NUR 631 FINAL EXAM STUDY GUIDE QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NUR 631 FINAL EXAM STUDY GUIDE QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 Removal of part of the liver leads to the remaining liver cells undergoing compensatory - Answers Compensatory hyperplasia is an adaptive mechanism that enables certain organs to regenerate. For example, the removal of part of the liver leads to hyperplasia of the remaining liver cells (hepatocytes) to compensate for the loss. Which of the following statements best describes Raynaud disease? a. An inflammatory disorder of small and medium-size arteries in the feet and sometimes in the hands b. A neoplastic disorder of the lining of the arteries and veins of the upper extremities c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly, the toes d. An autoimmune disorder of the large arteries and veins of the upper and lower extremities - Answers c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly, the toes A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures may result from this condition? a. Right heart failure b. Left heart failure c. Low-output failure d. High-output failure - Answers a. Right heart failure Exp: Right heart failure is defined as the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation at a normal central venous pressure. It most often results from the left heart failure when the increase in left ventricular filling pressure that is reflected back into the pulmonary circulation is severe enough. As pressure in the pulmonary circulation rises, the resistance to right ventricular emptying increases. What physical sign is the result of turbulent blood flow through a vessel? a. Increased blood pressure during periods of stress b. Bounding pulse felt on palpation c. Cyanosis observed on excretion d. Murmur heard on auscultation - Answers d. Murmur heard on auscultation Exp: Where flow is obstructed the vessel turns or blood flows over rough surfaces. The flow becomes turbulent with whorls or eddy currents that produce noise causing a murmur to be heard on auscultation such as occurs during blood pressure measurement with a sphygomanometer. This selection is the only option that accurately identifies the physical sign of turbulent vascular blood flow. pg 1113 Which congenital heart defects occur in trisomy 13, trisomy 18 and down syndrome? a. Coarctation of the aorta and pulmonary stenosis b. Tetralogy of Fallot and persistent truncus arteriosus c. Atrial septal defect and dextrocardia d. Ventricular septal defect and patent ductus arteriosus - Answers d. Ventricular septal defect and patent ductus arteriosus Exp: Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18 and down syndrome include VSD and PDA see Table 33-2 The other defects are not associated with dysfunction of trisomy 13 or 17 and down syndrome. pg 1200 An infant has a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Atrioventricular canal defect - Answers c. Patent ductus arteriosus Exp: If pulmonary vascular resistance has fallen then infants with will characteristically have a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole. If the PDA is significant then the infant also will have bounding pulses an active precordium, a thrill on palpation and signs and symptoms of pulmonary over circulation. The presentations of the other congenital heart defects are not consistent with the described the symptoms pages Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells? a. Lying on their left side b. Performing the valsalva maneuver c. Squatting d. hyperventilating - Answers c. Squatting Exp: squatting is a spontaneous compensatory mechanism used by older children to alleviate hypoxic spells. Squatting and its variants increase systemic resistance while decreasing venous return to the heart from the inferior vena cava. The other options would not result in these changes. pg 1209 An infant diagnosed with a small patent ductus arteriosus would likely exhibit which symptom? a. Intermittent murmur b. Lack of symptoms c. Need for surgical repair d. Triad of congenital defects - Answers b. Lack of symptoms Exp: Infants with a small PDA usually remain asymptomatic. page Fluid in the pleural space characterizes which condition? a. Pleural effusion b. Atelectasis c. Bronchiectasis d. Ischemia - Answers a. Pleural Effusion Exp: Pleural effusion is the presence of fluid in the pleural space. page1254 Which medication classification is generally included in the treatment of silicosis? a. Corticosteroids b. Antiboitics c. Bronchodilators d. Expectorants - Answers a. Corticosteroids Exp: No specific treatment exists for silicosis, although corticosteroids may produce some improvement in the early, more acute stages. page 1259 The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation? a. 16 and 24 b. 20 and 24 c. 24 and 30 d. 30 and 36 - Answers d. 30 and 36 Exp: Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases. page 1292 What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn? a. Low birth weight b. Alcohol consumption during pregnanc c. Premature birth d. Smoking during pregnancy - Answers a. Premature birth Exp: RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. page 1301 What is the primary cause of respiratory distress syndrome (RDS) of the newborn? a. Immature immune system b. Small alveoli c. Surfactant deficiency d. Anemia - Answers c. Surfactant deficiency Exp: RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. page 1301 What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn? a. Consolidation b. Pulmonary edema c. Atelectasis d. Bronchiolar plugging - Answers c. Atelectasis Exp: The primary problem is atelectasis, which causes significant hypoxemia and is difficult for the neonate to overcome because a significant negative inspiratory pressure is required to open the alveoli with each breath. None of the other options are considered a primary problem associated with RDS. page 1301 Which statement best describes cystic fibrosis? a. Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation b. Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging c. P!ulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens d. Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency - Answers c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens Exp: Cystic fibrosis is best described as a pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens. This selection is the only option that accurately describes cystic fibrosis. pages Cystic fibrosis is caused by which process? a. Autosomal recessive inheritance b. Autosomal dominant inheritance c. Infection d. Malignancy - Answers a. Autosomal recessive inheritance Exp: Cystic fibrosis is an autosomal recessive inherited disorder that is associated with defective epithelial ion transport. None of the other options cause cystic fibrosis. page 1310 What are the abnormalities in cytokines found in children with cystic fibrosis (CF)? a. Deficit of interleukin(IL)-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α) b. Deficit of IL-6 and an excess of IL-2, IL-8 and granulocyte colony-stimulating factor (G-CSF) c. Deficit of IL-10 and an excess of IL-1, IL-8 and TNF α d. Deficit of IL-3 and an excess of IL-14, IL- 24 & colony-stimulating factor (CSF) - Answers c. Deficit of IL-10 and an excess of IL-1 , IL-8 and TNF α Exp: Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. pages 1311-12 Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct? a. Antidiuretic hormone b. Aldosterone c. Cortisol d. Adrenocorticotropin hormone - Answers a. Antidiuretic hormone Exp: Antidiuretic hormone is required for water to be reabsorbed in the distal tubule and collecting duct. The later, straight segment of the distal tubule and the collecting duct are permeable to water as controlled by antidiuretic hormone. The other options are not involved in this process. page 1331 The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland? a. Posterior pituitary b. Thyroid c. Parathyroid d. Anterior pituitary - Answers a. Posterior pituitary Exp: ADH which is secreted from the posterior pituitary gland, controls the concentration of the final urine. Pages 1332 and 1333 What is the most common cause of uncomplicated urinary tract infections? a. Staphylococcus b. Klebsiella c. Proteus d. Escherichia coli - Answers d. Escherichia coli ; The most common infecting microorganisms are uropathic strains of E. coli (80% to 85%). page 1350 Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual? a. Confusion and poorly localized abdominal discomfort b. Dysuria, frequency, and suprapubic pain c. Hematuria and flank pain d. Pyuria, urgency, and frequency - Answers a. Confusion and poorly localized abdominal discomfort Exp: Older adults with cystitis may demonstrate confusion or vague abdominal discomfort or otherwise be asymptomatic. page 1351 Pyelonephritis is usually caused by which type of organism? a. Bacteria b. Fungi c. Viruses d. Parasite - Answers a. Bacteria Exp: Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or Pseudomonas. pages 1351-52 A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/ day with albumin as the major protein. These data suggest the presence of which disorder? a. Cystitis b. Chronic pyelonephritis c. Glomerulonephritis d. Nephrotic syndrome - Answers c. Glomerulonephritis Exp: The data suggest the patient has the disorder known as glomerulonephritis. Two major changes distinctive of more severe glomerulonephritis are (1) hematuria with red blood cell casts and (2) proteinuria exceeding 3-5 g/ day with albumin as the major protein. These symptoms do not support the diagnosis of the other options. page 1357 How are glucose and insulin used to treat hyperkalemia associated with acute renal failure? a. Glucose has an osmotic effect, which attracts water and sodium resulting in more dilute blood and a lower potassium concentration. b. When insulin transports glucose into the cell, it also carries potassium with it. c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell. d. Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen - Answers b. When insulin transports glucose into the cell, it also carries potassium with it. Exp: This selection is the only option that accurately describes glucose metabolism causing potassium to move to the intracellular fluid; insulin infusions therefore can be effective in shifting potassium from the extracellular to intracellular space, along with the transport of glucose. page 1363 ________ is used to correct the chronic anemia associated with chronic renal failure a. Intrinsic factor b. Vitamin B12 c. Vitamin D d. Erythropoietin - Answers d. Erythropoietin In glomerulonephritis, what damages the epithelial cells resulting in proteinuria? (Select all that apply) a. Ischemia b. Lysosomal enzymes c. Compression from edema d. Activated complement e. Altered membrane permeability - Answers d. Activated complement e. Altered membrane permeability Exp: Activated complement, inflammatory cytokines, oxidants, proteases, and growth factors attack epithelial cells, alter membrane permeability, and cause proteinuria. None of the other options are responsible for this process. page Prerenal injury from poor perfusion can result from which condition? (Select all that apply.) a. Bilateral ureteral obstruction b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension - Answers b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension Exp: Poor perfusion can result from renal artery thrombosis, hypotension related to hypovolemia (dehydration, diarrhea, fluid shifts) or hemorrhage, renal vasoconstriction and alterations in renal regional blood flow, microthrombi, or kidney edema that restricts arterial blood flow. Bilateral ureteral obstruction is not associated with prerenal injuries. page 1360. What initiates inflammation in acute poststreptococcal glomerulonephritis? a. Lysosomal enzymes b. Endotoxins from Streptococcus c. Immune complexes d. Immunoglobulin E (IgE) mediated response - Answers c. Immune complexes Exp: The immune complexes initiate inflammation and glomerular injury in acute poststreptococcal glomerulonephritis. Antigen-antibody complexes are deposited in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. The other options are not involved in initiating inflammation in this situation. page 1381 In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location? a. Juxtamedullary nephrons b. Glomerulus basement membranes c. Mesangium of the glomerular capillaries d. Parietal epithelium - Answers b. Glomerulus basement membranes Exp: Glomerulonephritis develops with the deposition of antigen-antibody complexes (IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement membrane (see figure 39-5) When considering IgG nephropathies the only location of the IgG immunoglobulins is the correct option. page 1381 By what mechanism does intussusception cause an intestinal obstruction? a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the blood supply c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus d. Forming fibrin and scar tissue that attach to the intestinal omentum, causing obstruction - Answers a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply Exp: Intussusception is the telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply. page 1431 Table 41-2 After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism? a. Anaphylactic reaction in which chemical mediators, such as histamine, prostaglandins, and leukotrienes, relax vascular smooth muscles, causing shock b. Postoperative hemorrhage during which a large volume of blood is lost, causing hypotension with compensatory tachycardia c. Concentrated bolus that moves from the stomach into the small intestine, causing hyperglycemia and resulting in polyuria and eventually hypovolemic shock d. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen - Answers d. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen Exp: Dumping syndrome occurs with varying severity in 5% to 10% of individuals who have undergone partial gastrectomy or pyloroplasty. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine cause a sudden shift of fluid from the vascular compartment to the intestinal lumen. Plasma volume decreases, causing vasomotor responses, such as increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness. Rapid distention of the intestine produces a feeling of epigastric fullness, cramping, nausea, vomiting, and diarrhea. This selection is the only option that accurately identifies the mechanism responsible for the described situation. page 1440 Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine? a. meconium cecum b. meconim ileus c. meconium obstruction d. meconium vivax - Answers b. meconim ileus Exp: Meconium ileus is the only term used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine, resisting passage beyond the terminal ileum. The cause is usually a lack of digestive enzymes during fetal life. page 1490 With which medical diagnosis is meconium ileus often associated? a. Muscular dystrophy b. Cerebral palsy c. Cystic fibrosis d. Congenital aganglionic megacolon - Answers c. Cystic fibrosis Exp: The detection of albumin in meconium has been used as a screening test for cystic fibrosis. This condition is not associated with any of the other options. page 1490 Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of which nervous system? a. Central b. Parasympathetic c. Sympathetic d. Somatic - Answers b. Parasympathetic Exp: A malformation related only to the parasympathetic nervous system causes congenital aganglionic megacolon. page 1491 Which term is used to describe an intestinal obstruction caused by the invagination of the ileum into the cecum and part of the ascending colon by collapsing through the ileocecal valve? a. Congenital aganglionic megacolon b. Malrotation c. Intussusception d. Volvulus - Answers c. Intussusception Exp: Intussusception is the telescoping or invagination of one portion of the intestine into another section of intestine. Usually, the ileum invaginates the cecum and part of the ascending colon by collapsing through the ileocecal valve. The other terms are not used to describe this event. page 1492 An infant suddenly develops abdominal pain, becomes irritable (colicky) and draws up the knees. Vomiting occurs soon afterward. The mother reports that the infant passed a normal stool, followed by one that looked like currant jelly. Based on these data, which disorder does the nurse suspect? a. Congenital aganglionic megacolon b. Intussusception c. Malrotation d. Volvulus - Answers b. Intussusception Exp: Based on these data, the nurse should suspect intussusception. A single normal stool may be passed, evacuating the colon distal to the apex of the intussusception. After passing a normal stool, 60% of infants will pass currant jelly stools, which appear dark and gelatinous because of their blood and mucus content. page 1493 Cystic fibrosis is characterized by which symptom? a. Excessive mucus production b. Elevated blood glucose levels c. Low sodium content in perspiration d. Abnormally thin exocrine secretions - Answers a. Excessive mucus production Exp: Excessive mucus production characterizes cystic fibrosis. However, the pathophysiologic triad that is the hallmark of cystic fibrosis includes (1) pancreatic enzyme deficiency, which causes maldigestion; (2) overproduction of mucus in the respiratory tract and an inability to clear secretions, which cause progressive chronic obstructive pulmonary disease; and (3) abnormally elevated sodium and chloride concentrations in sweat. Exocrine secretions tend to be abnormally thick and precipitate in the glandular ducts, obstructing flow. An elevated blood glucose level is not associated with this disorder page 1494 Which medication compensates for the deficiency that occurs as a result of cystic fibrosis? a. Salt tablets b. Pancreatic enzymes c. Antihypertensives d. Antibiotics - Answers b. Pancreatic enzymes Exp: Pancreatic replacement enzymes are administered before or with meals, and high/calorie, high/protein diets with frequent snacks and vitamin supplements are used to treat the deficiency. page 1494 What causes a person with cystic fibrosis to experience an exocrine pancreatic insufficiency? a. Pancreatic ducts are obstructed with mucus. b. Impaired blood supply to the pancreas causes ischemia. c. A genetically impaired pancreas is unable to produce digestive enzymes. d. The pancreas has a volvulus at the ampulla of water - Answers a. Pancreatic ducts are obstructed with mucus.