WorksheetsBiomed Capstone Final
Total questions: 60
Worksheet time: 30mins
A nurse phones a provider about a patient whose blood pressure has dropped from 128/76 to 86/52 in 15 minutes and who is now dizzy and pale. Which statement BEST represents a strong Assessment in SBAR?
“Something is wrong with him.”
“I think he may be becoming hemodynamically unstable due to possible internal bleeding.”
“His family is nervous, so can you come talk to them?”
“He doesn’t like hospitals.”
During an SBAR call, which piece of information belongs MOST appropriately in the Background section for a patient with new chest pain?
“I recommend you come see him now.”
“He is complaining of 9/10 chest pain.”
“He has a history of hypertension and high cholesterol and had a stent placed 2 years ago.”
“I think he’s having a panic attack.”
A student nurse gives SBAR but never clearly states what they want from the provider. What is the MOST likely consequence of this error?
The provider will automatically order every possible test.
The provider will hang up immediately.
The provider may not understand the urgency or what specific action is needed, delaying care.
The patient will always be transferred to the ICU.
Which example MOST completely shows a correct Recommendation in SBAR for a patient with new shortness of breath and abnormal vital signs?
“Can you call me back later?”
“I recommend you see the patient now and consider ordering a chest X-ray and ABG.”
“I guess you’ll decide what to do.”
“He doesn’t like his roommate.”
A phlebotomist draws blood without checking the patient’s ID band and later learns there are two patients with the same last name on the unit. What is the MOST appropriate next step?
Keep the sample and hope the lab catches any mix-up.
Relabel the tube with the other patient’s name.
Discard the specimen and redraw using proper identification at the bedside.
Ask the family which sample is correct.
A patient suddenly feels tingling and numbness in the fingers of the arm where a tourniquet has been applied for several minutes. Which explanation BEST links this symptom to what is happening physiologically?
The tourniquet is increasing oxygen delivery to the hand.
The tourniquet is compressing nerves and blood vessels, reducing blood flow distal to the site.
The tourniquet is cooling the skin and causing nerve growth.
The tourniquet is increasing blood flow to the heart.
During an IV infusion, a patient reports burning and the nurse notes redness and a palpable “cord” along the vein. Which complication is MOST likely, and what is the priority action?
Infiltration; increase the IV rate.
Phlebitis; stop the infusion and remove the IV.
Air embolus; place the patient on their left side.
Infection; ignore it if the patient is afebrile.
A patient’s IV site appears swollen, cool to the touch, and the infusion pump alarms “occlusion.” Which option BEST explains what is happening and what should be done?
Vein spasm; increase the infusion rate.
Infiltration; stop the IV, remove the catheter, and elevate the limb.
Normal finding; continue the infusion.
Dehydration; bolus more fluid through same IV.
A patient with chronic kidney disease shows this lab trend over 3 months: rising BUN and creatinine, falling GFR. Which conclusion is MOST appropriate?
Kidney function is improving.
Kidney function is progressively worsening.
Liver disease is resolving.
The patient is no longer anemic.
A patient’s hemoglobin drops from 13 g/dL to 7 g/dL over a day after surgery. Which set of symptoms BEST matches this lab change?
Flushed skin, high energy, decreased heart rate
Pale skin, tachycardia, shortness of breath with minimal exertion
Jaundice and itchy skin
Sweating, weight gain, and slow pulse
A patient with platelets of 30,000 is being discharged. Which discharge instruction BEST connects their lab value to safe behavior at home?
“Start lifting heavier weights to build strength.”
“You can play tackle football as long as you wear a helmet.”
“Use an electric razor and soft toothbrush, and report any unusual bruising or bleeding.”
“Avoid drinking water to prevent dilution of platelets.”
A patient’s sodium is normal, but potassium is dangerously low. Which scenario BEST explains the clinical significance of this potassium abnormality?
Increased risk of bone fractures
Risk of abnormal heart rhythms and muscle weakness
Risk of high blood sugar only
Only a cosmetic effect on skin tone
A patient with liver failure has AST/ALT 10× normal and an INR of 4.2. Which complication BEST connects these labs to what is happening in the body?
The liver is producing too many clotting factors, causing clots.
The liver is failing to produce adequate clotting factors, increasing bleeding risk.
The kidneys are excreting too much calcium.
The lungs are retaining too much CO₂.
A patient presents with chest pain and shortness of breath. The troponin is significantly elevated. Which statement BEST explains what is happening at the tissue level?
Skin cells are being destroyed by UV radiation.
Liver cells are undergoing rapid division.
Heart muscle cells are being damaged, releasing troponin into the bloodstream.
Bone marrow cells are producing too many platelets.
Two patients have the same elevated LDL, but one has very low HDL and high triglycerides while the other has high HDL and low triglycerides. Why is the first patient at higher risk for atherosclerosis?
Low HDL and high triglycerides promote plaque buildup and reduce “good cholesterol” removal of fats.
High HDL always causes heart attacks.
Triglycerides do not affect heart disease.
LDL is the only lab that matters for heart risk.
A burn destroys the entire epidermis and part of the dermis. Which complication BEST reflects the loss of normal skin function?
Excess bone growth
Increased protection from infection
Higher risk of fluid loss and infection because the barrier is compromised
Decreased need for temperature regulation
When a person is overheated, which combination of skin-related changes BEST explains how the body attempts to restore homeostasis?
Vasoconstriction and decreased sweating
Vasodilation and increased sweating
Vasoconstriction and shivering
Decreased sweat production and decreased blood flow to skin
Langerhans cells in the epidermis are MOST important because they:
Produce pigment to protect against UV light.
Detect pathogens and present antigens to immune cells.
Secrete sweat for temperature control.
Store fat for insulation.
A patient with severe dehydration has poor skin turgor and dry mucous membranes. Which BEST explains the role of the integumentary system in this situation?
The skin is absorbing extra water from the air.
Loss of fluid from the body reduces skin elasticity and moisture.
The skin is producing more sebum to fix dehydration.
The hair follicles are storing water.
A vaccine introduces a harmless form of a pathogen. Which event BEST explains why this leads to long-term protection?
The vaccine permanently kills all pathogens in the body.
Memory B and T cells form, allowing quicker and stronger responses to future exposures.
The vaccine replaces all white blood cells with new ones.
The vaccine thickens the skin barrier.
In an autoimmune disease affecting joints, such as rheumatoid arthritis, what is happening at the tissue level?
Bacteria are destroying the cartilage.
The immune system mistakenly attacks synovial membranes and joint tissues, causing inflammation and damage.
The joints lack any blood supply.
Only muscles are affected, not joints.
A patient with a severely low WBC count is placed in protective isolation. Which BEST explains the rationale?
They are a danger to others because they produce too many antibodies.
They are at high risk for infection because they have fewer immune cells to fight pathogens.
They do not require any protection because low WBC is harmless.
They will always have a fever, regardless of infection.
Which scenario BEST shows the role of antibodies in defending against infection?
Antibodies digest food in the intestine.
Antibodies bind to antigens on pathogens, helping tag them for destruction by other immune cells.
Antibodies generate electrical impulses for muscles.
Antibodies carry oxygen in the blood.
A patient eats peanuts and within minutes develops hives, swelling of the lips, wheezing, and dizziness. Which BEST explains what is happening to their blood vessels and airways?
Blood vessels constrict and airways relax.
Widespread vasodilation and increased capillary permeability occur, while airway smooth muscle constricts.
Blood vessels and airways both completely close off.
Only skin cells are affected.
In anaphylaxis, why is epinephrine the emergency treatment of choice?
It further dilates blood vessels and worsens blood pressure.
It reverses bronchoconstriction and vasodilation, supporting airway and blood pressure.
It only treats skin itching.
It replaces missing antibodies.
A patient has a red, warm, swollen area around a cut on their leg and red streaks extending toward the groin. Which condition is MOST likely?
Local allergic reaction
Cellulitis with lymphangitis
Simple bruise
Fungal infection of the nails
Which feature is MOST concerning for malignant melanoma using the ABCDE rule?
A small, symmetrical, single-color mole
A mole with asymmetry, irregular borders, and multiple colors that has grown recently
A stable, flesh-colored skin tag
A blister from a new pair of shoes
In leukemia, how does abnormal bone marrow activity lead to both infection and bleeding problems?
The marrow stops making all cells, so no issues occur.
Abnormal cells crowd out normal WBCs and platelets, weakening immune defense and clotting.
Only red blood cells are increased.
Only bone cells are replaced.
A nurse prepares a medication but the patient says, “That pill looks different than what I usually take.” What is the BEST action related to the “Right Medication” and “Right Patient”?
Tell the patient they are wrong and give it.
Double-check the order, drug, dose, and patient’s ID before administering.
A provider orders 25 mg of a medication. The tablets are 50 mg each. Which action BEST reflects the Right Dose?
Give the full 50 mg tablet to avoid wasting medication.
Skip the dose because the strength doesn’t match.
Give half a tablet after confirming the calculation and order.
Ask the patient to cut the tablet themselves.
A patient on a blood pressure medication becomes dizzy and refuses their next dose. Which action BEST respects the Right to Refuse and patient safety?
Force the medication because it is ordered.
Respect the refusal, assess symptoms, educate the patient, and notify the provider.
Hide the medication in their food.
Cancel the order without telling anyone.
A nurse gives a high-risk IV medication but forgets to document it. Which risk does this create related to the Right Documentation?
The patient will never be billed.
Another nurse may unknowingly re-dose the medication, causing toxicity.
The medication will disappear from the system.
The patient will automatically be discharged.
Which statement BEST explains how UV radiation can lead to skin cancer at the cellular level?
UV light only warms the skin and improves blood flow.
UV light cuts DNA into equal pieces that are easily repaired.
UV light causes DNA damage and mutations in skin cells, increasing the chance of uncontrolled growth.
UV light only affects hair follicles.
Why does having many severe sunburns early in life increase melanoma risk later?
Children’s skin cannot tan.
Early DNA damage accumulates over time, increasing the chance of malignant transformation in melanocytes.
The immune system becomes stronger against cancer.
Melanocytes die and can never become cancerous.
Metastasis of a skin cancer to the lung means:
Lung tissue spontaneously turned into skin tissue.
Cancer cells from the primary skin tumor traveled through blood or lymph and formed tumors in the lung.
The lung cancer appeared independently and is unrelated.
The immune system cured the primary tumor.
Chemotherapy targets rapidly dividing cells. Which combination of side effects MOST directly reflects this mechanism?
Hair loss, mouth sores, and low blood counts
Increased muscle strength and bone density
Improved digestion and hair growth
Permanent immunity to all infections
Why are patients receiving chemotherapy at high risk for infection?
Chemo only damages hair cells.
Chemo decreases bone marrow production of white blood cells, weakening immune defense.
Chemo thickens the skin barrier.
Chemo increases platelet counts.
In leukemia, why might a patient have normal or even high WBC count but still be prone to frequent infections?
The WBCs are abnormal and often cannot function properly to fight infection.
The WBCs are all memory cells.
The platelets absorb all antibodies.
The red blood cells fight infection instead.
A patient receiving IV antibiotics develops redness, warmth, and a small amount of pus at the IV site. Which is the MOST appropriate interpretation?
Normal reaction to medication
Local infection at the IV site
Only an allergic rash on the whole body
A sign of dehydration
A pump alarms occlusion and the nurse finds the patient’s arm bent sharply at the elbow near the IV. Which is the BEST first step?
Immediately remove the IV.
Straighten the arm and reassess the IV flow and site.
Ignore the alarm if the patient feels fine.
Turn off the pump permanently.
A patient with an infiltrated IV is at risk for tissue damage. Which nursing intervention BEST minimizes this risk?
Leaving the catheter in place to maintain access
Removing the IV, elevating the limb, and applying a warm or cool compress per protocol
Bolusing fluid through the same site quickly
Taping the site more tightly
A 70-year-old with long-standing knee osteoarthritis asks why their pain worsens after years of use. Which explanation BEST links normal anatomy to OA pathophysiology?
The synovial fluid becomes radioactive.
Articular cartilage gradually wears down, reducing smooth joint movement and causing bone-on-bone friction.
Ligaments become longer and stronger.
Muscles turn into cartilage.
In rheumatoid arthritis, why might a patient have joint deformities in the hands over time?
Repeated fractures that never heal
Chronic autoimmune inflammation destroys cartilage and bone, leading to joint instability and deformity.
Excess calcium deposits strengthen the joints.
Loss of all synovial fluid makes the joint longer.
An athlete experiences a sudden “pop” in the knee, immediate swelling, and instability when walking. Why does an ACL tear cause the knee to “give way”?
The ACL controls rotation of the shoulder.
The ACL stabilizes the tibia under the femur; tearing it allows abnormal forward movement.
The ACL is a muscle that pumps blood.
The ACL only controls foot movement.
A patient with a meniscus tear complains that their knee “locks” in a bent position. What is the BEST explanation at the tissue level?
The ACL is pulling the kneecap sideways.
A torn piece of cartilage can get caught between the femur and tibia, blocking smooth motion.
The patella has dislocated permanently.
The quadriceps tendon has fused to bone.
A rotator cuff tear MOST directly affects which normal function of the shoulder joint?
Flexing the wrist
Fine motor control of the fingers
Stabilizing and rotating the humeral head during arm elevation
Extending the knee
A patient with scoliosis has a visible rib hump when bending forward. What does this physical finding indicate about the spine?
A simple muscle strain
A lateral curvature with vertebral rotation causing rib prominence on one side
Complete fusion of all vertebrae
A fracture of the ribs only
Compartment syndrome in the lower leg after a crush injury can cause loss of pulses and motor function. Which statement BEST explains the underlying problem?
Excess bone formation in the leg compresses nerves.
Increased pressure within a closed muscle compartment compresses blood vessels and nerves, cutting off circulation.
The skin becomes too elastic.
Synovial fluid leaks into the muscles.
An endurance athlete collapses after an extreme workout in high heat. They report severe muscle pain and their urine is dark brown. Which pathophysiologic process is MOST likely occurring?
Increased bone marrow production of platelets
Massive muscle cell breakdown releasing myoglobin, which can damage kidneys
Overproduction of melanin in skin cells
Viral destruction of red blood cells
A patient with a herniated lumbar disc compressing the L5 nerve root is MOST likely to show which symptom pattern?
Shoulder pain when combing hair
Sharp radiating pain, numbness, or weakness down the leg in the L5 distribution
Only localized back itching
Pain only when swallowing
Which statement BEST distinguishes a sprain from a strain at the tissue level?
A sprain involves muscle; a strain involves bone.
A sprain involves ligament injury; a strain involves muscle or tendon injury.
A sprain involves nerve damage; a strain involves cartilage.
They are identical injuries with different names.
Inadequate warm-up, sudden high-intensity exercise, and poor technique MOST strongly increase the risk of which group of injuries?
Leukemia and melanoma
Sprains, strains, and exertional rhabdomyolysis
Fractures and strokes only
Anaphylaxis and cellulitis
A teen athlete asks how to lower their risk of ACL and meniscus injuries. Which advice BEST connects prevention to joint mechanics?
Avoid all sports and stay sedentary.
Focus only on upper-body strength.
Practice proper landing techniques, strengthen leg muscles, and avoid sudden cutting movements without training.
Never stretch before activity.
A patient with rheumatoid arthritis asks what they can do to protect their joints long-term. Which recommendation BEST aligns with joint protection principles?
Avoid all movement to “save” the joints.
Use proper body mechanics, low-impact exercise, and rest joints during painful flares.
Only exercise on days with severe pain.
Push through severe pain to “toughen up” the joint.
A fair-skinned patient with multiple blistering sunburns as a child asks how to reduce future skin cancer risk. Which plan is MOST appropriate?
Use tanning beds to build a base tan.
Avoid all outdoor activity.
Use broad-spectrum sunscreen, protective clothing, and avoid peak UV hours.
Only use sunscreen at the beach.
A patient at risk for cellulitis after a skin injury asks how to prevent infection. Which instruction BEST links integumentary structure to infection risk?
Leave wounds open to the air at all times.
Clean minor cuts, keep them covered, and watch for redness, warmth, or streaking.
Never wash wounds with any solution.
Only seek care if there is bone pain.
A patient on chemotherapy with low WBC asks why they can’t have many visitors. Which explanation is BEST?
“Visitors will make your pain worse.”
“With fewer white blood cells, your body has a harder time fighting off infections others might carry.”
“You are contagious to everyone else.”
“The chemotherapy will not work if you see people.”
A patient at risk for rhabdomyolysis asks how to exercise safely. Which plan BEST shows understanding of prevention?
Suddenly increasing intensity dramatically with no breaks
Exercising in extreme heat with no water
Gradually increasing workout intensity, staying hydrated, and resting when muscles are severely fatigued
Only exercising when ill with a fever
A patient on blood thinners asks how to avoid serious bleeding. Which advice BEST uses their lab information (high INR) to guide behavior?
Use a soft toothbrush, avoid high-risk activities, and report any unusual bruising or bleeding.
Avoid all walking and stay in bed.
Stop the blood thinner on their own.
Use sharp razors and contact sports to stay fit.
A young adult with new scoliosis is worried about long-term problems. Which statement BEST connects early detection with outcome?
“Scoliosis always causes paralysis later.”
“Early detection allows monitoring and, if needed, bracing or surgery to prevent worsening curvature and complications.”
“There is nothing that can be done for scoliosis.”
“Only heavy lifting helps scoliosis.”
