NU216 Fall 25 Final
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Free NU216 Fall 25 Final Questions
A nurse received an order to administer a tetanus vaccine to a patient who sustained a foot wound from a nail. The nurse is aware that this vaccine will cause the patient to develop which type of immunity?
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Active natural
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Passive natural
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Active artificial
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Passive artificial
Explanation
Correct Answer:
Active artificial
Explanation of Correct Answer:
A tetanus vaccine stimulates the body’s immune system to produce antibodies and memory cells against the tetanus toxin without causing disease. Because the immunity is acquired through intentional exposure to an antigen via vaccination, it is considered active artificial immunity. Protection develops over time and is long-lasting.
Why Other Options Are Incorrect:
Active natural
This occurs when immunity develops after direct exposure to a pathogen through natural infection, such as chickenpox after contact with an infected person—not through vaccination.
Passive natural
This occurs when antibodies are transferred naturally from mother to child, either through the placenta (IgG) or breast milk (IgA). It does not involve vaccines.
Passive artificial
This involves giving preformed antibodies, such as immune globulin injections, for immediate but short-term protection—not stimulating the body to make its own antibodies.
A patient with chronic bronchitis who has a new prescription for fluticasone and albuterol asks the nurse the purpose of using two drugs. What is the most appropriate explanation?
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The two drugs work together to block the effects of histamine on the bronchioles.
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The combination of two drugs works more quickly in an acute asthma attack.
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The two drugs are a combination of long-acting and slow-acting bronchodilators.
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One drug decreases inflammation, and the other is a bronchodilator.
Explanation
Correct Answer:
One drug decreases inflammation, and the other is a bronchodilator.
Explanation of Correct Answer:
Fluticasone is an inhaled corticosteroid that decreases airway inflammation and mucus production, improving long-term control of chronic bronchitis and other obstructive airway diseases. Albuterol is a short-acting beta2 agonist (SABA) that quickly relaxes bronchial smooth muscle, providing rapid relief of bronchospasm. Using both addresses two key problems in chronic bronchitis: airway inflammation and bronchoconstriction.
Why Other Options Are Incorrect:
The two drugs work together to block the effects of histamine on the bronchioles
This describes antihistamines, not corticosteroids or beta2 agonists.
The combination of two drugs works more quickly in an acute asthma attack
Fluticasone is not a rescue medication; it works over time to reduce inflammation, so it is not intended for acute symptom relief.
The two drugs are a combination of long-acting and slow-acting bronchodilators
Fluticasone is not a bronchodilator at all, so this statement is incorrect.
A patient with a sore throat and rhinitis has an elevated level of IgG in the blood. The nurse explains that the patient's symptoms are most likely from which cause?
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Re-infection by bacteria
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Allergy
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Initial viral infection
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Exposure to toxic fume
Explanation
Correct Answer:
Re-infection by bacteria
Explanation of Correct Answer:
IgG is the most abundant antibody in the blood and tissues and is primarily responsible for long-term immunity after infection or vaccination. Elevated IgG suggests a secondary immune response, meaning the body has encountered the pathogen before. A re-infection by bacteria would trigger IgG production quickly and strongly due to memory cell activation.
Why Other Options Are Incorrect:
Allergy
Allergic reactions primarily involve IgE, not IgG, as the main immunoglobulin.
Initial viral infection
An initial infection—viral or bacterial—would show elevated IgM first, as it is the antibody produced during the primary immune response.
Exposure to toxic fume
This causes irritation or inflammation, but it does not stimulate an adaptive immune response or increase IgG levels.
A nurse is reviewing laboratory results of a patient who is being evaluated for primary hypothyroidism. Which of the following laboratory findings is expected for a patient who has this condition?
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Elevated hemoglobin
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Elevated TSH
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Decreased triglycerides
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Decreased serum cholesterol
Explanation
Correct Answer:
Elevated TSH
Explanation of Correct Answer:
In primary hypothyroidism, the thyroid gland fails to produce enough T3 and T4. As a result, the pituitary gland increases secretion of thyroid-stimulating hormone (TSH) in an attempt to stimulate the thyroid. Laboratory findings typically show high TSH and low T3/T4 levels. This helps differentiate primary hypothyroidism from secondary causes.
Why Other Options Are Incorrect:
Elevated hemoglobin
Hypothyroidism does not cause elevated hemoglobin; in fact, anemia is more common due to reduced erythropoiesis.
Decreased triglycerides
Triglycerides are often normal or elevated in hypothyroidism due to reduced lipid metabolism, not decreased.
Decreased serum cholesterol
Hypothyroidism often causes increased cholesterol levels because of slower lipid breakdown, not decreased levels.
A patient presents to the emergency department with a closed tibial fracture. A cast is applied after a closed reduction. The patient reports that the pain is severe, unrelieved by medication, and worsens with passive movement of the leg.
Clinical Findings:
Pain score: 9/10
Paresthesia in toes
Pale skin distal to the cast
Capillary refill: 4 seconds
No pedal pulse detected with palpation
What are the nurse’s priority actions? Select all that apply.
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Notify the primary care provider immediately.
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Reassure patient this is a normal finding.
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Perform neurovascular checks.
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Apply ice to the affected area.
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Remove or loosen restrictive dressings.
Explanation
Correct Answers:
Notify the primary care provider immediately
Perform neurovascular checks
Remove or loosen restrictive dressings
Explanation of Correct Answers:
Notify the primary care provider immediately
These findings are consistent with compartment syndrome, a surgical emergency. The nurse must notify the provider at once, as delayed intervention could result in permanent tissue damage, loss of limb, or death. Timely communication is essential.
Perform neurovascular checks
Ongoing neurovascular checks are critical to monitor for worsening ischemia and nerve injury. Assessing pulses, sensation, skin color, and movement ensures early recognition of changes and guides urgent interventions.
Remove or loosen restrictive dressings
If restrictive dressings are contributing to impaired circulation, loosening them can help relieve pressure while awaiting definitive treatment. This step helps protect circulation and prevent further injury.
Why Other Options Are Wrong:
Reassure patient this is a normal finding
This is incorrect because severe pain unrelieved by medication, pallor, paresthesia, delayed capillary refill, and absent pulses are not normal postoperative findings. Reassuring the patient falsely delays emergency intervention.
Apply ice to the affected area
This is incorrect because while ice may reduce swelling in minor injuries, it does not treat compartment syndrome. Relying on ice alone would delay the urgent interventions required, such as fasciotomy, putting the patient at serious risk.
A patient arrives at the emergency department with severe fatigue, bradycardia (HR 48), and altered mental status. The nurse notes cold, dry skin and a puffy face. The patient's TSH is 25 mU/L (high), and T3/T4 levels are low. What is the priority nursing intervention?
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Administer IV levothyroxine
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Encourage oral fluid intake
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Monitor blood glucose levels
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Apply warming blankets
Explanation
Correct Answer:
Administer IV levothyroxine
Explanation of Correct Answer:
The patient is exhibiting signs of myxedema coma, a life-threatening complication of severe hypothyroidism. The priority intervention is rapid thyroid hormone replacement with IV levothyroxine to restore metabolic function and prevent cardiovascular collapse. Supportive measures like IV fluids and warming may follow, but hormone replacement is the definitive treatment to reverse the crisis.
Why Other Options Are Incorrect:
Encourage oral fluid intake
The patient’s altered mental status makes oral intake unsafe due to aspiration risk. IV support is required instead.
Monitor blood glucose levels
While hypoglycemia can occur in hypothyroidism, monitoring glucose is supportive—not the primary lifesaving intervention in myxedema coma.
Apply warming blankets
Gradual warming is part of supportive care, but it does not address the underlying cause. Thyroid hormone replacement is the immediate priority to stabilize the patient.
A patient with kidney cancer had a nephrectomy. Which nursing interventions are appropriate in the immediate post-op period? Select all that apply.
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Monitor intake and output.
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Position patient flat for 24 hours.
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Monitor signs of infection.
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Assess for signs of hemorrhage.
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Encourage high-protein diet.
Explanation
Correct Answers:
Monitor intake and output
Monitor signs of infection
Assess for signs of hemorrhage
Explanation of Correct Answers:
Monitor intake and output
After nephrectomy, monitoring urine output is essential to assess the function of the remaining kidney. Strict fluid balance ensures early recognition of renal impairment and guides postoperative management.
Monitor signs of infection
Surgical sites and urinary catheters increase infection risk. Monitoring for fever, redness, purulent drainage, or elevated WBC count helps detect infection early and initiate treatment promptly.
Assess for signs of hemorrhage
Kidneys are highly vascular, so hemorrhage is a major risk after nephrectomy. Monitoring vital signs, surgical drainage, and hemoglobin/hematocrit levels is critical to detect bleeding quickly.
Why Other Options Are Wrong:
Position patient flat for 24 hours
This is incorrect because patients are not kept flat for 24 hours after nephrectomy. They are generally encouraged to turn, cough, and deep breathe to prevent atelectasis. Prolonged immobility increases risks of pulmonary and circulatory complications.
Encourage high-protein diet
This is incorrect in the immediate postoperative period. A high-protein diet may stress the remaining kidney. Initially, fluid balance and renal function are the priority, and dietary modifications come later once stability is ensured.
Prescribed: Infuse 250 mL 10% Intralipids over 6 hours
How many mL/hr will the nurse set the infusion pump? Round and record the answer to the tenth.
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180.5 mL/hr
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41.5 mL/hr
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50.0 mL/hr
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60.2 mL/hr
Explanation
Correct Answer:
41.7 mL/hr
Step-by-Step Calculation:
Formula:
Rate (mL/hr) = Total Volume (mL) ÷ Time (hr)
Substitute the values:
Rate = 250 mL ÷ 6 hr
Rate = 41.666… mL/hr
Rounded to the tenth:
41.7 mL/hr
Why Other Options Are Wrong:
180.5 mL/hr
This would complete the infusion in less than 2 hours, which would exceed the ordered infusion time and risk complications from giving lipids too quickly.
50.0 mL/hr
At this rate, the infusion would finish in 5 hours, which is faster than prescribed and could cause metabolic overload.
60.2 mL/hr
At 60.2 mL/hr, the infusion would be completed in about 4 hours, which is still incorrect and faster than the ordered 6-hour period.
The registered nurse is providing nutritional information to a patient with recurrent renal calculi by limiting purines in their diet. Which patient statement indicates understanding of the proper diet?
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"I will limit red meat and shellfish."
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"I will limit the amount of fluid I drink."
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"I will limit fruits and vegetables in general."
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"I will limit milk and dairy products."
Explanation
Correct Answer:
A. "I will limit red meat and shellfish."
Explanation:
Purines are broken down into uric acid, which can contribute to the formation of uric acid kidney stones. Foods high in purines include red meats, organ meats, shellfish, and some fish (e.g., sardines, anchovies). Limiting these foods helps prevent recurrent renal calculi in patients prone to uric acid stones.
Why Other Options Are Wrong:
B. "I will limit the amount of fluid I drink."
This is incorrect because patients with recurrent renal calculi are encouraged to increase fluid intake (at least 2–3 liters/day) to dilute urine and reduce stone formation.
C. "I will limit fruits and vegetables in general."
This is not appropriate. Fruits and vegetables are beneficial and help alkalinize urine, reducing stone risk. They are not significant sources of purines.
D. "I will limit milk and dairy products."
This is unnecessary unless specifically indicated for calcium oxalate stones. In fact, moderate calcium intake can be protective by binding oxalates in the gut.
A patient is admitted to the emergency department with status asthmaticus. The patient is using accessory muscles to breathe, has diminished breath sounds, and is not responding to repeated doses of inhaled albuterol. What is the nurse's priority action?
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Administer IV corticosteroids as prescribed
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Prepare for intubation and mechanical ventilation
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Encourage pursed-lip breathing
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Obtain a sputum culture
Explanation
Correct Answer:
Prepare for intubation and mechanical ventilation
Explanation of Correct Answer:
Status asthmaticus is a severe, life-threatening asthma exacerbation unresponsive to standard bronchodilator therapy. Diminished breath sounds in this context indicate severely limited airflow and possible impending respiratory arrest. The priority is to secure the airway and ensure adequate oxygenation and ventilation by preparing for intubation and mechanical ventilation.
Why Other Options Are Incorrect:
Administer IV corticosteroids as prescribed
Steroids reduce airway inflammation but take hours to work, so they are not the immediate life-saving intervention.
Encourage pursed-lip breathing
This is useful for chronic COPD management, not for a patient in acute, life-threatening respiratory failure.
Obtain a sputum culture
Identifying infectious organisms is not a priority when the patient has impending respiratory arrest; airway management comes first.
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