NSG430 Exam 2 V3 | NSG 430 Adult Health
Nursing II | Grand Canyon University
1. A nurse is caring for a patient with prerenal acute kidney injury (AKI). Which of the
following conditions most likely contributed to this diagnosis?
A. Kidney stones causing obstruction
B. Gentamicin toxicity
C. Severe dehydration due to vomiting
D. Acute glomerulonephritis
Answer: C
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, leading to
decreased renal blood flow. Severe dehydration decreases cardiac output and perfusion to
the kidneys. The nurse must focus on fluid resuscitation to restore renal function.
2. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which provider order should the nurse implement first?
A. Administer sodium polystyrene sulfonate
B. Prepare the patient for hemodialysis
C. Initiate a low-potassium diet
D. Administer IV calcium gluconate
,Answer: D
Rationale: Calcium gluconate is administered to stabilize the myocardial cell membrane
and prevent life-threatening arrhythmias. While other treatments like dialysis or
Kayexalate lower potassium, they do not provide immediate cardiac protection. The nurse
must monitor the EKG continuously during administration.
3. Which clinical manifestation is expected in a patient diagnosed with Cushing’s Syndrome?
A. Weight loss and hypotension
B. Hyperkalemia and hyponatremia
C. Increased skin pigmentation
D. Trunkal obesity and moon face
Answer: D
Rationale: Cushing’s Syndrome results from an excess of corticosteroids, leading to
redistribution of fat. This typically manifests as trunkal obesity, a ‘buffalo hump,’ and a
rounded ‘moon’ face. The nurse should also monitor for hyperglycemia and hypertension in
these patients.
4. A patient is receiving Total Parenteral Nutrition (TPN) via a central line. The nurse notes the
bag is nearly empty, but the new bag has not arrived from the pharmacy. What is the priority
action?
A. Flush the line with heparin and wait
B. Hang 10% dextrose in water (D10W)
, C. Slow the current infusion rate to 10 mL/hr
D. Disconnect the tubing and cap the line
Answer: B
Rationale: To prevent rebound hypoglycemia when TPN is interrupted, the nurse should
hang D10W at the same rate. Sudden cessation of high-glucose concentrations in TPN can
cause the pancreas to continue secreting insulin, dropping blood sugar. The nurse must
also monitor blood glucose every 4 to 6 hours.
5. A patient with Peptic Ulcer Disease (PUD) reports sudden, severe abdominal pain that
radiates to the shoulder. The abdomen is rigid and board-like. What complication does the
nurse suspect?
A. Gastric outlet obstruction
B. Perforation
C. Upper GI hemorrhage
D. Dumping syndrome
Answer: B
Rationale: A rigid, board-like abdomen is a hallmark sign of peritonitis following a GI
perforation. Perforation is a surgical emergency where gastric contents leak into the
peritoneal cavity. The nurse should immediately notify the provider and prepare for
potential surgery.
Nursing II | Grand Canyon University
1. A nurse is caring for a patient with prerenal acute kidney injury (AKI). Which of the
following conditions most likely contributed to this diagnosis?
A. Kidney stones causing obstruction
B. Gentamicin toxicity
C. Severe dehydration due to vomiting
D. Acute glomerulonephritis
Answer: C
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, leading to
decreased renal blood flow. Severe dehydration decreases cardiac output and perfusion to
the kidneys. The nurse must focus on fluid resuscitation to restore renal function.
2. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which provider order should the nurse implement first?
A. Administer sodium polystyrene sulfonate
B. Prepare the patient for hemodialysis
C. Initiate a low-potassium diet
D. Administer IV calcium gluconate
,Answer: D
Rationale: Calcium gluconate is administered to stabilize the myocardial cell membrane
and prevent life-threatening arrhythmias. While other treatments like dialysis or
Kayexalate lower potassium, they do not provide immediate cardiac protection. The nurse
must monitor the EKG continuously during administration.
3. Which clinical manifestation is expected in a patient diagnosed with Cushing’s Syndrome?
A. Weight loss and hypotension
B. Hyperkalemia and hyponatremia
C. Increased skin pigmentation
D. Trunkal obesity and moon face
Answer: D
Rationale: Cushing’s Syndrome results from an excess of corticosteroids, leading to
redistribution of fat. This typically manifests as trunkal obesity, a ‘buffalo hump,’ and a
rounded ‘moon’ face. The nurse should also monitor for hyperglycemia and hypertension in
these patients.
4. A patient is receiving Total Parenteral Nutrition (TPN) via a central line. The nurse notes the
bag is nearly empty, but the new bag has not arrived from the pharmacy. What is the priority
action?
A. Flush the line with heparin and wait
B. Hang 10% dextrose in water (D10W)
, C. Slow the current infusion rate to 10 mL/hr
D. Disconnect the tubing and cap the line
Answer: B
Rationale: To prevent rebound hypoglycemia when TPN is interrupted, the nurse should
hang D10W at the same rate. Sudden cessation of high-glucose concentrations in TPN can
cause the pancreas to continue secreting insulin, dropping blood sugar. The nurse must
also monitor blood glucose every 4 to 6 hours.
5. A patient with Peptic Ulcer Disease (PUD) reports sudden, severe abdominal pain that
radiates to the shoulder. The abdomen is rigid and board-like. What complication does the
nurse suspect?
A. Gastric outlet obstruction
B. Perforation
C. Upper GI hemorrhage
D. Dumping syndrome
Answer: B
Rationale: A rigid, board-like abdomen is a hallmark sign of peritonitis following a GI
perforation. Perforation is a surgical emergency where gastric contents leak into the
peritoneal cavity. The nurse should immediately notify the provider and prepare for
potential surgery.
