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NUR 257 / NUR257 Final Exam: Integrated Concepts in Adult Health I - Galen College of Nursing – Updated Questions And Answers With Rationales

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NUR 257 / NUR257 Final Exam: Integrated Concepts in Adult Health I - Galen College of Nursing – Updated Questions And Answers With Rationales, 100% Guaranteed Pass || Complete A+ Guide. This document serves as a comprehensive review tool for core content in adult health nursing. The questions are organized thematically, reflecting the systems-based approach used in medical-surgical nursing education. The main content domains include: Immunology & Infectious Disease (Questions 1–17) Types of immunity (acquired, natural, humoral, phagocytic) Inflammatory response and cell types (neutrophils, eosinophils) Nutritional impacts on immunity (protein deficiency) HIV/AIDS pathophysiology, complications (encephalopathy, CD4+ thresholds), and nursing responses Allergic reactions: types (I–IV), immunoglobulins (IgE), atopy, urticaria, contact dermatitis, latex allergy Histamine effects and patient education for allergic rhinitis Autoimmune & Musculoskeletal Disorders (Questions 18–35) Rheumatoid arthritis (RA) vs. osteoarthritis (OA): pathophysiology, pannus formation, DMARDs (methotrexate), immunosuppressants (cyclophosphamide) Systemic lupus erythematosus (SLE): fatigue, anemia Spinal deformities (lordosis, kyphosis, scoliosis) Bone physiology (osteoblasts, osteoclasts, osteocytes) Osteoporosis risk factors (calcium, vitamin D) Paget’s disease, compartment syndrome, traction types (Buck’s extension), casting complications, hip replacement discharge goals Osteomyelitis prevention in diabetes Cardiovascular Nursing (Questions 36–48) Cardiac anatomy and conduction system (SA node → AV node → Bundle of His → Purkinje fibers) Diagnostic procedures: transesophageal echocardiography (TEE) prep, lipid profile fasting requirements Valve disorders: antibiotic prophylaxis for dental procedures post-mechanical valve replacement Heart transplant: immunosuppressants (cyclosporine, azathioprine) to prevent rejection Pericarditis: priority nursing diagnosis (acute pain) Endocarditis prevention (gentamicin before bronchoscopy) Anticoagulation management post-valve replacement (warfarin, INR monitoring) Heart failure: digoxin toxicity signs (bradycardia, confusion), beta-blocker use, oxygen transport effects on LOC Pulmonary edema: classic signs (cough with frothy sputum, cyanosis, moist breath sounds) Gastrointestinal & Digestive Health (Questions 49–62) Diagnostic procedures: colonoscopy positioning and bowel prep contraindications (inflammatory bowel disease) Abdominal assessment sequence (inspection, auscultation, percussion, palpation) Pancreatic enzymes (amylase, lipase, trypsin) Oral care for comatose patients (mechanical friction) Leukopenia precautions (restricting visitors with infections) GERD treatment (metoclopramide for gastric motility) Peptic ulcer disease: metronidazole education (avoid alcohol), perforation signs (rigid abdomen) Post-bariatric surgery complications (dumping syndrome) Diverticulitis with perforation (surgical emergency) Small bowel obstruction intervention (NG tube insertion) Gastric bypass self-management (fluids between meals) Post-endoscopy care (NPO until gag reflex returns) Pedagogical & Assessment Features Question Structure: Each item follows a standard multiple-choice format with one correct answer and three distractors. Integrated Rationales: Most answers include concise, clinically focused explanations that reinforce key concepts. Clinical Judgment Emphasis: Questions require application of knowledge to patient scenarios, prioritizing nursing actions, and recognizing complications. NCLEX-Style Format: The wording and content mirror the National Council Licensure Examination (NCLEX-RN), preparing students for licensure testing. Study Tool Design: The inclusion of rationales and systematic content grouping makes it effective for both self-testing and guided review.

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NUR 257 / NUR257
NUR 257 / NUR257 Final Exam: Integrated Concepts in Adult

Health I - Galen College of Nursing – Updated Questions

And Answers With Rationales
Ascorers Stuvia

This Exam Document Consists Of:

 NUR 257 / NUR257 Final Exam

 NUR257 Final Exam: Integrated Concepts in Adult Health I

 Galen College of Nursing NUR 257 Exam

 Questions And Answers With Rationales

 !00% Guaranteed Pass

 Complete A+ Guide

, NUR 257 / NUR257 Final Exam: Integrated Concepts in

Adult Health I - Galen College of Nursing – Updated

Questions And Answers With Rationales



1. The nurse is caring for an adult patient with HF who is prescribed
digoxin. When assessing the patient for adverse effects, the nurse should
assess for which of the following signs and symptoms?

A) Confusion and bradycardia
B) Uncontrolled diuresis and tachycardia
C) Numbness and tingling in the extremities
D) Chest pain and shortness of breath

Answer: A) Confusion and bradycardia

Expert Rationale:
Digoxin toxicity is a major concern with digitalis therapy and commonly
presents with confusion, bradycardia, nausea, vomiting, and visual disturbances
such as yellow halos. Digoxin slows AV conduction, making bradycardia a classic
toxic response. Neurologic changes like confusion occur due to altered
electrolyte balance, especially potassium. The other options do not reflect typical
digoxin toxicity patterns. Prompt identification prevents progression to life-
threatening arrhythmias.

,2. The nurse is reviewing the medication administration record of a patient
diagnosed with systolic HF. What medication should the nurse anticipate
administering to this patient?

A) A beta-adrenergic blocker
B) An antiplatelet aggregator
C) A calcium channel blocker
D) A nonsteroidal anti-inflammatory drug (NSAID)

Answer: A) A beta-adrenergic blocker

Expert Rationale:
Evidence-based guidelines recommend ACE inhibitors, beta-blockers, diuretics,
and sometimes digoxin for systolic heart failure because they improve mortality
and ventricular remodeling. Beta-blockers decrease sympathetic stimulation,
reduce myocardial oxygen demand, and improve ejection fraction over time.
NSAIDs cause sodium and fluid retention, worsening HF. Calcium channel
blockers are not first-line due to potential negative inotropic effects.
Antiplatelets have no therapeutic role in HF management.




3. The nurse is performing an initial assessment of a client diagnosed with
HF. The nurse also assesses the patient’s sensorium and LOC. Why is the

, assessment of the patient’s sensorium and LOC important in patients with
HF?

A) HF ultimately affects oxygen transportation to the brain.
B) Patients with HF are susceptible to overstimulation of the sympathetic
nervous system.
C) Decreased LOC causes an exacerbation of the signs and symptoms of HF.
D) The most significant adverse effect of medications used for HF treatment is
altered LOC.

Answer: A) HF ultimately affects oxygen transportation to the brain.

Expert Rationale:
As cardiac output decreases, less oxygenated blood reaches the brain, leading to
decreased LOC, confusion, or irritability. Neurologic changes can be an early
indicator of worsening HF. Although sympathetic stimulation increases with HF,
it is not the primary cause of altered LOC. Medications for HF may have CNS
effects, but they are not the most common or significant. Monitoring sensorium
provides important insight into cerebral perfusion and disease progression.




4. A nurse is caring for a patient scheduled for a colonoscopy whose bowel
preparation includes polyethylene glycol electrolyte lavage. The presence of
what health problem would contraindicate this form of bowel preparation?

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