• EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
EVOLVE ELSEVIER NUR 140 PHARM EXAM 4
PREP NEWEST 2026/2027 ACTUAL EXAM
COMPLETE EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALE
The nurse is assessing a client's laboratory values following administration of chemotherapy. Which lab value
leads the nurse to suspect that the client is experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL.
Oxygen saturation of 90%.
P 1
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Hemoglobin of 10 g/dL. –
Correct Answer :Serum calcium of 5 mg/dL.
Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A
serum calcium level of 5, which is low, is an indicator of possible tumor lysis syndrome.
The registered nurse (RN) assesses arterial blood gas results of a client that has emphysema. Which finding is
consistent with respiratory acidosis?
pH 7.32, pCO 2 46 mmHg, HCO 3 24 MEq/L.
pH 7.45 , pCO 2 37 mmHg, HCO 3 24 mEq/L.
pH 7.34, pCO 2 36 mmHg, HCO 3 21 mEq/L.
pH 7.46, pCO 2 35 mmHg, HCO 3 28 mEq/L. –
Correct Answer :pH 7.32, pCO 2 46 mmHg, HCO 3 24 MEq/L.
Normal ABG ranges are pH 7.35 to 7.45; pCO2 35 to 45 mmHg; HCO3 21 to 28 mEq/L, and pO2 80 to 100 mmHg.
An ABG of pH 7.32, pCO2 46 mmHg, HCO3 24 MEq/L represents a client with respiratory acidosis which is
characterized by: low pH, pCO2 higher than normal, and HCO3 within normal limits.
The nurse is caring for a client who has been diagnosed with primary hyperaldosteronism. Which laboratory test
result should the nurse expect an increase in the serum level?
Sodium
Antidiuretic hormone.
Potassium.
Glucose. - Correct Answer :Sodium
P 2
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Clients with primary aldosteronism exhibit an increase in serum sodium levels (hypernatremia) and have
profound decline in the serum levels of potassium (hypokalemia)--hypertension is the most prominent and
universal sign. Antidiuretic hormone is decreased with diabetes insipidus. Glucose is not affected by primary
aldosteronism.
Which condition should the nurse suspect when a client reports vaginal dryness during intercourse?
Obstructed Bartholin's glands
Hyperactive sebaceous glands.
Infected bulbourethral glands.
Strangulated prostate gland.
- Correct Answer :Obstructed Bartholin's glands
Bartholin's glands are located posteriorly on each side of the vaginal opening; they secrete lubrication fluid
during sexual excitement. The nurse should suspect obstructed Bartholin's glands when a client reports vaginal
dryness during intercourse.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 69, p. 1450.
A client is admitted to the emergency department after falling from a high roof. Which finding should the nurse
report immediately?
Clear, watery drainage from the ear.
Dried blood around the ear and neck.
Tenderness on palpation of the ear.
Pearly appearance of the tympanic membrane. –
P 3
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Correct Answer :Clear, watery drainage from the ear.
The nurse should immediately report the presence of clear, watery drainage from the ear in a client after a high
fall. This type of fluid can indicate leakage of cerebrospinal fluid, a sign associated with a basal skull fracture.
Jarvis, 2016., Physical Examination and Health Assessment, 7th ed., chapter 15, p. 334
A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the meaning
of staging and the type of receptors found on the cancer cells. Which explanation should the nurse provide?
Lymph node involvement is not significant.
Small tumors are aggressive and indicate poor prognosis.
The tumor's estrogen receptor guides treatment options.
Stage I indicates metastasis. –
Correct Answer :The tumor's estrogen receptor guides treatment options.
Treatment decisions and prediction of prognosis are related to the tumor's receptor status, such as estrogen
and progesterone receptor status which commonly are well-differentiated, have a lower chance of recurrence,
and are receptive to hormonal therapy. Tumor staging designates tumor size and spread of breast cancer cells
into axillary lymph nodes, which is one of the most important prognostic factors in early-stage breast cancer.
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer has the
poorest prognosis. Which information should the nurse offer the client?
Stage II.
Invasive infiltrating ductal carcinoma.
T1N0M0.
Inflammatory with peau d'orange. - Correct Answer :Inflammatory with peau d'orange.
P 4
NUR 140 PHARM 09/07/2026
EXAM
EVOLVE ELSEVIER NUR 140 PHARM EXAM 4
PREP NEWEST 2026/2027 ACTUAL EXAM
COMPLETE EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALE
The nurse is assessing a client's laboratory values following administration of chemotherapy. Which lab value
leads the nurse to suspect that the client is experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL.
Oxygen saturation of 90%.
P 1
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Hemoglobin of 10 g/dL. –
Correct Answer :Serum calcium of 5 mg/dL.
Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A
serum calcium level of 5, which is low, is an indicator of possible tumor lysis syndrome.
The registered nurse (RN) assesses arterial blood gas results of a client that has emphysema. Which finding is
consistent with respiratory acidosis?
pH 7.32, pCO 2 46 mmHg, HCO 3 24 MEq/L.
pH 7.45 , pCO 2 37 mmHg, HCO 3 24 mEq/L.
pH 7.34, pCO 2 36 mmHg, HCO 3 21 mEq/L.
pH 7.46, pCO 2 35 mmHg, HCO 3 28 mEq/L. –
Correct Answer :pH 7.32, pCO 2 46 mmHg, HCO 3 24 MEq/L.
Normal ABG ranges are pH 7.35 to 7.45; pCO2 35 to 45 mmHg; HCO3 21 to 28 mEq/L, and pO2 80 to 100 mmHg.
An ABG of pH 7.32, pCO2 46 mmHg, HCO3 24 MEq/L represents a client with respiratory acidosis which is
characterized by: low pH, pCO2 higher than normal, and HCO3 within normal limits.
The nurse is caring for a client who has been diagnosed with primary hyperaldosteronism. Which laboratory test
result should the nurse expect an increase in the serum level?
Sodium
Antidiuretic hormone.
Potassium.
Glucose. - Correct Answer :Sodium
P 2
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Clients with primary aldosteronism exhibit an increase in serum sodium levels (hypernatremia) and have
profound decline in the serum levels of potassium (hypokalemia)--hypertension is the most prominent and
universal sign. Antidiuretic hormone is decreased with diabetes insipidus. Glucose is not affected by primary
aldosteronism.
Which condition should the nurse suspect when a client reports vaginal dryness during intercourse?
Obstructed Bartholin's glands
Hyperactive sebaceous glands.
Infected bulbourethral glands.
Strangulated prostate gland.
- Correct Answer :Obstructed Bartholin's glands
Bartholin's glands are located posteriorly on each side of the vaginal opening; they secrete lubrication fluid
during sexual excitement. The nurse should suspect obstructed Bartholin's glands when a client reports vaginal
dryness during intercourse.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 69, p. 1450.
A client is admitted to the emergency department after falling from a high roof. Which finding should the nurse
report immediately?
Clear, watery drainage from the ear.
Dried blood around the ear and neck.
Tenderness on palpation of the ear.
Pearly appearance of the tympanic membrane. –
P 3
, • EVOLVE ELSEVIER
NUR 140 PHARM 09/07/2026
EXAM
Correct Answer :Clear, watery drainage from the ear.
The nurse should immediately report the presence of clear, watery drainage from the ear in a client after a high
fall. This type of fluid can indicate leakage of cerebrospinal fluid, a sign associated with a basal skull fracture.
Jarvis, 2016., Physical Examination and Health Assessment, 7th ed., chapter 15, p. 334
A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the meaning
of staging and the type of receptors found on the cancer cells. Which explanation should the nurse provide?
Lymph node involvement is not significant.
Small tumors are aggressive and indicate poor prognosis.
The tumor's estrogen receptor guides treatment options.
Stage I indicates metastasis. –
Correct Answer :The tumor's estrogen receptor guides treatment options.
Treatment decisions and prediction of prognosis are related to the tumor's receptor status, such as estrogen
and progesterone receptor status which commonly are well-differentiated, have a lower chance of recurrence,
and are receptive to hormonal therapy. Tumor staging designates tumor size and spread of breast cancer cells
into axillary lymph nodes, which is one of the most important prognostic factors in early-stage breast cancer.
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer has the
poorest prognosis. Which information should the nurse offer the client?
Stage II.
Invasive infiltrating ductal carcinoma.
T1N0M0.
Inflammatory with peau d'orange. - Correct Answer :Inflammatory with peau d'orange.
P 4
