417 FINAL EXAM QUESTIONS WITH CORRECT
ANSWERS 2025/2026
Which finding indicates to the nurse that demeclocycline has been effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. Weight has increased.
2. Urinary output has increased.
3. Peripheral edema has increased.
4. Urine specific gravity has increased. - CORRECT ANSWER -2. Urinary output has increased.
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and
increases urine output, producing more dilute urine. An increase in weight or an increase in
urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur
with SIADH. A sudden weight gain without edema is a common clinical manifestation of this
disorder.
Which patient statement indicates to the nurse that further instruction is needed about chronic
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. "I should weigh myself daily and report sudden weight loss or gain."
2. "I need to shop for foods low in sodium and avoid adding salt to food."
3. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
4. "I should eat foods high in potassium because diuretics cause potassium loss." - CORRECT
ANSWER -2. "I need to shop for foods low in sodium and avoid adding salt to food."
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed.
The other patient statements are correct and indicate successful teaching has occurred.
,A patient who is disoriented and reports a headache and muscle cramps is hospitalized with
syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would
the nurse expect?
1. Elevated hematocrit
2. Decreased serum sodium
3. Increased serum chloride
4. Low urine specific gravity - CORRECT ANSWER -2. Decreased serum sodium
When water is retained, the serum sodium level will drop below normal, causing the clinical
manifestations reported by the patient. The hematocrit will decrease because of the dilution
caused by water retention. Urine will be more concentrated with a higher specific gravity. The
serum chloride level will usually decrease along with the sodium level.
Which intervention will the nurse include in the plan of care for a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
1. Encourage fluids to 2 to 3 L/day.
2. Keep head of bed elevated to 30 degrees.
3. Monitor for increasing peripheral edema.
4. Offer the patient sugarless gum to chew. - CORRECT ANSWER -4. Offer the patient sugarless
gum to chew.
Chewing on sugarless gum decreases thirst for a patient on fluid restriction. Patients with SIADH
are on fluid restrictions of 800 to 1000 mL/day. Peripheral edema is not seen with SIADH. The
head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and
decrease antidiuretic hormone (ADH) release.
,Which information is most important for the nurse to communicate rapidly to the health care
provider about a patient admitted with possible syndrome of inappropriate antidiuretic
hormone (SIADH)?
1. The patient has a weight gain of 9 pounds.
2. The patient reports some dyspnea with activity.
3. The patient has a serum sodium level of 118 mEq/L.
4. The patient has a urine specific gravity of 1.025. - CORRECT ANSWER -3. The patient has a
serum sodium level of 118 mEq/L.
A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and
needs rapid correction. The other data are not unusual for a patient with SIADH and do not
indicate the need for rapid action.
Family members of a patient who has a traumatic brain injury ask the nurse about the purpose
of the ventriculostomy system being used for intracranial pressure monitoring. Which statement
by the nurse would be the best initial response for this situation?
1. "This is a complex type of monitoring system, and it is managed by skilled staff."
2. "The system measures pressures to determine whether blood flow to the brain is adequate."
3. "The ventriculostomy monitoring system helps check for changes in cerebral perfusion
pressure."
4. "This monitoring system has many benefits, including the ability to drain cerebrospinal fluid."
- CORRECT ANSWER -2. "The system measures pressures to determine whether blood flow to
the brain is adequate."
Short, simple, and accurate explanations should be given initially to patients and family
members. Explaining that the system is complex, and it is managed by skilled staff or that it has
multiple benefits does not address the family question about purpose for this patient.
, Terminology such as ventriculostomy and cerebral perfusion pressure is too complex for the
initial explanation and may increase family members' anxiety.
Admission vital signs for a patient who has a brain injury are blood pressure of 128/68 mm Hg,
pulse of 110 beats/min, and of respirations 26 breaths/min. Which set of vital signs, if taken 1
hour later, will be of most concern to the nurse?
1. Blood pressure 154/68 mm Hg, pulse 56 beats/min, respirations 12 breaths/min
2. Blood pressure 134/72 mm Hg, pulse 90 beats/min, respirations 32 breaths/min
3. Blood pressure 148/78 mm Hg, pulse 112 beats/min, respirations 28 breaths/min
4. Blood pressure 110/70 mm Hg, pulse 120 beats/min, respirations 30 breaths/min - CORRECT
ANSWER -1. Blood pressure 154/68 mm Hg, pulse 56 beats/min, respirations 12 breaths/min
Systolic hypertension with widening pulse pressure, bradycardia, and respiratory changes
represent Cushing's triad. These findings indicate that the intracranial pressure (ICP) has
increased, and brain herniation may be imminent unless immediate action is taken to reduce
ICP. The other vital signs may indicate the need for changes in treatment, but they are not
indicative of an immediately life-threatening process.
When a brain-injured patient responds to nail bed pressure with internal rotation, adduction,
and flexion of the arms, how would the nurse report the response?
1. Flexion withdrawal
2. Localization of pain
3. Decorticate posturing
4. Decerebrate posturing - CORRECT ANSWER -3. Decorticate posturing
ANSWERS 2025/2026
Which finding indicates to the nurse that demeclocycline has been effective for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. Weight has increased.
2. Urinary output has increased.
3. Peripheral edema has increased.
4. Urine specific gravity has increased. - CORRECT ANSWER -2. Urinary output has increased.
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and
increases urine output, producing more dilute urine. An increase in weight or an increase in
urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur
with SIADH. A sudden weight gain without edema is a common clinical manifestation of this
disorder.
Which patient statement indicates to the nurse that further instruction is needed about chronic
syndrome of inappropriate antidiuretic hormone (SIADH)?
1. "I should weigh myself daily and report sudden weight loss or gain."
2. "I need to shop for foods low in sodium and avoid adding salt to food."
3. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
4. "I should eat foods high in potassium because diuretics cause potassium loss." - CORRECT
ANSWER -2. "I need to shop for foods low in sodium and avoid adding salt to food."
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed.
The other patient statements are correct and indicate successful teaching has occurred.
,A patient who is disoriented and reports a headache and muscle cramps is hospitalized with
syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would
the nurse expect?
1. Elevated hematocrit
2. Decreased serum sodium
3. Increased serum chloride
4. Low urine specific gravity - CORRECT ANSWER -2. Decreased serum sodium
When water is retained, the serum sodium level will drop below normal, causing the clinical
manifestations reported by the patient. The hematocrit will decrease because of the dilution
caused by water retention. Urine will be more concentrated with a higher specific gravity. The
serum chloride level will usually decrease along with the sodium level.
Which intervention will the nurse include in the plan of care for a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
1. Encourage fluids to 2 to 3 L/day.
2. Keep head of bed elevated to 30 degrees.
3. Monitor for increasing peripheral edema.
4. Offer the patient sugarless gum to chew. - CORRECT ANSWER -4. Offer the patient sugarless
gum to chew.
Chewing on sugarless gum decreases thirst for a patient on fluid restriction. Patients with SIADH
are on fluid restrictions of 800 to 1000 mL/day. Peripheral edema is not seen with SIADH. The
head of the bed is elevated no more than 10 degrees to increase left atrial filling pressure and
decrease antidiuretic hormone (ADH) release.
,Which information is most important for the nurse to communicate rapidly to the health care
provider about a patient admitted with possible syndrome of inappropriate antidiuretic
hormone (SIADH)?
1. The patient has a weight gain of 9 pounds.
2. The patient reports some dyspnea with activity.
3. The patient has a serum sodium level of 118 mEq/L.
4. The patient has a urine specific gravity of 1.025. - CORRECT ANSWER -3. The patient has a
serum sodium level of 118 mEq/L.
A serum sodium of less than 120 mEq/L increases the risk for complications such as seizures and
needs rapid correction. The other data are not unusual for a patient with SIADH and do not
indicate the need for rapid action.
Family members of a patient who has a traumatic brain injury ask the nurse about the purpose
of the ventriculostomy system being used for intracranial pressure monitoring. Which statement
by the nurse would be the best initial response for this situation?
1. "This is a complex type of monitoring system, and it is managed by skilled staff."
2. "The system measures pressures to determine whether blood flow to the brain is adequate."
3. "The ventriculostomy monitoring system helps check for changes in cerebral perfusion
pressure."
4. "This monitoring system has many benefits, including the ability to drain cerebrospinal fluid."
- CORRECT ANSWER -2. "The system measures pressures to determine whether blood flow to
the brain is adequate."
Short, simple, and accurate explanations should be given initially to patients and family
members. Explaining that the system is complex, and it is managed by skilled staff or that it has
multiple benefits does not address the family question about purpose for this patient.
, Terminology such as ventriculostomy and cerebral perfusion pressure is too complex for the
initial explanation and may increase family members' anxiety.
Admission vital signs for a patient who has a brain injury are blood pressure of 128/68 mm Hg,
pulse of 110 beats/min, and of respirations 26 breaths/min. Which set of vital signs, if taken 1
hour later, will be of most concern to the nurse?
1. Blood pressure 154/68 mm Hg, pulse 56 beats/min, respirations 12 breaths/min
2. Blood pressure 134/72 mm Hg, pulse 90 beats/min, respirations 32 breaths/min
3. Blood pressure 148/78 mm Hg, pulse 112 beats/min, respirations 28 breaths/min
4. Blood pressure 110/70 mm Hg, pulse 120 beats/min, respirations 30 breaths/min - CORRECT
ANSWER -1. Blood pressure 154/68 mm Hg, pulse 56 beats/min, respirations 12 breaths/min
Systolic hypertension with widening pulse pressure, bradycardia, and respiratory changes
represent Cushing's triad. These findings indicate that the intracranial pressure (ICP) has
increased, and brain herniation may be imminent unless immediate action is taken to reduce
ICP. The other vital signs may indicate the need for changes in treatment, but they are not
indicative of an immediately life-threatening process.
When a brain-injured patient responds to nail bed pressure with internal rotation, adduction,
and flexion of the arms, how would the nurse report the response?
1. Flexion withdrawal
2. Localization of pain
3. Decorticate posturing
4. Decerebrate posturing - CORRECT ANSWER -3. Decorticate posturing
