NURS 4121 Final Exam Latest Update 2025-2026
Exam 550 Questions with 100% Verified Correct
Answers Guaranteed A+
1st degree AV block (1) - CORRECT ANSWER: Every impulse is conducted to the
ventricles, but duration of AV conduction is prolonged (the PR interval is prolonged, >
0,2 seconds) - usually asymptomatic, so check medications, continue to monitor
24-hour urine for free cortisol (1) - CORRECT ANSWER: Low-dose dexamethasone
suppression test used for baseline results of24-hout urine cortisol
2nd degree AV Block: Type 1 (1) - CORRECT ANSWER: Gradual lengthening of the PR
interval due to prolonged AV conduction time. Eventually, atrial impulse is not
conducted, and a QRS complex is blocked (missing). Almost always transient/well
tolerated
2nd degree AV block: type 2 (1) - CORRECT ANSWER: P wave is not conducted,
without progressive antecedent PR lengthening. Usually occurs when a block in one of
the bundle branches is present - more serious, usually pacemaker time!
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
,Temperature 36C
No obvious irregularities are found in her cardiopulmonary assessment. Her TSH levels
come back to 20.9 IU/L. She is diagnosed with hypothyroidism
What can the nurse tell her about the treatment and follow up? - CORRECT ANSWER:
Synthroid - need a lot of teaching because will need to take it every day for the rest of
their life, side effects. Younger so probably won't have the same side effects as older
adults but this is still important. Need to take at same time every day. Find out more
about her specific symptoms and if there is anything we can do to help manage them
(example constipation, trouble concentrating, how we can set her up for success with
the things she needs to get done). Encourage activity but to the extent that she can
tolerate until levels normalize. A lot of nursing is giving education but then allowing the
patient to figure out how they are going to incorporate this education into their lives.
Wording can also be important (example movement instead of exercise)
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
No obvious irregularities are found in her cardiopulmonary assessment. Her TSH levels
come back to 20.9 IU/L. She is diagnosed with hypothyroidism
What teaching will the nurse need to do with her before she leaves the clinic? -
CORRECT ANSWER: Teaching on Synthroid. What to look for - it will take a while for
levels to come up so don't expect to immediately feel better. Initial dosage may not be
right so will require follow up and possibly dosage adjustment. We want them to come
back in if the symptoms get worse. Also provide education about signs and symptoms of
,hyperthyroidism because possibility of them taking too much thyroid hormone, may get
shaky/sweaty
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
What are some possible causes of her symptoms? - CORRECT ANSWER:
Hypothyroidism, depression, anemia, cardiac disease, electrolyte
imbalance/dehydration/K+ irregularity, allergies. HCP would probably ask about
depression, then consider anemia. Good history and physical very important
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
, What do you notice about these findings? - CORRECT ANSWER: BP high, slightly
bradycardic, RR low end, temp is low especially for someone that is dressed
excessively warm. With hypothyroidism, even though metabolism is decreased
sometimes BP is high because of weakening heart muscle, not as efficient so works a
bit harder, vessels tighten (what causes low HR and high BP), do sometimes also see
low BP
3rd degree AV block (5) - CORRECT ANSWER: Form of AV dissociation in which no
impulses from the atria are conducted to the ventricles
Atria are stimulated and contract independently of the ventricles
Ventricular rhythm is an escape rhythm
Ectopic pacemaker may be above or below the bifurcation of the bundle of His
Pacemaker time!!!
A 30-year-old man is admitted to the hospital with general fatigue, lack of appetite,
headache, and yellowish complexion
Symptoms became progressive during the past few days
One month ago, he was in Guadalajara, Mexico, where he ate a lot of seafood
Physical examination indicates an enlarged tender liver and icterus
Laboratory results show: hemoglobin 12 g/dL; bilirubin (direct) 95.76 mcmol/L; bilirubin
(indirect) 58.14 mcmol/L; alkaline phosphatase 60 U/L; AST 120 U/L; ALT 151 U/L; urine
+ for bilirubin
How did he get infected? - CORRECT ANSWER: Contaminated food
A 30-year-old man is admitted to the hospital with general fatigue, lack of appetite,
headache, and yellowish complexion
Symptoms became progressive during the past few days
One month ago, he was in Guadalajara, Mexico, where he ate a lot of seafood
Physical examination indicates an enlarged tender liver and icterus
Exam 550 Questions with 100% Verified Correct
Answers Guaranteed A+
1st degree AV block (1) - CORRECT ANSWER: Every impulse is conducted to the
ventricles, but duration of AV conduction is prolonged (the PR interval is prolonged, >
0,2 seconds) - usually asymptomatic, so check medications, continue to monitor
24-hour urine for free cortisol (1) - CORRECT ANSWER: Low-dose dexamethasone
suppression test used for baseline results of24-hout urine cortisol
2nd degree AV Block: Type 1 (1) - CORRECT ANSWER: Gradual lengthening of the PR
interval due to prolonged AV conduction time. Eventually, atrial impulse is not
conducted, and a QRS complex is blocked (missing). Almost always transient/well
tolerated
2nd degree AV block: type 2 (1) - CORRECT ANSWER: P wave is not conducted,
without progressive antecedent PR lengthening. Usually occurs when a block in one of
the bundle branches is present - more serious, usually pacemaker time!
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
,Temperature 36C
No obvious irregularities are found in her cardiopulmonary assessment. Her TSH levels
come back to 20.9 IU/L. She is diagnosed with hypothyroidism
What can the nurse tell her about the treatment and follow up? - CORRECT ANSWER:
Synthroid - need a lot of teaching because will need to take it every day for the rest of
their life, side effects. Younger so probably won't have the same side effects as older
adults but this is still important. Need to take at same time every day. Find out more
about her specific symptoms and if there is anything we can do to help manage them
(example constipation, trouble concentrating, how we can set her up for success with
the things she needs to get done). Encourage activity but to the extent that she can
tolerate until levels normalize. A lot of nursing is giving education but then allowing the
patient to figure out how they are going to incorporate this education into their lives.
Wording can also be important (example movement instead of exercise)
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
No obvious irregularities are found in her cardiopulmonary assessment. Her TSH levels
come back to 20.9 IU/L. She is diagnosed with hypothyroidism
What teaching will the nurse need to do with her before she leaves the clinic? -
CORRECT ANSWER: Teaching on Synthroid. What to look for - it will take a while for
levels to come up so don't expect to immediately feel better. Initial dosage may not be
right so will require follow up and possibly dosage adjustment. We want them to come
back in if the symptoms get worse. Also provide education about signs and symptoms of
,hyperthyroidism because possibility of them taking too much thyroid hormone, may get
shaky/sweaty
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
What are some possible causes of her symptoms? - CORRECT ANSWER:
Hypothyroidism, depression, anemia, cardiac disease, electrolyte
imbalance/dehydration/K+ irregularity, allergies. HCP would probably ask about
depression, then consider anemia. Good history and physical very important
38 year old woman enters a community clinic. She is complaining of overwhelming
fatigue that is not relieved by rest
She is attending graduate school and is very sedentary. She is so exhausted that she
has difficulty waking for classes and trouble concentrating when studying. Her face is
puffy, and her skin is dry and pale. She is dressed inappropriately for warm weather.
She also complains of generalized body aches and pains with frequent muscle cramps
and constipation.
Vital signs:
BP 142/84
Heart rate 52
Respiratory rate 12
Temperature 36C
, What do you notice about these findings? - CORRECT ANSWER: BP high, slightly
bradycardic, RR low end, temp is low especially for someone that is dressed
excessively warm. With hypothyroidism, even though metabolism is decreased
sometimes BP is high because of weakening heart muscle, not as efficient so works a
bit harder, vessels tighten (what causes low HR and high BP), do sometimes also see
low BP
3rd degree AV block (5) - CORRECT ANSWER: Form of AV dissociation in which no
impulses from the atria are conducted to the ventricles
Atria are stimulated and contract independently of the ventricles
Ventricular rhythm is an escape rhythm
Ectopic pacemaker may be above or below the bifurcation of the bundle of His
Pacemaker time!!!
A 30-year-old man is admitted to the hospital with general fatigue, lack of appetite,
headache, and yellowish complexion
Symptoms became progressive during the past few days
One month ago, he was in Guadalajara, Mexico, where he ate a lot of seafood
Physical examination indicates an enlarged tender liver and icterus
Laboratory results show: hemoglobin 12 g/dL; bilirubin (direct) 95.76 mcmol/L; bilirubin
(indirect) 58.14 mcmol/L; alkaline phosphatase 60 U/L; AST 120 U/L; ALT 151 U/L; urine
+ for bilirubin
How did he get infected? - CORRECT ANSWER: Contaminated food
A 30-year-old man is admitted to the hospital with general fatigue, lack of appetite,
headache, and yellowish complexion
Symptoms became progressive during the past few days
One month ago, he was in Guadalajara, Mexico, where he ate a lot of seafood
Physical examination indicates an enlarged tender liver and icterus
