MARYVILLE UNIVERSITY NUR 303 ADULT HEALTH I –
FINAL EXAM 4|QUESTION AND VERIFIED
ANSWERS|2026 UPDATE|GRADED A+
1. A patient with left-sided heart failure presents with dyspnea, orthopnea, and crackles.
Which is the priority nursing intervention?
A. Administer diuretics
B. Encourage fluid intake
C. Monitor weight weekly
D. Restrict activity
Rationale: Pulmonary congestion from left-sided HF requires diuretics to reduce fluid overload
and improve oxygenation.
2. A patient with right-sided HF has edema, ascites, and JVD. Which electrolyte imbalance is
most likely?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypomagnesemia
Rationale: Diuretics commonly used in HF can cause potassium loss, increasing risk of
hypokalemia.
3. A patient with acute kidney injury has oliguria and elevated BUN/creatinine. What is the
priority intervention?
A. Administer IV potassium
B. Prepare for dialysis
C. Encourage high-protein diet
D. Restrict sodium only
Rationale: Severe AKI with oliguria may require dialysis to manage fluid and electrolyte
imbalances.
,4. A patient with hyperkalemia shows peaked T waves on ECG. Which action is priority?
A. Administer insulin with glucose
B. Administer potassium supplements
C. Monitor only
D. Restrict sodium
Rationale: Insulin shifts potassium into cells rapidly, reducing risk of life-threatening
arrhythmias.
5. A patient with hypocalcemia develops tetany. Which sign confirms this?
A. Trousseau’s sign
B. Bradycardia
C. Edema
D. Hypertension
Rationale: Trousseau’s and Chvostek’s signs indicate neuromuscular excitability due to low
calcium.
6. A patient with DKA presents with fruity breath and Kussmaul respirations. What is priority?
A. IV fluids and insulin
B. Oral glucose
C. Monitor only
D. Administer diuretics
Rationale: IV fluids restore perfusion; insulin halts ketone production and corrects acidosis.
7. A patient with chronic kidney disease has fatigue and pallor. Which lab is expected?
A. Low hemoglobin
B. High potassium
C. High calcium
D. Low sodium
Rationale: CKD causes anemia due to reduced erythropoietin production.
8. A patient with HF gains 3 kg in a week. Which action is priority?
A. Notify provider
, B. Restrict activity
C. Encourage fluids
D. Monitor only
Rationale: Rapid weight gain signals fluid retention and worsening HF.
9. A patient with cirrhosis develops jaundice. Which lab confirms this?
A. Elevated bilirubin
B. Elevated potassium
C. Low creatinine
D. High calcium
Rationale: Liver dysfunction impairs bilirubin metabolism, causing jaundice.
10. A patient with hyperthyroidism reports palpitations and weight loss. Which medication
manages symptoms?
A. Methimazole
B. Propranolol
C. Levothyroxine
D. Furosemide
Rationale: Beta-blockers reduce sympathetic symptoms like tachycardia and tremors.
11. A patient with hypothyroidism reports fatigue, cold intolerance, and constipation. Which
lab confirms diagnosis?
A. Low T3/T4 and high TSH
B. High T3/T4
C. Low TSH
D. High cortisol
Rationale: Low thyroid hormones with compensatory high TSH confirm hypothyroidism.
12. A patient with CKD has hyperphosphatemia. Which complication is most likely?
A. Hypocalcemia
B. Hyperkalemia
FINAL EXAM 4|QUESTION AND VERIFIED
ANSWERS|2026 UPDATE|GRADED A+
1. A patient with left-sided heart failure presents with dyspnea, orthopnea, and crackles.
Which is the priority nursing intervention?
A. Administer diuretics
B. Encourage fluid intake
C. Monitor weight weekly
D. Restrict activity
Rationale: Pulmonary congestion from left-sided HF requires diuretics to reduce fluid overload
and improve oxygenation.
2. A patient with right-sided HF has edema, ascites, and JVD. Which electrolyte imbalance is
most likely?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypomagnesemia
Rationale: Diuretics commonly used in HF can cause potassium loss, increasing risk of
hypokalemia.
3. A patient with acute kidney injury has oliguria and elevated BUN/creatinine. What is the
priority intervention?
A. Administer IV potassium
B. Prepare for dialysis
C. Encourage high-protein diet
D. Restrict sodium only
Rationale: Severe AKI with oliguria may require dialysis to manage fluid and electrolyte
imbalances.
,4. A patient with hyperkalemia shows peaked T waves on ECG. Which action is priority?
A. Administer insulin with glucose
B. Administer potassium supplements
C. Monitor only
D. Restrict sodium
Rationale: Insulin shifts potassium into cells rapidly, reducing risk of life-threatening
arrhythmias.
5. A patient with hypocalcemia develops tetany. Which sign confirms this?
A. Trousseau’s sign
B. Bradycardia
C. Edema
D. Hypertension
Rationale: Trousseau’s and Chvostek’s signs indicate neuromuscular excitability due to low
calcium.
6. A patient with DKA presents with fruity breath and Kussmaul respirations. What is priority?
A. IV fluids and insulin
B. Oral glucose
C. Monitor only
D. Administer diuretics
Rationale: IV fluids restore perfusion; insulin halts ketone production and corrects acidosis.
7. A patient with chronic kidney disease has fatigue and pallor. Which lab is expected?
A. Low hemoglobin
B. High potassium
C. High calcium
D. Low sodium
Rationale: CKD causes anemia due to reduced erythropoietin production.
8. A patient with HF gains 3 kg in a week. Which action is priority?
A. Notify provider
, B. Restrict activity
C. Encourage fluids
D. Monitor only
Rationale: Rapid weight gain signals fluid retention and worsening HF.
9. A patient with cirrhosis develops jaundice. Which lab confirms this?
A. Elevated bilirubin
B. Elevated potassium
C. Low creatinine
D. High calcium
Rationale: Liver dysfunction impairs bilirubin metabolism, causing jaundice.
10. A patient with hyperthyroidism reports palpitations and weight loss. Which medication
manages symptoms?
A. Methimazole
B. Propranolol
C. Levothyroxine
D. Furosemide
Rationale: Beta-blockers reduce sympathetic symptoms like tachycardia and tremors.
11. A patient with hypothyroidism reports fatigue, cold intolerance, and constipation. Which
lab confirms diagnosis?
A. Low T3/T4 and high TSH
B. High T3/T4
C. Low TSH
D. High cortisol
Rationale: Low thyroid hormones with compensatory high TSH confirm hypothyroidism.
12. A patient with CKD has hyperphosphatemia. Which complication is most likely?
A. Hypocalcemia
B. Hyperkalemia
