PORTAGE LEARNING PATHOPHYSIOLOGY
NURS 231 BIOD 331 FINAL EXAM 2025 WITH
QUESTIONS AND VERIFIED ANSWERS
(RATIONALE AVAILABLE) || ALREADY
GRADED A+ || GUARANTEED PASS
The unlicensed assistive personnel (UAP) tells the nurse the patient has a blood
pressure of 78/46 and a pulse of 116 using a vital signs machine. Which action
should the nurse implement first?
a) Notify the physician immediately.
b) Assess the patient's cardiovascular status.
c) Place the patient in Trendelenburg position.
d) Have the UAP re-check the patient's vital signs manually.
*After determining a shock state exists by performing a cardiovascular
assessment. - ANSWER-b) Assess the patient's cardiovascular status
Your patient is a 37 year old unconscious female in the ICU with a fever, coarse
scattered lung crackles and orders for 1200 mL tube feeding q 24 hours. Does
the data in this case point to FVD (Fluid volume deficit) or FVE (Fluid volume
excess)?
a) fluid volume deficit
b) neither fluid volume deficit or excess.
c) fluid volume excess - ANSWER-a) fluid volume deficit
,*Unconscious--can not respond to thirst mechanism. Fever--risk factor for
dehydration. Evidence of lung infection—risk factor for dehydration.
1200mL/24 hours--not enough fluid intake
A nurse is administering intravenous dopamine [Intropin] to a patient in the
intensive care unit. Which assessment finding would cause the most concern?
a) Increased urine output
b) Headache
c) Edema at IV insertion site
d) Blood pressure of 100/70 mm Hg - ANSWER-c) Edema at IV insertion site
*The nurse would be concerned if the patient's peripheral IV were edematous,
because this could signal infiltration of the solution into the tissues. Dopamine
can cause necrosis if it extravasates. Dopamine is indicated to increase the
patient's blood pressure; this blood pressure reading is acceptable. When
dopamine is effective at increasing cardiac output, it also causes an increase in
urine output. Headache is not a contraindication to the use of dopamine.
The nurse is caring for a patient who had an emergency appendectomy after
appendix rupture. The morning lab results (blood) include:
Blood cultures not back yet, but gram stain is positive for gram negative bacilli,
Lactate level: 3.6, K+ 4.8, BUN 29 mg/dL, Cr 2.1 mg/dL. The patient's heart
rate is 98/min and blood pressure is 99/56. Which of the following treatments
does the nurse anticipate? (Select all that apply)
a) ciprofloxacin 500 mgs every 12 hours IV
b) Insert foley catheter
c) Repeat lactate level in 4 hours
d) Normal saline IV 1000 mL over 2 hours then 200mL/hour
e) norepinephrine infusion 2-10 mcgs/min IV, titrate - ANSWER-a)
ciprofloxacin 500 mgs every 12 hours IV
b) Insert foley catheter
,c) Repeat lactate level in 4 hours
d) Normal saline IV 1000 mL over 2 hours then 200mL/hour
*Patient has evidence of sepsis-induced hypoperfusion (gram stain and lactate
level). Agressive fluid administration is needed (guidelines state 30ml/kg in first
3 hours). A foley is needed to monitor urine output during fluid administration.
Norepinephrine will not be used unless the patient develops hypotension,
despite fluid administration. Patient's MAP is currently 70.
Your client experiencing acidosis has all of the following symptoms. Which one
indicates to you that the acidosis is worsening?
a) The client is lethargic.
b) The client's deep tendon reflexes are 2+.
c) The patient has decreased urine output.
d) Trouseau's sign is positive. - ANSWER-a) The client is lethargic
*This would be congruent with hypocalcemia. Hypercalemia is associated with
acidosis.
The nurse is caring for a group of clients on a medical surgical unit. For which
of these individuals does the nurse provide immediate interventions to reduce
the risk for pulmonary embolism (PE)?
a) A client receiving IV fluids through a peripheral line
b) A client returning from an open reduction and internal fixation of the tibia
c) A client with diabetes and cellulitis of the leg
d) A client with fluid volume deficit and hypokalemia receiving potassium
supplements - ANSWER-b) A client returning from an open reduction and
internal fixation of the tibia
*Surgery and perioperative immobility are very high risks for DVT and PE.
Orthopedic surgery compounds this risk.
, *No evidence suggests that the client with DM is immobile, which is a risk
factor for PE.
*While severe fluid volume deficit and resulting hemoconcentration may pose a
risk for thrombosis, this is not as common as thromboembolic complications
after orthopedic surgery
The nurse is caring for a group of clients on a Telemetry unit. When providing
client education, which client will the nurse determine most needs information
regarding preventing pulmonary embolism (PE)?
a) A woman with a bleeding disorder
b) A man who works on a farm
c) A woman who frequently flies to Europe
d) A man admitted for a myocardial infarction - ANSWER-c) A woman who
frequently flies to Europe
*Individuals who engage in prolonged and frequent air travel are at higher risk
for PE due to the dependent position of the legs during long air flights.
*farmer poses a low risk due to active lifestyle
*MI is caused by a thrombus or occlusion of the coronary arteries, not of the leg
veins. If the MI client is on prolonged bedrest, the client's risk is increased.
The nurse is developing a plan of care for a client with PE. Which client
problem does the nurse establish as the priority?
a) Risk for infection related to leukocytosis
b) Inadequate nutrition related to food-drug interactions with anticoagulant
therapy
c) Hypoxemia related to ventilation-perfusion mismatch
d) Insufficient knowledge related to the cause of PE - ANSWER-c) Hypoxemia
related to ventilation-perfusion mismatch
NURS 231 BIOD 331 FINAL EXAM 2025 WITH
QUESTIONS AND VERIFIED ANSWERS
(RATIONALE AVAILABLE) || ALREADY
GRADED A+ || GUARANTEED PASS
The unlicensed assistive personnel (UAP) tells the nurse the patient has a blood
pressure of 78/46 and a pulse of 116 using a vital signs machine. Which action
should the nurse implement first?
a) Notify the physician immediately.
b) Assess the patient's cardiovascular status.
c) Place the patient in Trendelenburg position.
d) Have the UAP re-check the patient's vital signs manually.
*After determining a shock state exists by performing a cardiovascular
assessment. - ANSWER-b) Assess the patient's cardiovascular status
Your patient is a 37 year old unconscious female in the ICU with a fever, coarse
scattered lung crackles and orders for 1200 mL tube feeding q 24 hours. Does
the data in this case point to FVD (Fluid volume deficit) or FVE (Fluid volume
excess)?
a) fluid volume deficit
b) neither fluid volume deficit or excess.
c) fluid volume excess - ANSWER-a) fluid volume deficit
,*Unconscious--can not respond to thirst mechanism. Fever--risk factor for
dehydration. Evidence of lung infection—risk factor for dehydration.
1200mL/24 hours--not enough fluid intake
A nurse is administering intravenous dopamine [Intropin] to a patient in the
intensive care unit. Which assessment finding would cause the most concern?
a) Increased urine output
b) Headache
c) Edema at IV insertion site
d) Blood pressure of 100/70 mm Hg - ANSWER-c) Edema at IV insertion site
*The nurse would be concerned if the patient's peripheral IV were edematous,
because this could signal infiltration of the solution into the tissues. Dopamine
can cause necrosis if it extravasates. Dopamine is indicated to increase the
patient's blood pressure; this blood pressure reading is acceptable. When
dopamine is effective at increasing cardiac output, it also causes an increase in
urine output. Headache is not a contraindication to the use of dopamine.
The nurse is caring for a patient who had an emergency appendectomy after
appendix rupture. The morning lab results (blood) include:
Blood cultures not back yet, but gram stain is positive for gram negative bacilli,
Lactate level: 3.6, K+ 4.8, BUN 29 mg/dL, Cr 2.1 mg/dL. The patient's heart
rate is 98/min and blood pressure is 99/56. Which of the following treatments
does the nurse anticipate? (Select all that apply)
a) ciprofloxacin 500 mgs every 12 hours IV
b) Insert foley catheter
c) Repeat lactate level in 4 hours
d) Normal saline IV 1000 mL over 2 hours then 200mL/hour
e) norepinephrine infusion 2-10 mcgs/min IV, titrate - ANSWER-a)
ciprofloxacin 500 mgs every 12 hours IV
b) Insert foley catheter
,c) Repeat lactate level in 4 hours
d) Normal saline IV 1000 mL over 2 hours then 200mL/hour
*Patient has evidence of sepsis-induced hypoperfusion (gram stain and lactate
level). Agressive fluid administration is needed (guidelines state 30ml/kg in first
3 hours). A foley is needed to monitor urine output during fluid administration.
Norepinephrine will not be used unless the patient develops hypotension,
despite fluid administration. Patient's MAP is currently 70.
Your client experiencing acidosis has all of the following symptoms. Which one
indicates to you that the acidosis is worsening?
a) The client is lethargic.
b) The client's deep tendon reflexes are 2+.
c) The patient has decreased urine output.
d) Trouseau's sign is positive. - ANSWER-a) The client is lethargic
*This would be congruent with hypocalcemia. Hypercalemia is associated with
acidosis.
The nurse is caring for a group of clients on a medical surgical unit. For which
of these individuals does the nurse provide immediate interventions to reduce
the risk for pulmonary embolism (PE)?
a) A client receiving IV fluids through a peripheral line
b) A client returning from an open reduction and internal fixation of the tibia
c) A client with diabetes and cellulitis of the leg
d) A client with fluid volume deficit and hypokalemia receiving potassium
supplements - ANSWER-b) A client returning from an open reduction and
internal fixation of the tibia
*Surgery and perioperative immobility are very high risks for DVT and PE.
Orthopedic surgery compounds this risk.
, *No evidence suggests that the client with DM is immobile, which is a risk
factor for PE.
*While severe fluid volume deficit and resulting hemoconcentration may pose a
risk for thrombosis, this is not as common as thromboembolic complications
after orthopedic surgery
The nurse is caring for a group of clients on a Telemetry unit. When providing
client education, which client will the nurse determine most needs information
regarding preventing pulmonary embolism (PE)?
a) A woman with a bleeding disorder
b) A man who works on a farm
c) A woman who frequently flies to Europe
d) A man admitted for a myocardial infarction - ANSWER-c) A woman who
frequently flies to Europe
*Individuals who engage in prolonged and frequent air travel are at higher risk
for PE due to the dependent position of the legs during long air flights.
*farmer poses a low risk due to active lifestyle
*MI is caused by a thrombus or occlusion of the coronary arteries, not of the leg
veins. If the MI client is on prolonged bedrest, the client's risk is increased.
The nurse is developing a plan of care for a client with PE. Which client
problem does the nurse establish as the priority?
a) Risk for infection related to leukocytosis
b) Inadequate nutrition related to food-drug interactions with anticoagulant
therapy
c) Hypoxemia related to ventilation-perfusion mismatch
d) Insufficient knowledge related to the cause of PE - ANSWER-c) Hypoxemia
related to ventilation-perfusion mismatch
