NSG 3850 EXAM 4 STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED SOLUTIONS || 100% GUARANTEED PASS NEWEST VERSION

NSG 3850 EXAM 4 STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED SOLUTIONS || 100% GUARANTEED PASS NEWEST VERSION 1. Cholelithiasis - ANSWER Supersaturation of bile w/ cholesterol causing nucleation of crystals and hypomotility allowing stone growth Nucleation occurs where the cholesterol crystals aggregate together. Continued growth of the crystals then depends on the balance between cholesterol growth What would you see in your patient with this? • Intermittent biliary colic, persistent epigastric or RU abdominal pain • N/V, sweating, flatus, pain radiates to the back • May be precipitated by a meal, may manifest at night What would you teach your patient about what this is? • Need to worry about bile and cholesterol • No fatty foods, avoid alcohol, • Somatostatin---esophgeal varices -do not give • Not going to have somatostatin 2. Cholecystitis - ANSWER Acute inflammation of the gallbladder wall— obstruction of cystic duct=statis of bile in gallbladder What are the risk factors? • Diabetes and obesity What would you see in your patient with this? • Severe right upper abdominal pain that radiates to the back, abdominal tenderness, fever What testing should you anticipate? • Leukocytosis, mild elevations in bilirubin, • Ultrasound, CT, ERCP, no biopsy • Increased risk of cancer • Huge risk for sepsis 3. Hepatitis A - ANSWER enteric hepatitis -RNA virus Fecal-oral route—lack of sanitation and safe water 2-7-week incubation period Malaise, anorexia, nausea, low grade fever, RUQ pain, with or without jaundice Anti-HAV IgM =acute infection Anti-HAV IgG= previous infection or vaccination • immunity Supportive management—avoid alcohol and NSAIDs • Vaccination 4. Hypothyroidism - ANSWER Decreased basal metabolism, weakness, lethargy, cold intolerance, decreased appetite, bradycardia, narrowed pulse pressure, elevated levels of serum cholesterol and triglycerides, constipation, cool dry skin, heavy periods Slow and low, heavy periods 5. Hyperthyroidism - ANSWER Increased metabolic rate, insomnia, restlessness, tremor, irritability, palpitations, increased HR, heat intolerance, diaphoresis, weight loss, amenorrhea, 6. Primary hypothyroidism - ANSWER Congenital agenesis, autoimmune destruction, irradiation, trauma, surgical removal of the gland, iodine deficiency Secondary? • Caused by defects in TSH production—severe head trauma, cranial neoplasms, brain infections, cranial irradiation, TBIs 7. Cushing syndrome (hypercortisolism) - ANSWER Hyperfunction of the adrenal cortex results in conditions characterized by hypercortisolism What would you see in your patient with this? • Moon face, weight gain, dorsocervical fat pad, capillary friability, thinning of the skin with purple striae, ecchymoses over abdomen, arm and thighs • Hypertension—consequence of salt retaining activity of cortisol and of the increased blood volume • Reduction of serum potassium level because of excessive excretion of potassium by the kidneys, hyperglycemia, elevated cortisol levels • Excessive hair production What can cause this? • Primary—disease of the adrenal cortex—low ACTH • Secondary- hyperfunction of anterior pituitary ACTH-secreting cells, and tertiary disease is caused by hypothalamic dysfunction or injury What might you test? • Serum ACTH • Dexamethasone suppression test will be used to differentiate between pituitary causes and ectopic causes of excessive ACTH production 8. a disease of the adrenal cortex resulting in conditions characterized by hypercortisolism - ANSWER Cushing syndrome 9. primary: caused by disease of adrenal cortex (adrenal adenoma) Secondary: caused by ACTH secreting cells, Tertiary: caused by hypothalamic dysfunction or injury - ANSWER Cushing syndrome 10. clinical manifestations: truncal obesity, moon face, flushed cheeks, muscle wasting, petechia, risk for fracture, depression and anxiety - ANSWER Cushing syndrome 11. labs will show hyperglycemia, hypokalemia, elevated serum cortisol - ANSWER cushing syndrome 12. type I hypersensitivity= - ANSWER anaphylaxis 13. type II hypersinsitivity= - ANSWER transfusion reaction 14. type IIb hypersensitivity= - ANSWER graves disease 15. type III hypersensitivity complex glomerulonephritis can be related to... - ANSWER dormant bacterial infecton 16. type IV hypersensitivity= - ANSWER TB test 17. Myxedema coma is a severe condition associated with a. hypothyroidism. b. restlessness. c. acute cortisol insufficiency. d. pheochromocytoma. - ANSWER a. Hypothyroidism 18. Clinical manifestations of hypoparathyroidism a. are similar to those occurring with hypermagnesemia. b. result from decreased neuromuscular excitability. c. are similar to those occurring with hypokalemia. d. result from decreased serum ionized calcium. - ANSWER d. result from decreased serum ionized calcium. 19. The formation of active vitamin D a. occurs in the skin. b. is impaired in renal failure. c. is dependent on oral intake of vitamin D. d. is necessary for normal potassium metabolism. - ANSWER b. is impaired in renal failure 20. Aldosterone secretion is regulated by the presence of - in the circulation. a. progesterone b. corticoglobulin c. ACTH d. angiotensin II - ANSWER d. angiotensin II 21. A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is a. hypokalemia. b. hypoglycemia. c. hypertension. d. moon face. - ANSWER b. Hypoglycemia 22. What effect would adrenocortical insufficiency have on an individual's response to surgical stress? a. More prone to hyperglycemia b. Exaggerated sensitivity to anesthesia c. More susceptible to hypertensive crisis d. More prone to hypotension - ANSWER d. More prone to hypotension