NURA 1500 Final Exam 4 Study Guide
Questions with All Solved Solutions
2026-2027 Updated.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - Answer Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The
other conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - Answer Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K
to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client
for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia.
Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular
atrophy result from decreased estrogen metabolism by the diseased liver.
When evaluating a male client for complications of acute pancreatitis, the nurse would observe
for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - Answer Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal
failure that sometimes accompanies this condition. Intracranial pressure neither increases nor
decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with
pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a
hypovolemic complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-
tube has drained 750ml of green-brown drainage. Which nursing intervention is most
appropriate?
,A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - Answer Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then
turns to green-brown. The drainage is measured as output. The amount of expected drainage
will range from 500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is
located in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - Answer Answer: B
Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is
most important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - Answer Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight
will help protect against gallstones. Excessive dietary intake of cholesterol is associated with the
development of gallstones in many people. Dietary protein isn't implicated in cholecystitis.
Liquid protein and low-calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week)
are implicated as the cause of some cases of cholecystitis. Regular exercise (30 minutes/three
times a week) may help reduce weight and improve fat metabolism. Reducing stress may reduce
bile production, which may also indirectly decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - Answer Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present
,in peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up
abdominal muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - Answer Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present.
An abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A
barium swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus,
stomach, and duodenum.
A client being treated for chronic cholecystitis should be given which of the following
instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - Answer Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by
increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use
to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices
is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - Answer Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to
accommodate the large amount of blood necessary for homeostasis. The pressure in the liver
increases and causes increased pressure in the venous system. As the portal pressure increases,
fluid exudes into the abdominal cavity. This is called ascites.
The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to
control the bleeding. The most important assessment is for the nurse to:
A. Check that the hemostat is on the bedside
B. Monitor IV fluids for the shift
, C. Regularly assess respiratory status
D. Check that the balloon is deflated on a regular basis - Answer Answer: C
Explanation: The respiratory system can become occluded if the balloon slips and moves up the
esophagus, putting pressure on the trachea. This would result in respiratory distress and should
be assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs.
This is a safety intervention.
George has a T tube in place after gallbladder surgery. Before discharge, what information or
instructions should be given regarding the T tube drainage?
A. "If there is any drainage, notify the surgeon immediately."
B. "The drainage will decrease daily until the bile duct heals."
C. "First, the drainage is dark green; then it becomes dark yellow."
D. "If the drainage stops, milk the tube toward the puncture wound." - Answer Answer: B
Explanation: As healing occurs from the bile duct, bile drains from the tube; the amount of bile
should decrease. Teach the patient to expect dark green drainage and to notify the doctor if
drainage stops.
The student nurse is teaching the family of a patient with liver failure. You instruct them to limit
which foods in the patient's diet?
A. Meats and beans
B. Butter and gravies
C. Potatoes and pastas
D. Cakes and pastries - Answer Answer: A
Explanation: Meats and beans are high-protein foods. In liver failure, the liver is unable to
metabolize protein adequately, causing protein by-products to build up in the body rather than
be excreted
A patient has an acute upper GI hemorrhage. Your interventions include:
A. Treating hypovolemia
B. Treating hypervolemia
C. Controlling the bleeding source
D. Treating shock and diagnosing the bleeding source - Answer Answer: A
Explanation: A patient with an acute upper GI hemorrhage must be treated for hypovolemia and
hemorrhagic shock. You as a nurse can't diagnose the problem. Controlling the bleeding may
require surgery or intensive medical treatment
What information is correct about stomach cancer?
A. Stomach pain is often a late symptom
Questions with All Solved Solutions
2026-2027 Updated.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - Answer Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The
other conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - Answer Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K
to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client
for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia.
Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular
atrophy result from decreased estrogen metabolism by the diseased liver.
When evaluating a male client for complications of acute pancreatitis, the nurse would observe
for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - Answer Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal
failure that sometimes accompanies this condition. Intracranial pressure neither increases nor
decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with
pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a
hypovolemic complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-
tube has drained 750ml of green-brown drainage. Which nursing intervention is most
appropriate?
,A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - Answer Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then
turns to green-brown. The drainage is measured as output. The amount of expected drainage
will range from 500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is
located in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - Answer Answer: B
Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is
most important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - Answer Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight
will help protect against gallstones. Excessive dietary intake of cholesterol is associated with the
development of gallstones in many people. Dietary protein isn't implicated in cholecystitis.
Liquid protein and low-calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week)
are implicated as the cause of some cases of cholecystitis. Regular exercise (30 minutes/three
times a week) may help reduce weight and improve fat metabolism. Reducing stress may reduce
bile production, which may also indirectly decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - Answer Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present
,in peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up
abdominal muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - Answer Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present.
An abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A
barium swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus,
stomach, and duodenum.
A client being treated for chronic cholecystitis should be given which of the following
instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - Answer Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by
increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use
to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices
is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - Answer Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to
accommodate the large amount of blood necessary for homeostasis. The pressure in the liver
increases and causes increased pressure in the venous system. As the portal pressure increases,
fluid exudes into the abdominal cavity. This is called ascites.
The client being treated for esophageal varices has a Sengstaken-Blakemore tube inserted to
control the bleeding. The most important assessment is for the nurse to:
A. Check that the hemostat is on the bedside
B. Monitor IV fluids for the shift
, C. Regularly assess respiratory status
D. Check that the balloon is deflated on a regular basis - Answer Answer: C
Explanation: The respiratory system can become occluded if the balloon slips and moves up the
esophagus, putting pressure on the trachea. This would result in respiratory distress and should
be assessed frequently. Scissors should be kept at the bedside to cut the tube if distress occurs.
This is a safety intervention.
George has a T tube in place after gallbladder surgery. Before discharge, what information or
instructions should be given regarding the T tube drainage?
A. "If there is any drainage, notify the surgeon immediately."
B. "The drainage will decrease daily until the bile duct heals."
C. "First, the drainage is dark green; then it becomes dark yellow."
D. "If the drainage stops, milk the tube toward the puncture wound." - Answer Answer: B
Explanation: As healing occurs from the bile duct, bile drains from the tube; the amount of bile
should decrease. Teach the patient to expect dark green drainage and to notify the doctor if
drainage stops.
The student nurse is teaching the family of a patient with liver failure. You instruct them to limit
which foods in the patient's diet?
A. Meats and beans
B. Butter and gravies
C. Potatoes and pastas
D. Cakes and pastries - Answer Answer: A
Explanation: Meats and beans are high-protein foods. In liver failure, the liver is unable to
metabolize protein adequately, causing protein by-products to build up in the body rather than
be excreted
A patient has an acute upper GI hemorrhage. Your interventions include:
A. Treating hypovolemia
B. Treating hypervolemia
C. Controlling the bleeding source
D. Treating shock and diagnosing the bleeding source - Answer Answer: A
Explanation: A patient with an acute upper GI hemorrhage must be treated for hypovolemia and
hemorrhagic shock. You as a nurse can't diagnose the problem. Controlling the bleeding may
require surgery or intensive medical treatment
What information is correct about stomach cancer?
A. Stomach pain is often a late symptom
