1
NR 507 FINAL EXAM 2 LATEST VERSIONS
2023-2024 REAL EXAM QUESTIONS AND
CORRECT ANSWERS|AGRADE
VERSION A
➢ While checking arterial blood gas results, a nurse finds respiratory acidosis. What does
the nurse suspect is occurring in the patient?
reduced tidal volumes
➢ A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon
dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely
cause?
Hyperventilation
➢ The nurse is assessing a client with suspected respiratory acidosis. Which assessment
items are priority for the nurse to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of
the optic nerve
➢ The nurse is administering sodium bicarbonate to the client with respiratory acidosis. The
nurse understands that which is the primary goal of treatment for this client?
Removing excess acids in blood
➢
➢ The student nurse is assisting in the care for a client with acute respiratory acidosis. The
nurse explains to the student nurse that the client’s blood pH initially falls in the
development of acute respiratory acidosis because of which process?
Hypoventilation
➢ The nurse is preparing a client for testing to determine if the client has Cushing
syndrome. What tests are included in the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
➢ A client comes to the clinic with fatigue and muscle weakness. The client also states she
has been having diarrhea. The nurse observes the skin of the client has a bronze tone and
when asked, the client says she has not had any sun exposure. The mucous membranes of
the gums are bluish-black. When reviewing laboratory results from this client, what does
the nurse anticipate seeing?
Increased levels of ACTH
2
➢ A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to
begin replacement therapy. Regarding which type of replacement will the nurse educate
the client?
Cortisol replacement therapy
3
➢ Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to
stimulate the adrenal glands, the adrenals’ production of cortisol drops. This is an
example of which type of endocrine disorder?
Secondary
➢ The nurse is preparing a client for a test that will measure negative feedback suppression
of ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
➢ ACTH deficiency results in secondary
hypocortisolism
➢ ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
➢ 6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
➢ interpretation of ACTH levels requires simultaneous assessment of
plasma cortisol levels
➢ ACTH levels are normal to high in primary adrenal insufficiency
➢ ACTH levels are low to absent in secondary adrenal insufficiency
➢ The client has been taking an oral cortisol preparation for 2 years to manage an
autoimmune disease. What effects does the nurse expect this therapy to have on this
client’s circulating levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
➢ A nurse checks lab results as both Cushing syndrome and Addison disease can manifest
with elevated levels of:
Adrenocorticotropic hormone (ACTH)
➢ A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who
was fine the previous day, complained of a sore throat early in the morning and now has a
temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the
child gets panicky, immediately sits back up, and leans forward with her mouth open and
tongue out when the caregiver encourages her to lie down. The nurse suspects the child
has which of the following conditions?
4
Epiglottitis
➢ The caregivers of a child report that their child had a cold and complained of a sore
throat. When interviewed further they report that the child has a high fever, is very
anxious, and is breathing by sitting up and leaning forward with the mouth open and the
tongue out. The nurse recognizes these symptoms as those seen with which of the
following disorders?
Epiglottitis
➢ The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis.
The nurse recognizes a common complication of the disorder is for the child to:
be at risk for respiratory distress.
➢ A 5-year-old child is brought to the clinic by his father because the child developed a
high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs
and symptoms?
- Difficulty speaking • Drooling • Sitting with neck extended • Frightened
appearance
➢ A 36-year-old man enters the hospital in an extremely debilitated condition. He has
purple-brown skin lesions (a symptom of Kaposi’s sarcoma) and a persistent cough. A
physical examination reveals swollen lymph nodes, and laboratory tests find a very low
lymphocyte count. Information taken during the personal history reveals that he has
multiple sex partners with whom he frequently engages in unprotected sex. What is likely
to be the man’s problem and what is his prognosis?
He is probably suffering from AIDS. His outlook is poor once the disease has
progressed to this advanced stage. There is no cure, and drug therapy has
had limited short-term success.
➢ Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS)
include monitoring of T lymphocyte counts?
A decrease in the number of T cells would make the patient more susceptible
to infection and unusual cancers.
➢ What is the length of time from infection with the AIDS virus to seroconversion?
Up to six months
➢ A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with
cytomegalovirus. The nurse explains to the woman that the infection is caused by a
common organism that normally does not cause infection in someone with a healthy
immune system. This type of infection is called what?
Opportunistic infection