RNSG 2539 EXAM QUESTIONS AND
ANSWERS ALL CORRECT 2026
LATEST UPDATE
A nurse is performing an admission assessment of a patient with a diagnosis of
cirrhosis. What technique should the nurse use to palpate the patient's liver?
A) Place hand under the right lower abdominal quadrant and press down lightly with the
other hand.
B) Place the left hand over the abdomen and behind the left side at the 11th rib.
C) Place hand under right lower rib cage and press down lightly with the other hand.
D) Hold hand 90 degrees to right side of the abdomen and push down firmly. - Answer-
C) Place hand under right lower rib cage and press down lightly with the other hand
A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse
responds that the mode of transmission is predominantly by: Select all that apply.
A) Intravenous drug use
B) Fecal-oral route
C) Unprotected sexual intercourse
D) Sharing oral secretions by kissing
E) Inhalation of airborne droplets - Answer- A) Intravenous drug use
C) Unprotected sexual intercourse
A nurse is caring for a patient who has been admitted for the treatment of advanced
cirrhosis. What assessment should the nurse prioritize in this patient's plan of care?
A) Measurement of abdominal girth and body weight
B) Assessment for variceal bleeding
C) Assessment for signs and symptoms of jaundice
D) Monitoring of results of liver function testing - Answer- B) Assessment for variceal
bleeding
What are the normal ranges for ALT, AST, and Bilirubin? - Answer- -AST is between 10
to 40 units per liter
-ALT is between 7 to 56 units per liter
- Bilirubin is 0.1 to 1.2 mg/dL
,GI affects of sepsis - Answer- -stress ulcers in stomach causing risk for GI bleeding.
-bloody diarrhea
-GI ischemia leading to organ dysfunction causing toxins to enter blood stream.
An example of hematologic effects of sepsis would be what? - Answer- DIC
What are the physiological responses to all types of shock? - Answer- -hypoperfusion of
tissues
-hypermetabolism
-activation of inflammatory response
How does the body respond to shock? - Answer- by activating the sympathetic nervous
system and mounting hypermetabolic and inflammatroy resonse
in example:
-HR, BP, and cardiac contractility will increase
-increase in respirations and O2 Sats
-renin-angitensin activation will increase leading to increase in resabsorption of sodium
and H2O, thus leading to increase in preload and decrease in urine output
-increase in catecholamines (hormones made by your adrenal glands: norepinephrine,
epinephrine, and dopamine) and cortisol to provide increase glucose for metabolism
What vasodilator would you give to treat CARDIOGENIC SHOCK?
What catecholamine?
What opioid?
What beta-agonist? - Answer- -nitroglycerine
-dopamine
-morphine sulfate: to improve coronary artery perfusion
-dobutamine: to increase force of contraction
What surgical interventions could be life-saving to a patient experiencing cardiogenic
shock? - Answer- -intra aortic ballon and ventricular assist device (VAD)
-percutaneous coronary intervention (PCI) or bypass surgery
What are the clinical manifestations of cardiogenic shock? Select all that apply?
A) decreased mentation
B) dyspnea and bradycardia
,C) systemic and pulmonary edema
D) yellow skin color
E) blood pressure of 182/101
F) urine output of 0.5 ml/kg/hr - Answer- A) decreased mentation
C) systemic and pulmonary edema
F) urine output of 0.5 ml/kg/hr
Feedback:
Results from impaired cellular metabolism; Neurological deficits like decreased
mentation will occur. The patient can experience dyspena and tachypnea and their skin
color would be "dusky". They would be HYPOTENSION of <60 mmHg.
Your patient has had an alteration in mental status with a blood pressure of 90/60,
temperature of 96.8 degrees Fahrenheit and, has cold-clammy skin. As the nurse, what
would be the most appropriate position to place this patient in?
A) supine, with head of bed raised to 30 degrees
B) prone, with legs elevated to 15 degrees
C) prone with legs lowered below patients head
D) supine with legs elevated higher than patient's head - Answer- D) supine with legs
elevated higher than patient's head
Feedback:
The patient is experiencing hypovolemic shock. By placing the patient in a modified
trendelenburg position or passive leg raising, assists with fluid redistribution and
promotes return of venous blood.
According to the "Surviving the sepsis campaign bundle," what would you complete
within 3 hours of the patient's symptoms? - Answer- -obtain serum lactate level
-obtain blood cultures BEFORE giving antibiotics
-give broad-spectrum antibiotics (
-initiate aggressive fluid resuscitation using crystalloid solutions at 30 ml/kg
What lab testing results are indicative of DIC? - Answer- -Prothrombin Time (PT)
-partial throboplastin time (PTT)
-Activated Partial Thrompoplastin Time (aPTT)
-Bleeding Time
-Thrombin Time
Decrease levels: -Fibrogen
-Platelets
-Clotine factor II, V, VIII, & X
and Antithrombin III
, The nurse is reviewing the laboratory test results of a child diagnosed with disseminated
intravascular coagulation (DIC). Which of the following would the nurse interpret as
indicative of this disorder?
A) Shortened prothrombin time
B) Increased fibrinogen level
C) Positive fibrin split products
D) Increased platelets - Answer- C) Positive fibrin split products
The nurse is caring for a postpartum patient admitted to the intensive care unit with a
diagnosis of disseminated intravascular coagulation (DIC). What is the drug of choice to
treat this problem?
A. Heparin
B. Urokinase
C. Aspirin
D. Warfarin - Answer- A.) Heparin
In the ICU, a postsurgical client has developed sepsis and is being treated with multiple
medications. During the mid-morning assessment, which finding leads the nurse to
suspect the client may be developing a complication called disseminated intravascular
coagulation (DIC)? Select all that apply.
A) Headaches associated with light sensitivity
B) Oozing from all previous puncture and intravenous sites
C) Decreased O2 saturation and diminished breath sounds in lower lobes
D) Hemorrhage from the surgical site requiring deep pressure dressings
E) Urine from the Foley catheter is bloody - Answer- D) Hemorrhage from the surgical
site requiring deep pressure dressings
A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago,
but the mother has experienced postpartum hemorrhage. Which of the following
disorders is most likely to underlie the client's excessive bleeding after delivery?
A) Disseminated intravascular coagulation
B) Hemophilia A
C) Von Willebrand disease
D) Thrombotic thrombocytopenic purpura (TTP) - Answer- A) Disseminated
intravascular coagulation
What is the concept behind heparin for PT with DIC? - Answer- -It prevents the clotting
phase from being completed which inhibits the breakdown of fibrinogen.
- It also helps avoid hemorrhage by preventing the body from depleting entire stage of
coagulation factors.
ANSWERS ALL CORRECT 2026
LATEST UPDATE
A nurse is performing an admission assessment of a patient with a diagnosis of
cirrhosis. What technique should the nurse use to palpate the patient's liver?
A) Place hand under the right lower abdominal quadrant and press down lightly with the
other hand.
B) Place the left hand over the abdomen and behind the left side at the 11th rib.
C) Place hand under right lower rib cage and press down lightly with the other hand.
D) Hold hand 90 degrees to right side of the abdomen and push down firmly. - Answer-
C) Place hand under right lower rib cage and press down lightly with the other hand
A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse
responds that the mode of transmission is predominantly by: Select all that apply.
A) Intravenous drug use
B) Fecal-oral route
C) Unprotected sexual intercourse
D) Sharing oral secretions by kissing
E) Inhalation of airborne droplets - Answer- A) Intravenous drug use
C) Unprotected sexual intercourse
A nurse is caring for a patient who has been admitted for the treatment of advanced
cirrhosis. What assessment should the nurse prioritize in this patient's plan of care?
A) Measurement of abdominal girth and body weight
B) Assessment for variceal bleeding
C) Assessment for signs and symptoms of jaundice
D) Monitoring of results of liver function testing - Answer- B) Assessment for variceal
bleeding
What are the normal ranges for ALT, AST, and Bilirubin? - Answer- -AST is between 10
to 40 units per liter
-ALT is between 7 to 56 units per liter
- Bilirubin is 0.1 to 1.2 mg/dL
,GI affects of sepsis - Answer- -stress ulcers in stomach causing risk for GI bleeding.
-bloody diarrhea
-GI ischemia leading to organ dysfunction causing toxins to enter blood stream.
An example of hematologic effects of sepsis would be what? - Answer- DIC
What are the physiological responses to all types of shock? - Answer- -hypoperfusion of
tissues
-hypermetabolism
-activation of inflammatory response
How does the body respond to shock? - Answer- by activating the sympathetic nervous
system and mounting hypermetabolic and inflammatroy resonse
in example:
-HR, BP, and cardiac contractility will increase
-increase in respirations and O2 Sats
-renin-angitensin activation will increase leading to increase in resabsorption of sodium
and H2O, thus leading to increase in preload and decrease in urine output
-increase in catecholamines (hormones made by your adrenal glands: norepinephrine,
epinephrine, and dopamine) and cortisol to provide increase glucose for metabolism
What vasodilator would you give to treat CARDIOGENIC SHOCK?
What catecholamine?
What opioid?
What beta-agonist? - Answer- -nitroglycerine
-dopamine
-morphine sulfate: to improve coronary artery perfusion
-dobutamine: to increase force of contraction
What surgical interventions could be life-saving to a patient experiencing cardiogenic
shock? - Answer- -intra aortic ballon and ventricular assist device (VAD)
-percutaneous coronary intervention (PCI) or bypass surgery
What are the clinical manifestations of cardiogenic shock? Select all that apply?
A) decreased mentation
B) dyspnea and bradycardia
,C) systemic and pulmonary edema
D) yellow skin color
E) blood pressure of 182/101
F) urine output of 0.5 ml/kg/hr - Answer- A) decreased mentation
C) systemic and pulmonary edema
F) urine output of 0.5 ml/kg/hr
Feedback:
Results from impaired cellular metabolism; Neurological deficits like decreased
mentation will occur. The patient can experience dyspena and tachypnea and their skin
color would be "dusky". They would be HYPOTENSION of <60 mmHg.
Your patient has had an alteration in mental status with a blood pressure of 90/60,
temperature of 96.8 degrees Fahrenheit and, has cold-clammy skin. As the nurse, what
would be the most appropriate position to place this patient in?
A) supine, with head of bed raised to 30 degrees
B) prone, with legs elevated to 15 degrees
C) prone with legs lowered below patients head
D) supine with legs elevated higher than patient's head - Answer- D) supine with legs
elevated higher than patient's head
Feedback:
The patient is experiencing hypovolemic shock. By placing the patient in a modified
trendelenburg position or passive leg raising, assists with fluid redistribution and
promotes return of venous blood.
According to the "Surviving the sepsis campaign bundle," what would you complete
within 3 hours of the patient's symptoms? - Answer- -obtain serum lactate level
-obtain blood cultures BEFORE giving antibiotics
-give broad-spectrum antibiotics (
-initiate aggressive fluid resuscitation using crystalloid solutions at 30 ml/kg
What lab testing results are indicative of DIC? - Answer- -Prothrombin Time (PT)
-partial throboplastin time (PTT)
-Activated Partial Thrompoplastin Time (aPTT)
-Bleeding Time
-Thrombin Time
Decrease levels: -Fibrogen
-Platelets
-Clotine factor II, V, VIII, & X
and Antithrombin III
, The nurse is reviewing the laboratory test results of a child diagnosed with disseminated
intravascular coagulation (DIC). Which of the following would the nurse interpret as
indicative of this disorder?
A) Shortened prothrombin time
B) Increased fibrinogen level
C) Positive fibrin split products
D) Increased platelets - Answer- C) Positive fibrin split products
The nurse is caring for a postpartum patient admitted to the intensive care unit with a
diagnosis of disseminated intravascular coagulation (DIC). What is the drug of choice to
treat this problem?
A. Heparin
B. Urokinase
C. Aspirin
D. Warfarin - Answer- A.) Heparin
In the ICU, a postsurgical client has developed sepsis and is being treated with multiple
medications. During the mid-morning assessment, which finding leads the nurse to
suspect the client may be developing a complication called disseminated intravascular
coagulation (DIC)? Select all that apply.
A) Headaches associated with light sensitivity
B) Oozing from all previous puncture and intravenous sites
C) Decreased O2 saturation and diminished breath sounds in lower lobes
D) Hemorrhage from the surgical site requiring deep pressure dressings
E) Urine from the Foley catheter is bloody - Answer- D) Hemorrhage from the surgical
site requiring deep pressure dressings
A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago,
but the mother has experienced postpartum hemorrhage. Which of the following
disorders is most likely to underlie the client's excessive bleeding after delivery?
A) Disseminated intravascular coagulation
B) Hemophilia A
C) Von Willebrand disease
D) Thrombotic thrombocytopenic purpura (TTP) - Answer- A) Disseminated
intravascular coagulation
What is the concept behind heparin for PT with DIC? - Answer- -It prevents the clotting
phase from being completed which inhibits the breakdown of fibrinogen.
- It also helps avoid hemorrhage by preventing the body from depleting entire stage of
coagulation factors.
