NRSG 201 Exam 3 V1 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 3) | Ivy Tech
1. A nurse is caring for a client with Diabetes Insipidus (DI). Which assessment finding should
the nurse anticipate?
A. Urine output of 30 mL/hr
B. Serum sodium of 130 mEq/L
C. Urine specific gravity of 1.002
D. Weight gain of 2 kg in 24 hours
Correct Answer: C
Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone (ADH),
leading to the inability of the kidneys to concentrate urine. This results in the excretion of
large volumes of dilute urine with a very low specific gravity, typically between 1.001 and
1.005. The nurse must monitor for signs of dehydration and hypernatremia due to the
excessive water loss.
2. A client is being treated for an Addisonian Crisis. Which of the following provider orders
should the nurse prioritize?
A. Rapid intravenous infusion of 0.9% Normal Saline
B. Administer oral fludrocortisone
,C. Initiate a low-potassium diet
D. Perform daily weights
Correct Answer: A
An Addisonian Crisis is a life-threatening emergency characterized by severe hypotension,
hyponatremia, and hyperkalemia. Rapid fluid resuscitation with 0.9% Normal Saline is the
priority to restore circulating volume and stabilize blood pressure. Hydrocortisone will
also be administered intravenously to replace missing glucocorticoids.
3. Which clinical manifestation is a hallmark sign of Cushing’s Syndrome?
A. Hyperpigmentation of the skin
B. Truncal obesity and a buffalo hump
C. Weight loss and anorexia
D. Hypoglycemia and hypotension
Correct Answer: B
Cushing’s Syndrome results from an excess of cortisol, which leads to a redistribution of
fat to the trunk, face, and upper back. This creates the classic appearance of truncal obesity,
a ‘moon face,’ and a ‘buffalo hump’ on the neck. Hyperpigmentation is more commonly
associated with Addison’s disease due to high ACTH levels.
, 4. A nurse is monitoring a client receiving a blood transfusion. After 15 minutes, the client
reports back pain and dyspnea. What is the first action the nurse should take?
A. Stop the transfusion immediately
B. Notify the healthcare provider
C. Slow the infusion rate
D. Administer diphenhydramine
Correct Answer: A
Back pain and dyspnea are indicative of an acute hemolytic transfusion reaction, which is
a medical emergency. The nurse’s immediate priority is to stop the transfusion to prevent
further exposure to the incompatible blood. After stopping the infusion, the nurse should
maintain the IV line with normal saline and notify the provider and blood bank.
5. What is the primary goal of treatment for a client in the oliguric phase of Acute Kidney
Injury (AKI)?
A. Encourage fluid intake of 3,000 mL/day
B. Increase protein intake to 2g/kg
C. Maintain fluid and electrolyte balance
D. Promote heavy weight-bearing exercise
Correct Answer: C
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 3) | Ivy Tech
1. A nurse is caring for a client with Diabetes Insipidus (DI). Which assessment finding should
the nurse anticipate?
A. Urine output of 30 mL/hr
B. Serum sodium of 130 mEq/L
C. Urine specific gravity of 1.002
D. Weight gain of 2 kg in 24 hours
Correct Answer: C
Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone (ADH),
leading to the inability of the kidneys to concentrate urine. This results in the excretion of
large volumes of dilute urine with a very low specific gravity, typically between 1.001 and
1.005. The nurse must monitor for signs of dehydration and hypernatremia due to the
excessive water loss.
2. A client is being treated for an Addisonian Crisis. Which of the following provider orders
should the nurse prioritize?
A. Rapid intravenous infusion of 0.9% Normal Saline
B. Administer oral fludrocortisone
,C. Initiate a low-potassium diet
D. Perform daily weights
Correct Answer: A
An Addisonian Crisis is a life-threatening emergency characterized by severe hypotension,
hyponatremia, and hyperkalemia. Rapid fluid resuscitation with 0.9% Normal Saline is the
priority to restore circulating volume and stabilize blood pressure. Hydrocortisone will
also be administered intravenously to replace missing glucocorticoids.
3. Which clinical manifestation is a hallmark sign of Cushing’s Syndrome?
A. Hyperpigmentation of the skin
B. Truncal obesity and a buffalo hump
C. Weight loss and anorexia
D. Hypoglycemia and hypotension
Correct Answer: B
Cushing’s Syndrome results from an excess of cortisol, which leads to a redistribution of
fat to the trunk, face, and upper back. This creates the classic appearance of truncal obesity,
a ‘moon face,’ and a ‘buffalo hump’ on the neck. Hyperpigmentation is more commonly
associated with Addison’s disease due to high ACTH levels.
, 4. A nurse is monitoring a client receiving a blood transfusion. After 15 minutes, the client
reports back pain and dyspnea. What is the first action the nurse should take?
A. Stop the transfusion immediately
B. Notify the healthcare provider
C. Slow the infusion rate
D. Administer diphenhydramine
Correct Answer: A
Back pain and dyspnea are indicative of an acute hemolytic transfusion reaction, which is
a medical emergency. The nurse’s immediate priority is to stop the transfusion to prevent
further exposure to the incompatible blood. After stopping the infusion, the nurse should
maintain the IV line with normal saline and notify the provider and blood bank.
5. What is the primary goal of treatment for a client in the oliguric phase of Acute Kidney
Injury (AKI)?
A. Encourage fluid intake of 3,000 mL/day
B. Increase protein intake to 2g/kg
C. Maintain fluid and electrolyte balance
D. Promote heavy weight-bearing exercise
Correct Answer: C
