NR 324 Adult Health II Exam 9 Practice 2026 |Chamberlain College
1. A patient with a history of cirrhosis is admitted with suspected hepatic
encephalopathy. Which laboratory finding is most consistent with this
diagnosis?
A. Elevated serum creatinine
B. Increased serum ammonia
C. Decreased serum potassium
D. Elevated serum amylase
Answer: B
Rationale: In hepatic encephalopathy, the liver is unable to convert ammonia into urea,
leading to toxic levels of ammonia crossing the blood-brain barrier.
2. When caring for a patient on mechanical ventilation, the nurse notes that the
high-pressure alarm is sounding. Which action should the nurse take first?
A. Check for a disconnection in the circuit
B. Notify the respiratory therapist immediately
C. Check the patient’s oxygen saturation
D. Suction the patient for possible secretions
Answer: D
Rationale: High-pressure alarms are often triggered by obstructions such as secretions,
coughing, or biting the tube; suctioning is an appropriate initial intervention.
,3. A patient is diagnosed with Diabetes Insipidus (DI). What urinary finding
should the nurse expect?
A. Urine specific gravity of 1.035
B. High glucose concentration in urine
C. Presence of ketones in the urine
D. Urine specific gravity of 1.002
Answer: D
Rationale: DI results in the excretion of large amounts of dilute urine, which is
characterized by a very low specific gravity (typically less than 1.005).
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. What is the primary rationale for this intervention?
A. To improve cardiac output
B. To reduce the risk of aspiration
C. To decrease the patient’s work of breathing
D. To improve oxygenation by redistributing blood flow
Answer: D
Rationale: Prone positioning helps recruit collapsed alveoli in the posterior lung fields and
improves ventilation-perfusion matching, thereby improving oxygenation.
5. Which EKG rhythm is characterized by a ‘sawtooth’ pattern and requires
monitoring for potential blood clots?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree Heart Block
Answer: A
Rationale: Atrial Flutter is known for its sawtooth P-wave appearance; like A-fib, it
increases the risk of thrombus formation due to atrial stasis.
, 6. A patient in the ICU has a serum potassium level of 6.8 mEq/L. Which EKG
change is most likely to be seen?
A. Prominent U waves
B. ST-segment depression
C. Prolonged QT interval
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves, which can
progress to QRS widening and cardiac arrest.
7. What is the hallmark clinical manifestation of a tension pneumothorax?
A. Hyperresonance on the affected side
B. Tracheal deviation to the unaffected side
C. Dullness on percussion
D. Increased breath sounds on the affected side
Answer: B
Rationale: Tension pneumothorax causes a shift in mediastinal structures, leading to
tracheal deviation away from the affected side, which is a medical emergency.
8. A patient is exhibiting signs of SIADH. Which electrolyte abnormality is the
nurse most concerned about?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Rationale: SIADH leads to excessive water retention, which dilutes the serum sodium,
causing dilutional hyponatremia.
1. A patient with a history of cirrhosis is admitted with suspected hepatic
encephalopathy. Which laboratory finding is most consistent with this
diagnosis?
A. Elevated serum creatinine
B. Increased serum ammonia
C. Decreased serum potassium
D. Elevated serum amylase
Answer: B
Rationale: In hepatic encephalopathy, the liver is unable to convert ammonia into urea,
leading to toxic levels of ammonia crossing the blood-brain barrier.
2. When caring for a patient on mechanical ventilation, the nurse notes that the
high-pressure alarm is sounding. Which action should the nurse take first?
A. Check for a disconnection in the circuit
B. Notify the respiratory therapist immediately
C. Check the patient’s oxygen saturation
D. Suction the patient for possible secretions
Answer: D
Rationale: High-pressure alarms are often triggered by obstructions such as secretions,
coughing, or biting the tube; suctioning is an appropriate initial intervention.
,3. A patient is diagnosed with Diabetes Insipidus (DI). What urinary finding
should the nurse expect?
A. Urine specific gravity of 1.035
B. High glucose concentration in urine
C. Presence of ketones in the urine
D. Urine specific gravity of 1.002
Answer: D
Rationale: DI results in the excretion of large amounts of dilute urine, which is
characterized by a very low specific gravity (typically less than 1.005).
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. What is the primary rationale for this intervention?
A. To improve cardiac output
B. To reduce the risk of aspiration
C. To decrease the patient’s work of breathing
D. To improve oxygenation by redistributing blood flow
Answer: D
Rationale: Prone positioning helps recruit collapsed alveoli in the posterior lung fields and
improves ventilation-perfusion matching, thereby improving oxygenation.
5. Which EKG rhythm is characterized by a ‘sawtooth’ pattern and requires
monitoring for potential blood clots?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree Heart Block
Answer: A
Rationale: Atrial Flutter is known for its sawtooth P-wave appearance; like A-fib, it
increases the risk of thrombus formation due to atrial stasis.
, 6. A patient in the ICU has a serum potassium level of 6.8 mEq/L. Which EKG
change is most likely to be seen?
A. Prominent U waves
B. ST-segment depression
C. Prolonged QT interval
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves, which can
progress to QRS widening and cardiac arrest.
7. What is the hallmark clinical manifestation of a tension pneumothorax?
A. Hyperresonance on the affected side
B. Tracheal deviation to the unaffected side
C. Dullness on percussion
D. Increased breath sounds on the affected side
Answer: B
Rationale: Tension pneumothorax causes a shift in mediastinal structures, leading to
tracheal deviation away from the affected side, which is a medical emergency.
8. A patient is exhibiting signs of SIADH. Which electrolyte abnormality is the
nurse most concerned about?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Rationale: SIADH leads to excessive water retention, which dilutes the serum sodium,
causing dilutional hyponatremia.
