3 MAXE • 071 RUN
Galen College of Nursing
WE CHANGE THE LIFE OF ONE TO CARE FOR THE LIVES OF MANY
G
Nursing Education • Concepts of Medical-Surgical Nursing
EST. 1989
NUR 170 — Exam 3
CO N C E PTS O F M E D I C A L-S U R G I C A L N U R S I N G
INSTITUTION Galen College of Nursing COURSE CODE NUR 170
COURSE TITLE Concepts of Medical-Surgical Nursing ACADEMIC YEAR
GUIDE TYPE Study & Practice Guide QUESTION COUNT 159 Questions
SOURCE COVERAGE 159 numbered source items FORMAT MCQ + Select All That Apply + Clinical
Rationales
Language revised for clear, student-friendly U.S. nursing and NCLEX-style study use; clinical concepts, answers, and rationales preserved.
STUDY GUIDE INSTRUCTIONS & NUR 170 EXAM 3 CORE MAP
▸ This guide preserves all 159 numbered items from the supplied NUR 170 Exam 3 study-guide source and organizes them into the
nine major content sections represented in that material.
▸ Galen describes NUR 170 as Concepts of Medical-Surgical Nursing, focused on adult clients with common and less complex acute
health problems, clinical reasoning, professional standards, communication, legal/ethical responsibilities, and safe patient-centered
care.
▸ Use the answer immediately below each item for active-recall review. The rationale explains the clinical reasoning behind the keyed
response.
▸ For priority questions, assess instability first: airway, breathing, circulation/perfusion, acute neurologic change, severe bleeding, or
rapidly worsening status.
▸ For medication questions, connect the drug to the patient’s current vital signs, laboratory values, symptoms, contraindications, and
expected therapeutic effect.
▸ This is a study resource based on the supplied material and supporting clinical verification; it is not represented as an official Galen
College of Nursing examination or leaked exam.
You Already Know This
You already know the disease names. NUR 170 Exam 3 is about recognizing which physiologic change turns a routine finding
into a nursing priority.
The difficulty comes from the overlap: glucose problems can become electrolyte emergencies, cardiac symptoms can look
deceptively nonspecific, and a familiar medication can become dangerous when perfusion or laboratory values change.
The knowledge matters. But so does knowing what cannot wait.
NUR 170 Exam 3 Core Map.
1. Diabetes & Glycemic Emergencies 2. Rheumatologic Disorders
SMBG, hypoglycemia, DKA, HHS, insulin, foot care, delegation. RA, OA, systemic sclerosis, lupus, Sjögren syndrome, gout,
mobility and coping.
, 3. Endocrine Regulation 4. ACS & Cardiac Diagnostics
Pituitary, adrenal, parathyroid, ADH, electrolyte disturbances MI recognition, troponin, catheterization, TEE, hemodynamics
and testing. and safety.
5. Dysrhythmias & Devices 6. Heart Failure & Vascular Care
ECG interpretation, AF, VT/VF, bradycardia, pacemakers and Fluid overload, medications, hypertension, AAA, PAD, VTE and
cardioversion. anticoagulation.
Where Is Your Preparation Breaking Down?
If you are missing NUR 170 questions, do not automatically respond by memorizing more disease definitions. Check where the
reasoning chain breaks.
PriorityCan you identify the unstable finding before treating PhysiologyCan you connect the disease process to the
the routine one? assessment finding?
MedicationCan you recognize the lab value or vital sign that DelegationCan you separate routine data collection from
changes medication safety? nursing judgment?
DiagnosticsCan you recognize what a test actually establishes SafetyCan you identify the complication that cannot safely
—and what it does not? wait?
01
DIABETES MELLITUS & ACUTE GLYCEMIC EMERGENCIES 24 questions
1. A client newly diagnosed with type 2 diabetes will go home with a blood glucose meter for self-monitoring of blood
glucose (SMBG). When should the nurse teach the client how to use the meter?
A) While performing the test in the hospital
B) Stop insulin permanently when the blood glucose returns to normal.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. While performing the test in the hospital
RATIONALE Teaching is most effective during a hands-on activity. Explaining and demonstrating the procedure while the client
is checking glucose in the hospital helps the client learn and remember the skill. The nurse can also correct errors
and reinforce correct technique right away.
2. An intensive care client with diabetic ketoacidosis (DKA) is receiving an insulin infusion. When the cardiac monitor
shows ventricular ectopy, which assessment should the nurse make?
A) Potassium level
B) Have the UAP decide how much insulin the client needs.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. Potassium level
RATIONALE Insulin and correction of acidosis during DKA move potassium into the cells. This can cause low potassium. Low
potassium can cause abnormal heart rhythms, including ventricular ectopy. Checking the potassium level is the
priority because it can reveal the cause of the ectopy and guide treatment.
,3. A client with type 2 diabetes who is taking metformin (Glucophage) is seen in the diabetic clinic. The fasting blood
glucose is 108 mg/dL (6.0 mmol/L), and the glycosylated hemoglobin (HbA1C) is 8.2%. what should the nurse do next?
A) Ask the client about current dietary intake and medication use.
B) Use the HbA1c value to determine the client's glucose level at this moment.
C) Skip glucose checks when the client feels well.
D) Stop insulin permanently when the blood glucose returns to normal.
ANSWER A. Ask the client about current dietary intake and medication use.
RATIONALE The fasting glucose is within an acceptable range, but the HbA1c of 8.2% shows poor glucose control over the past
2–3 months. The nurse should first assess factors that can be changed, such as diet and medication use. This helps
identify why the HbA1c is high and guides teaching or changes to the care plan.
4. the nurse is teaching discharge teaching to a client with type 2 diabetes and peripheral neuropathy. Which statement
by the client shows that more teaching is needed about injury prevention?
A) "I can break in my shoes by wearing them all day."
B) Wait until discharge before teaching the skill.
C) Skip glucose checks when the client feels well.
D) Have the UAP decide how much insulin the client needs.
ANSWER A. "I can break in my shoes by wearing them all day."
RATIONALE Peripheral neuropathy reduces foot sensation, so the client may not feel an injury. New shoes should be worn for
short periods at first so the feet can be checked for pressure or irritation. Wearing new shoes all day can cause
blisters or sores that go unnoticed and may become infected.
5. A client with type 1 diabetes arrives in the emergency department breathing deeply and saying, "I can't catch my
breath." Vital signs are T 98.4°F (36.9°C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99%
on room air. What should the nurse do first?
A) Check the blood glucose.
B) Treat low blood glucose with a high-fat snack first.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. Check the blood glucose.
RATIONALE Deep, rapid Kussmaul respirations, tachycardia, and low blood pressure are classic findings of diabetic
ketoacidosis (DKA). Checking the blood glucose is the first step to confirm the likely cause and guide treatment.
Treatment may then include IV fluids and insulin.
, 6. The clinic nurse is providing teaching to a client with newly diagnosed diabetes. Which statement by the client shows a
correct understanding about the need to wear a MedicAlert bracelet?
A) "If I become hypoglycemic, I could become unconscious."
B) Use only diet changes for type 1 diabetes.
C) Use an ordinary bracelet without emergency medical information.
D) Wait until discharge before teaching the skill.
ANSWER A. "If I become hypoglycemic, I could become unconscious."
RATIONALE Severe low blood glucose can cause loss of consciousness, seizures, or inability to communicate. A MedicAlert
bracelet gives emergency responders important medical information. The client's statement correctly identifies
why this information can be important during an emergency.
7. The nurse in the endocrine clinic is reviewing type 1 and type 2 diabetes with a group of nursing students. Which
explanation by the students shows their understanding of the types of diabetes?
A) Those with type 2 diabetes make insulin, but in inadequate amounts.
B) Use only diet changes for type 1 diabetes.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Restrict fluids routinely during hyperglycemic emergencies.
ANSWER A. Those with type 2 diabetes make insulin, but in inadequate amounts.
RATIONALE Type 2 diabetes involves insulin resistance and a relative lack of insulin. The pancreas still makes insulin, but the
amount may not be enough to overcome the body's resistance to it. Type 1 diabetes is different because
autoimmune destruction of pancreatic beta cells causes an absolute lack of insulin.
8. Which nursing action will the home health nurse delegate to a home health aide who is making daily visits to a client
with newly diagnosed type 2 diabetes?
A) Assist the client with washing the feet and applying moisturizing lotion.
B) Use the HbA1c value to determine the client's glucose level at this moment.
C) Skip glucose checks when the client feels well.
D) Have the UAP decide how much insulin the client needs.
ANSWER A. Assist the client with washing the feet and applying moisturizing lotion.
RATIONALE Foot washing and applying moisturizer are routine, nonsterile tasks that can be delegated to a home health aide.
Clients with diabetes need daily foot care and inspection to prevent complications. This task supports safe,
consistent foot hygiene.
Galen College of Nursing
WE CHANGE THE LIFE OF ONE TO CARE FOR THE LIVES OF MANY
G
Nursing Education • Concepts of Medical-Surgical Nursing
EST. 1989
NUR 170 — Exam 3
CO N C E PTS O F M E D I C A L-S U R G I C A L N U R S I N G
INSTITUTION Galen College of Nursing COURSE CODE NUR 170
COURSE TITLE Concepts of Medical-Surgical Nursing ACADEMIC YEAR
GUIDE TYPE Study & Practice Guide QUESTION COUNT 159 Questions
SOURCE COVERAGE 159 numbered source items FORMAT MCQ + Select All That Apply + Clinical
Rationales
Language revised for clear, student-friendly U.S. nursing and NCLEX-style study use; clinical concepts, answers, and rationales preserved.
STUDY GUIDE INSTRUCTIONS & NUR 170 EXAM 3 CORE MAP
▸ This guide preserves all 159 numbered items from the supplied NUR 170 Exam 3 study-guide source and organizes them into the
nine major content sections represented in that material.
▸ Galen describes NUR 170 as Concepts of Medical-Surgical Nursing, focused on adult clients with common and less complex acute
health problems, clinical reasoning, professional standards, communication, legal/ethical responsibilities, and safe patient-centered
care.
▸ Use the answer immediately below each item for active-recall review. The rationale explains the clinical reasoning behind the keyed
response.
▸ For priority questions, assess instability first: airway, breathing, circulation/perfusion, acute neurologic change, severe bleeding, or
rapidly worsening status.
▸ For medication questions, connect the drug to the patient’s current vital signs, laboratory values, symptoms, contraindications, and
expected therapeutic effect.
▸ This is a study resource based on the supplied material and supporting clinical verification; it is not represented as an official Galen
College of Nursing examination or leaked exam.
You Already Know This
You already know the disease names. NUR 170 Exam 3 is about recognizing which physiologic change turns a routine finding
into a nursing priority.
The difficulty comes from the overlap: glucose problems can become electrolyte emergencies, cardiac symptoms can look
deceptively nonspecific, and a familiar medication can become dangerous when perfusion or laboratory values change.
The knowledge matters. But so does knowing what cannot wait.
NUR 170 Exam 3 Core Map.
1. Diabetes & Glycemic Emergencies 2. Rheumatologic Disorders
SMBG, hypoglycemia, DKA, HHS, insulin, foot care, delegation. RA, OA, systemic sclerosis, lupus, Sjögren syndrome, gout,
mobility and coping.
, 3. Endocrine Regulation 4. ACS & Cardiac Diagnostics
Pituitary, adrenal, parathyroid, ADH, electrolyte disturbances MI recognition, troponin, catheterization, TEE, hemodynamics
and testing. and safety.
5. Dysrhythmias & Devices 6. Heart Failure & Vascular Care
ECG interpretation, AF, VT/VF, bradycardia, pacemakers and Fluid overload, medications, hypertension, AAA, PAD, VTE and
cardioversion. anticoagulation.
Where Is Your Preparation Breaking Down?
If you are missing NUR 170 questions, do not automatically respond by memorizing more disease definitions. Check where the
reasoning chain breaks.
PriorityCan you identify the unstable finding before treating PhysiologyCan you connect the disease process to the
the routine one? assessment finding?
MedicationCan you recognize the lab value or vital sign that DelegationCan you separate routine data collection from
changes medication safety? nursing judgment?
DiagnosticsCan you recognize what a test actually establishes SafetyCan you identify the complication that cannot safely
—and what it does not? wait?
01
DIABETES MELLITUS & ACUTE GLYCEMIC EMERGENCIES 24 questions
1. A client newly diagnosed with type 2 diabetes will go home with a blood glucose meter for self-monitoring of blood
glucose (SMBG). When should the nurse teach the client how to use the meter?
A) While performing the test in the hospital
B) Stop insulin permanently when the blood glucose returns to normal.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. While performing the test in the hospital
RATIONALE Teaching is most effective during a hands-on activity. Explaining and demonstrating the procedure while the client
is checking glucose in the hospital helps the client learn and remember the skill. The nurse can also correct errors
and reinforce correct technique right away.
2. An intensive care client with diabetic ketoacidosis (DKA) is receiving an insulin infusion. When the cardiac monitor
shows ventricular ectopy, which assessment should the nurse make?
A) Potassium level
B) Have the UAP decide how much insulin the client needs.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. Potassium level
RATIONALE Insulin and correction of acidosis during DKA move potassium into the cells. This can cause low potassium. Low
potassium can cause abnormal heart rhythms, including ventricular ectopy. Checking the potassium level is the
priority because it can reveal the cause of the ectopy and guide treatment.
,3. A client with type 2 diabetes who is taking metformin (Glucophage) is seen in the diabetic clinic. The fasting blood
glucose is 108 mg/dL (6.0 mmol/L), and the glycosylated hemoglobin (HbA1C) is 8.2%. what should the nurse do next?
A) Ask the client about current dietary intake and medication use.
B) Use the HbA1c value to determine the client's glucose level at this moment.
C) Skip glucose checks when the client feels well.
D) Stop insulin permanently when the blood glucose returns to normal.
ANSWER A. Ask the client about current dietary intake and medication use.
RATIONALE The fasting glucose is within an acceptable range, but the HbA1c of 8.2% shows poor glucose control over the past
2–3 months. The nurse should first assess factors that can be changed, such as diet and medication use. This helps
identify why the HbA1c is high and guides teaching or changes to the care plan.
4. the nurse is teaching discharge teaching to a client with type 2 diabetes and peripheral neuropathy. Which statement
by the client shows that more teaching is needed about injury prevention?
A) "I can break in my shoes by wearing them all day."
B) Wait until discharge before teaching the skill.
C) Skip glucose checks when the client feels well.
D) Have the UAP decide how much insulin the client needs.
ANSWER A. "I can break in my shoes by wearing them all day."
RATIONALE Peripheral neuropathy reduces foot sensation, so the client may not feel an injury. New shoes should be worn for
short periods at first so the feet can be checked for pressure or irritation. Wearing new shoes all day can cause
blisters or sores that go unnoticed and may become infected.
5. A client with type 1 diabetes arrives in the emergency department breathing deeply and saying, "I can't catch my
breath." Vital signs are T 98.4°F (36.9°C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99%
on room air. What should the nurse do first?
A) Check the blood glucose.
B) Treat low blood glucose with a high-fat snack first.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Skip glucose checks when the client feels well.
ANSWER A. Check the blood glucose.
RATIONALE Deep, rapid Kussmaul respirations, tachycardia, and low blood pressure are classic findings of diabetic
ketoacidosis (DKA). Checking the blood glucose is the first step to confirm the likely cause and guide treatment.
Treatment may then include IV fluids and insulin.
, 6. The clinic nurse is providing teaching to a client with newly diagnosed diabetes. Which statement by the client shows a
correct understanding about the need to wear a MedicAlert bracelet?
A) "If I become hypoglycemic, I could become unconscious."
B) Use only diet changes for type 1 diabetes.
C) Use an ordinary bracelet without emergency medical information.
D) Wait until discharge before teaching the skill.
ANSWER A. "If I become hypoglycemic, I could become unconscious."
RATIONALE Severe low blood glucose can cause loss of consciousness, seizures, or inability to communicate. A MedicAlert
bracelet gives emergency responders important medical information. The client's statement correctly identifies
why this information can be important during an emergency.
7. The nurse in the endocrine clinic is reviewing type 1 and type 2 diabetes with a group of nursing students. Which
explanation by the students shows their understanding of the types of diabetes?
A) Those with type 2 diabetes make insulin, but in inadequate amounts.
B) Use only diet changes for type 1 diabetes.
C) Use the HbA1c value to determine the client's glucose level at this moment.
D) Restrict fluids routinely during hyperglycemic emergencies.
ANSWER A. Those with type 2 diabetes make insulin, but in inadequate amounts.
RATIONALE Type 2 diabetes involves insulin resistance and a relative lack of insulin. The pancreas still makes insulin, but the
amount may not be enough to overcome the body's resistance to it. Type 1 diabetes is different because
autoimmune destruction of pancreatic beta cells causes an absolute lack of insulin.
8. Which nursing action will the home health nurse delegate to a home health aide who is making daily visits to a client
with newly diagnosed type 2 diabetes?
A) Assist the client with washing the feet and applying moisturizing lotion.
B) Use the HbA1c value to determine the client's glucose level at this moment.
C) Skip glucose checks when the client feels well.
D) Have the UAP decide how much insulin the client needs.
ANSWER A. Assist the client with washing the feet and applying moisturizing lotion.
RATIONALE Foot washing and applying moisturizer are routine, nonsterile tasks that can be delegated to a home health aide.
Clients with diabetes need daily foot care and inspection to prevent complications. This task supports safe,
consistent foot hygiene.
