FINAL EXAM: NURS 5434 FAMILY III] QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027| - University of Texas, Arlington.
SECTION ONE: QUESTIONS 1-100
**1. A 45-year-old male with a history of hypertension presents with a new onset of fatigue and exertional
dyspnea. His ECG shows left ventricular hypertrophy. Which pathophysiological mechanism best explains the
development of his dyspnea?
A. Decreased cardiac output leading to poor tissue perfusion
B. Increased left ventricular end-diastolic pressure leading to pulmonary congestion
C. Right ventricular failure causing systemic venous congestion
D. Impaired relaxation of the ventricles leading to decreased stroke volume
🟢 B. Increased left ventricular end-diastolic pressure leading to pulmonary congestion
🔴 RATIONALE: Left ventricular hypertrophy from chronic hypertension increases the stiffness of the left
ventricle, leading to elevated left ventricular end-diastolic pressure (LVEDP). This pressure is transmitted
backward into the pulmonary vasculature, causing pulmonary congestion and the symptom of exertional
dyspnea.
**2. A 68-year-old female is admitted with a hip fracture after a fall. She has a history of osteoporosis. Which
medication classification is most appropriate for long-term management to reduce the risk of future fractures?
A. Bisphosphonates
B. Corticosteroids
C. Calcium channel blockers
D. Loop diuretics
🟢 A. Bisphosphonates
🔴 RATIONALE: Bisphosphonates are the first-line pharmacologic therapy for osteoporosis. They work by
,inhibiting osteoclast-mediated bone resorption, thereby increasing bone mineral density and reducing the risk
of both vertebral and non-vertebral fractures.
**3. According to the Family Systems Theory, which concept describes the boundaries that regulate the flow of
information and energy between the family and its environment?
A. Morphostasis
B. Entropy
C. Permeability
D. Equifinality
🟢 C. Permeability
🔴 RATIONALE: Permeability refers to the degree of openness or closedness of a family's boundaries. This
concept determines how much information, energy, and influence can pass between the family system and the
external environment, shaping the family's interactions and adaptation.
**4. A nurse is providing education to a family about advance directives. The son states, "I don't want to talk
about this; it's too morbid." Which response by the nurse is most therapeutic and appropriate?
A. "You are right, it is a difficult topic. We can discuss it another time."
B. "It is important to have these discussions now so your mother's wishes are known."
C. "I understand this is hard, but it is a necessary part of your mother's care plan."
D. "Your mother's physician will handle this; you don't have to worry."
🟢 B. "It is important to have these discussions now so your mother's wishes are known."
🔴 RATIONALE: While validating the son's feelings is important, the nurse's primary responsibility is to advocate
for the patient and ensure their wishes are documented. Option B is the most therapeutic as it acknowledges
the difficulty (implicitly) while firmly redirecting the conversation back to the patient's needs and the
importance of the discussion.
,**5. A nurse is caring for a patient with end-stage renal disease. The patient is contemplating stopping dialysis.
Which ethical principle is most directly challenged by this situation?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
🟢 C. Autonomy
🔴 RATIONALE: Autonomy is the principle of respecting a patient's right to make their own decisions regarding
their healthcare. When a patient with decision-making capacity chooses to stop life-sustaining treatment like
dialysis, it is a direct exercise of their autonomy, which can conflict with the healthcare team's duty of
beneficence.
**6. A family is experiencing conflict due to the transition of a young adult child leaving for college. According
to the Family Life Cycle theory, this family is navigating which stage?
A. Launching children and moving on
B. Family with adolescents
C. Couple without children
D. Family with young children
🟢 A. Launching children and moving on
🔴 RATIONALE: The "Launching children and moving on" stage is characterized by the departure of young adult
children from the home. This transition necessitates a redefinition of the parental role, the couple relationship,
and the parent-child relationship, often creating conflict as new boundaries are established.
**7. A 52-year-old patient presents with acute onset of right-sided weakness and expressive aphasia. Which
assessment finding would be most consistent with a stroke caused by an occlusion of the left middle cerebral
artery?
, A. Left-sided neglect
B. Right-sided facial droop
C. Inability to understand spoken language
D. Inability to produce coherent speech
🟢 D. Inability to produce coherent speech
🔴 RATIONALE: Expressive aphasia (Broca's aphasia) is characterized by difficulty in producing speech while
comprehension remains relatively intact. The left middle cerebral artery supplies Broca's area in the dominant
(usually left) hemisphere. An occlusion here results in an inability to produce coherent speech.
**8. A nurse is evaluating the effectiveness of a patient's pain management regimen. The patient rates their pain
as a 4 on a 0-10 scale and is able to participate in physical therapy. Which action by the nurse is most
appropriate?
A. Increase the opioid dose to achieve a pain level of 0.
B. Maintain the current pain management plan.
C. Administer a PRN dose of the opioid to further reduce the pain.
D. Document the pain level and continue to monitor.
🟢 B. Maintain the current pain management plan.
🔴 RATIONALE: The goal of pain management is not necessarily to achieve a pain score of 0, but to achieve a
level of pain that allows the patient to function and participate in their care. A score of 4 with functional
improvement indicates the current plan is adequate and should be maintained.
**9. A patient with type 2 diabetes is prescribed metformin. The nurse's teaching should include an explanation
that the primary mechanism of action of this medication is to:
A. Stimulate the pancreas to release more insulin.
B. Decrease hepatic glucose production and increase peripheral insulin sensitivity.
C. Slow the absorption of carbohydrates from the gastrointestinal tract.
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027| - University of Texas, Arlington.
SECTION ONE: QUESTIONS 1-100
**1. A 45-year-old male with a history of hypertension presents with a new onset of fatigue and exertional
dyspnea. His ECG shows left ventricular hypertrophy. Which pathophysiological mechanism best explains the
development of his dyspnea?
A. Decreased cardiac output leading to poor tissue perfusion
B. Increased left ventricular end-diastolic pressure leading to pulmonary congestion
C. Right ventricular failure causing systemic venous congestion
D. Impaired relaxation of the ventricles leading to decreased stroke volume
🟢 B. Increased left ventricular end-diastolic pressure leading to pulmonary congestion
🔴 RATIONALE: Left ventricular hypertrophy from chronic hypertension increases the stiffness of the left
ventricle, leading to elevated left ventricular end-diastolic pressure (LVEDP). This pressure is transmitted
backward into the pulmonary vasculature, causing pulmonary congestion and the symptom of exertional
dyspnea.
**2. A 68-year-old female is admitted with a hip fracture after a fall. She has a history of osteoporosis. Which
medication classification is most appropriate for long-term management to reduce the risk of future fractures?
A. Bisphosphonates
B. Corticosteroids
C. Calcium channel blockers
D. Loop diuretics
🟢 A. Bisphosphonates
🔴 RATIONALE: Bisphosphonates are the first-line pharmacologic therapy for osteoporosis. They work by
,inhibiting osteoclast-mediated bone resorption, thereby increasing bone mineral density and reducing the risk
of both vertebral and non-vertebral fractures.
**3. According to the Family Systems Theory, which concept describes the boundaries that regulate the flow of
information and energy between the family and its environment?
A. Morphostasis
B. Entropy
C. Permeability
D. Equifinality
🟢 C. Permeability
🔴 RATIONALE: Permeability refers to the degree of openness or closedness of a family's boundaries. This
concept determines how much information, energy, and influence can pass between the family system and the
external environment, shaping the family's interactions and adaptation.
**4. A nurse is providing education to a family about advance directives. The son states, "I don't want to talk
about this; it's too morbid." Which response by the nurse is most therapeutic and appropriate?
A. "You are right, it is a difficult topic. We can discuss it another time."
B. "It is important to have these discussions now so your mother's wishes are known."
C. "I understand this is hard, but it is a necessary part of your mother's care plan."
D. "Your mother's physician will handle this; you don't have to worry."
🟢 B. "It is important to have these discussions now so your mother's wishes are known."
🔴 RATIONALE: While validating the son's feelings is important, the nurse's primary responsibility is to advocate
for the patient and ensure their wishes are documented. Option B is the most therapeutic as it acknowledges
the difficulty (implicitly) while firmly redirecting the conversation back to the patient's needs and the
importance of the discussion.
,**5. A nurse is caring for a patient with end-stage renal disease. The patient is contemplating stopping dialysis.
Which ethical principle is most directly challenged by this situation?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
🟢 C. Autonomy
🔴 RATIONALE: Autonomy is the principle of respecting a patient's right to make their own decisions regarding
their healthcare. When a patient with decision-making capacity chooses to stop life-sustaining treatment like
dialysis, it is a direct exercise of their autonomy, which can conflict with the healthcare team's duty of
beneficence.
**6. A family is experiencing conflict due to the transition of a young adult child leaving for college. According
to the Family Life Cycle theory, this family is navigating which stage?
A. Launching children and moving on
B. Family with adolescents
C. Couple without children
D. Family with young children
🟢 A. Launching children and moving on
🔴 RATIONALE: The "Launching children and moving on" stage is characterized by the departure of young adult
children from the home. This transition necessitates a redefinition of the parental role, the couple relationship,
and the parent-child relationship, often creating conflict as new boundaries are established.
**7. A 52-year-old patient presents with acute onset of right-sided weakness and expressive aphasia. Which
assessment finding would be most consistent with a stroke caused by an occlusion of the left middle cerebral
artery?
, A. Left-sided neglect
B. Right-sided facial droop
C. Inability to understand spoken language
D. Inability to produce coherent speech
🟢 D. Inability to produce coherent speech
🔴 RATIONALE: Expressive aphasia (Broca's aphasia) is characterized by difficulty in producing speech while
comprehension remains relatively intact. The left middle cerebral artery supplies Broca's area in the dominant
(usually left) hemisphere. An occlusion here results in an inability to produce coherent speech.
**8. A nurse is evaluating the effectiveness of a patient's pain management regimen. The patient rates their pain
as a 4 on a 0-10 scale and is able to participate in physical therapy. Which action by the nurse is most
appropriate?
A. Increase the opioid dose to achieve a pain level of 0.
B. Maintain the current pain management plan.
C. Administer a PRN dose of the opioid to further reduce the pain.
D. Document the pain level and continue to monitor.
🟢 B. Maintain the current pain management plan.
🔴 RATIONALE: The goal of pain management is not necessarily to achieve a pain score of 0, but to achieve a
level of pain that allows the patient to function and participate in their care. A score of 4 with functional
improvement indicates the current plan is adequate and should be maintained.
**9. A patient with type 2 diabetes is prescribed metformin. The nurse's teaching should include an explanation
that the primary mechanism of action of this medication is to:
A. Stimulate the pancreas to release more insulin.
B. Decrease hepatic glucose production and increase peripheral insulin sensitivity.
C. Slow the absorption of carbohydrates from the gastrointestinal tract.
