NUR 170-171 COMPREHENSIVE
NURSING EXAM 4 QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A client with chronic kidney disease (CKD) is experiencing extreme pruritus. Which
physiological finding should the nurse recognize as the primary cause?
A. Excessive accumulation of bilirubin in the dermal layers
B. Uremic frost and deposition of urea crystals on the skin
C. Reduced sebum production due to sebaceous gland atrophy
D. Elevated serum calcium levels causing vascular calcification
Answer: B
Conceptual Explanation: In advanced CKD, high levels of urea in the blood lead to uremic
frost, where urea crystals are excreted through the sweat and deposited on the skin,
causing intense itching.
2. A patient is admitted with a diagnosis of Acute Pancreatitis. Which assessment finding
requires immediate notification of the healthcare provider?
A. Absence of bowel sounds in all four quadrants
B. Serum amylase level three times the normal limit
C. Reports of severe epigastric pain radiating to the back
,D. Grey Turner’s sign present on the flanks
Answer: D
Conceptual Explanation: Grey Turner’s sign (bluish discoloration of the flanks) indicates
retroperitoneal hemorrhage, a life-threatening complication of hemorrhagic pancreatitis.
3. Which pharmacological intervention is most appropriate for a client in the oliguric phase of
Acute Kidney Injury (AKI) who has a serum potassium of 6.8 mEq/L and EKG changes?
A. Intravenous calcium gluconate
B. Sodium polystyrene sulfonate orally
C. Intravenous loop diuretics
D. Oral potassium-sparing diuretics
Answer: A
Conceptual Explanation: While calcium gluconate does not lower potassium, it is the
priority intervention to stabilize the myocardium and prevent lethal dysrhythmias in the
presence of EKG changes.
4. A nurse is caring for a client with hepatic encephalopathy. The client is prescribed
lactulose. Which outcome indicates the medication is effective?
A. The client has three soft bowel movements per day
B. The client exhibits increased orientation and decreased lethargy
C. The client’s serum ammonia level is 90 mcg/dL
, D. The client’s abdominal girth decreases by 2 centimeters
Answer: B
Conceptual Explanation: The primary goal of lactulose in hepatic encephalopathy is to
reduce ammonia levels, which results in improved neurological status
(orientation/cognition).
5. A client in labor is receiving an oxytocin infusion. The nurse notes late decelerations on the
fetal heart rate monitor. What is the priority nursing action?
A. Increase the rate of the intravenous fluid bolus
B. Reposition the client to a side-lying position
C. Administer oxygen via non-rebreather mask at 10 L/min
D. Discontinue the oxytocin infusion
Answer: D
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
first action is to stop the oxytocin to reduce uterine contractions and improve blood flow to
the placenta.
6. A patient with Type 1 Diabetes Mellitus is admitted for Diabetic Ketoacidosis (DKA). Which
acid-base imbalance does the nurse expect to see on the arterial blood gas (ABG) report?
A. Respiratory Alkalosis with a low PaCO2
B. Respiratory Acidosis with a high PaCO2
NURSING EXAM 4 QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A client with chronic kidney disease (CKD) is experiencing extreme pruritus. Which
physiological finding should the nurse recognize as the primary cause?
A. Excessive accumulation of bilirubin in the dermal layers
B. Uremic frost and deposition of urea crystals on the skin
C. Reduced sebum production due to sebaceous gland atrophy
D. Elevated serum calcium levels causing vascular calcification
Answer: B
Conceptual Explanation: In advanced CKD, high levels of urea in the blood lead to uremic
frost, where urea crystals are excreted through the sweat and deposited on the skin,
causing intense itching.
2. A patient is admitted with a diagnosis of Acute Pancreatitis. Which assessment finding
requires immediate notification of the healthcare provider?
A. Absence of bowel sounds in all four quadrants
B. Serum amylase level three times the normal limit
C. Reports of severe epigastric pain radiating to the back
,D. Grey Turner’s sign present on the flanks
Answer: D
Conceptual Explanation: Grey Turner’s sign (bluish discoloration of the flanks) indicates
retroperitoneal hemorrhage, a life-threatening complication of hemorrhagic pancreatitis.
3. Which pharmacological intervention is most appropriate for a client in the oliguric phase of
Acute Kidney Injury (AKI) who has a serum potassium of 6.8 mEq/L and EKG changes?
A. Intravenous calcium gluconate
B. Sodium polystyrene sulfonate orally
C. Intravenous loop diuretics
D. Oral potassium-sparing diuretics
Answer: A
Conceptual Explanation: While calcium gluconate does not lower potassium, it is the
priority intervention to stabilize the myocardium and prevent lethal dysrhythmias in the
presence of EKG changes.
4. A nurse is caring for a client with hepatic encephalopathy. The client is prescribed
lactulose. Which outcome indicates the medication is effective?
A. The client has three soft bowel movements per day
B. The client exhibits increased orientation and decreased lethargy
C. The client’s serum ammonia level is 90 mcg/dL
, D. The client’s abdominal girth decreases by 2 centimeters
Answer: B
Conceptual Explanation: The primary goal of lactulose in hepatic encephalopathy is to
reduce ammonia levels, which results in improved neurological status
(orientation/cognition).
5. A client in labor is receiving an oxytocin infusion. The nurse notes late decelerations on the
fetal heart rate monitor. What is the priority nursing action?
A. Increase the rate of the intravenous fluid bolus
B. Reposition the client to a side-lying position
C. Administer oxygen via non-rebreather mask at 10 L/min
D. Discontinue the oxytocin infusion
Answer: D
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
first action is to stop the oxytocin to reduce uterine contractions and improve blood flow to
the placenta.
6. A patient with Type 1 Diabetes Mellitus is admitted for Diabetic Ketoacidosis (DKA). Which
acid-base imbalance does the nurse expect to see on the arterial blood gas (ABG) report?
A. Respiratory Alkalosis with a low PaCO2
B. Respiratory Acidosis with a high PaCO2
