NSG 2400 EXAM 4 COMPREHENSIVE
REVIEW VERIFIED QUESTIONS &
ANSWERS
Master your upcoming nursing exam with this definitive, high-yield
bank of expert-crafted multiple-choice questions. This
comprehensive study resource features clear correct-answer keys
and highly detailed, advanced rationales covering everything from
severe endometriosis management to critical care concepts like
ARDS and cardiac tamponade. Designed specifically to mimic
real clinical scenarios, it serves as the perfect last-minute cram
sheet to guarantee top marks on your exam day.
Question 1
A client with severe endometriosis is prescribed leuprolide
acetate. Which finding reported by the client should the
nurse identify as an expected adverse effect of this
medication?
A) Severe watery diarrhea and hyperkalemia
B) Hypertension and peripheral edema
C) Hot flashes and vaginal dryness
D) Excessive salivation and urinary frequency
Rationale: Leuprolide is a GnRH agonist that
suppresses ovarian estrogen production,
inducing a temporary hypoestrogenic
(menopausal) state. This commonly leads to hot
flashes, vaginal dryness, and bone density loss.
Options A, B, and D are not clinical
, manifestations associated with GnRH agonist
therapy.
Question 2
A client who underwent a diagnostic laparoscopy 4 hours
ago reports sharp right shoulder pain. Which nursing
intervention is the most appropriate initial action?
A) Encourage early ambulation and frequent
repositioning
B) Administer high-dose intravenous opioids
immediately
C) Apply a localized warm compress directly to the
shoulder
D) Prepare the client for an emergency repeat
laparoscopy
Rationale: Post-laparoscopy shoulder pain is
caused by residual carbon dioxide gas irritating
the phrenic nerve. Early ambulation and
movement help the body reabsorb and dissipate
the trapped gas. Opioids do not address the
underlying etiology, and this is an expected
finding, not an emergency.
Question 3
A nurse is preparing an educational session on
endometriosis. Which statement regarding the definitive
diagnosis of endometriosis should the nurse include?
, A) Diagnosis is confirmed via elevated serum CA-125
levels.
B) A transvaginal ultrasound is the definitive gold
standard for diagnosis.
C) Definitive diagnosis requires direct visualization via
laparoscopy.
D) Physical assessment finding of a fixed, retroverted
uterus is diagnostic.
Rationale: While imaging and lab tests can
support suspicion, a definitive diagnosis of
endometriosis requires direct visual inspection of
endometrial implants via laparoscopic surgery,
often accompanied by a biopsy.
Question 4
A client with endometriosis is prescribed oral contraceptive
therapy. When teaching the client about the mechanism of
action, which explanation should the nurse provide?
A) Oral contraceptives destroy ectopic endometrial
tissue directly through cellular lysis.
B) They suppress ovulation and thin the endometrium
to reduce bleeding and pain.
C) They increase circulating estrogen levels to
downregulate pelvic pain receptors.
D) They stimulate the immune system to phagocytize
ectopic implants.
, Rationale: Combined or progestin-only oral
contraceptives function by suppressing ovulation
and inducing a state of endometrial atrophy
(thinning), which minimizes cyclic bleeding and
reduces inflammatory pelvic pain.
Question 5
A 26-year-old female client with endometriosis expresses
a strong desire to become pregnant within the next year.
Which treatment option should the nurse anticipate the
healthcare provider will avoid?
A) Conservative laparoscopic ablation of implants
B) Long-term GnRH agonist therapy with leuprolide
C) Scheduled nonsteroidal anti-inflammatory drugs
(NSAIDs)
D) Short-term pelvic physical therapy
Rationale: GnRH agonists like leuprolide
suppress ovulation and induce a hypoestrogenic
state, preventing pregnancy. It is inappropriate for
a client actively trying to conceive in the near
future. Conservative surgical ablation preserves
fertility, and NSAIDs do not halt ovulation.
Question 6
During a pelvic examination of a client with suspected
endometriosis, the nurse notes severe pain upon uterine
motion and deep palpation. How should the nurse
document this specific clinical finding?
REVIEW VERIFIED QUESTIONS &
ANSWERS
Master your upcoming nursing exam with this definitive, high-yield
bank of expert-crafted multiple-choice questions. This
comprehensive study resource features clear correct-answer keys
and highly detailed, advanced rationales covering everything from
severe endometriosis management to critical care concepts like
ARDS and cardiac tamponade. Designed specifically to mimic
real clinical scenarios, it serves as the perfect last-minute cram
sheet to guarantee top marks on your exam day.
Question 1
A client with severe endometriosis is prescribed leuprolide
acetate. Which finding reported by the client should the
nurse identify as an expected adverse effect of this
medication?
A) Severe watery diarrhea and hyperkalemia
B) Hypertension and peripheral edema
C) Hot flashes and vaginal dryness
D) Excessive salivation and urinary frequency
Rationale: Leuprolide is a GnRH agonist that
suppresses ovarian estrogen production,
inducing a temporary hypoestrogenic
(menopausal) state. This commonly leads to hot
flashes, vaginal dryness, and bone density loss.
Options A, B, and D are not clinical
, manifestations associated with GnRH agonist
therapy.
Question 2
A client who underwent a diagnostic laparoscopy 4 hours
ago reports sharp right shoulder pain. Which nursing
intervention is the most appropriate initial action?
A) Encourage early ambulation and frequent
repositioning
B) Administer high-dose intravenous opioids
immediately
C) Apply a localized warm compress directly to the
shoulder
D) Prepare the client for an emergency repeat
laparoscopy
Rationale: Post-laparoscopy shoulder pain is
caused by residual carbon dioxide gas irritating
the phrenic nerve. Early ambulation and
movement help the body reabsorb and dissipate
the trapped gas. Opioids do not address the
underlying etiology, and this is an expected
finding, not an emergency.
Question 3
A nurse is preparing an educational session on
endometriosis. Which statement regarding the definitive
diagnosis of endometriosis should the nurse include?
, A) Diagnosis is confirmed via elevated serum CA-125
levels.
B) A transvaginal ultrasound is the definitive gold
standard for diagnosis.
C) Definitive diagnosis requires direct visualization via
laparoscopy.
D) Physical assessment finding of a fixed, retroverted
uterus is diagnostic.
Rationale: While imaging and lab tests can
support suspicion, a definitive diagnosis of
endometriosis requires direct visual inspection of
endometrial implants via laparoscopic surgery,
often accompanied by a biopsy.
Question 4
A client with endometriosis is prescribed oral contraceptive
therapy. When teaching the client about the mechanism of
action, which explanation should the nurse provide?
A) Oral contraceptives destroy ectopic endometrial
tissue directly through cellular lysis.
B) They suppress ovulation and thin the endometrium
to reduce bleeding and pain.
C) They increase circulating estrogen levels to
downregulate pelvic pain receptors.
D) They stimulate the immune system to phagocytize
ectopic implants.
, Rationale: Combined or progestin-only oral
contraceptives function by suppressing ovulation
and inducing a state of endometrial atrophy
(thinning), which minimizes cyclic bleeding and
reduces inflammatory pelvic pain.
Question 5
A 26-year-old female client with endometriosis expresses
a strong desire to become pregnant within the next year.
Which treatment option should the nurse anticipate the
healthcare provider will avoid?
A) Conservative laparoscopic ablation of implants
B) Long-term GnRH agonist therapy with leuprolide
C) Scheduled nonsteroidal anti-inflammatory drugs
(NSAIDs)
D) Short-term pelvic physical therapy
Rationale: GnRH agonists like leuprolide
suppress ovulation and induce a hypoestrogenic
state, preventing pregnancy. It is inappropriate for
a client actively trying to conceive in the near
future. Conservative surgical ablation preserves
fertility, and NSAIDs do not halt ovulation.
Question 6
During a pelvic examination of a client with suspected
endometriosis, the nurse notes severe pain upon uterine
motion and deep palpation. How should the nurse
document this specific clinical finding?
