NURA 1500 EXAM 4 QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - Answers Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other
conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client
has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - Answers Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to
produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for signs
of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and
orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from
decreased estrogen metabolism by the diseased liver.
When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - Answers Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal failure
that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in a
client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or
hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic
complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube
has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate?
A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - Answers Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then turns to
green-brown. The drainage is measured as output. The amount of expected drainage will range from
500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is located
in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - Answers Answer: B
Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most
important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - Answers Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight will help
protect against gallstones. Excessive dietary intake of cholesterol is associated with the development
of gallstones in many people. Dietary protein isn't implicated in cholecystitis. Liquid protein and low-
,calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week) are implicated as the cause of
some cases of cholecystitis. Regular exercise (30 minutes/three times a week) may help reduce weight
and improve fat metabolism. Reducing stress may reduce bile production, which may also indirectly
decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - Answers Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present in
peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up abdominal
muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - Answers Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present. An
abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A barium
swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus, stomach, and
duodenum.
A client being treated for chronic cholecystitis should be given which of the following instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - Answers Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by increasing
physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use to relax smooth
muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - Answers Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to accommodate
the large amount of blood necessary for homeostasis. The pressure in the liver increases and causes
increased pressure in the venous system. As the portal pressure increases, fluid exudes into the
abdominal cavity. This is called ascites.
The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control
the bleeding. The most important assessment is for the nurse to:
A. Check that the hemostat is on the bedside
B. Monitor IV fluids for the shift
C. Regularly assess respiratory status
D. Check that the balloon is deflated on a regular basis - Answers Answer: C
Explanation: The respiratory system can become occluded if the balloon slips and moves up the
esophagus, putting pressure on the trachea. This would result in respiratory distress and should be
assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs. This is a
safety intervention.
George has a T tube in place after gallbladder surgery. Before discharge, what information or
instructions should be given regarding the T tube drainage?
A. "If there is any drainage, notify the surgeon immediately."
B. "The drainage will decrease daily until the bile duct heals."
C. "First, the drainage is dark green; then it becomes dark yellow."
D. "If the drainage stops, milk the tube toward the puncture wound." - Answers Answer: B
, Explanation: As healing occurs from the bile duct, bile drains from the tube; the amount of bile should
decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.
The student nurse is teaching the family of a patient with liver failure. You instruct them to limit which
foods in the patient's diet?
A. Meats and beans
B. Butter and gravies
C. Potatoes and pastas
D. Cakes and pastries - Answers Answer: A
Explanation: Meats and beans are high-protein foods. In liver failure, the liver is unable to metabolize
protein adequately, causing protein by-products to build up in the body rather than be excreted
A patient has an acute upper GI hemorrhage. Your interventions include:
A. Treating hypovolemia
B. Treating hypervolemia
C. Controlling the bleeding source
D. Treating shock and diagnosing the bleeding source - Answers Answer: A
Explanation: A patient with an acute upper GI hemorrhage must be treated for hypovolemia and
hemorrhagic shock. You as a nurse can't diagnose the problem. Controlling the bleeding may require
surgery or intensive medical treatment
What information is correct about stomach cancer?
A. Stomach pain is often a late symptom
B. Surgery is often a successful treatment
C. Chemotherapy and radiation are often successful treatments
D. The patient can survive for an extended time with TPN - Answers Answer: A
Explanation: Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor
when the cancer reaches that point. Surgery, chemotherapy, and radiation have minimal positive
effects. TPN may enhance the growth of the cancer
Hepatic encephalopathy develops when the blood level of which substance increases?
A. Ammonia
B. Amylase
C. Calcium
D. Potassium - Answers Answer: A
Explanation: Ammonia levels increase d/t improper shunting of blood, causing ammonia to enter
systemic circulation, which carries it to the brain.
You're caring for a 28 y.o. woman with hepatitis B. She's concerned about the duration of her
recovery. Which response isn't appropriate?
A. Encourage her to not worry about the future.
B. Encourage her to express her feelings about the illness.
C. Discuss the effects of hepatitis B on future health problems.
D. Provide avenues for financial counseling if she expresses the need. - Answers Answer: A
Explanation: Telling her not to worry minimizes her feelings.
Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,"If I lie
still and avoid turning after the operation, I'll avoid pain. Do you think this is a good idea?" What is the
best response?
A. "You'll need to turn from side to side every 2 hours."
B. "It's always a good idea to rest quietly after surgery."
C. "The doctor will probably order you to lie flat for 24 hours."
D. "Why don't you decide about activity after you return from the recovery room? - Answers Answer:
A
Explanation: To prevent venous stasis and improve muscle tone, circulation, and respiratory function,
encourage her to move after surgery.
Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He's jaundiced and
reports weakness. Which intervention will you include in his care?
A. Regular exercise
B. A low-protein diet.
C. Allow patient to select his meals.
D. Rest period after small, frequent meals. - Answers Answer: D
Explanation: Rest periods and small frequent meals is indicated during the acute phase of hepatitis B.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - Answers Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The other
conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the client
has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - Answers Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K to
produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client for signs
of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia. Ascites and
orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular atrophy result from
decreased estrogen metabolism by the diseased liver.
When evaluating a male client for complications of acute pancreatitis, the nurse would observe for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - Answers Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal failure
that sometimes accompanies this condition. Intracranial pressure neither increases nor decreases in a
client with pancreatitis. Tachycardia, not bradycardia, usually is associated with pulmonary or
hypovolemic complications of pancreatitis. Hypotension can be caused by a hypovolemic
complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-tube
has drained 750ml of green-brown drainage. Which nursing intervention is most appropriate?
A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - Answers Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then turns to
green-brown. The drainage is measured as output. The amount of expected drainage will range from
500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is located
in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - Answers Answer: B
Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is most
important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - Answers Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight will help
protect against gallstones. Excessive dietary intake of cholesterol is associated with the development
of gallstones in many people. Dietary protein isn't implicated in cholecystitis. Liquid protein and low-
,calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week) are implicated as the cause of
some cases of cholecystitis. Regular exercise (30 minutes/three times a week) may help reduce weight
and improve fat metabolism. Reducing stress may reduce bile production, which may also indirectly
decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - Answers Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present in
peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up abdominal
muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - Answers Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present. An
abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A barium
swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus, stomach, and
duodenum.
A client being treated for chronic cholecystitis should be given which of the following instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - Answers Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by increasing
physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use to relax smooth
muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - Answers Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to accommodate
the large amount of blood necessary for homeostasis. The pressure in the liver increases and causes
increased pressure in the venous system. As the portal pressure increases, fluid exudes into the
abdominal cavity. This is called ascites.
The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to control
the bleeding. The most important assessment is for the nurse to:
A. Check that the hemostat is on the bedside
B. Monitor IV fluids for the shift
C. Regularly assess respiratory status
D. Check that the balloon is deflated on a regular basis - Answers Answer: C
Explanation: The respiratory system can become occluded if the balloon slips and moves up the
esophagus, putting pressure on the trachea. This would result in respiratory distress and should be
assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs. This is a
safety intervention.
George has a T tube in place after gallbladder surgery. Before discharge, what information or
instructions should be given regarding the T tube drainage?
A. "If there is any drainage, notify the surgeon immediately."
B. "The drainage will decrease daily until the bile duct heals."
C. "First, the drainage is dark green; then it becomes dark yellow."
D. "If the drainage stops, milk the tube toward the puncture wound." - Answers Answer: B
, Explanation: As healing occurs from the bile duct, bile drains from the tube; the amount of bile should
decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.
The student nurse is teaching the family of a patient with liver failure. You instruct them to limit which
foods in the patient's diet?
A. Meats and beans
B. Butter and gravies
C. Potatoes and pastas
D. Cakes and pastries - Answers Answer: A
Explanation: Meats and beans are high-protein foods. In liver failure, the liver is unable to metabolize
protein adequately, causing protein by-products to build up in the body rather than be excreted
A patient has an acute upper GI hemorrhage. Your interventions include:
A. Treating hypovolemia
B. Treating hypervolemia
C. Controlling the bleeding source
D. Treating shock and diagnosing the bleeding source - Answers Answer: A
Explanation: A patient with an acute upper GI hemorrhage must be treated for hypovolemia and
hemorrhagic shock. You as a nurse can't diagnose the problem. Controlling the bleeding may require
surgery or intensive medical treatment
What information is correct about stomach cancer?
A. Stomach pain is often a late symptom
B. Surgery is often a successful treatment
C. Chemotherapy and radiation are often successful treatments
D. The patient can survive for an extended time with TPN - Answers Answer: A
Explanation: Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor
when the cancer reaches that point. Surgery, chemotherapy, and radiation have minimal positive
effects. TPN may enhance the growth of the cancer
Hepatic encephalopathy develops when the blood level of which substance increases?
A. Ammonia
B. Amylase
C. Calcium
D. Potassium - Answers Answer: A
Explanation: Ammonia levels increase d/t improper shunting of blood, causing ammonia to enter
systemic circulation, which carries it to the brain.
You're caring for a 28 y.o. woman with hepatitis B. She's concerned about the duration of her
recovery. Which response isn't appropriate?
A. Encourage her to not worry about the future.
B. Encourage her to express her feelings about the illness.
C. Discuss the effects of hepatitis B on future health problems.
D. Provide avenues for financial counseling if she expresses the need. - Answers Answer: A
Explanation: Telling her not to worry minimizes her feelings.
Gail is scheduled for a cholecystectomy. After completion of preoperative teaching, Gail states,"If I lie
still and avoid turning after the operation, I'll avoid pain. Do you think this is a good idea?" What is the
best response?
A. "You'll need to turn from side to side every 2 hours."
B. "It's always a good idea to rest quietly after surgery."
C. "The doctor will probably order you to lie flat for 24 hours."
D. "Why don't you decide about activity after you return from the recovery room? - Answers Answer:
A
Explanation: To prevent venous stasis and improve muscle tone, circulation, and respiratory function,
encourage her to move after surgery.
Rob is a 46 y.o. admitted to the hospital with a suspected diagnosis of Hepatitis B. He's jaundiced and
reports weakness. Which intervention will you include in his care?
A. Regular exercise
B. A low-protein diet.
C. Allow patient to select his meals.
D. Rest period after small, frequent meals. - Answers Answer: D
Explanation: Rest periods and small frequent meals is indicated during the acute phase of hepatitis B.
