NR 507 FINAL EXAM STUDY GUIDE – ALL
POSSIBLE QUESTION AND ANSWERS
1. Acid base imbalance
While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the
nurse suspect is occurring in the patient?
reduced tidal volumes
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide
(CO2 ) levels. Which of the following does the nurse suspect is the most likely cause?
Hyperventilation
The nurse is assessing a client with suspected respiratory acidosis. Which assessment items
are priority for the nurse to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of
the optic nerve
o The nurse is administering sodium bicarbonate to the client with respiratory acidosis.
The nurse understands that which is the primary goal of treatment for this client?
Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse
explains to the student nurse that the client's blood pH initially falls in the development of
acute respiratory acidosis because of which process?
Hypoventilation
2. ACTH
The nurse is preparing a client for testing to determine if the client has Cushing syndrome.
What tests are included in the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
A client comes to the clinic with fatigue and muscle weakness. The client also states she has
been having diarrhea. The nurse observes the skin of the client has a bronze tone and when
asked, the client says she has not had any sun exposure. The mucous membranes of the gums
1
, are bluish-black. When reviewing laboratory results from this client, what does the nurse
anticipate seeing?
Increased levels of ACTH
A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin
replacement therapy. Regarding which type of replacement will the nurse educate the client?
Cortisol replacement therapy
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate
the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type
of endocrine disorder?
Secondary
The nurse is preparing a client for a test that will measure negative feedback suppression of
ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
ACTH deficiency results in secondary hypocortisolism
ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
interpretation of ACTH levels requires simultaneous assessment of plasma cortisol levels
ACTH levels are normal to high in primary adrenal insufficiency
ACTH levels are low to absent in secondary adrenal insufficiency
The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune
disease. What effects does the nurse expect this therapy to have on this client's circulating
levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
2
, A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with
elevated levels of:
Adrenocorticotropic hormone (ACTH)
3. Acute epiglottitis
A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was
fine the previous day, complained of a sore throat early in the morning and now has a
temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the child
gets panicky, immediately sits back up, and leans forward with her mouth open and tongue out
when the caregiver encourages her to lie down. The nurse suspects the child has which of the
following conditions?
Epiglottitis
The caregivers of a child report that their child had a cold and complained of a sore throat.
When interviewed further they report that the child has a high fever, is very anxious, and is
breathing by sitting up and leaning forward with the mouth open and the tongue out. The
nurse recognizes these symptoms as those seen with which of the following disorders?
Epiglottitis
The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The
nurse recognizes a common complication of the disorder is for the child to:
be at risk for respiratory distress.
A 5-year-old child is brought to the clinic by his father because the child developed a high
fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and
symptoms?
• Difficulty speaking • Drooling • Sitting with neck extended • Frightened
appearance
4. AIDS
A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-
brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A physical
examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte
count. Information taken during the personal history reveals that he has multiple sex partners
with whom he frequently engages in unprotected sex. What is likely to be the man's problem
and what is his prognosis?
3
, He is probably suffering from AIDS. His outlook is poor once the disease has
progressed to this advanced stage. There is no cure, and drug therapy has
had limited short-term success.
Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS) include
monitoring of T lymphocyte counts?
A decrease in the number of T cells would make the patient more susceptible
to infection and unusual cancers.
What is the length of time from infection with the AIDS virus to seroconversion?
Up to six months
A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with
cytomegalovirus. The nurse explains to the woman that the infection is caused by a common
organism that normally does not cause infection in someone with a healthy immune system.
This type of infection is called what?
Opportunistic infection
The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the
nurse, "How long will I live?" Which of the following is an appropriate response by the nurse?
"AIDS is considered to be a chronic illness today."
Which of the following clients is at the greatest risk for developing an intracellular pathogen
infection?
An AIDS client with a decreased CD4+ TH1 count
5. Alveolar ventilation/perfusion
A consequence of alveolar hypoxia is:
Pulmonary artery vasoconstriction
The pressure required to inflate an alveolus is inversely related to:
Alveolus radius
The nurse is describing the movement of blood into and out of the
capillary beds of the lungs to the body organs and tissues. What term
should the nurse use to describe this process?
Perfusion
A pulmonologist is discussing the base of the lungs with staff. Which
information should be included? At the base of the lungs:
4
POSSIBLE QUESTION AND ANSWERS
1. Acid base imbalance
While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the
nurse suspect is occurring in the patient?
reduced tidal volumes
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide
(CO2 ) levels. Which of the following does the nurse suspect is the most likely cause?
Hyperventilation
The nurse is assessing a client with suspected respiratory acidosis. Which assessment items
are priority for the nurse to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of
the optic nerve
o The nurse is administering sodium bicarbonate to the client with respiratory acidosis.
The nurse understands that which is the primary goal of treatment for this client?
Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse
explains to the student nurse that the client's blood pH initially falls in the development of
acute respiratory acidosis because of which process?
Hypoventilation
2. ACTH
The nurse is preparing a client for testing to determine if the client has Cushing syndrome.
What tests are included in the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
A client comes to the clinic with fatigue and muscle weakness. The client also states she has
been having diarrhea. The nurse observes the skin of the client has a bronze tone and when
asked, the client says she has not had any sun exposure. The mucous membranes of the gums
1
, are bluish-black. When reviewing laboratory results from this client, what does the nurse
anticipate seeing?
Increased levels of ACTH
A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin
replacement therapy. Regarding which type of replacement will the nurse educate the client?
Cortisol replacement therapy
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate
the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type
of endocrine disorder?
Secondary
The nurse is preparing a client for a test that will measure negative feedback suppression of
ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
ACTH deficiency results in secondary hypocortisolism
ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
interpretation of ACTH levels requires simultaneous assessment of plasma cortisol levels
ACTH levels are normal to high in primary adrenal insufficiency
ACTH levels are low to absent in secondary adrenal insufficiency
The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune
disease. What effects does the nurse expect this therapy to have on this client's circulating
levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
2
, A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with
elevated levels of:
Adrenocorticotropic hormone (ACTH)
3. Acute epiglottitis
A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who was
fine the previous day, complained of a sore throat early in the morning and now has a
temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the child
gets panicky, immediately sits back up, and leans forward with her mouth open and tongue out
when the caregiver encourages her to lie down. The nurse suspects the child has which of the
following conditions?
Epiglottitis
The caregivers of a child report that their child had a cold and complained of a sore throat.
When interviewed further they report that the child has a high fever, is very anxious, and is
breathing by sitting up and leaning forward with the mouth open and the tongue out. The
nurse recognizes these symptoms as those seen with which of the following disorders?
Epiglottitis
The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The
nurse recognizes a common complication of the disorder is for the child to:
be at risk for respiratory distress.
A 5-year-old child is brought to the clinic by his father because the child developed a high
fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and
symptoms?
• Difficulty speaking • Drooling • Sitting with neck extended • Frightened
appearance
4. AIDS
A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-
brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A physical
examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte
count. Information taken during the personal history reveals that he has multiple sex partners
with whom he frequently engages in unprotected sex. What is likely to be the man's problem
and what is his prognosis?
3
, He is probably suffering from AIDS. His outlook is poor once the disease has
progressed to this advanced stage. There is no cure, and drug therapy has
had limited short-term success.
Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS) include
monitoring of T lymphocyte counts?
A decrease in the number of T cells would make the patient more susceptible
to infection and unusual cancers.
What is the length of time from infection with the AIDS virus to seroconversion?
Up to six months
A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with
cytomegalovirus. The nurse explains to the woman that the infection is caused by a common
organism that normally does not cause infection in someone with a healthy immune system.
This type of infection is called what?
Opportunistic infection
The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the
nurse, "How long will I live?" Which of the following is an appropriate response by the nurse?
"AIDS is considered to be a chronic illness today."
Which of the following clients is at the greatest risk for developing an intracellular pathogen
infection?
An AIDS client with a decreased CD4+ TH1 count
5. Alveolar ventilation/perfusion
A consequence of alveolar hypoxia is:
Pulmonary artery vasoconstriction
The pressure required to inflate an alveolus is inversely related to:
Alveolus radius
The nurse is describing the movement of blood into and out of the
capillary beds of the lungs to the body organs and tissues. What term
should the nurse use to describe this process?
Perfusion
A pulmonologist is discussing the base of the lungs with staff. Which
information should be included? At the base of the lungs:
4
