NURA 1500 EXAM 4 QUESTIONS AND
ANSWERS. VERIFIED 2026.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - ANS Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The
other conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - ANS Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K
to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client
for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia.
Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular
atrophy result from decreased estrogen metabolism by the diseased liver.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,When evaluating a male client for complications of acute pancreatitis, the nurse would observe
for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - ANS Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal
failure that sometimes accompanies this condition. Intracranial pressure neither increases nor
decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with
pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a
hypovolemic complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-
tube has drained 750ml of green-brown drainage. Which nursing intervention is most
appropriate?
A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - ANS Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then
turns to green-brown. The drainage is measured as output. The amount of expected drainage
will range from 500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is
located in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - ANS Answer: B
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is
most important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - ANS Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight
will help protect against gallstones. Excessive dietary intake of cholesterol is associated with the
development of gallstones in many people. Dietary protein isn't implicated in cholecystitis.
Liquid protein and low-calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week)
are implicated as the cause of some cases of cholecystitis. Regular exercise (30 minutes/three
times a week) may help reduce weight and improve fat metabolism. Reducing stress may reduce
bile production, which may also indirectly decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - ANS Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present
in peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up
abdominal muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - ANS Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present.
An abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A
barium swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus,
stomach, and duodenum.
A client being treated for chronic cholecystitis should be given which of the following
instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - ANS Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by
increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use
to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices
is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - ANS Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to
accommodate the large amount of blood necessary for homeostasis. The pressure in the liver
increases and causes increased pressure in the venous system. As the portal pressure increases,
fluid exudes into the abdominal cavity. This is called ascites.
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS. VERIFIED 2026.
Which condition is most likely to have a nursing diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer - ANS Answer: B
Explanation: Hypovolemic shock from fluid shifts is a major factor in acute pancreatitis. The
other conditions are less likely to exhibit fluid volume deficit.
The nurse is caring for a male client with cirrhosis. Which assessment findings indicate that the
client has deficient vitamin K absorption caused by this hepatic disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy - ANS Answer: C
Explanation: A hepatic disorder, such as cirrhosis, may disrupt the liver's normal use of vitamin K
to produce prothrombin (a clotting factor). Consequently, the nurse should monitor the client
for signs of bleeding, including purpura and petechiae. Dyspnea and fatigue suggest anemia.
Ascites and orthopnea are unrelated to vitamin K absorption. Gynecomastia and testicular
atrophy result from decreased estrogen metabolism by the diseased liver.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,When evaluating a male client for complications of acute pancreatitis, the nurse would observe
for:
A. increased intracranial pressure
B. decreased urine output
C. bradycardia
D. hypertension - ANS Answer: B
Explanation: Acute pancreatitis can cause decreased urine output, which results from the renal
failure that sometimes accompanies this condition. Intracranial pressure neither increases nor
decreases in a client with pancreatitis. Tachycardia, not bradycardia, usually is associated with
pulmonary or hypovolemic complications of pancreatitis. Hypotension can be caused by a
hypovolemic complication, but hypertension usually isn't related to acute pancreatitis.
The nurse is assessing a client 24 hours following a cholecystectomy. The nurse notes that the T-
tube has drained 750ml of green-brown drainage. Which nursing intervention is most
appropriate?
A. Notify the physician
B. Document the findings
C. Irrigate the T-tube
D. Clamp the T-tube - ANS Answer: B
Explanation: Following cholecystectomy, drainage from the T-tube is initially bloody and then
turns to green-brown. The drainage is measured as output. The amount of expected drainage
will range from 500 to 1000 ml per day. The nurse would document the output.
The nurse would assess the client experiencing an acute episode of cholecysitis for pain that is
located in the right
A. Upper quadrant and radiates to the left scapula and shoulder
B. Upper quadrant and radiates to the right scapula and shoulder
C. Lower quadrant and radiates to the umbilicus
D. Lower quadrant and radiates to the back - ANS Answer: B
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Explanation: During an acute "gallbladder attack," the client may complain of severe right upper
quadrant pain that radiates to the right scapula and shoulder. This is governed by the pattern on
dermatomes in the body.
When counseling a client in ways to prevent cholecystitis, which of the following guidelines is
most important?
A. Eat a low-protein diet
B. Eat a low-fat, low-cholesterol diet
C. Limit exercise to 10 minutes/day
D. Keep weight proportionate to height - ANS Answer: D
Explanation: Obesity is a known cause of gallstones, and maintaining a recommended weight
will help protect against gallstones. Excessive dietary intake of cholesterol is associated with the
development of gallstones in many people. Dietary protein isn't implicated in cholecystitis.
Liquid protein and low-calorie diets (with rapid weight loss of more than 5 lb [2.3kg] per week)
are implicated as the cause of some cases of cholecystitis. Regular exercise (30 minutes/three
times a week) may help reduce weight and improve fat metabolism. Reducing stress may reduce
bile production, which may also indirectly decrease the chances of developing cholecystitis.
Which of the following symptoms best describes Murphy's sign?
A. Periumbilical ecchymosis exists
B. On deep palpitation and release, pain in elicited
C. On deep inspiration, pain is elicited and breathing stops
D. Abdominal muscles are tightened in anticipation of palpation - ANS Answer: C
Explanation: Murphy's sign is elicited when the client reacts to pain and stops breathing. It's a
common finding in clients with cholecystitis. Periumbilical ecchymosis, Cullen's sign, is present
in peritonitis. Pain on deep palpation and release is rebound tenderness. Tightening up
abdominal muscles in anticipation of palpation is guarding.
Which of the following tests is most commonly used to diagnose cholecystitis?
A. Abdominal CT scan
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, B. Abdominal ultrasound
C. Barium swallow
D. Endoscopy - ANS Answer: B
Explanation: An abdominal ultrasound can show if the gallbladder is enlarged, if gallstones are
present, if the gallbladder wall is thickened, or if distention of the gallbladder lumen is present.
An abdominal CT scan can be used to diagnose cholecystitis, but it usually isn't necessary. A
barium swallow looks at the stomach and the duodenum. Endoscopy looks at the esophagus,
stomach, and duodenum.
A client being treated for chronic cholecystitis should be given which of the following
instructions?
A. Increase rest
B. Avoid antacids
C. Increase protein in diet
D. Use anticholinergics as prescribed - ANS Answer: D
Explanation: Conservative therapy for chronic cholecystitis includes weight reduction by
increasing physical activity, a low-fat diet, antacid use to treat dyspepsia, and anticholinergic use
to relax smooth muscles and reduce ductal tone and spasm, thereby reducing pain.
The most important pathophysiologic factor contributing to the formation of esophageal varices
is:
A. Decreased prothrombin formation
B. Decreased albumin formation by the liver
C. Portal hypertension
D. Increased central venous pressure - ANS Answer: C
Explanation: As the liver cells become fatty and degenerate, they are no longer able to
accommodate the large amount of blood necessary for homeostasis. The pressure in the liver
increases and causes increased pressure in the venous system. As the portal pressure increases,
fluid exudes into the abdominal cavity. This is called ascites.
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
