NUR 2502 MULTIDIMENSIONAL CARE II
EXAM REVIEW QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with Chronic Kidney Disease (CKD) whose GFR has dropped to
12 mL/min. Which physiological change should the nurse prioritize in the plan of care?
A. Decreased serum phosphorus levels leading to bone density loss
B. Increase in erythropoietin production causing polycythemia
C. Elevation in serum potassium levels leading to cardiac dysrhythmias
D. Metabolic alkalosis due to excessive bicarbonate retention
Answer: C
Conceptual Explanation: At GFR Stage 5 (ESRD), the kidneys cannot effectively excrete
potassium, leading to life-threatening hyperkalemia and potential cardiac arrest.
2. Which assessment finding in a client with Acute Pancreatitis requires immediate
notification of the healthcare provider?
A. Report of epigastric pain radiating to the back
B. Bluish discoloration around the periumbilical area
,C. Serum amylase level three times the normal limit
D. Absent bowel sounds in all four quadrants
Answer: B
Conceptual Explanation: Cullen’s sign (periumbilical bruising) indicates retroperitoneal
hemorrhage, a severe complication of necrotizing pancreatitis.
3. A client is admitted with Thyroid Storm. Which medication should the nurse expect to
administer to block the peripheral conversion of T4 to T3?
A. Levothyroxine
B. Radioactive Iodine
C. Propylthiouracil (PTU)
D. Calcium Gluconate
Answer: C
Conceptual Explanation: PTU not only inhibits the synthesis of new thyroid hormones but
also prevents the peripheral conversion of T4 to the more active T3.
4. The nurse is assessing a client with Cirrhosis who has Hepatic Encephalopathy. Which lab
value is most consistent with this diagnosis?
A. Ammonia 110 mcg/dL
B. Bilirubin 1.2 mg/dL
C. Albumin 4.5 g/dL
, D. Platelets 250,000/mm3
Answer: A
Conceptual Explanation: Hepatic encephalopathy is primarily caused by the accumulation
of ammonia, a neurotoxin, which the diseased liver cannot convert to urea.
5. A client is in the oliguric phase of Acute Kidney Injury (AKI). Which dietary modification is
most appropriate?
A. Increased sodium intake to maintain blood pressure
B. Restriction of potassium and fluid intake
C. High protein diet to prevent muscle wasting
D. Increased intake of magnesium-rich foods
Answer: B
Conceptual Explanation: During the oliguric phase, the client is at risk for fluid volume
overload and hyperkalemia; therefore, both must be restricted.
6. Following a Paracentesis, which assessment finding is the most critical for the nurse to
monitor?
A. Decreased abdominal girth
B. Heart rate 115 bpm and BP 88/54 mmHg
C. Increased urinary output
D. Clear fluid leaking from the puncture site
EXAM REVIEW QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with Chronic Kidney Disease (CKD) whose GFR has dropped to
12 mL/min. Which physiological change should the nurse prioritize in the plan of care?
A. Decreased serum phosphorus levels leading to bone density loss
B. Increase in erythropoietin production causing polycythemia
C. Elevation in serum potassium levels leading to cardiac dysrhythmias
D. Metabolic alkalosis due to excessive bicarbonate retention
Answer: C
Conceptual Explanation: At GFR Stage 5 (ESRD), the kidneys cannot effectively excrete
potassium, leading to life-threatening hyperkalemia and potential cardiac arrest.
2. Which assessment finding in a client with Acute Pancreatitis requires immediate
notification of the healthcare provider?
A. Report of epigastric pain radiating to the back
B. Bluish discoloration around the periumbilical area
,C. Serum amylase level three times the normal limit
D. Absent bowel sounds in all four quadrants
Answer: B
Conceptual Explanation: Cullen’s sign (periumbilical bruising) indicates retroperitoneal
hemorrhage, a severe complication of necrotizing pancreatitis.
3. A client is admitted with Thyroid Storm. Which medication should the nurse expect to
administer to block the peripheral conversion of T4 to T3?
A. Levothyroxine
B. Radioactive Iodine
C. Propylthiouracil (PTU)
D. Calcium Gluconate
Answer: C
Conceptual Explanation: PTU not only inhibits the synthesis of new thyroid hormones but
also prevents the peripheral conversion of T4 to the more active T3.
4. The nurse is assessing a client with Cirrhosis who has Hepatic Encephalopathy. Which lab
value is most consistent with this diagnosis?
A. Ammonia 110 mcg/dL
B. Bilirubin 1.2 mg/dL
C. Albumin 4.5 g/dL
, D. Platelets 250,000/mm3
Answer: A
Conceptual Explanation: Hepatic encephalopathy is primarily caused by the accumulation
of ammonia, a neurotoxin, which the diseased liver cannot convert to urea.
5. A client is in the oliguric phase of Acute Kidney Injury (AKI). Which dietary modification is
most appropriate?
A. Increased sodium intake to maintain blood pressure
B. Restriction of potassium and fluid intake
C. High protein diet to prevent muscle wasting
D. Increased intake of magnesium-rich foods
Answer: B
Conceptual Explanation: During the oliguric phase, the client is at risk for fluid volume
overload and hyperkalemia; therefore, both must be restricted.
6. Following a Paracentesis, which assessment finding is the most critical for the nurse to
monitor?
A. Decreased abdominal girth
B. Heart rate 115 bpm and BP 88/54 mmHg
C. Increased urinary output
D. Clear fluid leaking from the puncture site
