NURSl 5463/l NURS5463l Examl 2l (Newl
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Review|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Whatl shouldl thel AGACNPl assessl next?
a.)l Repeatl labs
b.)l Cardiopulmonaryl status
c.)l Mentall status
d.)l Fluidl volumel status
Answer:
d.)l Fluidl volumel status
Thel nextl stepl inl thel differentiationl ofl al hyponatremial isl tol assessl fluidl status.l Thisl
patientl hasl hypotonic,l Euvolemic,l hyponatremial andl thel assessmentl ofl hisl fluidl statusl isl
thel nextl stepl inl thel diagnosis.
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
,sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Urinel osmolalityl isl 300l m0sm/kgl andl urinel sodiuml 35l mEq/L.l Whatl isl thel
mostl likelyl diagnosis?
a.)l Cerebrall Saltl Wasting
b.)l Diabetesl Inspidus
c.)l SIADH
d.)l Adrenall Insufficiency
Answer:
c.)l SIADH
Thel clinicall scenariol isl consistentl withl SIADH.l Therel isl nothingl inl thel scenariol tol
suggestl anyl otherl diagnosis.l ADHl secretionl isl increasedl forl thel firstl fewl daysl postl
operatively.l Alsol painl andl nauseal mayl alsol causel anl increasel secretionl ofl ADH.
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Urinel osmolalityl isl 300l m0sm/kgl andl urinel sodiuml 35l mEq/L.l Howl shouldl
thisl conditionl bel treated?
a.)l Freel waterl restrictionl ofl 900mll perl day
b.)l Sodiuml replacementl withl hypertonicl saline
c.)l Saltl tabletsl TID
d.)l Sodiuml replacementl withl Normall saline
Answer:
a.)l Freel waterl restrictionl ofl 900mll perl day
,Thel mostl appropriatel treatmentl forl SIADHl inl thisl instancel isl al freel waterl restriction.l
Sodiuml replacementl withl hypertonicl salinel shouldl notl occurl unlessl thel personl hasl al
severel hyponatremia.l Saltl tabletsl mayl bel usedl inl cerebrall saltl wastingl andl havel nol
rolel inl thel treatmentl ofl SIADH.l Administrationl ofl normall salinel willl worsenl al
hyponatremial whichl isl secondaryl tol SIADH.
QUESTION
Twol daysl afterl caringl forl al patientl withl SIADHl onl al freel waterl restriction,l thel patientl
becomesl confusedl andl hisl sodiuml levell hasl droppedl tol 118l mEq/L.l Hisl creatininel isl
nowl elevatedl atl 2.5l mg/dLl andl twol daysl agol itl wasl 1.2l mg/dL.l Whichl interventionsl
shouldl thel AGACNPl dol next?
a.)l Consultl nephrologyl andl transferl tol thel intensivel carel unit
b.)l Administerl furosemidel IV,l consultl yourl collaboratingl physicianl andl givel normall
saline
c.)l Consultl theirl collaboratingl physicianl andl administerl normall saline
d.)l Consultl endocrinologyl andl administerl normall salinel infusion
Answer:
a.)l Consultl nephrologyl andl transferl tol thel intensivel carel unit
Thisl patientl hasl al severel hyponatremial whichl requiresl thel administrationl ofl hypertonicl
salinel andl ICUl admission.l Thel situationl isl complicatedl byl anl AKIl andl thisl warrantsl
thel involvementl ofl nephrology.l Normall salinel willl makel thel hyponatremial worse.l Therel
isl nol indicationl forl consultationl withl endocrinologyl orl thel collaboratingl physician.
QUESTION
Al patientl withl SIADHl isl beingl dischargedl homel withl al freel waterl fluidl restriction.l
Anticipatoryl guidancel forl thisl patientl shouldl includel whichl item?
a.)l Instructionsl tol returnl tol thel EDl inl 2l daysl tol havel hisl sodiuml levell rechecked.
b.)l Instructionsl tol continuel thel fluidl restrictionl indefinitely.
c.)l Instructionsl tol stopl thel fluidl restrictionl tomorrow.
d.)l Instructionsl onl whenl tol followl upl withl theirl primaryl carel provider.
Answer:
d.)l Instructionsl onl whenl tol followl upl withl theirl primaryl carel provider.
, Thisl patientl shouldl bel informedl whenl tol followl upl withl theirl PCP.l Theyl shouldl notl
stopl thel freel waterl restrictionl withoutl havingl al followl upl appointmentl andl labs.l Theyl
shouldl notl returnl tol thel EDl forl routinel care.
QUESTION
Thel AGACNPl isl calledl tol evaluatel anl AAl malel patientl admittedl onl thel generall
medicall floorl forl ETOHl withdrawal.l Uponl arrivall shel notesl thatl thel patientl isl veryl
agitated,l isl pacingl inl andl outl ofl hisl room,l hasl injectedl eyesl andl isl refusingl care.l Hel
isl orientedl tol personl only.l Hel hasl hadl al lorazepaml (Ativan)l 12l mgl IVl overl thel lastl 3l
hoursl withoutl anyl response.l Whichl interventionl isl mostl importantl forl thel AGACNPl dol
next?
a.)l Increasel thel dosel ofl Ativan
b.)l Consultl withl thel collaboratingl physician
c.)l Addl Chlordiazepoxidel (Librium)l PO
d.)l Consultl thel ICUl Team
Answer:
d.)l Consultl thel ICUl Team
Thisl patientl hasl al severel casel ofl ETOHl withdrawall whichl isl notl respondingl tol currentl
treatment.l Hel requiresl al higherl levell ofl carel andl al lorazepaml infusion.l Thisl canl onlyl
bel donel inl thel ICUl setting.l Therel isl nol needl tol consultl withl thel collaboratingl
physicianl atl thisl time,l thel mostl importantl consultl isl thel ICU.
QUESTION
Uponl admissionl forl al leftl hipl fracture,l itl isl mostl importantl thatl al patientl withl al longl
historyl ofl dailyl ETOHl abusel receivel anticipatoryl guidancel andl educationl regardingl
whichl topic?
a.)l Alcoholicsl Anonymous
b.)l Malnutrition
c.)l Cessation
d.)l Deliriuml Tremens
Answer:
d.)l Deliriuml Tremens
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Review|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Whatl shouldl thel AGACNPl assessl next?
a.)l Repeatl labs
b.)l Cardiopulmonaryl status
c.)l Mentall status
d.)l Fluidl volumel status
Answer:
d.)l Fluidl volumel status
Thel nextl stepl inl thel differentiationl ofl al hyponatremial isl tol assessl fluidl status.l Thisl
patientl hasl hypotonic,l Euvolemic,l hyponatremial andl thel assessmentl ofl hisl fluidl statusl isl
thel nextl stepl inl thel diagnosis.
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
,sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Urinel osmolalityl isl 300l m0sm/kgl andl urinel sodiuml 35l mEq/L.l Whatl isl thel
mostl likelyl diagnosis?
a.)l Cerebrall Saltl Wasting
b.)l Diabetesl Inspidus
c.)l SIADH
d.)l Adrenall Insufficiency
Answer:
c.)l SIADH
Thel clinicall scenariol isl consistentl withl SIADH.l Therel isl nothingl inl thel scenariol tol
suggestl anyl otherl diagnosis.l ADHl secretionl isl increasedl forl thel firstl fewl daysl postl
operatively.l Alsol painl andl nauseal mayl alsol causel anl increasel secretionl ofl ADH.
QUESTION
Youl arel thel medicall consultantl forl al 75-year-oldl malel patientl whol wasl admittedl tol thel
hospitall forl repairl ofl al leftl hipl fracture.l Orthopedicsl hasl consultedl youl tol assistl withl
thel evaluationl andl managementl ofl hyponatremia.l Todayl hel isl 2l daysl postl opl andl hisl
sodiuml hasl droppedl froml 138l mEq/Ll onl admissionl tol 130l mEq/Ll today.l Hel reportsl
thatl hel hasl al lotl ofl painl froml hisl surgeryl andl hisl painl levell isl 8l outl ofl 10l today.l Hel
hasl somel nausea,l butl thel ondansetronl (Zofran)l isl working.l Hel isl alertl andl orientedl x3.l
Vitalsl andl examl arel unremarkable.l Labs:l Creatininel 1.0l mg/dLl andl BUNl 10l mg/dL,l Nal
130l mEq/L,l Potassiuml isl 3.2l mEq/L,l glucosel isl 90l mg/dL.l Seruml osmolalityl isl 274.5l
mOm/kg.l Urinel osmolalityl isl 300l m0sm/kgl andl urinel sodiuml 35l mEq/L.l Howl shouldl
thisl conditionl bel treated?
a.)l Freel waterl restrictionl ofl 900mll perl day
b.)l Sodiuml replacementl withl hypertonicl saline
c.)l Saltl tabletsl TID
d.)l Sodiuml replacementl withl Normall saline
Answer:
a.)l Freel waterl restrictionl ofl 900mll perl day
,Thel mostl appropriatel treatmentl forl SIADHl inl thisl instancel isl al freel waterl restriction.l
Sodiuml replacementl withl hypertonicl salinel shouldl notl occurl unlessl thel personl hasl al
severel hyponatremia.l Saltl tabletsl mayl bel usedl inl cerebrall saltl wastingl andl havel nol
rolel inl thel treatmentl ofl SIADH.l Administrationl ofl normall salinel willl worsenl al
hyponatremial whichl isl secondaryl tol SIADH.
QUESTION
Twol daysl afterl caringl forl al patientl withl SIADHl onl al freel waterl restriction,l thel patientl
becomesl confusedl andl hisl sodiuml levell hasl droppedl tol 118l mEq/L.l Hisl creatininel isl
nowl elevatedl atl 2.5l mg/dLl andl twol daysl agol itl wasl 1.2l mg/dL.l Whichl interventionsl
shouldl thel AGACNPl dol next?
a.)l Consultl nephrologyl andl transferl tol thel intensivel carel unit
b.)l Administerl furosemidel IV,l consultl yourl collaboratingl physicianl andl givel normall
saline
c.)l Consultl theirl collaboratingl physicianl andl administerl normall saline
d.)l Consultl endocrinologyl andl administerl normall salinel infusion
Answer:
a.)l Consultl nephrologyl andl transferl tol thel intensivel carel unit
Thisl patientl hasl al severel hyponatremial whichl requiresl thel administrationl ofl hypertonicl
salinel andl ICUl admission.l Thel situationl isl complicatedl byl anl AKIl andl thisl warrantsl
thel involvementl ofl nephrology.l Normall salinel willl makel thel hyponatremial worse.l Therel
isl nol indicationl forl consultationl withl endocrinologyl orl thel collaboratingl physician.
QUESTION
Al patientl withl SIADHl isl beingl dischargedl homel withl al freel waterl fluidl restriction.l
Anticipatoryl guidancel forl thisl patientl shouldl includel whichl item?
a.)l Instructionsl tol returnl tol thel EDl inl 2l daysl tol havel hisl sodiuml levell rechecked.
b.)l Instructionsl tol continuel thel fluidl restrictionl indefinitely.
c.)l Instructionsl tol stopl thel fluidl restrictionl tomorrow.
d.)l Instructionsl onl whenl tol followl upl withl theirl primaryl carel provider.
Answer:
d.)l Instructionsl onl whenl tol followl upl withl theirl primaryl carel provider.
, Thisl patientl shouldl bel informedl whenl tol followl upl withl theirl PCP.l Theyl shouldl notl
stopl thel freel waterl restrictionl withoutl havingl al followl upl appointmentl andl labs.l Theyl
shouldl notl returnl tol thel EDl forl routinel care.
QUESTION
Thel AGACNPl isl calledl tol evaluatel anl AAl malel patientl admittedl onl thel generall
medicall floorl forl ETOHl withdrawal.l Uponl arrivall shel notesl thatl thel patientl isl veryl
agitated,l isl pacingl inl andl outl ofl hisl room,l hasl injectedl eyesl andl isl refusingl care.l Hel
isl orientedl tol personl only.l Hel hasl hadl al lorazepaml (Ativan)l 12l mgl IVl overl thel lastl 3l
hoursl withoutl anyl response.l Whichl interventionl isl mostl importantl forl thel AGACNPl dol
next?
a.)l Increasel thel dosel ofl Ativan
b.)l Consultl withl thel collaboratingl physician
c.)l Addl Chlordiazepoxidel (Librium)l PO
d.)l Consultl thel ICUl Team
Answer:
d.)l Consultl thel ICUl Team
Thisl patientl hasl al severel casel ofl ETOHl withdrawall whichl isl notl respondingl tol currentl
treatment.l Hel requiresl al higherl levell ofl carel andl al lorazepaml infusion.l Thisl canl onlyl
bel donel inl thel ICUl setting.l Therel isl nol needl tol consultl withl thel collaboratingl
physicianl atl thisl time,l thel mostl importantl consultl isl thel ICU.
QUESTION
Uponl admissionl forl al leftl hipl fracture,l itl isl mostl importantl thatl al patientl withl al longl
historyl ofl dailyl ETOHl abusel receivel anticipatoryl guidancel andl educationl regardingl
whichl topic?
a.)l Alcoholicsl Anonymous
b.)l Malnutrition
c.)l Cessation
d.)l Deliriuml Tremens
Answer:
d.)l Deliriuml Tremens
