NU 578 Unit 3 Study Guide (2026/2027) (PDF) |
Advanced Nursing | University of South Alabama
,NU 578 Unit 3 Study Guide (Questions 1–50)
Advanced Nursing | University of South Alabama | 2026/2027
Core Topics Covered in This Unit:
• Advanced pathophysiology
• Complex clinical assessment
• Diagnostic reasoning and clinical decision-making
• Acute and chronic disease management
• Advanced pharmacologic principles
• Evidence-based interventions
• Health promotion / risk reduction
1–10: Advanced Pathophysiology & Assessment
1. The most common cause of fluid volume excess in adults is:
A. Dehydration
B. Heart failure
C. Diabetes mellitus
D. Hyperthyroidism
Answer: B – Heart failure
Rationale: In heart failure, cardiac output declines, triggering fluid retention via RAAS and ADH, leading
to edema and volume overload.
2. Which finding is most consistent with systemic inflammation?
A. Elevated CRP and ESR
B. Decreased WBC count
C. Hypothermia
D. Hypernatremia
Answer: A – Elevated CRP and ESR
Rationale: C-reactive protein and erythrocyte sedimentation rate rise with inflammation from infection,
tissue injury, or chronic disease.
3. A key pathophysiologic feature of chronic obstructive pulmonary disease (COPD) is:
A. Reversible airway obstruction
B. Inflammation and alveolar destruction
,C. Viral infection only
D. Immune complex deposition
Answer: B – Inflammation and alveolar destruction
Rationale: Chronic inflammation from irritants like smoking leads to emphysema and airway remodeling
in COPD.
4. A patient with sepsis often demonstrates:
A. Hypotension unresponsive to fluids
B. Bradycardia
C. Hypothermia only
D. Early leukopenia only
Answer: A – Hypotension unresponsive to fluids
Rationale: Sepsis involves dysregulated host response and vasodilation; hypotension may persist despite
fluids.
5. Which assessment best reflects tissue perfusion?
A. Capillary refill, mental status, skin temperature
B. Blood glucose only
C. Reflexes only
D. Respiratory rate only
Answer: A – Capillary refill, mental status, skin temperature
Rationale: These reflect peripheral perfusion and early shock detection.
6. A new murmur in a patient with fever and positive blood cultures suggests:
A. Endocarditis
B. COPD
C. Asthma
D. Hyperlipidemia
Answer: A – Endocarditis
Rationale: Infective endocarditis causes vegetations on valves, producing new murmurs and systemic
infection.
7. The earliest sign of hypoxemia is often:
A. Restlessness
B. Bradycardia
C. Hypotension only
D. Hyperglycemia
, Answer: A – Restlessness
Rationale: Early cerebral hypoxia first manifests as mental status changes before vital sign
abnormalities.
8. In acute kidney injury, a distinguishing lab finding is:
A. Rising creatinine and BUN
B. Low sodium only
C. Normal BUN only
D. Elevated amylase
Answer: A – Rising creatinine and BUN
Rationale: These reflect reduced glomerular filtration and accumulating nitrogenous waste.
9. A primary indicator of myocardial ischemia on ECG is:
A. ST-segment depression or elevation
B. Prolonged QT only
C. U waves only
D. Peaked P waves
Answer: A – ST changes
Rationale: ST deviations indicate injury or infarction; critical in ACS evaluation.
10. Which assessment is most important for suspected increased intracranial pressure (ICP)?
A. Pupillary response and mental status
B. Lung sounds only
C. Urinalysis only
D. Reflexes only
Answer: A – Pupillary response and mental status
Rationale: Changes in cognition and pupil reactivity are early markers of increased ICP.
11–20: Diagnostic Reasoning & Clinical Judgment
11. A differential diagnosis should be based on:
A. History, physical exam, and risk factors
B. Insurance status
C. Age only
D. Symptom duration only
Answer: A – History, exam, and risk factors
Rationale: Accurate differential diagnosis integrates subjective and objective data.
Advanced Nursing | University of South Alabama
,NU 578 Unit 3 Study Guide (Questions 1–50)
Advanced Nursing | University of South Alabama | 2026/2027
Core Topics Covered in This Unit:
• Advanced pathophysiology
• Complex clinical assessment
• Diagnostic reasoning and clinical decision-making
• Acute and chronic disease management
• Advanced pharmacologic principles
• Evidence-based interventions
• Health promotion / risk reduction
1–10: Advanced Pathophysiology & Assessment
1. The most common cause of fluid volume excess in adults is:
A. Dehydration
B. Heart failure
C. Diabetes mellitus
D. Hyperthyroidism
Answer: B – Heart failure
Rationale: In heart failure, cardiac output declines, triggering fluid retention via RAAS and ADH, leading
to edema and volume overload.
2. Which finding is most consistent with systemic inflammation?
A. Elevated CRP and ESR
B. Decreased WBC count
C. Hypothermia
D. Hypernatremia
Answer: A – Elevated CRP and ESR
Rationale: C-reactive protein and erythrocyte sedimentation rate rise with inflammation from infection,
tissue injury, or chronic disease.
3. A key pathophysiologic feature of chronic obstructive pulmonary disease (COPD) is:
A. Reversible airway obstruction
B. Inflammation and alveolar destruction
,C. Viral infection only
D. Immune complex deposition
Answer: B – Inflammation and alveolar destruction
Rationale: Chronic inflammation from irritants like smoking leads to emphysema and airway remodeling
in COPD.
4. A patient with sepsis often demonstrates:
A. Hypotension unresponsive to fluids
B. Bradycardia
C. Hypothermia only
D. Early leukopenia only
Answer: A – Hypotension unresponsive to fluids
Rationale: Sepsis involves dysregulated host response and vasodilation; hypotension may persist despite
fluids.
5. Which assessment best reflects tissue perfusion?
A. Capillary refill, mental status, skin temperature
B. Blood glucose only
C. Reflexes only
D. Respiratory rate only
Answer: A – Capillary refill, mental status, skin temperature
Rationale: These reflect peripheral perfusion and early shock detection.
6. A new murmur in a patient with fever and positive blood cultures suggests:
A. Endocarditis
B. COPD
C. Asthma
D. Hyperlipidemia
Answer: A – Endocarditis
Rationale: Infective endocarditis causes vegetations on valves, producing new murmurs and systemic
infection.
7. The earliest sign of hypoxemia is often:
A. Restlessness
B. Bradycardia
C. Hypotension only
D. Hyperglycemia
, Answer: A – Restlessness
Rationale: Early cerebral hypoxia first manifests as mental status changes before vital sign
abnormalities.
8. In acute kidney injury, a distinguishing lab finding is:
A. Rising creatinine and BUN
B. Low sodium only
C. Normal BUN only
D. Elevated amylase
Answer: A – Rising creatinine and BUN
Rationale: These reflect reduced glomerular filtration and accumulating nitrogenous waste.
9. A primary indicator of myocardial ischemia on ECG is:
A. ST-segment depression or elevation
B. Prolonged QT only
C. U waves only
D. Peaked P waves
Answer: A – ST changes
Rationale: ST deviations indicate injury or infarction; critical in ACS evaluation.
10. Which assessment is most important for suspected increased intracranial pressure (ICP)?
A. Pupillary response and mental status
B. Lung sounds only
C. Urinalysis only
D. Reflexes only
Answer: A – Pupillary response and mental status
Rationale: Changes in cognition and pupil reactivity are early markers of increased ICP.
11–20: Diagnostic Reasoning & Clinical Judgment
11. A differential diagnosis should be based on:
A. History, physical exam, and risk factors
B. Insurance status
C. Age only
D. Symptom duration only
Answer: A – History, exam, and risk factors
Rationale: Accurate differential diagnosis integrates subjective and objective data.
