NUSC 1165 FINAL EXAM NEWEST 2024- 2025 ACTUAL EXAM QUESTIONS AND DETAILED CORRECT ANSWERS, Exams of Nutrition

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NUR251 CDU FINAL EXAM PRACTICE

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ANSWERS WITH RATIONALES | 2024 -

What is the most likely treatment plan for reoccurring endometrial cancer? Correct Answer Progesterone therapy. Endometrial cancer is the most common invasive gynaecological cancer in Australia. Surgery is the treatment of choice for primary diagnosis of endometrial cancer. Approximately 1/3 of women respond well to progesterone therapy with chemotherapy the least effective. Whilst inserting an indwelling catheter you observe blisters on a female patient's labia majora. On further assessment she states the blisters are new onset and painful. What is the most likely cause of these symptoms? Correct Answer First episode of genital herpes. Red papules appear 2-10 days after exposure to the herpes virus with the first outbreak or first episode lasting up to 12 days. The clear fluid in the papules contains virus particles and is highly infectious.

Whilst inserting an indwelling catheter you observe cauliflower shaped lesions on the shaft of a male patient's penis. What is the most likely condition causing this? Correct Answer Genital warts. Genital warts (condyloma acuminate) are caused by the human papillomavirus (HPV) which is chronic, incurable and largely asymptomatic. During a nursing assessment a female patients stated an abnormal watery vaginal discharge with an offensive 'fishy' odour. What is the most likely cause of these symptoms? Correct Answer Bacterial vaginosis. Non-specific vaginitis is the most common cause of vaginal infections in women of reproductive age and is easily treated with oral or intravaginal antibacterial agents. You are providing discharge education to a female patient diagnosed with the STI chlamydia. Which of the following statements would not be included? Correct Answer Now you have had it once you cant can't get it again. Chlamydia is asymptomatic in most women until the uterus and fallopian tubes have been invaded and delay in treatment can result in devastating long term complications with fertility. Regular screening is recommended for people who are young, sexually active and do not use condoms.

Sexually transmitted infections are harmless when pregnant and to newborns? Correct Answer False. Chlamydia is a leading cause of preventable blindness in newborns. Gonorrhoea causes blindness, infection of joints and potentially lethal infection of the blood in newborns. All pregnant women are screened for STIs on confirmation of pregnancy. During your nursing assessment you observe a reddish- brown rash on the palms of both hands and the soles of your patient's feet. What focused assessment should you conduct? Correct Answer A complete sexual health assessment. Rash to hands and feet is a secondary manifestation of syphilis. The primary stage of syphilis is characterised by the appearance of a chancre which you should ask about in your sexual health assessment. Chancre can go unnoticed as they self- resolve within 4-6 weeks. It is highly contagious in both primary and secondary stages. You are providing nursing care for a 20 year old female patient admitted for treatment of pelvic inflammatory disease (PID). You are providing discharge education to prevent reoccurrence of PID. Which of the following is not a risk factor for PID? Correct Answer Poor personal hygiene.

Pelvic inflammatory disease (PID) can have severe and life threatening complications. Health promotion and education is vital for prevention and good sexual health. Douching is washing or cleaning out the inside of the vagina with water or other mixtures of fluids. Douching before or after sex does not prevent STIs as it removes some of the normal bacteria in the vagina that protects from infection therefore increasing the risk. You are providing patient education for someone with herpes simplex virus II (HSV2). Which of the following statements are incorrect? Correct Answer This condition causes cervical cancer. Blisters contain the highly infectious virus and create patches of painful ulcers that can last up to six weeks. Touching these blisters and then rubbing, scratching or touching other areas can spread the infection. Abstinence is required from sexual contact from the time symptoms appear until 10days after all lesions have healed. Prevent and control of STIs are based on the principles of education, early detection, diagnosis and treatment of infected people and their sexual partners? Correct Answer True.

Sexual health assessment is essential to the prevention and control of STIs. When conducting an assessment remember to include the 5Ps - partners, prevention of pregnancy, protection from STIs, current practice and past history. Good, professional, non-judgemental communication is key in sexual health assessment. Which sexually transmitted virus causes cervical cancer? Correct Answer Human papillomavirus. Almost all cervical cancer is caused by the human papillomavirus (HPV). Current screening using pap smears is recommended for all sexually active females every 2 years. The Gardasil vaccine has been included to the National Vaccination Program which will see changes to screening in the future. What is NOT a function of the kidneys? Correct Answer Hormone production including insulin. Excretion: the removal of wastes from body fluids. Elimination: the elimination of wastes from the body. Homeostatic: regulation of the volume and solute concentration of plasma in the blood. Which of the following is a normal result from a urinary sample? Correct Answer Light - straw to amber - yellow coloured urine.

When assessing a patient, ask about changes in urinary habits, frequency, pain and smell. Also ask about recent food intake or changes to diet as some food can cause distinct odours in urine. Remember medications can also affect the appearance of urine (e.g. Vitamin B can produce bright yellow urine) The patient you are provide nursing care to, complains of severe pain to bilateral flank region. What could this indicate? Correct Answer Acute kidney pain. When assessing a patient always explore the location, duration and intensity of their pain. Kidney pain is experienced in the back region, costovertebral angel and may spread to the umbilicus. If pain is associated with pyuria and infective process is indicated. The patient you are providing nursing care to state urinary symptoms during assessment. What further investigation will you conduct? Correct Answer Urinalysis. A routine urinalysis (dipstick) from a clean catch urine sample will provide a quick snapshot of any abnormalities. If sample results are abnormal, it should be sent off for MSU test to determine causative agent. The glomerular filtration rate (GFR) of >90mL/min/1.73m indicated normal kidney function? Correct Answer True.

Glomerular filtration rate is the passive, nonselective process where hydrostatic pressure forces fluid and solutes from the blood into the glomerular capsule. Remember to keep in mind age related renal changes which can be as low as 60mL/min/1.73m2 for this cohort. On inserting a urinary catheter a patient voids 450mls. What is this urine output considered to be? Correct Answer Normal. In healthy adults the bladder holds about 300- 500 mls of urine. However, it can hold more than twice that amount if necessary. Normal hourly output should be above 30mls/hr. Results from a routine urinalysis show +3 ketones in the urine. What could this indicate? Correct Answer Diabetes mellitus. Presence of ketones in the urine is called ketonuria. When the body is unable to get enough glucose for energy it will use body fats. Ketones are the result of body breaking down these fats to use for energy. Normal ketones should be negative. A patient with an indwelling catheter is demonstrating signs of bacteriuria. Which of the following would be the recommended treatment plan? Correct Answer Remove the catheter and begin antibiotic therapy.

The recommended treatment for catheter associated UTI is immediate removal of IDC and 10-14 days of antibiotic therapy to eliminate infection. An elderly patient suddenly starts to act confused and disorientated. What in the most likely cause? Correct Answer UTI. The older adult may not complain of dysuria and often inflammatory and immune responses diminish with age. Foul smelling urine, incontinence and confusion are just some of the symptoms to look out for. What psychosocial impacts can incontinence have on people? Correct Answer Embarrrassment; Withdrawal; Isolation; Helplessness. Urinary incontinence can have a significant impact on an individual's quality of life and can lead to other physical and mental conditions. It is not a normal aspect of ageing. Oliguria is characterised by urine output of: Correct Answer <400mls per day. Oliguria = less than 400mls per day; Anuria = no urine output; Polyuria = greater than 2500mls per day.

During which phase of acute kidney injury (AKI) is the highest risk of heart failure and pulmonary oedema? Correct Answer Maintenance phase. During this phase a person can experience oedema and hypertension from salt and water retention; confusion, lethargy and even coma from uraemic toxicity, anorexia, nausea and vomiting. A person with chronic kidney disease (CKD) is diagnosed with hypertension. Why does the person's blood pressure need to be controlled? Correct Answer Blood pressure control can slow the decline in kidney function. Hypertension can be a cause or consequence of CKD. It is associated with adverse outcomes such as worsening renal function and the development of heart disease. Kidneys play a key role in blood pressure; impaired kidneys cannot regulate blood pressure. Which of the following interventions would be appropriate for a person with excess fluid volume related to chronic glomerulonephritis? Correct Answer Daily weighs. Excess fluid volume resulting in oedema is the most common manifestation of glomerular disorders. Accurate daily weights are the best indicator of approximate fluid balance.

A person with acute kidney injury (AKI) is prescribed frusemide. Why is this medication helpful? Correct Answer It will reduce oedema. Frusemide is a loop diuretic. In AKI the kidneys are unable to excrete adequate urine to maintain a normal extracellular fluid balance. Oedema results from fluid retention and heart failure can develop. A person who is recovering from acute renal injury is being discharged. Which of the following should the nurse include in the discharge instructions? Correct Answer Avoid alcohol. During recovery nephrons remain vulnerable to damage by nephrotoxins. Alcohol increases the nephrotoxicity of some materials so it is discouraged. The most common cause of kidney damage is: Correct Answer Blunt trauma. Injury ranges from small contusion to haematomas to fragmentation or shattering of the kidney that causes significant blood loss and urine extravasation. Tearing of renal vessels may cause rapid haemorrhage and death. A person diagnosed with only 45% of the normal glomerular filtration rate is experiencing which of the following: Correct Answer Renal insufficiency.

Renal insufficiency is the broad term describing any condition in which kidneys are unable to remove accumulated metabolites from the blood, leading to altered fluid, electrolytes and acid-base balance. A patient undergoing haemodialysis must have their vascular access site assessed for pulsation or vibration and an audible bruit? Correct Answer True. Infection & thrombus formation are the most common problems affecting the access site in haemodialysis. Always alert staff to the extremity with the vascular access so it is not used for any procedures, this can damage vessels and lead to failure of the arteriovenous fistula Stage 4 kidney disease is also known as end stage kidney disease? Correct Answer False. Stage 5 is also known as end stage kidney disease is the terminal phase of CKD, kidney replacement therapy is needed to sustain life. The postoperative instruction is to ambulate the patient gradually. You are aware the patient is feeling weak from inadequate fluid pre and intra operatively. How can you implement these instructions? Correct Answer Assist the person to move into different positions in stages. The person with fluid volume deficit is at risk of injury because of dizziness and loss of balance resulting from

decreased cerebral perfusion secondary to hypovolaemia. Teach ways to reduce orthostatic hypotension - go slowly. A person is prescribed 40mEq potassium replacement. How should this be administered? Correct Answer Mixed in the prescribed intravenous fluid. Potassium should always be diluted and administered using an electronic infusion device. It should be given no quicker than 10-20mEq/hour. Rapid administration of potassium can lead to hyperkalaemia and cardiac arrest. A man has been admitted with elevated serum sodium levels after being stranded in bushland for 5 days with no fresh water. Which of the following is he most at risk of developing? Correct Answer Cerebral bleeding. Rapid water replacement or rapid changes in serum sodium or osmolality can cause fluid shift within the brain, increasing the risk of bleeding and/or cerebral oedema. In severe, acute cases of hypernatraemia, the osmotic shift of water from cells leads to shrinkage of the brain with tearing of the meningeal vessels resulting in intracranial haemorrhage. A patient has been admitted with acute renal failure. Which electrolyte will be most affected? Correct Answer Potassium. Impaired renal excretion of potassium is the primary cause of hyperkalaemia. Kidneys control the balance of

potassium in your body, if they are not working properly, they will be unable to filter and remove excess potassium from the body. The patient you are providing post-operative care to has been diagnosed with fluid volume excess (hypervolaemia). Which of the following would you expect to observe? Correct Answer Distended neck veins. Excess fluid volume effects circulation. Your patient may also have a bounding pulse as well as distended neck and peripheral veins, increased central venous pressure, moist cough, peripheral oedema and ascites may develop. Males diagnosed with diabetes and coronary artery diseases are more likely to experience erectile dysfunction. Correct Answer True. To assist in maintaining an erection an O ring can be worn at the base of the penis to constrict blood flow out of the penis whilst still allowing blood flow in. What is the most common cause of scrotal swelling Correct Answer Hydrocele. Hydroceles can occur secondary to trauma, infection or a tumour. A hydrocele may be differentiated from a solid mass by trans illumination or ultrasound of the scrotum. Hydroceles are not associated with infertility.

A man presents to the emergency department concerned his erection has lasted more than 4 hours. Your nursing assessment must include; Correct Answer Use of medications or supplements for erectile dysfunction. Priapism is an involuntary, sustained, painful erection that is associated with sexual arousal. Nursing management focusses on assessment, monitoring urine output and pain control. What is the most common cause of epididymitis? Correct Answer Chlamydia, Gonorrhoea. Epididymitis is an infection or inflammation of the epididymis, the structure that lies along the posterior boarder of the testis. Early manifestation includes pain and oedema of the scrotum which can be relieved with analgesia, scrotal supports and ice packs. Epididymitis is treated with antibiotics - if the course of antibiotics is not completed what is most likely to develop? Correct Answer Orchitis. Orchitis is an acute inflammation of the testes; it is a common complication of system illness or an extension of epididymitis. What is the most common treatment for testicular cancer? Correct Answer Surgical removal of the affected testicle.

Radical orchidectomy is used in all forms and stages of testicular cancer. Nursing care is complex and the must be inclusive of patient reactions to diagnosis, change to body image and sexual/reproductive issues. What patient education is needed to manage the symptoms of prostatitis? Correct Answer Void frequently; Maintain regular bowel movements; Increase fluid intake to approx. 3L daily. Prostatitis refers to different types of inflammatory disorders of the prostate gland. Education focusses on symptom management. Urinary incontinence is not a normal part of aging. What is the most common cause urinary problem in men? Correct Answer Benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate gland and is a common disorder of the ageing male. Nursing care focuses on correcting or minimising the urinary obstruction and preventing or treating complications. A TURP can be performed to treat benign prostatic hyperplasia (BPH), what does TURP stand for? Correct Answer Transurethral resection of the prostate. A transurethral resection of the prostate is the most common surgical procedure used to treat BPH. The obstructing prostate tissue is removed using a wire loop

resectopscope and electrocautery inserted through the urethra. Early stage prostate cancer is often asymptomatic? Correct Answer True. Symptoms which may occur are due to metastasis of bone and can affect the genitourinary, musculoskeletal and neurological systems. You are providing nursing care to a 55 year old female patient who voices concerns about constant anxiety, inability to sleep, headaches and just not feeling like herself. What is the most likely cause of these symptoms? Correct Answer Menopause. Nursing care for women experiencing menopausal symptoms focuses on symptomatic relief and education. Menopause is the permanent cessation of menses and is a normal physiological process. A female complains about increasing premenstrual symptoms over the past few years and thinks something must be wrong. What is the most likely cause? Correct Answer Normal pattern of premenstrual syndrome (PMS). Premenstrual syndrome (PMS) is a complex group of symptoms from mood swings to breast tenderness, fatigue, irritability, food cravings and depression. Usually limited to 2-14 days and self-resolving.

The nurse is assisting a female patient with ways to reduce the severity of her monthly menstrual discomforts associated with PMS. What healthy lifestyle choices may provide symptom relief? Correct Answer Limited alcohol intake; Regular exercise; Relaxation techniques. Teaching complementary therapies and coping mechanism is helpful. Techniques for relaxation and stress management include deep abdominal breathing, medication and muscle relaxation. Alcohol and unhealthy diets should be avoided as it exacerbates the symptoms of PMS. What factors most likely contribute to a uterine prolapse into the vaginal canal? Correct Answer Multiple pregnancies. When the uterus is displaced within the pelvic cavity, it can be mild to completely prolapsed (outside the vagina) it is commonly due to weakened pelvic musculature usually attributable to stretching of the supporting ligaments and muscles during pregnancy. Which of the following is not a term for dysfunctional uterine bleeding? Correct Answer Dyspareunia. Dysfunctional uterine bleeding is any abnormal volume, duration or time of bleeding. Factors including stress,

extreme weight changes, use of oral contraceptives or intra-uterine devices (IUD) can impact uterine bleeding. On a mammogram an abnormal mass has been identified in the left breast of a 42 year old female. What would be the next treatment option advised? Correct Answer Surgical biopsy is needed to rule out cancer. Aspiration biopsy removes cells via a needle from a breast lesion. Excisional biopsy removed tissue from the breast. Nursing care needs to focus on support and education surrounding the procedure and decreasing anxiety related to potential diagnoses. You are providing nursing care for a female diagnosed with breast cancer scheduled for a mastectomy later that day. What signs would she display for anticipatory grieving? Correct Answer Sitting quietly and occasionally crying. Any breast surgery can alter the appearance of the breast and for most women this directly impacts self-image and self-esteem. Grief is a normal response, nursing care needs to focus on provide a non-threatening environment for open communication and ongoing education. A hysterectomy may involve an abdominal, vaginal or laparoscopic approach depending on the underlying disorder and investigation needed. Which approach leaves no visible scaring? Correct Answer Vaginal hysterectomy.

Vaginal hysterectomy is the removal of the uterus through the vagina and leaves no visible abdominal scaring. You are providing discharge education for a woman following a laparoscopic hysterectomy. What important information will you provide to ensure a successful discharge? Correct Answer Maintain an iron rich balanced diet; Restrict physical activity for 4-6 weeks; Regular analgesia for therapeutic pain management. Sexual intercourse and anything inserted into the vagina (i.e. tampon) should be avoided until after the postoperative check-up. This precaution reduces the risk of infection. An elderly patient is being discharged with oedema to bilateral lower legs due to fluid volume excess. What discharge education will you include? Correct Answer Wear compression socks. Wearing compression garments or support hose assist with decreasing oedema. The compression action reduces the diameter of distended veins and improves blood flow. In the clinical environment they are often referred to as TED stocking. You are providing nursing care to a patient with poor verbal communication due to dementia. How can you assess if the person is dehydrated? Correct Answer Assess urine specific gravity.

Specific gravity measures the concentration of urine. When someone is dehydrated, the kidneys conserve water resulting in the increased specific gravity and osmolality of urine. A patient states they are experiencing several days of watery diarrhoea and abdominal/muscle cramping. What condition are they most at risk of? Correct Answer Hyponatraemia. These signs are very early indicators of decreasing sodium levels. As they continue to decrease the brain and nervous system are affected by cellular oedema. When sodium levels drop dangerously low convulsions or coma are likely. You perform an ECG with has peaked T waves and widened QRS complexes. What is the most likely cause? Correct Answer Hyperkalaemia. Hyperkalaemia alters the cell membrane, increasing the concentration of potassium outside the cell. Cardiac depolarisation is decreased as a result. All ECGs needs to be reviewed by a medical officer to initiate the appropriate treatment. You are providing nursing care to a patient with a history of sodium retention. During assessment you identify skipping heart beats and leg tremors. What is the most likely cause? Correct Answer Using salt alternative.

Salt substitutes usually contain potassium. These are symptoms of hyperkalaemia. Take the opportunity to discuss the importance of hydrating using adequate fluids to maintain renal function and eliminate potassium from the body. A patient is having a blood transfusion. You note their temperature has risen from 36.3oC to 37.5oC and they feel flushed. What is not a correct nursing intervention? Correct Answer Administer 1g paracetamol. Adverse reactions to blood transfusions can be mild to life threatening. Baseline vital signs prior to transfusion are a critical step. Continue to check and monitor your patient's vital signs whilst you wait for the doctor to attend. DOCUMENT as soon as possible. You have received blood products from the blood bank for a transfusion. How long can you keep it out of the fridge for? Correct Answer Must be used within 4 hours. Due to increased risk of bacterial growth in the products when out of refrigeration, all transfusion should be completed within 4 hours. Unrefrigerated bloods not used within 4 hours must be returned to the blood bank. The mechanism of hypertonic solutions in equalising the fluid concentration is: Correct Answer Osmosis.

The higher osmotic pressure draws water out of the cells into the ECF therefore it initially expands the ECF. Hypertonic solutions are useful in the treatment of hypovolaemia and hyponatraemia. The fluid replacement of choice for a patient with fluid volume deficit is: Correct Answer Hartmann's. Isotonic solutions such as Hartmann's and 0.9% normal saline expand only in the ECF which is ideal replacement for patients with fluid volume deficit. Ensure you commence a fluid balance chart and monitor hourly urine output. You are reviewing a person's blood pH level. Which body system helps regulate blood pH? Correct Answer Renal. The renal system is responsible for the long term regulation of acid base balance in the body via excreting or retaining acid in the form of hydrogen ions. An elderly post-operative patient is demonstrating lethargy, confusion and respiratory rate of 8bpm. Which of the following acid-base disorders is most likely the cause? Correct Answer Metabolic alkalosis. Treatment for metabolic alkalosis includes restoring normal fluid volume and administering potassium chloride and sodium chloride solution. Due to the patient's depressed respiratory effort, the risk of hypoxaemia is high.

The blood gas of a person with an acid-base disorder shows a blood pH outside of normal limits. Which of the following best describes the status of the disorder? Correct Answer Partially compensated. The lungs respond to metabolic disorders and the kidneys respond to respiratory disorders to regain acid-base balance. Complete compensation occurs when the pH returns to normal. The lungs act as an acid-base buffer by: Correct Answer Increasing respiratory rate & depth when CO2 levels are high reducing acid load. The increase rate and depth of lung ventilation eliminates CO2 from the body and carbonic acid levels fall bringing the pH into normal range What is the most likely fluid given to an individual involved in a trauma who is experiencing shock? Correct Answer Albumin. Albumin is a plasma expander, specially a colloid. Treat like other blood products with baseline vitals and then as per institutional policy. To determine acid base balance you need to calculate what on a ABG (arterial blood gas)? Correct Answer PaCO2, Bi-Carb HCO3 and CO2.

Refer to 3rd edition p229 BOX 9.10 Interpreting arterial blood gases or 2nd edition p 250 BOX 10.10 for more information. The central nervous system consists of: Correct Answer Brain and spinal cord. The CNS consists of the brain and spinal cord. The PNS consists of the cranial nerves, the spinal nerves and the autonomic system. What two (2) electrolytes are essential for action potential? Correct Answer Potassium & sodium. Action potentials are impulses that allow neurons to communicate with other neurons. Movement of impulses to and from the CNS are made possible by afferent and efferent neurons. The brain has four (4) regions, which region is responsible for gait, balance and coordination of movement? Correct Answer Cerebellum. Did you know the brain weighs between 1.4 - 1.6kg! The cerebrum is the largest region and accounts for almost 60% of the brains weight. What is the purpose of cerebrospinal fluid? Correct Answer It surrounds and protects the CNS. It bathes the brain and spine in nutrients and eliminates waste

products. It also cushions them to help prevent injury in the event of trauma. Cerebrospinal fluid is also referred to as CSF is a clear, colourless liquid consisting of 99% water and protein, sodium, chloride, potassium bicarbonate and glucose the remaining 1%. What activity best assesses the function of cranial nerve XI (spinal accessory)? Correct Answer Shrug shoulders and turn head against resistance. Look for equal strength when shrugging both shoulders and note symmetry of the shoulders. When a nurse asks a patient to walk heel to toe, on toes and then on heels, what function is being assessed? Correct Answer Cerebellar. Ataxia is a lack of coordination and clumsiness of movement i.e. staggering or unbalances gait. The inability to walk on toes and heels may indicate disease of the upper motor neurons. Dorsiflexion of the big toe and fanning of other toes is called: Correct Answer Babinski's sign. The reflex determines adequacy of the higher central nervous system. It is obtained by stimulating the outside of the sole of the foot, causing extension movement of the