Nurs 497 Exam 2 Questions With Verified Solutions Latest Update 2026

NURS 497 EXAM 2 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 What is the cause of the hyperpigmentation seen in people with Cushing's syndrome? a. Permissive effects of aldosterone when cortisol levels are altered b. Abnormal levels of cortisol c. Hypersensitivity of melanocytes with sun exposure d. Elevated levels of ACTH - Answers d. Elevated levels of ACTH Which of the following alterations would the nurse expect to find in a patient with untreated Cushing's disease or syndrome? a. Bradycardia b. Hypertension c. Hyperkalemia d. Tachypnea - Answers b. Hypertension What is the earliest manifestation of diabetes-induced kidney dysfunction? a. Polyuria b. Glycosuria c. Microalbuminuria d. Decreased glomerular filtration - Answers c. Microalbuminuria A 65-year-old patient has been taking prednisone to manage symptoms of Crohn's disease for the past several years. When following up with her gastroenterologist, she was diagnosed with Cushing syndrome. Which signs and symptoms would the nurse expect to observe that would support this diagnosis? select all that apply a. Elevated serum ACTH level b. Excess bruising on arms and legs c. Watery bowel movements d. Abdominal cramping e. Hypokalemia f. Hypoglycemia g. Muscle weakness in legs and arms h. Increased facial hair - Answers b. Excess bruising on arms and legs e. Hypokalemia g. Muscle weakness in legs and arms h. Increased facial hair What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test? a. Checking for hyperlipidemia b. Measuring fasting glucose levels c. Monitoring long-term serum glucose control d. Detecting acute complications of diabetes - Answers c. Monitoring long-term serum glucose control A patient is admitted to the medical unit for complications of long-term, poorly controlled type 2 DM. Which of the following would the nurse expect to find in addition to elevated glucose? a. Metabolic alkalosis b. Atherosclerosis c. Anemia d. Elevated liver enzymes - Answers b. Atherosclerosis Which physical feature supports the diagnosis of Cushing's syndrome? a. Pallor and swollen tongue b. Weight loss and muscle wasting c. Truncal obesity and moon face d. Depigmented skin and eyelid lag - Answers c. Truncal obesity and moon face What causes the chronic microvascular and macrovascular complications of DM? a. Hyperglycemia b. Pancreatic changes c. Ketone toxicity d. Hyperinsulinemia - Answers a. Hyperglycemia A nurse checks laboratory results as both Cushing's disease and Addison's disease can manifest with elevated levels of: a. aldosterone. b. estrogen. c. adrenocorticotropic hormone (ACTH). d. ADH. - Answers c. adrenocorticotropic hormone (ACTH). What is the most common cause of Addison's disease? a. An autoimmune reaction b. Cancer c. Viral infection of the pituitary gland d. Dietary deficiency of sodium and potassium - Answers a. An autoimmune reaction A client has a history of daily bourbon drinking for the past 6 months. He is brought to an emergency department by family, who report that his last drink was 1 hour ago. It is now 12 midnight. When should a nurse expect this client to exhibit withdrawal symptoms? A. At the beginning of the third day B. Shortly after a 24-hour period C. Withdrawal is individualized and cannot be predicted. D. Between 3 a.m. and 11 a.m. - Answers D. Between 3 a.m. and 11 a.m. a client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess? A. Gross tremors, delirium, hyperactivity, and hypertension B. Disorientation, peripheral neuropathy, and hypotension C. Hallucinations, fine tremors, confabulation, and orthostatic hypotension D. Oculogyric crisis, amnesia, ataxia, and hypertension - Answers A. Gross tremors, delirium, hyperactivity, and hypertension A military veteran is being assessed for outpatient therapy after he reports having problems at home and at work. Which of the symptoms that he describes are commonly associated with PTSD? Select all that apply. A. "I've been having intense pain in the leg where I sustained a combat wound." B. "I slapped my wife when she was trying to hug me." C. "I've been drinking and smoking pot daily." D. "I've been having trouble sleeping and I think I've been having nightmares but I can't remember them." - Answers B. "I slapped my wife when she was trying to hug me." C. "I've been drinking and smoking pot daily." D. "I've been having trouble sleeping and I think I've been having nightmares but I can't remember them." A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first? A. A client diagnosed with oppositional defiant disorder being sexually inappropriate with staff B. A client diagnosed with conduct disorder who is demanding special attention from staff C. A client diagnosed with attention-deficit disorder who has a history of self-mutilation D. A client diagnosed with conduct disorder who is verbally abusing a peer in the milieu - Answers D. A client diagnosed with conduct disorder who is verbally abusing a peer in the milieu A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total body weight. Which subjective client response would the nurse assess to support this medical diagnosis? A. "I am losing lots of hair. It's coming out in handfuls." B. "I do not use any laxatives or diuretics to lose weight." C. "I don't know why people are worried. I need to lose this weight." D. "I know that I am thin, but I refuse to be fat!" - Answers C. "I don't know why people are worried. I need to lose this weight." A nursing instructor presents a case study in which a 3-year-old child is in constant motion and is unable to sit still during story time. The instructor asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation? A. "This child has symptoms of attention-deficit/hyperactivity disorder." B. "This child has symptoms of the early stages of autistic disorder." C. "This child's behavior indicates possible symptoms of oppositional defiant disorder." D. "This child's behavior must be evaluated according to developmental norms." - Answers D. "This child's behavior must be evaluated according to developmental norms." A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates that learning has occurred? A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not." B. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not." C. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not." D. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not." - Answers A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not." A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this assessment finding? A. Poor dental and oral hygiene leads to dental caries. B. Purging causes the depletion of dietary calcium. C. Food is rapidly ingested without proper mastication. D. The emesis produced during purging is acidic and corrodes the tooth enamel. - Answers D. The emesis produced during purging is acidic and corrodes the tooth enamel. A child has been diagnosed with autism spectrum disorder. The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing reply is most appropriate? A. "Researchers really don't know what causes autistic disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored." B. "Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control." C. "Research has shown that the mother appears to play a greater role in the development of this disorder than the father." D. "Lack of early infant bonding with the mother has shown to be a cause of autistic disorder. Did you breastfeed or bottle-feed?" - Answers B. "Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control." A nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention? a. to assess for emotional strength b. to assess for Wernicke-Korsakoff syndrome c. to assess for tachycardia d. to assess for fine tremors - Answers d. to assess for fine tremors how should the nurse assess a patient for alcohol addiction? a. by referring the client for physician examination b. by using a screening tool such as the CAGE questionnaire c. by asking directly if the client has ever had an issue with alcohol - Answers b. by using a screening tool such as the CAGE questionnaire a pt is admitted to the ED for recent meth use. What assessments need to be prioritzed be the nurse? a. obtain a health history including prior drug use b. monitor client's ECG and vital signs c. reorient the client at frequent intervals d. keep the client in a quiet and darkened room - Answers b. monitor client's ECG and vital signs a client arrives at the ED with severe chest pain and agitation. What should the nurse do first? a. give the PRN naloxone IV b. ask about any use of stimulant drugs c. assess orientation to person, place, and time d. check blood pressure, pulse, and respirations - Answers d. check blood pressure, pulse, and respirations what are main symptoms ofopioid withdrawal? a. nausea and vomiting b. tremors and seizures c. lethargy and disorientation d. delusions and hallucinations - Answers a. nausea and vomiting which of the following routes of cocaine administration results in the fastest absorption and the highest "rush"? a. smoking b. oral c. buccal d. intranasal - Answers a. smoking acute intoxication of psychoactive substances responses usually resolve with which of the following time frames? a. 4 hours b. 24 hours c. 12 hours d. 48 hours - Answers b. 24 hours a nurse finds nasal sores and necrosis of the nasal septum. What substance use disorder may the nurse suspect? a. marijuana b. cocaine c. tobacco d. heroin - Answers b. cocaine which of the following assessment data should the nurse expect for a pt with alcohol use? a. low blood pressure b. decreased heart rate c. elevated temperature d. abdominal tenderness - Answers d. abdominal tenderness The nurse is caring for a patient with anemia who is experiencing increased fatigue and occasional palpitations at rest. Which of the following laboratory findings should the nurse expect? A. RBC count of 4.5 × 1012/L B. Normal red blood cell (RBC) indices C. Hemoglobin (Hb) of 86 g/L D. Hematocrit (Hct) of 38% - Answers C. Hemoglobin (Hb) of 86 g/L A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient? (Select all that apply.) a. Swelling in the tissues b. Failure of mechanisms of compensatory erythropoiesis c. Increased basal metabolic rate d. Disturbances of the iron cycle e. Decreased erythrocyte life span - Answers b. Failure of mechanisms of compensatory erythropoiesis d. Disturbances of the iron cycle e. Decreased erythrocyte life span Considering anemia, what effect do vitamin B12 and folate deficiencies have on red blood cells? a. Erythrocytes contain malformed hemoglobin molecules. b. O2-carrying capacity is decreased in erythrocytes. c. Erythrocyte life span is shorter. d. Stem cells are unable to differentiate into erythrocytes. - Answers c. Erythrocyte life span is shorter. Which of the following statements about a patient with sickle cell anemia indicates good understanding of the nurse's teaching about prevention of a sickle cell crisis? A. Risk for crisis can be lowered by having an annual influenza vaccination B. Routine continuous dosage narcotics are prescribed to prevent a crisis C. There are no effective medications that can prevent sickling D. Home oxygen therapy is frequently used to decrease sickling - Answers A. Risk for crisis can be lowered by having an annual influenza vaccination A 60-year-old patient diagnosed with emphysema experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand?