NURS 5220 COMPREHENSIVE EXAM
PREP QUESTIONS WITH CORRECT
VERIFIED ANSWERS | GURANTEED A+
1. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L.
Which of the following is the most likely acid-base imbalance?
A. Metabolic Acidosis, compensated
B. Respiratory Acidosis, uncompensated
C. Respiratory Alkalosis, partially compensated
D. Metabolic Alkalosis, uncompensated
Answer: B
Conceptual Explanation: The low pH (<7.35) indicates acidosis, and the elevated PaCO2
(>45 mmHg) indicates a respiratory cause. The normal HCO3 shows no compensation has
occurred yet.
2. Which cellular adaptation is characterized by a decrease in cell size due to a lack of
hormonal stimulation or disuse?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
,D. Atrophy
Answer: D
Conceptual Explanation: Atrophy is the shrinkage in cell size by loss of cell substance,
often due to decreased workload, loss of innervation, or diminished blood supply.
3. A patient taking an ACE inhibitor develops a dry, non-productive cough. This side effect is
primarily attributed to the accumulation of which substance?
A. Angiotensin II
B. Renin
C. Aldosterone
D. Bradykinin
Answer: D
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, leading to its
accumulation in the lungs, which causes the characteristic dry cough.
4. In the pharmacokinetics of a drug, what does the term ‘First-pass effect’ refer to?
A. The rapid excretion of a drug by the kidneys.
B. The binding of a drug to plasma proteins.
C. The metabolism of an oral drug in the liver before it reaches systemic circulation.
D. The initial distribution of a drug to highly perfused organs.
, Answer: C
Conceptual Explanation: The first-pass effect describes the process where the
concentration of a drug is greatly reduced before it reaches the systemic circulation due to
liver metabolism.
5. During a physical assessment, the nurse performs the Murphy sign. A positive result is
indicative of which condition?
A. Appendicitis
B. Cholecystitis
C. Splenomegaly
D. Nephrolithiasis
Answer: B
Conceptual Explanation: Murphy sign is a test for gallbladder inflammation
(cholecystitis) where the patient catches their breath upon deep palpation of the right
upper quadrant.
6. Which of the following describes the mechanism of action of Heparin?
A. Inhibition of Vitamin K synthesis
B. Inhibition of platelet aggregation via COX-1
C. Direct inhibition of Factor Xa
D. Activation of antithrombin III
PREP QUESTIONS WITH CORRECT
VERIFIED ANSWERS | GURANTEED A+
1. A patient presents with a plasma pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L.
Which of the following is the most likely acid-base imbalance?
A. Metabolic Acidosis, compensated
B. Respiratory Acidosis, uncompensated
C. Respiratory Alkalosis, partially compensated
D. Metabolic Alkalosis, uncompensated
Answer: B
Conceptual Explanation: The low pH (<7.35) indicates acidosis, and the elevated PaCO2
(>45 mmHg) indicates a respiratory cause. The normal HCO3 shows no compensation has
occurred yet.
2. Which cellular adaptation is characterized by a decrease in cell size due to a lack of
hormonal stimulation or disuse?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
,D. Atrophy
Answer: D
Conceptual Explanation: Atrophy is the shrinkage in cell size by loss of cell substance,
often due to decreased workload, loss of innervation, or diminished blood supply.
3. A patient taking an ACE inhibitor develops a dry, non-productive cough. This side effect is
primarily attributed to the accumulation of which substance?
A. Angiotensin II
B. Renin
C. Aldosterone
D. Bradykinin
Answer: D
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, leading to its
accumulation in the lungs, which causes the characteristic dry cough.
4. In the pharmacokinetics of a drug, what does the term ‘First-pass effect’ refer to?
A. The rapid excretion of a drug by the kidneys.
B. The binding of a drug to plasma proteins.
C. The metabolism of an oral drug in the liver before it reaches systemic circulation.
D. The initial distribution of a drug to highly perfused organs.
, Answer: C
Conceptual Explanation: The first-pass effect describes the process where the
concentration of a drug is greatly reduced before it reaches the systemic circulation due to
liver metabolism.
5. During a physical assessment, the nurse performs the Murphy sign. A positive result is
indicative of which condition?
A. Appendicitis
B. Cholecystitis
C. Splenomegaly
D. Nephrolithiasis
Answer: B
Conceptual Explanation: Murphy sign is a test for gallbladder inflammation
(cholecystitis) where the patient catches their breath upon deep palpation of the right
upper quadrant.
6. Which of the following describes the mechanism of action of Heparin?
A. Inhibition of Vitamin K synthesis
B. Inhibition of platelet aggregation via COX-1
C. Direct inhibition of Factor Xa
D. Activation of antithrombin III
