Test 1 Materials NURS 5432 Questions With Complete Solutions
Institution
University Of Texas - Arlington
Course
NURS 54321) A 52-year-old patient presents with fatigue, weight gain, and cold intolerance.
Labs show elevated TSH and low T4. What is the most likely diagnosis?
A. Primary hyperthyroidism
B. Primary hypothyroidism
C. Secondary hypothyroidism
D. Thyroid storm
Answer: B
Rationale: Elevated TSH with low T4 indicates primary hypothyroidism, since the thyroid
gland is failing but the pituitary continues to stimulate it.
2) Which pharmacokinetic process is most affected in patients with chronic kidney disease?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D
Rationale: Excretion is impaired in CKD, leading to drug accumulation and increased risk of
toxicity.
3) A nurse notes that a patient with COPD has a chronic CO₂ retention. Which
compensatory mechanism is expected?
A. Respiratory alkalosis
B. Renal retention of bicarbonate
C. Decreased erythropoietin production
D. Decreased hematocrit
Answer: B
Rationale: In chronic respiratory acidosis, kidneys retain bicarbonate to buffer excess CO₂.
4) Which type of hypersensitivity reaction is anaphylaxis?
A. Type I (IgE-mediated)
,B. Type II (cytotoxic)
C. Type III (immune complex)
D. Type IV (delayed T-cell)
Answer: A
Rationale: Anaphylaxis is an IgE-mediated Type I hypersensitivity reaction.
5) Which of the following antihypertensive drugs is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors
D. Hydralazine
Answer: C
Rationale: ACE inhibitors are teratogenic and contraindicated in pregnancy; labetalol,
methyldopa, and hydralazine are preferred.
6) A patient receiving warfarin presents with an INR of 6.5 and no active bleeding. What is
the most appropriate nursing action?
A. Continue warfarin as ordered
B. Administer vitamin K
C. Administer protamine sulfate
D. Hold warfarin for one dose
Answer: B
Rationale: With an INR >6, vitamin K should be given to reverse anticoagulation, even if no
bleeding is present.
7) Which auscultatory finding is most consistent with left-sided heart failure?
A. Wheezing in the upper lobes
B. Crackles at lung bases
C. Diminished breath sounds at apices
D. Hyperresonance to percussion
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion → crackles due to fluid
accumulation.
,8) Which electrolyte imbalance is most likely to cause peaked T waves on ECG?
A. Hypocalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Rationale: Hyperkalemia produces tall, peaked T waves and can lead to arrhythmias.
9) A nurse is reviewing medications. Which patient is most at risk for digoxin toxicity?
A. Patient with hypernatremia
B. Patient with hypokalemia
C. Patient with hypercalcemia
D. Patient with hypermagnesemia
Answer: B
Rationale: Hypokalemia increases binding of digoxin to cardiac cells, raising toxicity risk.
10) Which of the following is the best first-line treatment for acute asthma exacerbation?
A. Inhaled corticosteroids
B. Oral prednisone
C. IV magnesium
D. Inhaled short-acting beta agonist
Answer: D
Rationale: Short-acting beta agonists (SABAs, e.g., albuterol) are first-line rescue therapy for
acute asthma attacks.
11) Which phase of the cardiac cycle is represented by the QRS complex?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Answer: B
Rationale: The QRS complex represents ventricular depolarization and precedes ventricular
contraction.
, 12) Which clinical manifestation is most specific for meningitis?
A. Photophobia
B. Nuchal rigidity
C. Headache
D. Nausea
Answer: B
Rationale: While many symptoms overlap, nuchal rigidity (stiff neck) is a hallmark sign of
meningitis.
13) Which of the following describes preload?
A. Resistance left ventricle must overcome
B. Pressure during ventricular contraction
C. Volume of blood returning to the heart
D. Force of myocardial contraction
Answer: C
Rationale: Preload refers to ventricular filling volume (end-diastolic volume).
14) A patient taking corticosteroids long-term is at greatest risk for which complication?
A. Hypoglycemia
B. Addisonian crisis
C. Immunosuppression
D. Hypotension
Answer: C
Rationale: Long-term steroids suppress the immune system, increasing infection risk.
15) In heart failure, activation of the renin-angiotensin-aldosterone system (RAAS)
primarily leads to:
A. Vasodilation and reduced afterload
B. Sodium and water retention
C. Increased urine output
D. Decreased preload
Answer: B
Rationale: RAAS activation increases sodium/water retention, which worsens fluid overload in
HF.
Institution
University Of Texas - Arlington
Course
NURS 54321) A 52-year-old patient presents with fatigue, weight gain, and cold intolerance.
Labs show elevated TSH and low T4. What is the most likely diagnosis?
A. Primary hyperthyroidism
B. Primary hypothyroidism
C. Secondary hypothyroidism
D. Thyroid storm
Answer: B
Rationale: Elevated TSH with low T4 indicates primary hypothyroidism, since the thyroid
gland is failing but the pituitary continues to stimulate it.
2) Which pharmacokinetic process is most affected in patients with chronic kidney disease?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D
Rationale: Excretion is impaired in CKD, leading to drug accumulation and increased risk of
toxicity.
3) A nurse notes that a patient with COPD has a chronic CO₂ retention. Which
compensatory mechanism is expected?
A. Respiratory alkalosis
B. Renal retention of bicarbonate
C. Decreased erythropoietin production
D. Decreased hematocrit
Answer: B
Rationale: In chronic respiratory acidosis, kidneys retain bicarbonate to buffer excess CO₂.
4) Which type of hypersensitivity reaction is anaphylaxis?
A. Type I (IgE-mediated)
,B. Type II (cytotoxic)
C. Type III (immune complex)
D. Type IV (delayed T-cell)
Answer: A
Rationale: Anaphylaxis is an IgE-mediated Type I hypersensitivity reaction.
5) Which of the following antihypertensive drugs is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors
D. Hydralazine
Answer: C
Rationale: ACE inhibitors are teratogenic and contraindicated in pregnancy; labetalol,
methyldopa, and hydralazine are preferred.
6) A patient receiving warfarin presents with an INR of 6.5 and no active bleeding. What is
the most appropriate nursing action?
A. Continue warfarin as ordered
B. Administer vitamin K
C. Administer protamine sulfate
D. Hold warfarin for one dose
Answer: B
Rationale: With an INR >6, vitamin K should be given to reverse anticoagulation, even if no
bleeding is present.
7) Which auscultatory finding is most consistent with left-sided heart failure?
A. Wheezing in the upper lobes
B. Crackles at lung bases
C. Diminished breath sounds at apices
D. Hyperresonance to percussion
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion → crackles due to fluid
accumulation.
,8) Which electrolyte imbalance is most likely to cause peaked T waves on ECG?
A. Hypocalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Rationale: Hyperkalemia produces tall, peaked T waves and can lead to arrhythmias.
9) A nurse is reviewing medications. Which patient is most at risk for digoxin toxicity?
A. Patient with hypernatremia
B. Patient with hypokalemia
C. Patient with hypercalcemia
D. Patient with hypermagnesemia
Answer: B
Rationale: Hypokalemia increases binding of digoxin to cardiac cells, raising toxicity risk.
10) Which of the following is the best first-line treatment for acute asthma exacerbation?
A. Inhaled corticosteroids
B. Oral prednisone
C. IV magnesium
D. Inhaled short-acting beta agonist
Answer: D
Rationale: Short-acting beta agonists (SABAs, e.g., albuterol) are first-line rescue therapy for
acute asthma attacks.
11) Which phase of the cardiac cycle is represented by the QRS complex?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Answer: B
Rationale: The QRS complex represents ventricular depolarization and precedes ventricular
contraction.
, 12) Which clinical manifestation is most specific for meningitis?
A. Photophobia
B. Nuchal rigidity
C. Headache
D. Nausea
Answer: B
Rationale: While many symptoms overlap, nuchal rigidity (stiff neck) is a hallmark sign of
meningitis.
13) Which of the following describes preload?
A. Resistance left ventricle must overcome
B. Pressure during ventricular contraction
C. Volume of blood returning to the heart
D. Force of myocardial contraction
Answer: C
Rationale: Preload refers to ventricular filling volume (end-diastolic volume).
14) A patient taking corticosteroids long-term is at greatest risk for which complication?
A. Hypoglycemia
B. Addisonian crisis
C. Immunosuppression
D. Hypotension
Answer: C
Rationale: Long-term steroids suppress the immune system, increasing infection risk.
15) In heart failure, activation of the renin-angiotensin-aldosterone system (RAAS)
primarily leads to:
A. Vasodilation and reduced afterload
B. Sodium and water retention
C. Increased urine output
D. Decreased preload
Answer: B
Rationale: RAAS activation increases sodium/water retention, which worsens fluid overload in
HF.
