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)

BSN NURS, NURS 419 Patho-Pharm 1, Nursing questions

Isaura K

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