NUR185/NUR 185 Final Exam V3 |
Concepts of Adult Health Nursing for the
Practical Nurse II Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with Type 2 Diabetes Mellitus who is prescribed Metformin.
Which lab result would require the nurse to hold the medication and notify the provider?
A. A blood glucose level of 140 mg/dL
B. An elevated Hemoglobin A1C
C. A decreased potassium level
D. An elevated serum creatinine level
Correct Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can cause lactic acidosis if
renal function is impaired. An elevated serum creatinine indicates potential kidney
dysfunction, making the medication unsafe to administer. The nurse must prioritize renal
health assessment before continuing this biguanide therapy.
2. Which clinical manifestation is most characteristic of a patient experiencing a Left-Sided
Heart Failure?
A. Crackles in the lungs on auscultation
B. Peripheral edema in the lower extremities
,C. Jugular venous distention
D. Splenomegaly and hepatomegaly
Correct Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. This congestion manifests as crackles, dyspnea, and
orthopnea during the physical assessment. Right-sided heart failure is more associated
with systemic symptoms like peripheral edema and jugular venous distention.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.5 mEq/L.
Which medication should the nurse anticipate administering to lower the potassium level
quickly?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular insulin with intravenous glucose
D. Calcium carbonate
Correct Answer: C
Rationale: Regular insulin shifts potassium from the extracellular space into the
intracellular space, rapidly lowering serum levels. Glucose is administered simultaneously
to prevent hypoglycemia during this shift. While Kayexalate removes potassium from the
body, it works much slower than the insulin-glucose protocol.
, 4. When providing discharge teaching to a patient with a new diagnosis of Hypothyroidism,
which statement by the patient indicates a need for further instruction?
A. ‘I will take my levothyroxine on an empty stomach every morning.’
B. ‘I can stop taking this medication once my energy levels return to normal.’
C. ‘I will need to have my blood tested regularly for TSH levels.’
D. ‘I should report any chest pain or rapid heart rate to my doctor.’
Correct Answer: B
Rationale: Levothyroxine therapy for hypothyroidism is typically lifelong and should
never be stopped abruptly without medical supervision. Patients must understand that the
medication replaces a hormone their body is no longer producing. Consistent morning
administration on an empty stomach is vital for optimal absorption.
5. A nurse is assessing a patient with suspected Cushing’s Syndrome. Which physical finding
would the nurse expect to observe?
A. Buffalo hump and moon face
B. Bronze-colored skin pigmentation
C. Weight loss and hypotension
D. Thinning of the neck and facial features
Correct Answer: A
Concepts of Adult Health Nursing for the
Practical Nurse II Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with Type 2 Diabetes Mellitus who is prescribed Metformin.
Which lab result would require the nurse to hold the medication and notify the provider?
A. A blood glucose level of 140 mg/dL
B. An elevated Hemoglobin A1C
C. A decreased potassium level
D. An elevated serum creatinine level
Correct Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can cause lactic acidosis if
renal function is impaired. An elevated serum creatinine indicates potential kidney
dysfunction, making the medication unsafe to administer. The nurse must prioritize renal
health assessment before continuing this biguanide therapy.
2. Which clinical manifestation is most characteristic of a patient experiencing a Left-Sided
Heart Failure?
A. Crackles in the lungs on auscultation
B. Peripheral edema in the lower extremities
,C. Jugular venous distention
D. Splenomegaly and hepatomegaly
Correct Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. This congestion manifests as crackles, dyspnea, and
orthopnea during the physical assessment. Right-sided heart failure is more associated
with systemic symptoms like peripheral edema and jugular venous distention.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.5 mEq/L.
Which medication should the nurse anticipate administering to lower the potassium level
quickly?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular insulin with intravenous glucose
D. Calcium carbonate
Correct Answer: C
Rationale: Regular insulin shifts potassium from the extracellular space into the
intracellular space, rapidly lowering serum levels. Glucose is administered simultaneously
to prevent hypoglycemia during this shift. While Kayexalate removes potassium from the
body, it works much slower than the insulin-glucose protocol.
, 4. When providing discharge teaching to a patient with a new diagnosis of Hypothyroidism,
which statement by the patient indicates a need for further instruction?
A. ‘I will take my levothyroxine on an empty stomach every morning.’
B. ‘I can stop taking this medication once my energy levels return to normal.’
C. ‘I will need to have my blood tested regularly for TSH levels.’
D. ‘I should report any chest pain or rapid heart rate to my doctor.’
Correct Answer: B
Rationale: Levothyroxine therapy for hypothyroidism is typically lifelong and should
never be stopped abruptly without medical supervision. Patients must understand that the
medication replaces a hormone their body is no longer producing. Consistent morning
administration on an empty stomach is vital for optimal absorption.
5. A nurse is assessing a patient with suspected Cushing’s Syndrome. Which physical finding
would the nurse expect to observe?
A. Buffalo hump and moon face
B. Bronze-colored skin pigmentation
C. Weight loss and hypotension
D. Thinning of the neck and facial features
Correct Answer: A
