BIOD 331 | NURS 231 Pathophysiology Final
Exam
BIOD 331 | NURS 231 Pathophysiology Final
Exam | VERIFIED QUESTIONS AND ANSWERS
WITH DETAILED RATIONLES GRADED A+
GUARANTEED PASS ACE YOUR TEST –
PDFTESTBANK Questions and Answers | 2025
Update | 100% Correct.
A nurse assesses a client after a thoracentesis. Which assessment finding warrants immediate action?
a. The client rates pain as a 5/10 at the site of the procedure.
b. A small amount of drainage from the site is noted.
c. Pulse oximetry is 93% on 2 liters of oxygen.
d. The trachea is deviated toward the opposite side of the neck
. - ANS :d. The trachea is deviated toward the opposite side of the neck.
*A deviated trachea is a manifestation of a tension pneumothorax, which is a medical emergency. The otherfindings
are normal or near normal.
A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the clients oxygen
saturation has not significantly improved. What response by the nurse is best?
a. Breathing so rapidly interferes with oxygenation.
b. Maybe the client has respiratory distress syndrome.
c. The blood clot interferes with perfusion in the lungs.
d. The client needs immediate intubation and mechanical
[AUTHOR NAME] 1
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
ventilation. –
ANS :c. The blood clot interferes with perfusion in the lungs.
*A large blood clot in the lungs will significantly impair gas exchange and oxygenation. Unless the clot is
dissolved, this process will continue unabated. Hyperventilation can interfere with oxygenation by shallow breathing,
but there is no evidence that the client is hyperventilating, and this is also not the most precise physiologic answer.
Respiratory distress syndrome can occur, but this is not as likely. The client may need to be mechanically ventilated,
but without concrete data on FiO2 and SaO2, the nurse cannot make that judgment.
nurse is caring for four clients on intravenous heparin therapy. Which laboratory value possibly indicates
that a serious side effect has occurred?
a. Hemoglobin: 14.2
b. Platelet count: 82,000
c. Red blood cell count: 4.8
d. White blood cell count: 8,700 –
ANS :b. Platelet count: 82,000
This platelet count is low and could indicate heparin-induced thrombocytopenia. The other values are normal for
either gender.
A client appears dyspneic, but the oxygen saturation is 97%. What action by the nurse is best?
a. Assess for other manifestations of hypoxia.
b. Change the sensor on the pulse oximeter.
c. Obtain a new oximeter from central
supply.
d. Tell the client to take slow, deep breath –
[AUTHOR NAME] 2
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
ANS :a. Assess for other manifestations of hypoxia.
Pulse oximetry is not always the most accurate assessment tool for hypoxia as many factors can interfere, producing
normal or near-normal readings in the setting of hypoxia. The nurse should conduct a more thorough assessment.
The other actions are not appropriate for a hypoxic client.
nurse is assisting the health care provider who is intubating a client. The provider has been attempting to
intubate for 40 seconds. What action by the nurse takes priority?
a. Ensure the client has adequate sedation.
b. Find another provider to intubate.
c. Interrupt the procedure to give oxygen.
d. Monitor the clients oxygen saturation. –
ANS :c. Interrupt the procedure to give oxygen.
Each intubation attempt should not exceed 30 seconds (15 is preferable) as it causes hypoxia. The nurse should
interrupt the intubation attempt and give the client oxygen. The nurse should also have adequate sedation during
the procedure and monitor the clients oxygen saturation, but these do not take priority. Finding another provider is
not appropriate at this time.
An intubated clients oxygen saturation has dropped to 88%. What action by the nurse takes priority?
a. Determine if the tube is kinked.
b. Ensure all connections are patent.
c. Listen to the clients lung sounds.
d. Suction the endotracheal tube.
- ANS :c. Listen to the clients lung sounds.
[AUTHOR NAME] 3
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
*When an intubated client shows signs of hypoxia, check for DOPE: displaced tube (most common cause),
obstruction (often by secretions), pneumothorax, and equipment problems. The nurse listens for equal, bilateral
breath sounds first to determine if the endotracheal tube is still correctly placed. If this assessment is normal, the
nurse would follow the mnemonic and assess the patency of the tube and connections and perform suction
client is on a ventilator and is sedated. What care may the nurse delegate to the unlicensed assistive personnel
(UAP)?
a. Assess the client for sedation needs.
b. Get family permission for restraints.
c. Provide frequent oral care per protocol.
d. Use nonverbal pain assessment tools. –
ANS :c. Provide frequent oral care per protocol.
The client on mechanical ventilation needs frequent oral care, which can be delegated to the UAP. The other actions
fall within the scope of practice of the nurse.
A nurse is caring for a client on mechanical ventilation and finds the client agitated and thrashing about.
What action by the nurse is most appropriate?
a. Assess the cause of the agitation.
b. Reassure the client that he or she is
safe.
c. Restrain the clients hands.
d. Sedate the client immediately. –
ANS :a. Assess the cause of the agitation.
*The nurse needs to determine the cause of the agitation. The inability to communicate often makes clients anxious,
even to the point of panic. Pain and confusion can also cause agitation. Once the nurse determines the cause of the
agitation, he or she can implement measures to relieve the underlying cause. Reassurance is also important but may
not address the etiology of the agitation. Restraints and more sedation may be necessary, but not as a first step.
[AUTHOR NAME] 4
Exam
BIOD 331 | NURS 231 Pathophysiology Final
Exam | VERIFIED QUESTIONS AND ANSWERS
WITH DETAILED RATIONLES GRADED A+
GUARANTEED PASS ACE YOUR TEST –
PDFTESTBANK Questions and Answers | 2025
Update | 100% Correct.
A nurse assesses a client after a thoracentesis. Which assessment finding warrants immediate action?
a. The client rates pain as a 5/10 at the site of the procedure.
b. A small amount of drainage from the site is noted.
c. Pulse oximetry is 93% on 2 liters of oxygen.
d. The trachea is deviated toward the opposite side of the neck
. - ANS :d. The trachea is deviated toward the opposite side of the neck.
*A deviated trachea is a manifestation of a tension pneumothorax, which is a medical emergency. The otherfindings
are normal or near normal.
A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the clients oxygen
saturation has not significantly improved. What response by the nurse is best?
a. Breathing so rapidly interferes with oxygenation.
b. Maybe the client has respiratory distress syndrome.
c. The blood clot interferes with perfusion in the lungs.
d. The client needs immediate intubation and mechanical
[AUTHOR NAME] 1
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
ventilation. –
ANS :c. The blood clot interferes with perfusion in the lungs.
*A large blood clot in the lungs will significantly impair gas exchange and oxygenation. Unless the clot is
dissolved, this process will continue unabated. Hyperventilation can interfere with oxygenation by shallow breathing,
but there is no evidence that the client is hyperventilating, and this is also not the most precise physiologic answer.
Respiratory distress syndrome can occur, but this is not as likely. The client may need to be mechanically ventilated,
but without concrete data on FiO2 and SaO2, the nurse cannot make that judgment.
nurse is caring for four clients on intravenous heparin therapy. Which laboratory value possibly indicates
that a serious side effect has occurred?
a. Hemoglobin: 14.2
b. Platelet count: 82,000
c. Red blood cell count: 4.8
d. White blood cell count: 8,700 –
ANS :b. Platelet count: 82,000
This platelet count is low and could indicate heparin-induced thrombocytopenia. The other values are normal for
either gender.
A client appears dyspneic, but the oxygen saturation is 97%. What action by the nurse is best?
a. Assess for other manifestations of hypoxia.
b. Change the sensor on the pulse oximeter.
c. Obtain a new oximeter from central
supply.
d. Tell the client to take slow, deep breath –
[AUTHOR NAME] 2
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
ANS :a. Assess for other manifestations of hypoxia.
Pulse oximetry is not always the most accurate assessment tool for hypoxia as many factors can interfere, producing
normal or near-normal readings in the setting of hypoxia. The nurse should conduct a more thorough assessment.
The other actions are not appropriate for a hypoxic client.
nurse is assisting the health care provider who is intubating a client. The provider has been attempting to
intubate for 40 seconds. What action by the nurse takes priority?
a. Ensure the client has adequate sedation.
b. Find another provider to intubate.
c. Interrupt the procedure to give oxygen.
d. Monitor the clients oxygen saturation. –
ANS :c. Interrupt the procedure to give oxygen.
Each intubation attempt should not exceed 30 seconds (15 is preferable) as it causes hypoxia. The nurse should
interrupt the intubation attempt and give the client oxygen. The nurse should also have adequate sedation during
the procedure and monitor the clients oxygen saturation, but these do not take priority. Finding another provider is
not appropriate at this time.
An intubated clients oxygen saturation has dropped to 88%. What action by the nurse takes priority?
a. Determine if the tube is kinked.
b. Ensure all connections are patent.
c. Listen to the clients lung sounds.
d. Suction the endotracheal tube.
- ANS :c. Listen to the clients lung sounds.
[AUTHOR NAME] 3
, BIOD 331 | NURS 231 Pathophysiology Final
Exam
*When an intubated client shows signs of hypoxia, check for DOPE: displaced tube (most common cause),
obstruction (often by secretions), pneumothorax, and equipment problems. The nurse listens for equal, bilateral
breath sounds first to determine if the endotracheal tube is still correctly placed. If this assessment is normal, the
nurse would follow the mnemonic and assess the patency of the tube and connections and perform suction
client is on a ventilator and is sedated. What care may the nurse delegate to the unlicensed assistive personnel
(UAP)?
a. Assess the client for sedation needs.
b. Get family permission for restraints.
c. Provide frequent oral care per protocol.
d. Use nonverbal pain assessment tools. –
ANS :c. Provide frequent oral care per protocol.
The client on mechanical ventilation needs frequent oral care, which can be delegated to the UAP. The other actions
fall within the scope of practice of the nurse.
A nurse is caring for a client on mechanical ventilation and finds the client agitated and thrashing about.
What action by the nurse is most appropriate?
a. Assess the cause of the agitation.
b. Reassure the client that he or she is
safe.
c. Restrain the clients hands.
d. Sedate the client immediately. –
ANS :a. Assess the cause of the agitation.
*The nurse needs to determine the cause of the agitation. The inability to communicate often makes clients anxious,
even to the point of panic. Pain and confusion can also cause agitation. Once the nurse determines the cause of the
agitation, he or she can implement measures to relieve the underlying cause. Reassurance is also important but may
not address the etiology of the agitation. Restraints and more sedation may be necessary, but not as a first step.
[AUTHOR NAME] 4
