WPU NUR 3300 EXAM 2 – NURSING PRACTICE II (2026)
COMPLETE PRACTICE QUESTION BANK |QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED RATIONALES |
100% GUARANTEE PASS
Primary Content Areas:
• Gastrointestinal Disorders – GI bleeding, inflammatory bowel disease,
bowel obstructions, liver/pancreatic disorders
• Renal & Urinary Disorders – Acute kidney injury, chronic kidney disease,
urinary tract infections, dialysis
• Endocrine Disorders – Diabetes mellitus (DKA, HHNS), thyroid disorders,
adrenal insufficiency
• Musculoskeletal Disorders – Fractures, osteoarthritis, rheumatoid arthritis,
hip fractures, osteomyelitis
• Neurological Disorders – Stroke (CVA), seizures, Parkinson's disease,
head injuries, increased ICP
• Integumentary & Infectious Diseases – Pressure injuries, wound care,
cellulitis, sepsis, HIV/AIDS
• Hematological Disorders – Anemia, sickle cell crisis, DIC, thrombocytopenia
• Pharmacology & Clinical Judgment – Medication interactions, side effects,
patient education, prioritization
SECTION 1 – GASTROINTESTINAL DISORDERS (Questions 1–35)
Question 1
A nurse is caring for a patient with acute upper gastrointestinal bleeding. The
patient's vital signs are: BP 90/60 mm Hg, HR 120 bpm, RR 22/min. Which
intervention should the nurse prioritize?
A) Insert a nasogastric (NG) tube and perform a gastric lavage
B) Administer IV fluids and prepare for blood transfusion
C) Administer oral proton pump inhibitor (PPI)
D) Prepare the patient for an upper endoscopy
Answer: B
Rationale: The patient is showing signs of hypovolemic shock (hypotension,
tachycardia) due to acute blood loss. The priority is to restore intravascular
volume with IV fluids (crystalloids) and prepare for blood transfusion to
maintain perfusion to vital organs. While NG tube placement, PPIs, and
endoscopy are important, they are secondary to hemodynamic stabilization.
Without adequate volume resuscitation, the patient could progress to cardiac
arrest. The nurse should establish two large‑bore IV lines and initiate fluid
1
,resuscitation per protocol.
Question 2
A patient with Crohn's disease is prescribed infliximab (Remicade). The nurse
should monitor the patient for which serious adverse effect?
A) Hepatotoxicity
B) Opportunistic infections (e.g., tuberculosis reactivation)
C) Nephrotoxicity
D) Cardiac arrhythmias
Answer: B
Rationale: Infliximab is a tumor necrosis factor‑alpha (TNF‑α) inhibitor used
for moderate to severe Crohn's disease. It suppresses the immune system,
significantly increasing the risk of opportunistic infections, including
reactivation of latent tuberculosis (TB). The nurse must ensure the patient has
a negative TB test before starting therapy. Hepatotoxicity, nephrotoxicity, and
cardiac arrhythmias are not primary concerns with this medication.
Question 3
A patient is 2 days post‑operative after a colon resection. The nurse assesses
the patient and notes absent bowel sounds, abdominal distention, and nausea.
What is the most appropriate nursing action?
A) Encourage oral intake to stimulate bowel motility
B) Administer a laxative to promote bowel movement
C) Continue to monitor; this is a normal postoperative finding up to 3‑5 days
D) Notify the surgeon and prepare for possible nasogastric tube insertion
Answer: C
Rationale: After abdominal surgery, a paralytic ileus (temporary cessation of
bowel motility) is expected for 24‑72 hours. Absent bowel sounds, abdominal
distention, and nausea are common during this period. The nurse should continue
to monitor the patient, maintain NPO status, and provide comfort measures.
Encouraging oral intake or administering laxatives before bowel sounds return
can lead to complications such as vomiting, aspiration, or perforation. If
symptoms persist beyond 3‑5 days, notify the surgeon.
Question 4
A patient with cirrhosis is experiencing ascites. Which intervention should the
nurse implement to manage this complication?
A) Encourage high‑sodium diet to maintain blood pressure
2
,B) Restrict fluid intake to 1000 mL per day
C) Administer diuretics (e.g., spironolactone) as ordered
D) Place the patient in a supine position to promote renal perfusion
Answer: C
Rationale: Ascites in cirrhosis results from portal hypertension and decreased
albumin production, leading to fluid accumulation in the peritoneal cavity.
Spironolactone (a potassium‑sparing diuretic) is the first‑line diuretic used
to reduce fluid volume and manage ascites. Sodium restriction (not high‑sodium)
is also essential. Fluid restriction may be needed if hyponatremia is present,
but not routinely. Supine positioning does not specifically promote renal
perfusion in this context.
Question 5
A patient with acute pancreatitis has severe abdominal pain radiating to the
back. Which laboratory finding is most specific for the diagnosis of acute
pancreatitis?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated white blood cell count
D) Elevated serum glucose
Answer: B
Rationale: Serum lipase is more specific for pancreatic inflammation than serum
amylase. Lipase remains elevated longer and is less affected by other
conditions (e.g., salivary gland disease, renal failure). While amylase is also
elevated, it is less specific. WBC elevation is a non‑specific sign of
inflammation, and glucose may be elevated but is not diagnostic.
Question 6
A nurse is caring for a patient with a new ileostomy. Which stool characteristic
should the nurse expect?
A) Formed, brown stool
B) Liquid, yellow‑green effluent
C) Semi‑formed, bulky stool
D) Dark, tarry stool
Answer: B
Rationale: An ileostomy is created from the ileum (small intestine), where stool
has not undergone water reabsorption in the colon. The effluent is therefore
liquid to semi‑liquid, yellow‑green, and contains digestive enzymes, which can
3
, be irritating to the skin. Formed stool is expected with a colostomy. Dark,
tarry stool indicates upper GI bleeding.
Question 7
A patient with ulcerative colitis is experiencing frequent, bloody diarrhea.
Which complication should the nurse monitor for most closely?
A) Bowel obstruction
B) Toxic megacolon
C) Perforation
D) Fistula formation
Answer: B
Rationale: Toxic megacolon is a life‑threatening complication of ulcerative
colitis (less commonly Crohn's) characterized by severe colonic dilation with
systemic toxicity (fever, tachycardia, leukocytosis). It can lead to perforation
and peritonitis. Bowel obstruction, perforation, and fistulas can occur in
Crohn's disease but are less characteristic of ulcerative colitis, which is
limited to the mucosa of the colon.
Question 8
A patient is receiving total parenteral nutrition (TPN) via a central venous
catheter. The nurse notes that the TPN bag is empty and a new bag is not yet
available. Which action should the nurse take?
A) Hang a 10% dextrose solution until the new TPN arrives
B) Hang normal saline at the same rate
C) Wait until the TPN arrives and then restart it
D) Flush the line with heparin and cap it off
Answer: A
Rationale: Abrupt cessation of TPN can cause rebound hypoglycemia because the
patient's pancreas is still producing insulin in response to the high glucose
load. To prevent hypoglycemia, a 10% dextrose solution should be infused at the
same rate until the new TPN bag is available. Normal saline does not provide
glucose and would not prevent hypoglycemia. Waiting would lead to a dangerous
drop in blood glucose.
Question 9
A patient is diagnosed with diverticulitis. Which dietary instruction should the
nurse provide during the acute phase?
A) High‑fiber diet to promote bowel movements
4
COMPLETE PRACTICE QUESTION BANK |QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED RATIONALES |
100% GUARANTEE PASS
Primary Content Areas:
• Gastrointestinal Disorders – GI bleeding, inflammatory bowel disease,
bowel obstructions, liver/pancreatic disorders
• Renal & Urinary Disorders – Acute kidney injury, chronic kidney disease,
urinary tract infections, dialysis
• Endocrine Disorders – Diabetes mellitus (DKA, HHNS), thyroid disorders,
adrenal insufficiency
• Musculoskeletal Disorders – Fractures, osteoarthritis, rheumatoid arthritis,
hip fractures, osteomyelitis
• Neurological Disorders – Stroke (CVA), seizures, Parkinson's disease,
head injuries, increased ICP
• Integumentary & Infectious Diseases – Pressure injuries, wound care,
cellulitis, sepsis, HIV/AIDS
• Hematological Disorders – Anemia, sickle cell crisis, DIC, thrombocytopenia
• Pharmacology & Clinical Judgment – Medication interactions, side effects,
patient education, prioritization
SECTION 1 – GASTROINTESTINAL DISORDERS (Questions 1–35)
Question 1
A nurse is caring for a patient with acute upper gastrointestinal bleeding. The
patient's vital signs are: BP 90/60 mm Hg, HR 120 bpm, RR 22/min. Which
intervention should the nurse prioritize?
A) Insert a nasogastric (NG) tube and perform a gastric lavage
B) Administer IV fluids and prepare for blood transfusion
C) Administer oral proton pump inhibitor (PPI)
D) Prepare the patient for an upper endoscopy
Answer: B
Rationale: The patient is showing signs of hypovolemic shock (hypotension,
tachycardia) due to acute blood loss. The priority is to restore intravascular
volume with IV fluids (crystalloids) and prepare for blood transfusion to
maintain perfusion to vital organs. While NG tube placement, PPIs, and
endoscopy are important, they are secondary to hemodynamic stabilization.
Without adequate volume resuscitation, the patient could progress to cardiac
arrest. The nurse should establish two large‑bore IV lines and initiate fluid
1
,resuscitation per protocol.
Question 2
A patient with Crohn's disease is prescribed infliximab (Remicade). The nurse
should monitor the patient for which serious adverse effect?
A) Hepatotoxicity
B) Opportunistic infections (e.g., tuberculosis reactivation)
C) Nephrotoxicity
D) Cardiac arrhythmias
Answer: B
Rationale: Infliximab is a tumor necrosis factor‑alpha (TNF‑α) inhibitor used
for moderate to severe Crohn's disease. It suppresses the immune system,
significantly increasing the risk of opportunistic infections, including
reactivation of latent tuberculosis (TB). The nurse must ensure the patient has
a negative TB test before starting therapy. Hepatotoxicity, nephrotoxicity, and
cardiac arrhythmias are not primary concerns with this medication.
Question 3
A patient is 2 days post‑operative after a colon resection. The nurse assesses
the patient and notes absent bowel sounds, abdominal distention, and nausea.
What is the most appropriate nursing action?
A) Encourage oral intake to stimulate bowel motility
B) Administer a laxative to promote bowel movement
C) Continue to monitor; this is a normal postoperative finding up to 3‑5 days
D) Notify the surgeon and prepare for possible nasogastric tube insertion
Answer: C
Rationale: After abdominal surgery, a paralytic ileus (temporary cessation of
bowel motility) is expected for 24‑72 hours. Absent bowel sounds, abdominal
distention, and nausea are common during this period. The nurse should continue
to monitor the patient, maintain NPO status, and provide comfort measures.
Encouraging oral intake or administering laxatives before bowel sounds return
can lead to complications such as vomiting, aspiration, or perforation. If
symptoms persist beyond 3‑5 days, notify the surgeon.
Question 4
A patient with cirrhosis is experiencing ascites. Which intervention should the
nurse implement to manage this complication?
A) Encourage high‑sodium diet to maintain blood pressure
2
,B) Restrict fluid intake to 1000 mL per day
C) Administer diuretics (e.g., spironolactone) as ordered
D) Place the patient in a supine position to promote renal perfusion
Answer: C
Rationale: Ascites in cirrhosis results from portal hypertension and decreased
albumin production, leading to fluid accumulation in the peritoneal cavity.
Spironolactone (a potassium‑sparing diuretic) is the first‑line diuretic used
to reduce fluid volume and manage ascites. Sodium restriction (not high‑sodium)
is also essential. Fluid restriction may be needed if hyponatremia is present,
but not routinely. Supine positioning does not specifically promote renal
perfusion in this context.
Question 5
A patient with acute pancreatitis has severe abdominal pain radiating to the
back. Which laboratory finding is most specific for the diagnosis of acute
pancreatitis?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated white blood cell count
D) Elevated serum glucose
Answer: B
Rationale: Serum lipase is more specific for pancreatic inflammation than serum
amylase. Lipase remains elevated longer and is less affected by other
conditions (e.g., salivary gland disease, renal failure). While amylase is also
elevated, it is less specific. WBC elevation is a non‑specific sign of
inflammation, and glucose may be elevated but is not diagnostic.
Question 6
A nurse is caring for a patient with a new ileostomy. Which stool characteristic
should the nurse expect?
A) Formed, brown stool
B) Liquid, yellow‑green effluent
C) Semi‑formed, bulky stool
D) Dark, tarry stool
Answer: B
Rationale: An ileostomy is created from the ileum (small intestine), where stool
has not undergone water reabsorption in the colon. The effluent is therefore
liquid to semi‑liquid, yellow‑green, and contains digestive enzymes, which can
3
, be irritating to the skin. Formed stool is expected with a colostomy. Dark,
tarry stool indicates upper GI bleeding.
Question 7
A patient with ulcerative colitis is experiencing frequent, bloody diarrhea.
Which complication should the nurse monitor for most closely?
A) Bowel obstruction
B) Toxic megacolon
C) Perforation
D) Fistula formation
Answer: B
Rationale: Toxic megacolon is a life‑threatening complication of ulcerative
colitis (less commonly Crohn's) characterized by severe colonic dilation with
systemic toxicity (fever, tachycardia, leukocytosis). It can lead to perforation
and peritonitis. Bowel obstruction, perforation, and fistulas can occur in
Crohn's disease but are less characteristic of ulcerative colitis, which is
limited to the mucosa of the colon.
Question 8
A patient is receiving total parenteral nutrition (TPN) via a central venous
catheter. The nurse notes that the TPN bag is empty and a new bag is not yet
available. Which action should the nurse take?
A) Hang a 10% dextrose solution until the new TPN arrives
B) Hang normal saline at the same rate
C) Wait until the TPN arrives and then restart it
D) Flush the line with heparin and cap it off
Answer: A
Rationale: Abrupt cessation of TPN can cause rebound hypoglycemia because the
patient's pancreas is still producing insulin in response to the high glucose
load. To prevent hypoglycemia, a 10% dextrose solution should be infused at the
same rate until the new TPN bag is available. Normal saline does not provide
glucose and would not prevent hypoglycemia. Waiting would lead to a dangerous
drop in blood glucose.
Question 9
A patient is diagnosed with diverticulitis. Which dietary instruction should the
nurse provide during the acute phase?
A) High‑fiber diet to promote bowel movements
4
