NU 155 Final Exam Medical-Surgical
Nursing I (2026) PDF | Galen
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Rationales 2026\2027 update
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A patient is admitted with severe vomiting and has a serum
potassium level of 3.0 mEq/L. Which assessment finding should the
nurse anticipate?
A. Hyperactive deep tendon reflexes
B. Decreased deep tendon reflexes
C. Increased peristalsis
D. Elevated blood pressure
Correct Answer: B. Decreased deep tendon reflexes
Rationale: Hypokalemia (low potassium) causes muscle weakness
and decreased or absent deep tendon reflexes. Hyperactive reflexes
are seen in hyperkalemia. Peristalsis decreases, leading to
hypoactive bowel sounds, and blood pressure typically drops due to
decreased vascular tone.
The nurse is reviewing the laboratory results for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH). Which
finding would the nurse expect?
A. Serum sodium of 120 mEq/L
B. Serum sodium of 150 mEq/L
C. Urine specific gravity of 1.002
D. Serum osmolality of 310 mOsm/kg
Correct Answer: A. Serum sodium of 120 mEq/L
Rationale: SIADH causes excessive water retention, leading to
dilutional hyponatremia (low serum sodium) and decreased serum
osmolality. Urine specific gravity is high (concentrated) rather than
dilute.
, A patient with a history of heart failure is admitted with shortness of
breath and a new prescription of 40 mg IV furosemide. Which
electrolyte imbalance is the patient most at risk for developing?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes the kidneys to
excrete potassium along with water and sodium. Therefore, patients
on loop diuretics are at high risk for hypokalemia.
The nurse is assessing a patient with arterial blood gas (ABG)
results: pH 7.32, PaCO2 48 mmHg, HCO3 24 mEq/L. Which
condition do these results indicate?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale: The pH is low (acidosis), and the PaCO2 is high (greater
than 45 mmHg), indicating a respiratory cause. The bicarbonate
level is normal, indicating no compensation has occurred yet.
A patient with a serum potassium level of 6.8 mEq/L is receiving
regular insulin and 50% dextrose IV. What is the primary reason for
administering this combination?
A. To force potassium out of the cells
B. To force potassium into the cells
C. To increase renal excretion of potassium
D. To prevent cardiac arrhythmias by blocking potassium channels
Correct Answer: B. To force potassium into the cells
Nursing I (2026) PDF | Galen
Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
A patient is admitted with severe vomiting and has a serum
potassium level of 3.0 mEq/L. Which assessment finding should the
nurse anticipate?
A. Hyperactive deep tendon reflexes
B. Decreased deep tendon reflexes
C. Increased peristalsis
D. Elevated blood pressure
Correct Answer: B. Decreased deep tendon reflexes
Rationale: Hypokalemia (low potassium) causes muscle weakness
and decreased or absent deep tendon reflexes. Hyperactive reflexes
are seen in hyperkalemia. Peristalsis decreases, leading to
hypoactive bowel sounds, and blood pressure typically drops due to
decreased vascular tone.
The nurse is reviewing the laboratory results for a patient with
syndrome of inappropriate antidiuretic hormone (SIADH). Which
finding would the nurse expect?
A. Serum sodium of 120 mEq/L
B. Serum sodium of 150 mEq/L
C. Urine specific gravity of 1.002
D. Serum osmolality of 310 mOsm/kg
Correct Answer: A. Serum sodium of 120 mEq/L
Rationale: SIADH causes excessive water retention, leading to
dilutional hyponatremia (low serum sodium) and decreased serum
osmolality. Urine specific gravity is high (concentrated) rather than
dilute.
, A patient with a history of heart failure is admitted with shortness of
breath and a new prescription of 40 mg IV furosemide. Which
electrolyte imbalance is the patient most at risk for developing?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes the kidneys to
excrete potassium along with water and sodium. Therefore, patients
on loop diuretics are at high risk for hypokalemia.
The nurse is assessing a patient with arterial blood gas (ABG)
results: pH 7.32, PaCO2 48 mmHg, HCO3 24 mEq/L. Which
condition do these results indicate?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale: The pH is low (acidosis), and the PaCO2 is high (greater
than 45 mmHg), indicating a respiratory cause. The bicarbonate
level is normal, indicating no compensation has occurred yet.
A patient with a serum potassium level of 6.8 mEq/L is receiving
regular insulin and 50% dextrose IV. What is the primary reason for
administering this combination?
A. To force potassium out of the cells
B. To force potassium into the cells
C. To increase renal excretion of potassium
D. To prevent cardiac arrhythmias by blocking potassium channels
Correct Answer: B. To force potassium into the cells
