NURS 221
EXAM 2
ACTUAL Questions with Rationales
(Concepts of Pathophysiology in Nursing)
Drexel University
This Document Description:
This document contains a collection of Verified
questions with accurate Answers with
Rationales from Exam 2 of NURS 221 at the
Drexel University. It covers core topics assessed in
the course and reflects the actual exam format and question
style. Ideal for exam preparation and concept reinforcement.
,1. The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic
shock. The nurse is most concerned if the client's output is:
a. 20 mL/hour
b. 40 mL/hour
c. 60 mL/hour
d. 80 mL/hour
Correct Answer:
a. 20 mL/hour
Expert Explanation:
In hypovolemic shock, decreased circulating volume lowers renal perfusion. Urine
output below 30 mL/hour is concerning because it suggests inadequate kidney blood
flow and impaired tissue perfusion.
2. A client recovered from influenza 2 days ago and informs the nurse that she is
feeling better but now has a fever, chills, pain when breathing, and a productive
cough. What complication does the nurse anticipate the client will be treated for?
a. A secondary bacterial pneumonia
b. A relapse of the flu
c. Reye syndrome
d. Tuberculosis
Correct Answer:
a. A secondary bacterial pneumonia; people usually start to feel better and then
symptoms return
Expert Explanation:
Influenza can damage respiratory epithelium and impair local immune defenses,
allowing bacteria to invade. A return of fever, chills, pleuritic pain, and productive cough
after improvement is classic for secondary bacterial pneumonia.
3. Which client is at risk for developing acute respiratory failure?
,a. A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has
pneumonia with low O2 saturation
b. An older adult female living in senior housing who has been exposed to a "cold" while
her grandchildren visited
c. A teenager in a high school who has had an increase in student absences due to an
outbreak of strep throat
d. A toddler in daycare who has been sharing toys with peers before the staff could
sanitize properly
Correct Answer:
a. A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has
pneumonia with low O2 saturation
Expert Explanation:
ALS weakens respiratory muscles, reducing ventilation and cough effectiveness.
Pneumonia further impairs gas exchange, making this client at high risk for acute
respiratory failure.
4. A client with a history of chronic kidney disease (CKD) is experiencing increasing
fatigue, lethargy, and activity intolerance. The care team has established that the
client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which
laboratory assessments will most likely be prescribed to help determine the cause of
these new symptoms?
a. Blood work for white cells and differential
b. Cystoscopy and ureteroscopy
c. Assessment of pancreatic exocrine and endocrine function
d. Blood work for hemoglobin, red blood cells, and hematocrit
Correct Answer:
d. Blood work for hemoglobin, red blood cells, and hematocrit
Expert Explanation:
CKD decreases erythropoietin production, reducing red blood cell formation. Fatigue,
lethargy, and activity intolerance suggest anemia, so hemoglobin, RBC count, and
hematocrit are appropriate tests.
, 5. Following several weeks of increasing fatigue and a subsequent diagnostic workup,
a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve
would have which hemodynamic consequences?
a. Backup of blood from the right atrium into the superior vena cava
b. Backflow from the right ventricle to the right atrium during systole
c. Inhibition of the SA node's normal action potential
d. Backflow from the left ventricle to left atrium
Correct Answer:
d. Backflow from the left ventricle to left atrium
Expert Explanation:
The mitral valve separates the left atrium and left ventricle. In mitral regurgitation, the
valve does not close properly during systole, allowing blood to flow backward into the
left atrium.
6. A client with a suspected MI is brought to the emergency department by
ambulance. The nurse caring for this client would expect to receive an order for which
laboratory test to confirm a diagnosis of MI?
a. Creatine kinase marker
b. Complete blood components
c. Calcium level
d. Troponin level
Correct Answer:
d. Troponin level
Expert Explanation:
Troponin is highly specific for myocardial cell injury. When cardiac myocytes die during
myocardial infarction, troponin is released into the blood.
7. A client has been diagnosed with aortic stenosis and asks the nurse what this
means. The most appropriate response would be:
EXAM 2
ACTUAL Questions with Rationales
(Concepts of Pathophysiology in Nursing)
Drexel University
This Document Description:
This document contains a collection of Verified
questions with accurate Answers with
Rationales from Exam 2 of NURS 221 at the
Drexel University. It covers core topics assessed in
the course and reflects the actual exam format and question
style. Ideal for exam preparation and concept reinforcement.
,1. The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic
shock. The nurse is most concerned if the client's output is:
a. 20 mL/hour
b. 40 mL/hour
c. 60 mL/hour
d. 80 mL/hour
Correct Answer:
a. 20 mL/hour
Expert Explanation:
In hypovolemic shock, decreased circulating volume lowers renal perfusion. Urine
output below 30 mL/hour is concerning because it suggests inadequate kidney blood
flow and impaired tissue perfusion.
2. A client recovered from influenza 2 days ago and informs the nurse that she is
feeling better but now has a fever, chills, pain when breathing, and a productive
cough. What complication does the nurse anticipate the client will be treated for?
a. A secondary bacterial pneumonia
b. A relapse of the flu
c. Reye syndrome
d. Tuberculosis
Correct Answer:
a. A secondary bacterial pneumonia; people usually start to feel better and then
symptoms return
Expert Explanation:
Influenza can damage respiratory epithelium and impair local immune defenses,
allowing bacteria to invade. A return of fever, chills, pleuritic pain, and productive cough
after improvement is classic for secondary bacterial pneumonia.
3. Which client is at risk for developing acute respiratory failure?
,a. A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has
pneumonia with low O2 saturation
b. An older adult female living in senior housing who has been exposed to a "cold" while
her grandchildren visited
c. A teenager in a high school who has had an increase in student absences due to an
outbreak of strep throat
d. A toddler in daycare who has been sharing toys with peers before the staff could
sanitize properly
Correct Answer:
a. A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has
pneumonia with low O2 saturation
Expert Explanation:
ALS weakens respiratory muscles, reducing ventilation and cough effectiveness.
Pneumonia further impairs gas exchange, making this client at high risk for acute
respiratory failure.
4. A client with a history of chronic kidney disease (CKD) is experiencing increasing
fatigue, lethargy, and activity intolerance. The care team has established that the
client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which
laboratory assessments will most likely be prescribed to help determine the cause of
these new symptoms?
a. Blood work for white cells and differential
b. Cystoscopy and ureteroscopy
c. Assessment of pancreatic exocrine and endocrine function
d. Blood work for hemoglobin, red blood cells, and hematocrit
Correct Answer:
d. Blood work for hemoglobin, red blood cells, and hematocrit
Expert Explanation:
CKD decreases erythropoietin production, reducing red blood cell formation. Fatigue,
lethargy, and activity intolerance suggest anemia, so hemoglobin, RBC count, and
hematocrit are appropriate tests.
, 5. Following several weeks of increasing fatigue and a subsequent diagnostic workup,
a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve
would have which hemodynamic consequences?
a. Backup of blood from the right atrium into the superior vena cava
b. Backflow from the right ventricle to the right atrium during systole
c. Inhibition of the SA node's normal action potential
d. Backflow from the left ventricle to left atrium
Correct Answer:
d. Backflow from the left ventricle to left atrium
Expert Explanation:
The mitral valve separates the left atrium and left ventricle. In mitral regurgitation, the
valve does not close properly during systole, allowing blood to flow backward into the
left atrium.
6. A client with a suspected MI is brought to the emergency department by
ambulance. The nurse caring for this client would expect to receive an order for which
laboratory test to confirm a diagnosis of MI?
a. Creatine kinase marker
b. Complete blood components
c. Calcium level
d. Troponin level
Correct Answer:
d. Troponin level
Expert Explanation:
Troponin is highly specific for myocardial cell injury. When cardiac myocytes die during
myocardial infarction, troponin is released into the blood.
7. A client has been diagnosed with aortic stenosis and asks the nurse what this
means. The most appropriate response would be:
