GALEN NUR 242 MEDICAL-SURGICAL
EXAM 3: ENDOCRINE, RENAL, AND
HEMATOLOGY. EXAM QUESTIONS
AND ANSWERS
1. A patient with Diabetes Insipidus (DI) is receiving vasopressin. Which assessment finding
indicates the medication is effective?
A. Urine output of 400 mL/hr
B. Increased serum sodium levels
C. Urine specific gravity of 1.015
D. Decreased body weight
Answer: C
Conceptual Explanation: Vasopressin acts as ADH, increasing water reabsorption. A
specific gravity of 1.015 is within normal limits, indicating the urine is becoming more
concentrated, which is the desired effect in DI.
2. Which electrolyte imbalance should a nurse monitor for in a patient diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Hyponatremia
,B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: A
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
blood, leading to dilutional hyponatremia.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes Kussmaul
respirations. What is the physiological purpose of this breathing pattern?
A. To increase oxygen saturation
B. To reduce the workload of the heart
C. To expel carbon dioxide and reduce acidosis
D. To compensate for metabolic alkalosis
Answer: C
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that the body
uses to blow off CO2 to compensate for metabolic acidosis.
4. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
provider order should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally
B. Give IV regular insulin and 50% dextrose
, C. Obtain a 12-lead EKG
D. Place the patient on a low-potassium diet
Answer: C
Conceptual Explanation: Hyperkalemia can cause life-threatening arrhythmias. Assessing
the heart rhythm with an EKG is the priority to determine the severity of the cardiac effect.
5. Which clinical manifestation is expected in a patient experiencing an Addisonian Crisis?
A. Hypoglycemia
B. Hypertension
C. Hypervolemia
D. Hypokalemia
Answer: A
Conceptual Explanation: Addisonian crisis involves acute adrenal insufficiency, leading to
severe hypoglycemia, hypotension, and hyperkalemia due to lack of cortisol and
aldosterone.
6. A patient post-thyroidectomy develops tingling in the fingers and a positive Chvostek’s
sign. Which medication should the nurse have available?
A. Potassium chloride
B. Sodium bicarbonate
C. Calcium gluconate
EXAM 3: ENDOCRINE, RENAL, AND
HEMATOLOGY. EXAM QUESTIONS
AND ANSWERS
1. A patient with Diabetes Insipidus (DI) is receiving vasopressin. Which assessment finding
indicates the medication is effective?
A. Urine output of 400 mL/hr
B. Increased serum sodium levels
C. Urine specific gravity of 1.015
D. Decreased body weight
Answer: C
Conceptual Explanation: Vasopressin acts as ADH, increasing water reabsorption. A
specific gravity of 1.015 is within normal limits, indicating the urine is becoming more
concentrated, which is the desired effect in DI.
2. Which electrolyte imbalance should a nurse monitor for in a patient diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Hyponatremia
,B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: A
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
blood, leading to dilutional hyponatremia.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes Kussmaul
respirations. What is the physiological purpose of this breathing pattern?
A. To increase oxygen saturation
B. To reduce the workload of the heart
C. To expel carbon dioxide and reduce acidosis
D. To compensate for metabolic alkalosis
Answer: C
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that the body
uses to blow off CO2 to compensate for metabolic acidosis.
4. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
provider order should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally
B. Give IV regular insulin and 50% dextrose
, C. Obtain a 12-lead EKG
D. Place the patient on a low-potassium diet
Answer: C
Conceptual Explanation: Hyperkalemia can cause life-threatening arrhythmias. Assessing
the heart rhythm with an EKG is the priority to determine the severity of the cardiac effect.
5. Which clinical manifestation is expected in a patient experiencing an Addisonian Crisis?
A. Hypoglycemia
B. Hypertension
C. Hypervolemia
D. Hypokalemia
Answer: A
Conceptual Explanation: Addisonian crisis involves acute adrenal insufficiency, leading to
severe hypoglycemia, hypotension, and hyperkalemia due to lack of cortisol and
aldosterone.
6. A patient post-thyroidectomy develops tingling in the fingers and a positive Chvostek’s
sign. Which medication should the nurse have available?
A. Potassium chloride
B. Sodium bicarbonate
C. Calcium gluconate
