NU 185 Exam 2 | Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A patient with Type 1 Diabetes is found unconscious with Kussmaul
respirations and a fruity breath odor. What is the nurse’s priority action?
A. Initiate fluid resuscitation with Normal Saline
B. Administer 50% Dextrose IV push
C. Administer 10 units of subcutaneous Glargine
D. Provide oral orange juice with sugar
Answer: A
Rationale: The symptoms describe Diabetic Ketoacidosis (DKA). Dehydration is a primary
concern; therefore, fluid resuscitation with Normal Saline is the priority before starting
insulin therapy.
2. Which laboratory value is most indicative of long-term glucose control over
the past 3 months?
A. Hemoglobin A1c
B. Postprandial Glucose
C. Fasting Blood Glucose
D. Serum Ketones
Answer: A
Rationale: Hemoglobin A1c measures the average blood glucose level over the 120-day
lifespan of red blood cells, providing a 3-month overview.
,3. A patient with hyperthyroidism is being treated for a thyroid storm. Which
medication should the nurse expect to administer to decrease the peripheral
conversion of T4 to T3?
A. Levothyroxine
B. Spironolactone
C. Calcium Gluconate
D. Propylthiouracil (PTU)
Answer: D
Rationale: Propylthiouracil (PTU) blocks the synthesis of thyroid hormones and also
inhibits the peripheral conversion of T4 to T3, which is critical in thyroid storm.
4. Which assessment finding should the nurse prioritize in a patient immediately
following a thyroidectomy?
A. Trousseau’s sign
B. Hoarseness of voice
C. Decreased appetite
D. Soreness at the incision site
Answer: A
Rationale: A positive Trousseau’s sign indicates hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are accidentally removed or damaged.
5. A patient with Addison’s disease is admitted for an Addisonian Crisis. Which
electrolyte imbalance is most likely?
A. Hypokalemia and Hypernatremia
B. Hypercalcemia and Hypophosphatemia
C. Hyperkalemia and Hyponatremia
D. Hypomagnesemia and Hyperkalemia
Answer: C
, Rationale: In Addison’s disease, the lack of aldosterone leads to sodium wasting
(hyponatremia) and potassium retention (hyperkalemia).
6. A patient with SIADH is experiencing fluid volume excess. Which intervention
should the nurse include in the plan of care?
A. Encourage fluid intake up to 3 liters per day
B. Administer Desmopressin (DDAVP)
C. Increase sodium intake via oral salt tablets only
D. Implement a fluid restriction of 800-1000 mL per day
Answer: D
Rationale: SIADH involves excessive ADH, leading to water retention. Fluid restriction is
the primary treatment to prevent further dilution of sodium.
7. Which clinical manifestation is a hallmark sign of Diabetes Insipidus (DI)?
A. Excessive thirst and dilute urine
B. High urine specific gravity
C. Peripheral edema and hypertension
D. Elevated blood glucose levels
Answer: A
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria of very
dilute urine and compensatory polydipsia (excessive thirst).
8. A patient is diagnosed with Cushing’s Syndrome. Which physical assessment
finding is consistent with this diagnosis?
A. Hyperpigmentation of the skin
B. Truncal obesity and moon face
C. Thin, wasted appearance of the trunk
D. Weight loss and hypotension
Answer: B
College
1. A patient with Type 1 Diabetes is found unconscious with Kussmaul
respirations and a fruity breath odor. What is the nurse’s priority action?
A. Initiate fluid resuscitation with Normal Saline
B. Administer 50% Dextrose IV push
C. Administer 10 units of subcutaneous Glargine
D. Provide oral orange juice with sugar
Answer: A
Rationale: The symptoms describe Diabetic Ketoacidosis (DKA). Dehydration is a primary
concern; therefore, fluid resuscitation with Normal Saline is the priority before starting
insulin therapy.
2. Which laboratory value is most indicative of long-term glucose control over
the past 3 months?
A. Hemoglobin A1c
B. Postprandial Glucose
C. Fasting Blood Glucose
D. Serum Ketones
Answer: A
Rationale: Hemoglobin A1c measures the average blood glucose level over the 120-day
lifespan of red blood cells, providing a 3-month overview.
,3. A patient with hyperthyroidism is being treated for a thyroid storm. Which
medication should the nurse expect to administer to decrease the peripheral
conversion of T4 to T3?
A. Levothyroxine
B. Spironolactone
C. Calcium Gluconate
D. Propylthiouracil (PTU)
Answer: D
Rationale: Propylthiouracil (PTU) blocks the synthesis of thyroid hormones and also
inhibits the peripheral conversion of T4 to T3, which is critical in thyroid storm.
4. Which assessment finding should the nurse prioritize in a patient immediately
following a thyroidectomy?
A. Trousseau’s sign
B. Hoarseness of voice
C. Decreased appetite
D. Soreness at the incision site
Answer: A
Rationale: A positive Trousseau’s sign indicates hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are accidentally removed or damaged.
5. A patient with Addison’s disease is admitted for an Addisonian Crisis. Which
electrolyte imbalance is most likely?
A. Hypokalemia and Hypernatremia
B. Hypercalcemia and Hypophosphatemia
C. Hyperkalemia and Hyponatremia
D. Hypomagnesemia and Hyperkalemia
Answer: C
, Rationale: In Addison’s disease, the lack of aldosterone leads to sodium wasting
(hyponatremia) and potassium retention (hyperkalemia).
6. A patient with SIADH is experiencing fluid volume excess. Which intervention
should the nurse include in the plan of care?
A. Encourage fluid intake up to 3 liters per day
B. Administer Desmopressin (DDAVP)
C. Increase sodium intake via oral salt tablets only
D. Implement a fluid restriction of 800-1000 mL per day
Answer: D
Rationale: SIADH involves excessive ADH, leading to water retention. Fluid restriction is
the primary treatment to prevent further dilution of sodium.
7. Which clinical manifestation is a hallmark sign of Diabetes Insipidus (DI)?
A. Excessive thirst and dilute urine
B. High urine specific gravity
C. Peripheral edema and hypertension
D. Elevated blood glucose levels
Answer: A
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria of very
dilute urine and compensatory polydipsia (excessive thirst).
8. A patient is diagnosed with Cushing’s Syndrome. Which physical assessment
finding is consistent with this diagnosis?
A. Hyperpigmentation of the skin
B. Truncal obesity and moon face
C. Thin, wasted appearance of the trunk
D. Weight loss and hypotension
Answer: B
