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BSN NURS 419 Patho-Pharm 1

Question 1: Diabetic Ketoacidosis (DKA)

BSN NURS 419 Patho-Pharm 1. A nurse is reviewing the lab results and physical assessment of a patient with Diabetic Ketoacidosis (DKA). Which of the following would the nurse NOT expect to find?

  • Fruity breath odor
  • Kussmaul respirations
  • A blood glucose level of 60 mg/dl
  • Presence of ketones in the urine

Question 2: Cholecystitis

A patient is diagnosed with cholecystitis (inflammation of the gallbladder). The nurse understands that this condition may cause a blockage in the release of bile. This will most likely result in:

  • Increased absorption of water-soluble vitamins
  • Impaired digestion of fats
  • Decreased production of stomach acid
  • Increased production of insulin

Question 3: Type I Diabetes Mellitus

The most common cause of Type I Diabetes Mellitus is:

  • A high sugar diet
  • Insulin resistance
  • Immune destruction of the pancreas
  • Obesity

Question 4: Adverse Reactions

Which patient has the greatest predisposition to an adverse reaction?

  • A 30 y/o man with liver disease
  • A 75 y/o woman with normal liver and kidney function
  • A 50 y/o man with a history of high blood pressure
  • A 25 y/o woman who is an athlete

Question 5: Antidiuretic Hormone (ADH)

Why is the Antidiuretic Hormone (ADH) important?

  • The body’s blood sugar levels
  • The body’s fight or flight response
  • The body’s metabolic rate
  • The body’s water balance and urine concentration

Question 6: Alpha-1 Antitrypsin Deficiency

Which of the following statements by the patient requires further teaching?

  • “I know that I should quit smoking to help my lungs.”
  • “I will make sure to take my medications as prescribed.”
  • “I read on the internet that I may have gotten bronchitis because I was born with an enzyme deficiency called alpha-1 antitrypsin”
  • “I will avoid being around others who are sick.”

Question 7: Graves’ Disease

Which of the following is an endocrine disorder?

  • Graves’ disease
  • Asthma
  • Multiple Sclerosis
  • Rheumatoid arthritis

Question 8: Peptic Ulcer Disease (PUD)

A patient with Peptic Ulcer Disease (PUD) is being educated on the risk factors for PUD. Which of the following is a risk factor for PUD?

  • Eating a high-fiber diet
  • Daily cigarette smoke
  • Drinking plenty of water
  • Getting 8 hours of sleep each night

Question 9: Metoprolol and Hypoglycemia

A patient with diabetes is starting on metoprolol for hypertension. Which of the following should be included in the patient teaching?

  • “Metoprolol will help your blood sugar stay stable.”
  • “Metoprolol can mask early signs of hypoglycemia, such as tachycardia.”
  • “Metoprolol will increase your insulin requirements.”
  • “Metoprolol will prevent you from having any more low blood sugar episodes.” BSN NURS 419 Patho-Pharm 1

Question 10: Hematochezia

A patient reports having bright red blood from the rectum. This is called:

  • Melena
  • Hematochezia
  • Hematemesis
  • Occult blood

Question 11: Iron Deficiency Anemia

Which of the following is a sign of iron deficiency anemia?

  • Hyperactivity
  • Spoon-shaped nails
  • Ruddy complexion
  • High blood pressure

Question 12: Cirrhosis Signs

Which of the following is a common physical assessment finding in a patient with chronic cirrhosis?

  • Palmar erythema and spider angiomas
  • Hyperactivity and increased energy
  • Pale, dry skin
  • Low blood pressure

Question 13: Asthma Maintenance

What is the medication of choice for the maintenance of persistent asthma?

  • Oral glucocorticoids
  • Short-acting beta2 agonists (SABA)
  • Combination inhaled glucocorticoids/long-acting beta2 agonists
  • Anticholinergics

Question 14: Oral Iron Supplementation

Which of the following should be included in the patient teaching for a patient starting on oral iron replacement?

  • “You should take your iron supplement with a large glass of milk.”
  • “If you experience any stomach upset, you should stop taking the medication immediately.”
  • “Iron supplements can cause gastrointestinal upset and constipation. Increase your fiber and fluid intake to manage these side effects”
  • “You should only take your iron supplement once a week.”

Question 15: Cardiac Output

What is the definition of cardiac output?

  • The amount of blood in the ventricles at the end of diastole
  • The amount of blood the heart pumps each minute
  • The pressure the heart must pump against
  • The percentage of blood ejected from the heart with each beat

Question 16: Posterior Pituitary

The posterior pituitary secretes which of the following? BSN NURS 419 Patho-Pharm 1

  • ADH and Oxytocin
  • Growth hormone and Prolactin
  • TSH and ACTH
  • FSH and LH

Question 17: Pneumonia Classification

A patient is admitted to the hospital for a hip fracture. On day 3 of the hospital stay, the patient develops a cough and a fever. A chest x-ray reveals pneumonia. This would be classified as:

  • Community-acquired pneumonia
  • Hospital-acquired pneumonia
  • Aspiration pneumonia
  • Viral pneumonia

Question 18: Tuberculosis Transmission

Tuberculosis (TB) is transmitted through:

  • Direct skin contact
  • Contaminated food or water
  • Airborne particles
  • Bloodborne pathogens

Question 19: Isotonic Solution

A blood cell is placed in an isotonic solution. The cell will:

  • Shrink
  • Swell and burst
  • Neither shrink nor swell
  • Change shape but stay the same size

Question 20: Aplastic Anemia Findings

A patient presents with fatigue, frequent nosebleeds, and recurrent infections. Laboratory results show decreased RBCs, WBCs, and platelets. Which diagnosis is most consistent with these findings?

  • Post-hemorrhagic anemia
  • Sickle cell anemia
  • Aplastic anemia
  • Iron deficiency anemia

Question 21: Hemoglobin A1C

You inform your patient that her glycosylated hemoglobin (hemoglobin A1C) level is high. She asks what this means. You tell her that the purpose of this test is to:

  • Measure fasting glucose levels
  • Check for hyperlipidemia
  • Detect acute complications of diabetes
  • Monitor long-term serum glucose control

Question 22: Atherosclerosis

A patient wants to know what causes atherosclerosis. How should you respond? The first step in atherosclerosis formation is:

  • Endothelial injury and inflammation
  • High serum cholesterol levels
  • An increase in antithrombotic substances
  • Congenital heart disease

Question 23: Metformin (Biguanides)

Biguanides (Metformin) lower blood glucose levels by:

  • Improving insulin sensitivity
  • Decreasing insulin secretion from the pancreatic beta-cell
  • Inhibiting GLP-1 production
  • Increasing hepatic production of glucose

Question 24: Sulfasalazine

You are providing education to a patient with ulcerative colitis who is being treated with a 5-aminosalicylate called sulfasalazine (Azulfidine). What statement by the patient best demonstrates understanding the action of sulfasalazine?

  • “It increases the reabsorption of fluid”
  • “It reduces the inflammation”
  • “It treats the infection that triggers the condition”
  • “It enhances the immune response”

Question 25: Mononucleosis Education

You are providing education to a patient with infectious mononucleosis. What instruction would you give to prevent the spread of the infection to others?

  • Bathe daily with chlorhexidine
  • Do not share drinking glasses or eating utensils
  • Avoid all contact with people
  • Wear a surgical mask when others are in the room

Question 26: Erythropoiesis Nutrition

Which of the following nutritional components would you encourage a patient to consume as it is needed for erythropoiesis?

  • Folic acid
  • Vitamin B12
  • Iron
  • All of the above

Question 27: H. pylori Mechanisms

Which information indicates correct understanding of the pathophysiologic mechanisms that lead to peptic ulcer formation from chronic infection with Helicobacter pylori (H. pylori)?

  • H. pylori produces toxins and enzymes that promote inflammation and ulceration
  • H. pylori inhibits prostaglandins, which causes decreased mucus production
  • H. pylori causes the pyloric sphincter to open

Question 33

A patient with sickle cell anemia is being educated on triggers for a sickle cell crisis. Which of the following should be included?

  • Low oxygen tension (hypoxia)
  • Infection
  • Dehydration
  • All of the above

Question 34

The nurse is reviewing the mechanism of action for the medication spironolactone. Which of the following is correct?

  • Inhibiting the sodium-potassium-chloride cotransporter
  • Blocking aldosterone receptors
  • Increasing the excretion of potassium
  • Stimulating the release of renin. BSN NURS 419 Patho-Pharm 1

Question 35

A patient is admitted with diabetic ketoacidosis (DKA). Which electrolyte imbalance is most commonly associated with this condition and requires careful monitoring during treatment?

  • Hypernatremia
  • Hypokalemia
  • Hypocalcemia
  • Hypermagnesemia

Question 36

A 65 y/o male is diagnosed with a vitamin B12 deficiency. He had a gastric bypass 15 years ago. His B12 deficiency is most likely:

  • Aplastic
  • Hemolytic
  • Pernicious
  • Iron deficiency

Question 37

A nurse is preparing to administer insulin to a patient. Which type of insulin peaks in approximately 2.5 hours?

  • Regular insulin
  • Insulin glargine
  • Insulin lispro
  • NPH insulin

Question 39

The nurse is administering a beta1 agonist. The nurse knows that this medication will primarily affect which of the following?

  • Lungs
  • Heart
  • Kidneys
  • Liver

Question 40

A 45 y/o female is diagnosed with primary thrombocythemia. A blood smear reveals that platelets are:

  • Overproduced
  • Underproduced
  • Normal in number
  • Not present

Question 41

A 52 y/o male with a history of cirrhosis is diagnosed with hepatic encephalopathy. The nurse understands this condition is primarily caused by:

  • Elevated blood glucose levels
  • Impaired ammonia metabolism
  • Excessive alcohol consumption
  • Low serum albumin levels

Question 42

A 56 y/o male with a history of liver disease presents with ascites. The nurse understands the primary cause for ascites in this patient is a deficiency in:

  • Albumin
  • Globulin
  • Fibrinogen
  • Prothrombin

Question 43

A patient is diagnosed with angina. The nurse understands that the pain associated with angina occurs because:

  • The myocardial oxygen supply has fallen below demand
  • There is a total blockage of a coronary artery
  • The heart rate is too slow to maintain cardiac output
  • There is excessive inflammation in the pericardium

Question 44

A nurse is caring for a patient who is experiencing hypoglycemia. The patient is unconscious and does not have IV access. What is the priority medication to administer?

  • Regular insulin
  • Oral glucose gel
  • Glucagon
  • Normal saline

Question 45

Which statement by the student nurse indicates a need for further teaching about beta blockers?

  • “Beta blockers can be used to treat hypertension.”
  • “Beta blockers should be used with caution in patients with asthma.”
  • “Beta blockers decrease heart rate and should be held if the pulse is below 60 bpm”
  • “Beta blockers can mask the symptoms of hypoglycemia.”

Question 46

What does the ‘C’ in the acronym UIC stand for?

  • College
  • Chicago
  • Center
  • Council

Question 47

A nurse is caring for a patient with HIV who is taking tenofovir. Which of the following is a priority for the nurse to follow up on?

  • Rising creatinine level
  • Occasional headaches
  • Mild nausea after taking the medication
  • A slight decrease in CD4 count

Question 48

A patient who takes metformin is scheduled for a CT scan with contrast. Which of the following is correct?

  • Hold metformin 48 hours after contrast administration
  • Increase the dose of metformin before the procedure
  • Metformin can be taken as usual
  • Metformin should be taken with the contrast

Question 49

A 50 y/o male is at risk for atherosclerosis. Which of the following lab results would be of most concern?

  • Elevated low-density lipoprotein
  • Elevated high-density lipoprotein
  • Normal triglyceride levels
  • Normal total cholesterol

Question 50

A nurse is caring for a patient with advanced liver disease. The nurse understands that this patient is at risk for bleeding because:

  • Clotting factors are produced in the liver
  • The liver stores excess vitamin K
  • Liver disease causes an overproduction of platelets
  • Red blood cells are destroyed in the liver

Question 51

Your patient has a new diagnosis of hepatitis D. You know that the only way the patient can contract hepatitis D is if he is already infected with:

  • Hepatitis A
  • Hepatitis C
  • Hepatitis B
  • Hepatitis E

Question 52

A 54 y/o patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

  • Hyponatremia
  • Hyperkalemia
  • Hypernatremia
  • Hypokalemia

Question 53

You are obtaining an admission history on an adult patient, and note that the patient has a heart rate of 62 bpm, a blood pressure of 105/62, and a temperature of 96.2 F. The patient appears pale and complains of always feeling cold, tired, and constipated. You would contact the provider to discuss tests for which condition?

  • Hypothyroidism
  • Cretinism
  • Graves’ disease
  • Plummer’s disease

Question 54

Both Cushing syndrome and Addison disease can manifest with elevated levels of:

  • Aldosterone
  • ADH
  • Cortisol
  • Adrenocorticotropic hormone (ACTH)

Question 55

You are teaching your patient about a medication that alters the function of the sympathetic nervous system. To evaluate understanding, you ask the patient to describe which functions the sympathetic nervous system primarily regulates. Which answer is an indication that further teaching is needed? BSN NURS 419 Patho-Pharm 1

  • “The digestive system”
  • “The cardiovascular system”
  • “The fight-or-flight response”
  • “Body temperature”

Question 56

Your patient has disseminated intravascular clotting (DIC). You would assess for active bleeding after intravascular clotting because:

  • Clotting factors are depleted
  • Prothrombin is activated
  • Tissue factor (TF) is inactivated
  • Inflammatory mediators are released

Question 57

Your patient would be diagnosed with thrombocytopenia when the platelet count is below ___ platelets per cubic millimeter.

  • 15,000
  • 150,000
  • 50,000
  • 400,000

Question 58

Which non-pharmaceutical intervention can be used to reduce symptoms of gastroesophageal reflux disease?

  • Drinking soft drinks/soda
  • Eating a low-carb diet
  • Small meals and staying upright after meals
  • Consuming a glass of wine with meals

Question 59

The icteric phase of hepatitis is characterized by which of the following clinical manifestations?

  • Fatigue, malaise, vomiting
  • Fulminant liver failure, hepatorenal syndrome
  • Jaundice, dark urine, enlarged liver
  • Resolution of jaundice, liver function returns to normal

Question 60

A patient taking a GLP-1 receptor agonist calls the clinic reporting new symptoms. Which symptom should prompt the nurse to suspect a serious adverse effect and instruct the patient to seek immediate medical attention?

  • Severe, persistent abdominal pain radiating to the back, accompanied by nausea and vomiting
  • Mild nausea and occasional diarrhea after meals
  • Occasional headaches and episodes of dizziness over the past week
  • Increased thirst and urination over the past few days

Question 61

Your patient has metabolic acidosis. You would expect the body to compensate for this by:

  • Increasing respiratory rate
  • Increasing cardiac output
  • Increasing urine output
  • Increasing blood pressure

Question 62

A 45 y/o female has elevated thyroid hormone production. Which of the following would accompany this condition?

  • Decreased T4
  • Increased thyroid-releasing hormone (TRH)
  • Increased anterior pituitary stimulation
  • Decreased thyroid-stimulating hormone (TSH)

Question 63

An individual with Graves disease has a goiter. Which pathophysiologic mechanism for a goiter would the health care provider (HCP) consider when planning care for this individual?

  • Infiltrative changes involving the orbital contents with enlargement of the ocular muscles
  • Functional abnormalities resulting from hyperactivity of the sympathetic nervous system
  • Autoantibodies activation of the thyroid-stimulating hormone (TSH) receptors in the gland
  • Pretibial myxedema preventing formation of thyroxine hormone in the thyroid

Question 64

Infectivity allows pathogens to:

  • Invade and multiply in the host
  • Spread from one individual to another and cause disease
  • Induce an immune response
  • Damage tissue

Question 65

Which of the following are properties of an ideal drug? (Multiple Answer) BSN NURS 419 Patho-Pharm 1

  • Irreversible action
  • Predictability
  • Ease of administration
  • A recognizable trade name
  • Chemical stability

Question 66

A 57 y/o male presents to his primary care provider with reddened face, hands, feet, and ears. He also complains of headaches and his blood pressure has increased since his last visit. A blood smear reveals an increased number of erythrocytes. His most likely diagnosis would be:

  • Sideroblastic anemia
  • Leukemia
  • Hemosiderosis
  • Polycythemia vera (PV)

Question 67

When planning care for a dehydrated patient, the nurse remembers the principle of water balance is most closely related to ___ balance.

  • sodium
  • bicarbonate
  • potassium
  • chloride

Question 68

A patient with newly diagnosed asthma asks a nurse about his short-acting beta2-agonist (SABA) medication. What will the nurse tell this patient?

  • SABAs act as bronchoconstrictors
  • SABAs can be used on an as-needed basis to treat symptoms
  • SABAs reduce the risk of pneumonia
  • SABAs should never be used with an inhaled glucocorticoid

Question 69

You are caring for a 49 y/o male with cirrhosis. Which of the following lab values would you NOT expect for this patient?

  • Elevated AST and ALT
  • Decreased ammonia levels
  • Decreased prothrombin time
  • Low serum albumin

Question 5

Your patient wants to know why ADH is important in the body. You would respond that ADH is important in:

  • Stimulation of aldosterone secretion
  • Follicular maturation
  • Regulation of metabolic processes
  • The body’s water balance and urine concentration

Question 6

A 51 y/o male has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the following statements, if made by the patient, demonstrates good understanding of his diagnosis?

  • I read on the internet that I may have gotten bronchitis because I was born with an enzyme deficiency called alpha-1 antitrypsin
  • I think I probably could have prevented this if I had gotten in the habit of exercising more when I was younger
  • I’m pretty sure I first caught bronchitis from the person who has a cubicle next to mine at work
  • If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis

Question 32

A patient with type 2 diabetes mellitus is prescribed an SGLT-2 inhibitor. What is the primary mechanism of action of this medication?

  • Stimulates insulin secretion from pancreatic beta cells
  • Delays carbohydrate absorption in the gastrointestinal tract
  • Increases insulin sensitivity in muscle and liver tissues
  • Promotes glucose excretion through the urine by inhibiting renal glucose reabsorption

Question 70

The cardinal signs of small bowel obstruction are:

  • Abdominal pain and rectal bleeding
  • Diarrhea and excessive thirst
  • Dehydration and epigastric pain
  • Vomiting and abdominal distention

Question 71

Derek was diagnosed with pre-diabetes… Today at his appointment, Derek’s fasting blood glucose was 134 mg/dl and his 2 hour blood glucose was 200 mg/dl. He is diagnosed with type 2 diabetes. What would you expect to be prescribed for Derek after today’s appointment?

  • Insulin
  • Gastric bypass surgery
  • Biguanides (Metformin)
  • Acarbose (Precose)

Question 72

Your patient is hospitalized with head trauma after a motor vehicle accident. You note a marked increase in the output of pale, dilute urine. You suspect which condition?

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • Water intoxication
  • Diabetes insipidus
  • Diabetes mellitus. BSN NURS 419 Patho-Pharm 1

Question 73

An 11 y/o diagnosed with type 1 DM. Which classic symptoms should you assess the patient for?

  • Weakness, vomiting, hypotension, mental confusion
  • Polydipsia, polyuria, polyphagia, and weight loss
  • Recurrent infections, visual changes, fatigue, paresthesias
  • Vomiting, abdominal pain, sweet fruity breath, dehydration

Question 74

A 50 y/o male complains of frequently recurring abdominal pain, diarrhea, and bloody stools. A possible diagnosis would be:

  • Ulcerative colitis
  • Pyloric obstruction
  • Achalasia
  • Hiatal hernia

Question 75

You are prioritizing care for your four patients today. Which patient should you assess first?

  • The patient with a blood pressure of 136/92 mmHg who complains of having a headache
  • The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
  • The patient with a pulse of 58 beats/min who is scheduled to receive digoxin in an hour
  • The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin)

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