaciscnotcseencwithcSIADH.cThe
headcofcthecbedciscelevatedcnocmorecthanc10cdegreesctocincreasecleſtcatrialcfillingcpressurecand
decreasecantidiureticchormonec(ADH)crelease.
,c
Whichcinformationciscmostcimportantcforcthecnursectoccommunicatecrapidlyctocthechealthccare
providercaboutcacpatientcadmittedcwithcpossiblecsyndromecofcinappropriatecantidiuretic
hormonec(SIADH)?
1.cThecpatientchascacweightcgaincofc9cpounds.
2.cThecpatientcreportscsomecdyspneacwithcactivity.
3.cThecpatientchascacserumcsodiumclevelcofc118cmEq/L.
4.cThecpatientchascacurinecspecificcgravitycofc1.025.c-cCORRECTcANSWERc-3.cThecpatientchasca
serumcsodiumclevelcofc118cmEq/L.
Acserumcsodiumcofclesscthanc120cmEq/Lcincreasescthecriskcforccomplicationscsuchcascseizurescand
needscrapidccorrection.cThecothercdatacarecnotcunusualcforcacpatientcwithcSIADHcandcdocnot
indicatecthecneedcforcrapidcaction.
Familycmemberscofcacpatientcwhochascactraumaticcbraincinjurycaskcthecnursecaboutcthecpurpose
ofcthecventriculostomycsystemcbeingcusedcforcintracranialcpressurecmonitoring.cWhichcstatement
bycthecnursecwouldcbecthecbestcinitialcresponsecforcthiscsituation?
1.c"Thisciscaccomplexctypecofcmonitoringcsystem,candcitciscmanagedcbycskilledcstaff."
2.c"Thecsystemcmeasurescpressuresctocdeterminecwhethercbloodcflowctocthecbrainciscadequate."
3.c"Thecventriculostomycmonitoringcsystemchelpsccheckcforcchangescinccerebralcperfusion
pressure."
4.c"Thiscmonitoringcsystemchascmanycbenefits,cincludingcthecabilityctocdrainccerebrospinalcfluid."
- CORRECTcANSWERc-2.c"Thecsystemcmeasurescpressuresctocdeterminecwhethercbloodcflowcto
thecbrainciscadequate."
Short,csimple,candcaccuratecexplanationscshouldcbecgivencinitiallyctocpatientscandcfamily
members.cExplainingcthatcthecsystemcisccomplex,candcitciscmanagedcbycskilledcstaffcorcthatcitchas
multiplecbenefitscdoescnotcaddresscthecfamilycquestioncaboutcpurposecforcthiscpatient.
,c
Terminologycsuchcascventriculostomycandccerebralcperfusioncpressurecisctooccomplexcforcthe
initialcexplanationcandcmaycincreasecfamilycmembers'canxiety.
Admissioncvitalcsignscforcacpatientcwhochascacbraincinjurycarecbloodcpressurecofc128/68cmmcHg,
pulsecofc110cbeats/min,candcofcrespirationsc26cbreaths/min.cWhichcsetcofcvitalcsigns,cifctakenc1
hourclater,cwillcbecofcmostcconcernctocthecnurse?
1.cBloodcpressurec154/68cmmcHg,cpulsec56cbeats/min,crespirationsc12cbreaths/min
2.cBloodcpressurec134/72cmmcHg,cpulsec90cbeats/min,crespirationsc32cbreaths/min
3.cBloodcpressurec148/78cmmcHg,cpulsec112cbeats/min,crespirationsc28cbreaths/min
4.cBloodcpressurec110/70cmmcHg,cpulsec120cbeats/min,crespirationsc30cbreaths/minc-cCORRECT
ANSWERc-1.cBloodcpressurec154/68cmmcHg,cpulsec56cbeats/min,crespirationsc12cbreaths/min
Systolicchypertensioncwithcwideningcpulsecpressure,cbradycardia,candcrespiratorycchanges
representcCushing'sctriad.cThesecfindingscindicatecthatcthecintracranialcpressurec(ICP)chas
increased,candcbraincherniationcmaycbecimminentcunlesscimmediatecactioncisctakenctocreduce
ICP.cThecothercvitalcsignscmaycindicatecthecneedcforcchangescinctreatment,cbutctheycarecnot
indicativecofcancimmediatelyclife-threateningcprocess.
Whencacbrain-injuredcpatientcrespondsctocnailcbedcpressurecwithcinternalcrotation,cadduction,
andcflexioncofcthecarms,chowcwouldcthecnursecreportcthecresponse?
1.cFlexioncwithdrawal
2.cLocalizationcofcpain
3.cDecorticatecposturing
4.cDecerebratecposturingc-cCORRECTcANSWERc-3.cDecorticatecposturing
ANSWERS 2025/2026
Which finding indicates to the nurse that demeclocycline has been effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. Weight has increased.
2. Urinary output has increased.
3. Peripheral edema has increased.
4. Urine specific gravity has increased. - CORRECT ANSWER -2. Urinary output has increased.
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and
increases urine output, producing more dilute urine. An increase in weight or an increase in
urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur
with SIADH. A sudden weight gain without edema is a common clinical manifestation of this
disorder.
Which patient statement indicates to the nurse that further instruction is needed about chronic
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. "I should weigh myself daily and report sudden weight loss or gain."
2. "I need to shop for foods low in sodium and avoid adding salt to food."
3. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
4. "I should eat foods high in potassium because diuretics cause potassium loss." - CORRECT
ANSWER -2. "I need to shop for foods low in sodium and avoid adding salt to food."
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed.
The other patient statements are correct and indicate successful teaching has occurred.
,A patient who is disoriented and reports a headache and muscle cramps is hospitalized with
syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would
the nurse expect?
1. Elevated hematocrit
2. Decreased serum sodium
3. Increased serum chloride
4. Low urine specific gravity - CORRECT ANSWER -2. Decreased serum sodium
When water is retained, the serum sodium level will drop below normal, causing the clinical
manifestations reported by the patient. The hematocrit will decrease because of the dilution
caused by water retention. Urine will be more concentrated with a higher specific gravity. The
serum chloride level will usually decrease along with the sodium level.
Which intervention will the nurse include in the plan of care for a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
1. Encourage fluids to 2 to 3 L/day.
2.cKeepcheadcofcbedcelevatedctoc30cdegrees.
3.cMonitorcforcincreasingcperipheralcedema.
4.cOffercthecpatientcsugarlesscgumctocchew.c-cCORRECTcANSWERc-4.cOffercthecpatientcsugarless
gumctocchew.
Chewingconcsugarlesscgumcdecreasescthirstcforcacpatientconcfluidcrestriction.cPatientscwithcSIADH
areconcfluidcrestrictionscofc800ctoc1000cmL/day.cPeripheralcedemaciscnotcseencwithcSIADH.cThe
headcofcthecbedciscelevatedcnocmorecthanc10cdegreesctocincreasecleſtcatrialcfillingcpressurecand
decreasecantidiureticchormonec(ADH)crelease.
,c
Whichcinformationciscmostcimportantcforcthecnursectoccommunicatecrapidlyctocthechealthccare
providercaboutcacpatientcadmittedcwithcpossiblecsyndromecofcinappropriatecantidiuretic
hormonec(SIADH)?
1.cThecpatientchascacweightcgaincofc9cpounds.
2.cThecpatientcreportscsomecdyspneacwithcactivity.
3.cThecpatientchascacserumcsodiumclevelcofc118cmEq/L.
4.cThecpatientchascacurinecspecificcgravitycofc1.025.c-cCORRECTcANSWERc-3.cThecpatientchasca
serumcsodiumclevelcofc118cmEq/L.
Acserumcsodiumcofclesscthanc120cmEq/Lcincreasescthecriskcforccomplicationscsuchcascseizurescand
needscrapidccorrection.cThecothercdatacarecnotcunusualcforcacpatientcwithcSIADHcandcdocnot
indicatecthecneedcforcrapidcaction.
Familycmemberscofcacpatientcwhochascactraumaticcbraincinjurycaskcthecnursecaboutcthecpurpose
ofcthecventriculostomycsystemcbeingcusedcforcintracranialcpressurecmonitoring.cWhichcstatement
bycthecnursecwouldcbecthecbestcinitialcresponsecforcthiscsituation?
1.c"Thisciscaccomplexctypecofcmonitoringcsystem,candcitciscmanagedcbycskilledcstaff."
2.c"Thecsystemcmeasurescpressuresctocdeterminecwhethercbloodcflowctocthecbrainciscadequate."
3.c"Thecventriculostomycmonitoringcsystemchelpsccheckcforcchangescinccerebralcperfusion
pressure."
4.c"Thiscmonitoringcsystemchascmanycbenefits,cincludingcthecabilityctocdrainccerebrospinalcfluid."
- CORRECTcANSWERc-2.c"Thecsystemcmeasurescpressuresctocdeterminecwhethercbloodcflowcto
thecbrainciscadequate."
Short,csimple,candcaccuratecexplanationscshouldcbecgivencinitiallyctocpatientscandcfamily
members.cExplainingcthatcthecsystemcisccomplex,candcitciscmanagedcbycskilledcstaffcorcthatcitchas
multiplecbenefitscdoescnotcaddresscthecfamilycquestioncaboutcpurposecforcthiscpatient.
,c
Terminologycsuchcascventriculostomycandccerebralcperfusioncpressurecisctooccomplexcforcthe
initialcexplanationcandcmaycincreasecfamilycmembers'canxiety.
Admissioncvitalcsignscforcacpatientcwhochascacbraincinjurycarecbloodcpressurecofc128/68cmmcHg,
pulsecofc110cbeats/min,candcofcrespirationsc26cbreaths/min.cWhichcsetcofcvitalcsigns,cifctakenc1
hourclater,cwillcbecofcmostcconcernctocthecnurse?
1.cBloodcpressurec154/68cmmcHg,cpulsec56cbeats/min,crespirationsc12cbreaths/min
2.cBloodcpressurec134/72cmmcHg,cpulsec90cbeats/min,crespirationsc32cbreaths/min
3.cBloodcpressurec148/78cmmcHg,cpulsec112cbeats/min,crespirationsc28cbreaths/min
4.cBloodcpressurec110/70cmmcHg,cpulsec120cbeats/min,crespirationsc30cbreaths/minc-cCORRECT
ANSWERc-1.cBloodcpressurec154/68cmmcHg,cpulsec56cbeats/min,crespirationsc12cbreaths/min
Systolicchypertensioncwithcwideningcpulsecpressure,cbradycardia,candcrespiratorycchanges
representcCushing'sctriad.cThesecfindingscindicatecthatcthecintracranialcpressurec(ICP)chas
increased,candcbraincherniationcmaycbecimminentcunlesscimmediatecactioncisctakenctocreduce
ICP.cThecothercvitalcsignscmaycindicatecthecneedcforcchangescinctreatment,cbutctheycarecnot
indicativecofcancimmediatelyclife-threateningcprocess.
Whencacbrain-injuredcpatientcrespondsctocnailcbedcpressurecwithcinternalcrotation,cadduction,
andcflexioncofcthecarms,chowcwouldcthecnursecreportcthecresponse?
1.cFlexioncwithdrawal
2.cLocalizationcofcpain
3.cDecorticatecposturing
4.cDecerebratecposturingc-cCORRECTcANSWERc-3.cDecorticatecposturing
