NR 324 Adult Health II Exam 4 Practice Questions 2026 |Chamberlain
College
1. A patient with cirrhosis and hepatic encephalopathy is prescribed lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce the risk of gastrointestinal bleeding
B. To decrease serum ammonia levels by promoting excretion through stool
C. To increase the absorption of dietary proteins
D. To treat underlying bacterial infections in the gut
Answer: B
Rationale: Lactulose works by trapping ammonia in the gut and promoting its excretion
through bowel movements, which helps alleviate the neurotoxic effects of hepatic
encephalopathy.
2. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Serum amylase
B. Serum lipase
C. Blood urea nitrogen (BUN)
D. Aspartate aminotransferase (AST)
Answer: B
Rationale: Serum lipase is more specific to the pancreas and stays elevated longer than
amylase, making it a more reliable diagnostic marker for acute pancreatitis.
,3. A client is diagnosed with prerenal acute kidney injury (AKI). What is a
common cause of this condition?
A. Nephrotoxic drugs like aminoglycosides
B. Bladder outlet obstruction
C. Glomerulonephritis
D. Hypovolemia due to hemorrhage or dehydration
Answer: D
Rationale: Prerenal AKI is caused by factors that reduce systemic blood flow to the
kidneys, such as hypovolemia, heart failure, or decreased cardiac output.
4. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, the
nurse should perform which action?
A. Draw blood samples from the fistula for routine labs
B. Apply a blood pressure cuff to the arm with the fistula
C. Palpate for a thrill and auscultate for a bruit
D. Ensure the fistula is covered with a tight pressure dressing
Answer: C
Rationale: A functional AV fistula should have a palpable thrill and an audible bruit, which
indicate adequate blood flow through the access point.
5. In the management of Diabetic Ketoacidosis (DKA), which type of insulin is
administered intravenously?
A. Insulin Glargine (Lantus)
B. Insulin Lispro (Humalog)
C. NPH Insulin
D. Regular Insulin (Humulin R)
Answer: D
Rationale: Regular insulin is the only insulin that can be safely administered intravenously
for the rapid correction of blood glucose and ketones in DKA.
, 6. Which clinical manifestation is expected in a patient experiencing a Thyroid
Storm?
A. Hyperthermia, tachycardia, and agitation
B. Bradycardia and hypothermia
C. Weight gain and constipation
D. Hypotension and lethargy
Answer: A
Rationale: Thyroid storm is a life-threatening hypermetabolic state characterized by high
fever (hyperthermia), severe tachycardia, and central nervous system effects like agitation.
7. A patient with cirrhosis has significant ascites. Which dietary modification
should the nurse prioritize?
A. High-sodium diet
B. Fluid restriction and low-sodium diet
C. Low-protein, high-fat diet
D. High-potassium diet
Answer: B
Rationale: Sodium restriction is essential to minimize fluid retention, and fluid restriction
may be necessary if hyponatremia is present in patients with ascites.
8. The nurse notes a bluish discoloration around the umbilicus in a patient with
acute pancreatitis. This is known as:
A. Cullen’s sign
B. Murphy’s sign
C. Turner’s sign
D. Chvostek’s sign
Answer: A
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage.
College
1. A patient with cirrhosis and hepatic encephalopathy is prescribed lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce the risk of gastrointestinal bleeding
B. To decrease serum ammonia levels by promoting excretion through stool
C. To increase the absorption of dietary proteins
D. To treat underlying bacterial infections in the gut
Answer: B
Rationale: Lactulose works by trapping ammonia in the gut and promoting its excretion
through bowel movements, which helps alleviate the neurotoxic effects of hepatic
encephalopathy.
2. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Serum amylase
B. Serum lipase
C. Blood urea nitrogen (BUN)
D. Aspartate aminotransferase (AST)
Answer: B
Rationale: Serum lipase is more specific to the pancreas and stays elevated longer than
amylase, making it a more reliable diagnostic marker for acute pancreatitis.
,3. A client is diagnosed with prerenal acute kidney injury (AKI). What is a
common cause of this condition?
A. Nephrotoxic drugs like aminoglycosides
B. Bladder outlet obstruction
C. Glomerulonephritis
D. Hypovolemia due to hemorrhage or dehydration
Answer: D
Rationale: Prerenal AKI is caused by factors that reduce systemic blood flow to the
kidneys, such as hypovolemia, heart failure, or decreased cardiac output.
4. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, the
nurse should perform which action?
A. Draw blood samples from the fistula for routine labs
B. Apply a blood pressure cuff to the arm with the fistula
C. Palpate for a thrill and auscultate for a bruit
D. Ensure the fistula is covered with a tight pressure dressing
Answer: C
Rationale: A functional AV fistula should have a palpable thrill and an audible bruit, which
indicate adequate blood flow through the access point.
5. In the management of Diabetic Ketoacidosis (DKA), which type of insulin is
administered intravenously?
A. Insulin Glargine (Lantus)
B. Insulin Lispro (Humalog)
C. NPH Insulin
D. Regular Insulin (Humulin R)
Answer: D
Rationale: Regular insulin is the only insulin that can be safely administered intravenously
for the rapid correction of blood glucose and ketones in DKA.
, 6. Which clinical manifestation is expected in a patient experiencing a Thyroid
Storm?
A. Hyperthermia, tachycardia, and agitation
B. Bradycardia and hypothermia
C. Weight gain and constipation
D. Hypotension and lethargy
Answer: A
Rationale: Thyroid storm is a life-threatening hypermetabolic state characterized by high
fever (hyperthermia), severe tachycardia, and central nervous system effects like agitation.
7. A patient with cirrhosis has significant ascites. Which dietary modification
should the nurse prioritize?
A. High-sodium diet
B. Fluid restriction and low-sodium diet
C. Low-protein, high-fat diet
D. High-potassium diet
Answer: B
Rationale: Sodium restriction is essential to minimize fluid retention, and fluid restriction
may be necessary if hyponatremia is present in patients with ascites.
8. The nurse notes a bluish discoloration around the umbilicus in a patient with
acute pancreatitis. This is known as:
A. Cullen’s sign
B. Murphy’s sign
C. Turner’s sign
D. Chvostek’s sign
Answer: A
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage.
