NURS 231 PATHOPHYSIOLOGY ACTUAL
TEST SCRIPT WITH SOLVED QUESTIONS
AND VERIFIED ANSWERS
●● Match the lab profile with the most likely fluid imbalance like A)
Fluid Volume Deficit 2) Fluid Volume Excess
1) ____Na 148; Hct 40% yesterday, 49% today; serum osmolarity 308
2) ____Hgb 13.2 yesterday, 10.1 today; Urine specific gravity 1.001
3) ____BUN 45; Cr 0.7
Answer: 1) A
2) B
3) A
●● The nurse is preparing to administer lisinopril (Zestril) to a patient
with acute coronary syndrome. Which of the following findings should
prompt the nurse to hold the medication and consult the healthcare
provider?
a) Serum sodium level 134
b) Serum potassium 5.6
c) Heart rate 58
d) Blood pressure 125/78
Answer: b) Serum potassium 5.6
*ACE inhibitors can cause/exacerbate hyperkalemia.
,●● The nurse is caring for a patient who is in hypovolemic shock
following an extensive burn injury. What is the intravenous fluid of
choice for this patient in the emergent phase of treatment?
a) Lactated Ringers
b) 0.45 NS with 20 mEq potassium chloride
c) Fresh Frozen Plasma
d) 5% Dextrose in saline
Answer: a) Lactated Ringers
*Isotonic solutions (crystalloids) are used to restore fluid volume in
patients with shock. Lactated Ringers is isotonic. Normal saline is also
isotonic.
●● The client on a ventilator is assessed for untoward responses to the
therapy. Which of the following would indicate a possible complication
of ventilator therapy?
a) Blood pressure has increased 5mmHg in the last 24 hours
b) Lung sounds absent on one side.
c) Forceful cough periodically
d) Broncho-vesicular breath sounds throughout peripheral lung fields.
Answer: b) Lung sounds absent on one side.
*This may indicate a pneumothorax--a complication caused by
barotrauma.
,●● The pressure reading during inspiration on the ventilator of a client
receiving mechanical ventilation is high and alarming intermittently.
What is the nurse's first action?
a) Assess the client's oxygenation.
b) Call the RT to check the ventilator settings.
c) Listen for bilateral lung sounds.
d) Determine whether an air leak is present in the client's endotracheal
tube cuff.
Answer: a) Assess the client's oxygenation.
●● Which assessment finding best indicates that fluid resuscitation
therapy for the patient with hypertonic dehydration has acheived the
desired effect?
a) Peripheral pulses changed from 1+ to 3+
b) Neck veins slightly distended @ 30 degrees
c) Serum sodium level has changed from 151 to 143.
d) Pulse oximetry shows oxygen saturation of 95%
Answer: c) Serum sodium level has changed from 151 to 143.
●● Which intravenous solution should you be prepared to administer to
a patient with isotonic dehydration?
a) 0.45% saline
b) Dextrose 5% in water
c) Dextrose 10% in water
, d) 0.9% saline
Answer: d) 0.9% saline
●● A patient is receiving dobutamine [Dobutrex] as a continuous
infusion in the immediate postoperative period. The patient also is
receiving a diuretic. What adverse drug reactions are possible in this
patient? (select all that apply)
a)Angina
b)Hypotension
c)Dysrhythmias
d)Oliguria
e)Tachycardia
Answer: a)Angina
c)Dysrhythmias
e)Tachycardia
*Is a beta1 aderenergic agonist; general anesthetics can increase the
likelihood of dysrhythmias. Dobutamine elevates BP by increasing CO.
Diuretics complement the beneficial effects of dobutamine on the
kidney, so urine output would be increased, not decreased.
●● A patient who has severe sepsis is receiving an intravenous normal
saline infusion. She weighs 78 kgs. Which of the following is an
indicator that the therapeutic goal has been met?
TEST SCRIPT WITH SOLVED QUESTIONS
AND VERIFIED ANSWERS
●● Match the lab profile with the most likely fluid imbalance like A)
Fluid Volume Deficit 2) Fluid Volume Excess
1) ____Na 148; Hct 40% yesterday, 49% today; serum osmolarity 308
2) ____Hgb 13.2 yesterday, 10.1 today; Urine specific gravity 1.001
3) ____BUN 45; Cr 0.7
Answer: 1) A
2) B
3) A
●● The nurse is preparing to administer lisinopril (Zestril) to a patient
with acute coronary syndrome. Which of the following findings should
prompt the nurse to hold the medication and consult the healthcare
provider?
a) Serum sodium level 134
b) Serum potassium 5.6
c) Heart rate 58
d) Blood pressure 125/78
Answer: b) Serum potassium 5.6
*ACE inhibitors can cause/exacerbate hyperkalemia.
,●● The nurse is caring for a patient who is in hypovolemic shock
following an extensive burn injury. What is the intravenous fluid of
choice for this patient in the emergent phase of treatment?
a) Lactated Ringers
b) 0.45 NS with 20 mEq potassium chloride
c) Fresh Frozen Plasma
d) 5% Dextrose in saline
Answer: a) Lactated Ringers
*Isotonic solutions (crystalloids) are used to restore fluid volume in
patients with shock. Lactated Ringers is isotonic. Normal saline is also
isotonic.
●● The client on a ventilator is assessed for untoward responses to the
therapy. Which of the following would indicate a possible complication
of ventilator therapy?
a) Blood pressure has increased 5mmHg in the last 24 hours
b) Lung sounds absent on one side.
c) Forceful cough periodically
d) Broncho-vesicular breath sounds throughout peripheral lung fields.
Answer: b) Lung sounds absent on one side.
*This may indicate a pneumothorax--a complication caused by
barotrauma.
,●● The pressure reading during inspiration on the ventilator of a client
receiving mechanical ventilation is high and alarming intermittently.
What is the nurse's first action?
a) Assess the client's oxygenation.
b) Call the RT to check the ventilator settings.
c) Listen for bilateral lung sounds.
d) Determine whether an air leak is present in the client's endotracheal
tube cuff.
Answer: a) Assess the client's oxygenation.
●● Which assessment finding best indicates that fluid resuscitation
therapy for the patient with hypertonic dehydration has acheived the
desired effect?
a) Peripheral pulses changed from 1+ to 3+
b) Neck veins slightly distended @ 30 degrees
c) Serum sodium level has changed from 151 to 143.
d) Pulse oximetry shows oxygen saturation of 95%
Answer: c) Serum sodium level has changed from 151 to 143.
●● Which intravenous solution should you be prepared to administer to
a patient with isotonic dehydration?
a) 0.45% saline
b) Dextrose 5% in water
c) Dextrose 10% in water
, d) 0.9% saline
Answer: d) 0.9% saline
●● A patient is receiving dobutamine [Dobutrex] as a continuous
infusion in the immediate postoperative period. The patient also is
receiving a diuretic. What adverse drug reactions are possible in this
patient? (select all that apply)
a)Angina
b)Hypotension
c)Dysrhythmias
d)Oliguria
e)Tachycardia
Answer: a)Angina
c)Dysrhythmias
e)Tachycardia
*Is a beta1 aderenergic agonist; general anesthetics can increase the
likelihood of dysrhythmias. Dobutamine elevates BP by increasing CO.
Diuretics complement the beneficial effects of dobutamine on the
kidney, so urine output would be increased, not decreased.
●● A patient who has severe sepsis is receiving an intravenous normal
saline infusion. She weighs 78 kgs. Which of the following is an
indicator that the therapeutic goal has been met?
