NU 185 Exam 2: Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A nurse is caring for a patient with liver cirrhosis who is receiving lactulose.
Which finding indicates the medication is achieving its therapeutic effect?
A. Increase in blood pressure
B. Decrease in serum ammonia levels
C. Decrease in urine output
D. Increase in serum glucose levels
Answer: B
Rationale: Lactulose is an osmotic laxative used in cirrhosis to reduce serum ammonia
levels by trapping ammonia in the gut and expelling it through feces to prevent hepatic
encephalopathy.
2. Which assessment finding is most characteristic of a patient in the oliguric
phase of acute kidney injury (AKI)?
A. Urine output of 1500 mL/day
B. Urine output less than 400 mL/day
C. Serum creatinine decrease
D. Metabolic alkalosis
Answer: B
Rationale: The oliguric phase of AKI is characterized by a significant drop in urine output,
typically defined as less than 400 mL in 24 hours.
,3. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations
and a fruity breath odor. What is the priority nursing intervention?
A. Administering oral glucose gel
B. Applying a cooling blanket
C. Initiating intravenous fluid resuscitation
D. Administering subcutaneous glucagon
Answer: C
Rationale: These are signs of Diabetic Ketoacidosis (DKA). Dehydration is a major concern;
therefore, restoring fluid volume with IV normal saline is the priority.
4. A nurse is monitoring a patient post-thyroidectomy. Which sign would
indicate the accidental removal of the parathyroid glands?
A. Negative Babinski sign
B. Positive Chvostek’s sign
C. Hyporeflexia
D. Bradycardia
Answer: B
Rationale: Accidental parathyroid removal causes hypocalcemia. A positive Chvostek’s
sign (facial twitching when the facial nerve is tapped) is an indicator of low calcium.
5. A patient with chronic kidney disease (CKD) is prescribed erythropoietin.
What is the intended outcome of this therapy?
A. Increased serum calcium
B. Increased hemoglobin and hematocrit
C. Decreased serum potassium
D. Decreased blood urea nitrogen
Answer: B
Rationale: CKD patients often have anemia because the kidneys cannot produce enough
erythropoietin. Synthetic erythropoietin stimulates red blood cell production.
, 6. Which laboratory result is most specific for diagnosing acute pancreatitis?
A. Elevated serum lipase
B. Elevated serum amylase
C. Decreased white blood cell count
D. Elevated serum bilirubin
Answer: A
Rationale: While both amylase and lipase rise in pancreatitis, lipase is more specific to the
pancreas and stays elevated longer.
7. A patient is diagnosed with Cushing’s syndrome. Which physical assessment
finding should the nurse expect?
A. Hyperpigmentation of the skin
B. Weight loss and muscle wasting in the trunk
C. Hypotension and tachycardia
D. Truncal obesity and a ‘buffalo hump’
Answer: D
Rationale: Cushing’s syndrome is caused by excess cortisol, leading to fat redistribution to
the face (moon face), upper back (buffalo hump), and trunk.
8. What is the primary goal of medical management for a patient with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Fluid restriction
B. Increasing fluid intake to 3L/day
C. Administering vasopressin
D. Administering hypotonic IV fluids
Answer: A
Rationale: SIADH involves excessive ADH, causing water retention and hyponatremia.
Fluid restriction is the primary treatment to prevent further dilution of serum sodium.
College
1. A nurse is caring for a patient with liver cirrhosis who is receiving lactulose.
Which finding indicates the medication is achieving its therapeutic effect?
A. Increase in blood pressure
B. Decrease in serum ammonia levels
C. Decrease in urine output
D. Increase in serum glucose levels
Answer: B
Rationale: Lactulose is an osmotic laxative used in cirrhosis to reduce serum ammonia
levels by trapping ammonia in the gut and expelling it through feces to prevent hepatic
encephalopathy.
2. Which assessment finding is most characteristic of a patient in the oliguric
phase of acute kidney injury (AKI)?
A. Urine output of 1500 mL/day
B. Urine output less than 400 mL/day
C. Serum creatinine decrease
D. Metabolic alkalosis
Answer: B
Rationale: The oliguric phase of AKI is characterized by a significant drop in urine output,
typically defined as less than 400 mL in 24 hours.
,3. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations
and a fruity breath odor. What is the priority nursing intervention?
A. Administering oral glucose gel
B. Applying a cooling blanket
C. Initiating intravenous fluid resuscitation
D. Administering subcutaneous glucagon
Answer: C
Rationale: These are signs of Diabetic Ketoacidosis (DKA). Dehydration is a major concern;
therefore, restoring fluid volume with IV normal saline is the priority.
4. A nurse is monitoring a patient post-thyroidectomy. Which sign would
indicate the accidental removal of the parathyroid glands?
A. Negative Babinski sign
B. Positive Chvostek’s sign
C. Hyporeflexia
D. Bradycardia
Answer: B
Rationale: Accidental parathyroid removal causes hypocalcemia. A positive Chvostek’s
sign (facial twitching when the facial nerve is tapped) is an indicator of low calcium.
5. A patient with chronic kidney disease (CKD) is prescribed erythropoietin.
What is the intended outcome of this therapy?
A. Increased serum calcium
B. Increased hemoglobin and hematocrit
C. Decreased serum potassium
D. Decreased blood urea nitrogen
Answer: B
Rationale: CKD patients often have anemia because the kidneys cannot produce enough
erythropoietin. Synthetic erythropoietin stimulates red blood cell production.
, 6. Which laboratory result is most specific for diagnosing acute pancreatitis?
A. Elevated serum lipase
B. Elevated serum amylase
C. Decreased white blood cell count
D. Elevated serum bilirubin
Answer: A
Rationale: While both amylase and lipase rise in pancreatitis, lipase is more specific to the
pancreas and stays elevated longer.
7. A patient is diagnosed with Cushing’s syndrome. Which physical assessment
finding should the nurse expect?
A. Hyperpigmentation of the skin
B. Weight loss and muscle wasting in the trunk
C. Hypotension and tachycardia
D. Truncal obesity and a ‘buffalo hump’
Answer: D
Rationale: Cushing’s syndrome is caused by excess cortisol, leading to fat redistribution to
the face (moon face), upper back (buffalo hump), and trunk.
8. What is the primary goal of medical management for a patient with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Fluid restriction
B. Increasing fluid intake to 3L/day
C. Administering vasopressin
D. Administering hypotonic IV fluids
Answer: A
Rationale: SIADH involves excessive ADH, causing water retention and hyponatremia.
Fluid restriction is the primary treatment to prevent further dilution of serum sodium.
