NURS 221 EXAM 3 STUDY GUIDE | COMPLETE NURSING EXAM REVIEW
QUESTIONS AND ANSWERS 2026/2027
Rheumatoid arthritis, scleroderma, and systemic lupus erythematosus all have what in common?
a. They are examples of postinfectious disorders of systemic joint function.
b. Rashes are found with all of them.
c. Weight-bearing joints are most affected.
d. These are immune-mediated systemic disorders of joint function. - correct answer ✔✔d. These are
immune-mediated systemic disorders of joint function.
A patient has osteoarthritis. Which principle is important for the nurse to remember?
a. This is a systemic autoimmune disorder that causes symmetric peripheral arthritis
b. This is a type of arthritis where bacteria invade the synovial membrane
c. This is a progressive, noninflammatory disease of weight-bearing joints.
d. This is a deposition of uric acid crystals in joints causing inflammation. - correct answer ✔✔c. This is a
progressive, noninflammatory disease of weight-bearing joints.
A patient has an eruption of vesicles with erythematous bases localized to a dermatomal segment of skin
caused by the same virus as chickenpox. Which disorder will the clinician observe documented on the
chart?
a. Varrucae-warts
b. Herpes zoster
c. Lichen planus
d. Scleroderma - correct answer ✔✔b. Herpes zoster
A patient has tinea corporis. Which area is affected and which organism causes this disorder?
a. Scalp and bacteria
b. Face and parasites
c. Trunk and fungus
d. Groin and viruses - correct answer ✔✔c. Trunk and fungus
Clinical manifestations of hypoparathyroidism
a. result from decreased neuromuscular excitability.
b. are similar to those occurring with hypokalemia.
c. result from decreased serum ionized calcium.
d. are similar to those occurring with hypermagnesemia - correct answer ✔✔c. result from decreased
serum ionized calcium.
Secondary injury that occurs after reestablishing blood flow to an ischemic area of the brain is called
what injury?
,a. autoregulation
b. reperfusion
c. dysconjugate
d. stuporous - correct answer ✔✔b. reperfusion
The physiologic change most likely to lead to an increase in intracranial pressure is
a. REM sleep
b. cerebral vasodilation
c. respiratory hyperventilation
d. hypernatremia - correct answer ✔✔b. cerebral vasodilation
Your patient with a head injury is unconscious with arms flexed towards the core. Which of the following
does this describe?
a. Decerebrate Posturing
b. Decorticate Posturing
c. Abnormal PERRLA
d. Increased GCS - correct answer ✔✔b. Decorticate Posturing
Your patient is admitted with repeated tonic-clonic seizures. You know that which of the following are
potential causes of seizures? Select all that apply.
a. Cerebral vascular accident
b. Head injury
c. Hyperkalemia
d. Hypoglycemia
e. Hypernatremia - correct answer ✔✔a, b, d, and e
Which patient ABG (arterial blood gas) results should the nurse act on immediately?
a. pH 6.9
b. CO2 = 35 mm Hg
c. HCO3- = 25 mEq/L
d. O2 saturation = 98% - correct answer ✔✔a. pH 6.9
The nursing instructor is reviewing acid base concepts to students. Which statement by the instructor is
correct regarding acid-base balance? Select all that apply.
a. Respiratory compensation is fast acting
b. When blood CO2 levels increase... the kidney excretes HCO3-
c. The normal ratio of HCO3- to H2CO3- is 1 to 20
d. Buffer system is the first line of defense to control pH levels
e. Renal compensation is long lasting
f .Renal compensation is fast acting
g. Respiratory compensation is short lasting - correct answer ✔✔a, d, e, and g
ADH (antidiuretic hormone) release is stimulated by which condition? (Select all that apply.)
, a. Alcohol use
b. Anxiety over serious medical diagnosis
c. Low blood volume
d. Hyper-Osmolality of the ECF - correct answer ✔✔b, c, and d
The patient has an approximate 1.5 kg. increase in weight over the last two days. Approximately how
much fluid has the patient lost?
a. 500 mL
b. 1000 mL
c. 1500 mL
d. 2000 mL - correct answer ✔✔c. 1500 mL
Fluid distribution between the interstitial and intracellular compartments occurs by which mechanism?
a. filtration across permeable capillaries.
b. capillary hydrostatic pressure.
c. capillary osmotic pressure.
d. osmosis - correct answer ✔✔d. osmosis
Which of the following are true regarding isotonic fluid volume excess? Select all that apply.
a. Fluid and sodium are gained in proportional amounts leading to an overall gain in extracellular fluid
volume without a change in serum osmolality.
b. More fluid is gained than sodium
c. Renal failure leads to the decreased excretion of water and sodium
d. Plasma hydrostatic pressure is equal to interstitial hydrostatic pressure - correct answer ✔✔a and c
Which patient electrolyte value is most concerning to the nurse?
a. Sodium 137 mEq/L
b. Potassium 3.8 mEq/L
c. Bicarbonate 20 mEq/L
d. Magnesium 2.0 mg/dL - correct answer ✔✔c. Bicarbonate 20 mEq/L
The concentration of which cation indicates the serum osmolality of a patient?
a. Sodium level
b. Calcium Level
c. Potassium Level
d. Magnesium level - correct answer ✔✔a. Sodium level
Which of the following is NOT a purpose of the large intestine?
a. Absorb water
b. Absorb electrolytes
c. Store feces
QUESTIONS AND ANSWERS 2026/2027
Rheumatoid arthritis, scleroderma, and systemic lupus erythematosus all have what in common?
a. They are examples of postinfectious disorders of systemic joint function.
b. Rashes are found with all of them.
c. Weight-bearing joints are most affected.
d. These are immune-mediated systemic disorders of joint function. - correct answer ✔✔d. These are
immune-mediated systemic disorders of joint function.
A patient has osteoarthritis. Which principle is important for the nurse to remember?
a. This is a systemic autoimmune disorder that causes symmetric peripheral arthritis
b. This is a type of arthritis where bacteria invade the synovial membrane
c. This is a progressive, noninflammatory disease of weight-bearing joints.
d. This is a deposition of uric acid crystals in joints causing inflammation. - correct answer ✔✔c. This is a
progressive, noninflammatory disease of weight-bearing joints.
A patient has an eruption of vesicles with erythematous bases localized to a dermatomal segment of skin
caused by the same virus as chickenpox. Which disorder will the clinician observe documented on the
chart?
a. Varrucae-warts
b. Herpes zoster
c. Lichen planus
d. Scleroderma - correct answer ✔✔b. Herpes zoster
A patient has tinea corporis. Which area is affected and which organism causes this disorder?
a. Scalp and bacteria
b. Face and parasites
c. Trunk and fungus
d. Groin and viruses - correct answer ✔✔c. Trunk and fungus
Clinical manifestations of hypoparathyroidism
a. result from decreased neuromuscular excitability.
b. are similar to those occurring with hypokalemia.
c. result from decreased serum ionized calcium.
d. are similar to those occurring with hypermagnesemia - correct answer ✔✔c. result from decreased
serum ionized calcium.
Secondary injury that occurs after reestablishing blood flow to an ischemic area of the brain is called
what injury?
,a. autoregulation
b. reperfusion
c. dysconjugate
d. stuporous - correct answer ✔✔b. reperfusion
The physiologic change most likely to lead to an increase in intracranial pressure is
a. REM sleep
b. cerebral vasodilation
c. respiratory hyperventilation
d. hypernatremia - correct answer ✔✔b. cerebral vasodilation
Your patient with a head injury is unconscious with arms flexed towards the core. Which of the following
does this describe?
a. Decerebrate Posturing
b. Decorticate Posturing
c. Abnormal PERRLA
d. Increased GCS - correct answer ✔✔b. Decorticate Posturing
Your patient is admitted with repeated tonic-clonic seizures. You know that which of the following are
potential causes of seizures? Select all that apply.
a. Cerebral vascular accident
b. Head injury
c. Hyperkalemia
d. Hypoglycemia
e. Hypernatremia - correct answer ✔✔a, b, d, and e
Which patient ABG (arterial blood gas) results should the nurse act on immediately?
a. pH 6.9
b. CO2 = 35 mm Hg
c. HCO3- = 25 mEq/L
d. O2 saturation = 98% - correct answer ✔✔a. pH 6.9
The nursing instructor is reviewing acid base concepts to students. Which statement by the instructor is
correct regarding acid-base balance? Select all that apply.
a. Respiratory compensation is fast acting
b. When blood CO2 levels increase... the kidney excretes HCO3-
c. The normal ratio of HCO3- to H2CO3- is 1 to 20
d. Buffer system is the first line of defense to control pH levels
e. Renal compensation is long lasting
f .Renal compensation is fast acting
g. Respiratory compensation is short lasting - correct answer ✔✔a, d, e, and g
ADH (antidiuretic hormone) release is stimulated by which condition? (Select all that apply.)
, a. Alcohol use
b. Anxiety over serious medical diagnosis
c. Low blood volume
d. Hyper-Osmolality of the ECF - correct answer ✔✔b, c, and d
The patient has an approximate 1.5 kg. increase in weight over the last two days. Approximately how
much fluid has the patient lost?
a. 500 mL
b. 1000 mL
c. 1500 mL
d. 2000 mL - correct answer ✔✔c. 1500 mL
Fluid distribution between the interstitial and intracellular compartments occurs by which mechanism?
a. filtration across permeable capillaries.
b. capillary hydrostatic pressure.
c. capillary osmotic pressure.
d. osmosis - correct answer ✔✔d. osmosis
Which of the following are true regarding isotonic fluid volume excess? Select all that apply.
a. Fluid and sodium are gained in proportional amounts leading to an overall gain in extracellular fluid
volume without a change in serum osmolality.
b. More fluid is gained than sodium
c. Renal failure leads to the decreased excretion of water and sodium
d. Plasma hydrostatic pressure is equal to interstitial hydrostatic pressure - correct answer ✔✔a and c
Which patient electrolyte value is most concerning to the nurse?
a. Sodium 137 mEq/L
b. Potassium 3.8 mEq/L
c. Bicarbonate 20 mEq/L
d. Magnesium 2.0 mg/dL - correct answer ✔✔c. Bicarbonate 20 mEq/L
The concentration of which cation indicates the serum osmolality of a patient?
a. Sodium level
b. Calcium Level
c. Potassium Level
d. Magnesium level - correct answer ✔✔a. Sodium level
Which of the following is NOT a purpose of the large intestine?
a. Absorb water
b. Absorb electrolytes
c. Store feces
