NR324/NR 324 Exam 3 V2 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A patient is admitted with suspected acute pancreatitis. Which laboratory result is the
most specific indicator for confirming this diagnosis?
A. Elevated serum amylase
B. Decreased serum calcium
C. Elevated serum lipase
D. Increased white blood cell count
Correct Answer: C
Rationale: Serum lipase is more specific than amylase for diagnosing acute pancreatitis
because it remains elevated for a longer period. Amylase can rise due to other conditions
such as mumps or intestinal obstruction. Lipase levels usually rise within 4 to 8 hours of
symptom onset and peak at 24 hours, making it a reliable clinical marker for pancreatic
inflammation.
2. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Graves’ disease?
A. Exophthalmos and tremors
B. Cold intolerance and lethargy
,C. Bradycardia and weight gain
D. Periorbital edema and dry skin
Correct Answer: A
Rationale: Graves’ disease is a form of hyperthyroidism characterized by a hypermetabolic
state. Common signs include exophthalmos (bulging eyes) due to tissue swelling behind the
eyes and fine tremors of the hands. Patients also typically experience heat intolerance,
tachycardia, and weight loss despite an increased appetite.
3. A patient with cirrhosis and esophageal varices is prescribed lactulose. What is the primary
therapeutic goal of this medication?
A. To decrease portal vein pressure
B. To manage fluid volume excess in the abdomen
C. To reduce the risk of gastrointestinal bleeding
D. To promote the excretion of ammonia
Correct Answer: D
Rationale: Lactulose is an osmotic laxative used in cirrhosis to prevent or treat hepatic
encephalopathy. It works by trapping ammonia in the gut and facilitating its excretion
through the stool. The effectiveness of the therapy is monitored by the patient’s improved
neurological status and having two to three soft stools per day.
, 4. When assessing a patient with Cushing syndrome, which physical finding is most
characteristic of the disorder?
A. Bronze-colored skin pigmentation
B. Weight loss and hypotension
C. Thinning of the skin with purpuric striae
D. Enlarged hands and feet
Correct Answer: C
Rationale: Cushing syndrome results from excessive corticosteroids, which leads to
structural changes such as thin, fragile skin and purple striae on the abdomen. Other classic
signs include ‘moon face,’ ‘buffalo hump,’ and truncal obesity. In contrast, bronze
pigmentation and hypotension are associated with Addison’s disease (adrenal
insufficiency).
5. A patient is recovering from a thyroidectomy. The nurse notes the patient has developed
laryngeal stridor and positive Chvostek’s sign. Which action should the nurse take first?
A. Encourage the patient to cough and deep breathe
B. Document the findings as normal post-operative results
C. Administer intravenous calcium gluconate
D. Notify the physician and prepare for immediate intubation
Correct Answer: C
Q&A with Rationale | Chamberlain
University
1. A patient is admitted with suspected acute pancreatitis. Which laboratory result is the
most specific indicator for confirming this diagnosis?
A. Elevated serum amylase
B. Decreased serum calcium
C. Elevated serum lipase
D. Increased white blood cell count
Correct Answer: C
Rationale: Serum lipase is more specific than amylase for diagnosing acute pancreatitis
because it remains elevated for a longer period. Amylase can rise due to other conditions
such as mumps or intestinal obstruction. Lipase levels usually rise within 4 to 8 hours of
symptom onset and peak at 24 hours, making it a reliable clinical marker for pancreatic
inflammation.
2. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Graves’ disease?
A. Exophthalmos and tremors
B. Cold intolerance and lethargy
,C. Bradycardia and weight gain
D. Periorbital edema and dry skin
Correct Answer: A
Rationale: Graves’ disease is a form of hyperthyroidism characterized by a hypermetabolic
state. Common signs include exophthalmos (bulging eyes) due to tissue swelling behind the
eyes and fine tremors of the hands. Patients also typically experience heat intolerance,
tachycardia, and weight loss despite an increased appetite.
3. A patient with cirrhosis and esophageal varices is prescribed lactulose. What is the primary
therapeutic goal of this medication?
A. To decrease portal vein pressure
B. To manage fluid volume excess in the abdomen
C. To reduce the risk of gastrointestinal bleeding
D. To promote the excretion of ammonia
Correct Answer: D
Rationale: Lactulose is an osmotic laxative used in cirrhosis to prevent or treat hepatic
encephalopathy. It works by trapping ammonia in the gut and facilitating its excretion
through the stool. The effectiveness of the therapy is monitored by the patient’s improved
neurological status and having two to three soft stools per day.
, 4. When assessing a patient with Cushing syndrome, which physical finding is most
characteristic of the disorder?
A. Bronze-colored skin pigmentation
B. Weight loss and hypotension
C. Thinning of the skin with purpuric striae
D. Enlarged hands and feet
Correct Answer: C
Rationale: Cushing syndrome results from excessive corticosteroids, which leads to
structural changes such as thin, fragile skin and purple striae on the abdomen. Other classic
signs include ‘moon face,’ ‘buffalo hump,’ and truncal obesity. In contrast, bronze
pigmentation and hypotension are associated with Addison’s disease (adrenal
insufficiency).
5. A patient is recovering from a thyroidectomy. The nurse notes the patient has developed
laryngeal stridor and positive Chvostek’s sign. Which action should the nurse take first?
A. Encourage the patient to cough and deep breathe
B. Document the findings as normal post-operative results
C. Administer intravenous calcium gluconate
D. Notify the physician and prepare for immediate intubation
Correct Answer: C
