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Adult Health Exam 3 EXAM 2025 AND
PRACTICE QUESTIONS |ACCURATE
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The nurse is caring for a patient who has an order to discontinue the administration of parenteral nutrition. What will the nurse do to prevent the occurrence of rebound hypoglycemia? A) Stop PN abruptly without replacement B) Administer normal saline immediately C) Administer D10 solution for 1–2 hours after discontinuing PN D) Restrict oral fluids for 4 hours Correct Answer: C) Administer D10 solution for 1–2 hours after discontinuing PN Rationale: Stopping PN suddenly can cause rebound hypoglycemia due to abrupt loss of glucose supply. Giving D10 maintains glucose levels until the body readjusts. You are caring for a patient with a subclavian catheter who is receiving parenteral nutrition. In preparing a plan of care for this patient, what nursing diagnosis will you give the highest priority to? A) Risk for fluid volume deficit B) Risk for impaired skin integrity C) Risk for infection related to the presence of the subclavian catheter D) Risk for constipation Correct Answer: C) Risk for infection related to the presence of the subclavian catheter Rationale: Central venous catheters present a high infection risk, making infection prevention the highest nursing priority. You are caring for an elderly patient with Alzheimer’s disease who just began gastrostomy tube feeding. What is the greatest concern? A) Diarrhea B) Aspiration C) Nausea
D) Constipation Correct Answer: B) Aspiration Rationale: Patients with cognitive impairment have poor protective reflexes, placing them at high risk for aspiration with tube feeding. A nurse is caring for a patient with GI intubation. What is a reason for gastrointubation? A) To prevent aspiration pneumonia B) To remove gas and fluid, to lavage, and to diagnose GI motility disorders C) To reduce metabolic rate D) To promote weight loss Correct Answer: B) To remove gas and fluid, to lavage, and to diagnose GI motility disorders Rationale: Gastrointubation serves diagnostic and therapeutic purposes such as decompression, lavage, or motility testing. The nurse is caring for a patient who has been diagnosed with a peptic ulcer. The patient asks what a peptic ulcer is. What is the best response? A) “A growth inside the stomach.” B) “An erosion of the lining of the stomach or intestine.” C) “A tumor that blocks acid secretion.” D) “A tear in the esophagus.” Correct Answer: B) An erosion of the lining of the stomach or intestine Rationale: Peptic ulcers are defined as mucosal erosions caused by acid and pepsin digestion. The nurse caring for a patient who has had bariatric surgery is developing a teaching plan. Which information is essential? A) Eat 3 large meals daily B) Avoid all fluids with meals C) Eat 6 small meals daily spaced at equal intervals D) Eat only once hunger develops Correct Answer: C) Eat 6 small meals daily spaced at equal intervals Rationale: Small, frequent meals prevent dumping syndrome and allow better tolerance after bariatric surgery.
Correct Answer: B) Knowledge of the causes of obesity and its associated risks Rationale: Candidates must show motivation and understanding of obesity’s risks to ensure adherence post-surgery. What are the most commonly used therapies for peptic ulcers? A) Corticosteroids and antacids B) Antibiotics, proton pump inhibitors, and bismuth salts C) Antihistamines and laxatives D) Opioids and sucralfate Correct Answer: B) Antibiotics, proton pump inhibitors, and bismuth salts Rationale: The combination eradicates H. pylori , reduces acid production, and protects the mucosa, which is the standard treatment regimen. You are caring for an elderly patient with a broken hip who also has chronic constipation. What should be included in the teaching? A) Avoid fluids after meals B) Consume high-residue, high-fiber foods C) Take only laxatives daily D) Eliminate all dairy products Correct Answer: B) Consume high-residue, high-fiber foods Rationale: Fiber increases stool bulk and promotes bowel regularity, preventing constipation in immobilized patients. A nursing instructor is discussing ulcerative colitis. What stool characteristics should students expect in these patients? A) Hard, pellet-like stools B) Oily and fatty stools C) Watery stools with blood and mucus D) Clay-colored stools Correct Answer: C) Watery stools with blood and mucus Rationale: Ulcerative colitis causes inflammation and ulceration in the colon, producing frequent bloody, mucous-filled diarrhea. A patient with a new ileostomy is preparing to go home. What teaching is essential? A) Change pouch once daily regardless of need B) Apply a skin barrier to the peristomal skin before applying the pouch
C) Remove the pouch during sleep D) Avoid all high-fiber foods Correct Answer: B) Apply a skin barrier to the peristomal skin before applying the pouch Rationale: Skin barriers prevent irritation from continuous drainage, which is especially important with ileostomies. A patient with acute diverticulitis is being assessed. What is a sign of bowel perforation? A) Decreased bowel sounds B) Elevated white blood cell count C) Hyperactive bowel sounds D) Abdominal distention only Correct Answer: B) Elevated white blood cell count Rationale: Perforation triggers peritonitis, usually associated with fever, leukocytosis, and abdominal tenderness. A 35-year-old patient presents with suspected small bowel obstruction. What finding is characteristic? A) Jaundice B) Nausea and vomiting C) Painless rectal bleeding D) Weight gain Correct Answer: B) Nausea and vomiting Rationale: SBO typically causes abdominal distention, colicky pain, and vomiting due to blocked intestinal contents. A 16-year-old with appendicitis presents to the ED. What findings should the nurse expect? A) Jaundice and pruritus B) Rebound tenderness, McBurney’s sign, and low-grade fever C) Bright red rectal bleeding D) Steatorrhea and bloating Correct Answer: B) Rebound tenderness, McBurney’s sign, and low-grade fever Rationale: These are hallmark signs of appendicitis. Pain at McBurney’s point is especially classic.
Correct Answer: B) Glargine and Detemir Rationale: Glargine (Lantus) and Detemir (Levemir) provide basal coverage lasting up to 24 hours. What are intermediate-acting insulins? A) Glargine and Detemir B) Lispro and Aspart C) NPH D) Regular (Humulin R, Novolin R) Correct Answer: C) NPH Rationale: NPH has an onset of 2–4 hours, peak at 6–8 hours, and lasts up to 18 hours. What are short-acting insulins? A) Regular (Humulin R, Novolin R, Iletin II) B) Glargine and Detemir C) Lispro and Aspart D) NPH only Correct Answer: A) Regular (Humulin R, Novolin R, Iletin II) Rationale: Regular insulin is the only insulin that can be given IV and has a short action profile. What are rapid-acting insulins? A) Lispro, Aspart, Glulisine B) NPH only C) Glargine and Detemir D) Acarbose and Miglitol Correct Answer: A) Lispro, Aspart, Glulisine Rationale: Rapid-acting insulins have an onset of 15 minutes and are given with meals to control postprandial glucose. Dipeptidyl Peptidase-4 inhibitors end in: A) – amide B) – liptin C) – litazone D) – linide
Correct Answer: B) – liptin Rationale: Examples include sitagliptin and saxagliptin. Second-generation sulfonylureas end in: A) – ide B) – liptin C) – litazone D) – linide Correct Answer: A) – ide Rationale: Examples: glipizide, glyburide. Thiazolidinediones end in: A) – linide B) – amide C) – litazone D) – liptin Correct Answer: C) – litazone Rationale: Examples include pioglitazone and rosiglitazone. Non-sulfonylurea insulin secretagogues end in: A) – linide B) – ide C) – litazone D) – liptin Correct Answer: A) – linide Rationale: Examples include repaglinide and nateglinide. First-generation sulfonylureas end in: A) – amide B) – ide C) – litazone D) – linide Correct Answer: A) – amide Rationale: Examples include tolbutamide, chlorpropamide.
Rationale: Sick-day rules help prevent hypoglycemia and ketoacidosis during illness by maintaining carbohydrate intake. What is the treatment of DKA? A) IV corticosteroids and oral fluids B) 0.9% NS → 0.45% NS → D5W, plus electrolyte replacement and insulin administration C) High-dose oral metformin D) Fluid restriction and glucagon Correct Answer: B) 0.9% NS → 0.45% NS → D5W, plus electrolyte replacement and insulin administration Rationale: Management focuses on fluid resuscitation, correcting electrolytes, and insulin to reverse acidosis. What is Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)? A) A condition of excess insulin with hypoglycemia B) A complication of type I diabetes C) Low amounts of insulin, more common in type II diabetes D) A rare condition unrelated to glucose levels Correct Answer: C) Low amounts of insulin, more common in type II diabetes Rationale: HHNS is seen in type II diabetes, with hyperglycemia and dehydration but minimal ketone production. Which are examples of macrovascular complications of diabetes? A) Retinopathy and nephropathy B) Neuropathy and gastroparesis C) Atherosclerotic changes in large vessels (MI, CAD, CVA, PVD) D) Glaucoma and cataracts Correct Answer: C) Atherosclerotic changes in large vessels (MI, CAD, CVA, PVD) Rationale: Macrovascular complications involve medium and large blood vessels, leading to cardiovascular disease. Which are examples of microvascular complications of diabetes? A) Hypertension and stroke B) Retinopathy and nephropathy due to capillary basement membrane thickening
C) Coronary artery disease and peripheral vascular disease D) COPD and asthma Correct Answer: B) Retinopathy and nephropathy due to capillary basement membrane thickening Rationale: Microvascular complications involve small blood vessels, especially in the eyes and kidneys. Endocrine Hormones – Pituitary & Target Organs Which hormones are secreted by the posterior pituitary? A) ACTH and GH B) ADH and Oxytocin C) TSH and FSH D) Cortisol and Aldosterone Correct Answer: B) ADH and Oxytocin Rationale: The posterior pituitary releases ADH (water balance) and oxytocin (uterine contractions, lactation). Which organ does ADH primarily stimulate? A) Heart B) Kidney C) Liver D) Pancreas Correct Answer: B) Kidney Rationale: ADH acts on renal tubules to promote water reabsorption. Which organs does oxytocin primarily stimulate? A) Liver and spleen B) Uterus and breast C) Kidney and bladder D) Heart and lungs Correct Answer: B) Uterus and breast Rationale: Oxytocin promotes uterine contractions during labor and milk ejection in breastfeeding.
Which hormone is secreted by the adrenal cortex? A) Epinephrine B) Adrenocorticosteroids C) Insulin D) Oxytocin Correct Answer: B) Adrenocorticosteroids Rationale: The adrenal cortex secretes cortisol, aldosterone, and androgens. Which hormone is secreted by the thyroid gland? A) Calcitonin and thyroid hormone B) Cortisol C) Oxytocin D) Prolactin Correct Answer: A) Calcitonin and thyroid hormone Rationale: The thyroid releases T3, T4, and calcitonin to regulate metabolism and calcium. Which organs do FSH & LH stimulate in males? A) Adrenal medulla B) Testes C) Thyroid D) Pancreas Correct Answer: B) Testes Rationale: FSH promotes spermatogenesis; LH stimulates testosterone secretion. Which hormone do the testes secrete? A) Estrogen B) Testosterone C) Progesterone D) Cortisol Correct Answer: B) Testosterone Rationale: Testosterone regulates male reproductive development and secondary sex traits. Which organs do FSH & LH stimulate in females? A) Kidneys
B) Ovaries and corpus luteum C) Pancreas D) Thyroid Correct Answer: B) Ovaries and corpus luteum Rationale: FSH stimulates ovarian follicle growth, and LH triggers ovulation and corpus luteum function. Which hormone is secreted by the ovary? A) Progesterone B) Estrogen C) Cortisol D) Aldosterone Correct Answer: B) Estrogen Rationale: Estrogen regulates menstrual cycles and secondary female characteristics. Which hormone is secreted by the corpus luteum? A) Progesterone B) Testosterone C) Thyroxine D) GH Correct Answer: A) Progesterone Rationale: Progesterone supports uterine lining for implantation and pregnancy maintenance. Which organ does prolactin stimulate? A) Pancreas B) Thyroid C) Breast D) Kidney Correct Answer: C) Breast Rationale: Prolactin stimulates milk production in mammary glands. Diabetes Risk & Diagnosis Which are 5 risk factors for diabetes? A) Family history, obesity, ethnicity, hypertension, gestational diabetes history
You are talking with a group of nursing students about esophageal cancer. What would you tell the students is most significant risk factor for esophageal cancer? - answer_Chronic gastroesphageal reflux disease A patient with cancer of the tongue has had a radical neck dissection. What nursing assessment would be a priority for this client - answer_Respiratory status and airway clearance After surgery for esophageal cancer, the patient is instructed to remain upright for at least 2 hours to allow the food to move through the GI tract. What drug is used to promote gastric motility in these patients? - answer_Reglan The patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would you do to prevent reflect gastric contents form coming through the blue vent of a gastric sump tube - answer_Keep the vent lumen above the patient's waist The nursing instructor is talking about caring for feeding patients with feeding tubes and endotracheal tubes (ET). Th instructor tell the students that before each feeding, the nurse should check for tube placement as well as residual volume. what is the purpose of the nurses actions? - answer_prevent aspiration The nurse is administering TPN to a client who underwent surgery for gastric cancer. What is a major complication of TPN - answer_Hyperglycemia The nurse is initiating parenteral nutrition on a postoperative patient. The nurse will initiate the therapy by: - answer_Initiating the infusion slowly and monitoring the patient's fluid and glucose tolerance What is Insulin - answer_hormone secreted by beta cells (one of 4 types of cells in islet of langerhans) in the pancreas
What are the main functions of insulin - answer_transport and metabolize glucose for energy, stimulate storage of glucose liver and muscle in the form of glycogen, signals liver to stop releasing glucose, enhance storage of fat in adipose tissue, inhibits the breakdown of stored glucose, protein and fat, accelerated transport of amino acids into cells Name two pancreatic hormones - answer_insulin, glucagon What is the name of the cells that secrete glucagon - answer_alpha cells What is Type 1 diabetes classified as - answer_destruction of pancreatic beta cells What are ketones - answer_highly acidic substance that is formed when the liver breaks down fatty acids in the absence of insulin What is DKA - answer_metabolic derangement most common in Type 1 diabetes due to a deficiency of insulin, highly acidic ketones are formed and metabolic acidosis occurs What are the 3 major derangements - answer_hyperglycemia, ketosis, and metabolic acidosis What are the clinical manifestations of DKA - answer_>1 day of polyuria, polydipsia, n/v, fatigue, hyperventilation with kussmaul respirations, blurred vision, breath is a fruity odor due to ketoacids, mental status changes, weakness, anorexia, headache, abdominal pain. What is hypoglycemia - answer_glucose <50-60mg/dL What causes hypoglycemia - answer_too much insulin, inappropriate oral meds, too little food, excessive physical activity
What is the treatment of HHNS - answer_REHYDRATION: fluid replacement, correction of electrolyte imbalance, insulin administration. What are the possible causes of hypothyroidism - answer_disease of the hypothalamus, radiation therapy, trauma, tumor, or vascular lesions What are the clinical manifestations of hypothyroidism - answer_autoimmune (hashimoto's), aging (atrophy), therapy, medications, radiation, infiltrative disease, iodine deficiency, iodine excess What is a severe form of hypothyroidism - answer_Hashimoto's What is the clinical manifestations of hypothyroidism - answer_extreme fatigue, weight gain, slow speech, tongue/hands/feet may enlarge, numbness and tingling Acromegaly - answer_over secretion of GH enlargement of viscera, increased height, and giantism Dwarfism - answer_under secretion of GH What is normal specific gravity - answer_1.020-1. SIADH - answer_excessive ADH secretion, fluid retention, & dilutional hyponatremia. Treatment of SIADH - answer_restrict fluids, administer diuretics, daily weights, assess near status, and supportive measures.
Name three hormones the thyroid produces - answer_Triiodothyronine (T3), Throxine (T4), and calcitonin (increases Ca+ deposits into the bone) What is essential for thyroid to synthesize hormones - answer_iodine What is the normal range for T4 - answer_4.5-11. What is the normal range for T3 - answer_70- 220 Between T3 and T4 which is the more accurate indicator of hypothyroidism - answer_T What is the single best test to check for thyroid function - answer_TSH What is cretinism - answer_inadequate secretion of thyroid hormone during fetal and neonatal development What is hypothyroidism - answer_when thyroid is sluggish, everything is slow What is hyperthyroidism - answer_when metabolism is constantly go go go, loss of weight, even with increased appetite Goiter - answer_enlarged thyroid gland Hashimoto's thyroiditis - answer_when immune system attacks the thyroid gland that results in hypothyroidism
