GALEN NUR 242 MED-SURG EXAM 3 -
ADVANCED NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) is in the diuretic phase. Which finding is the nurse
most concerned about?
A. Urine output of 4 L/day
B. Serum potassium of 6.2 mEq/L
C. Serum sodium of 128 mEq/L
D. Blood Pressure of 150/90 mmHg
Answer: C
Conceptual Explanation: In the diuretic phase of AKI, the patient loses massive amounts
of water and electrolytes. Hyponatremia and hypokalemia are common risks due to
dilution and loss; however, severe hyponatremia (128) can lead to seizures and
neurological collapse, making it a critical concern alongside the risk of dehydration.
2. Which clinical manifestation should the nurse anticipate in a patient experiencing a Thyroid
Storm?
A. Bradycardia and constipation
,B. Hypoventilation and cold intolerance
C. Hyperthermia and systolic hypertension
D. Lethargy and muffled heart sounds
Answer: C
Conceptual Explanation: Thyroid storm is an extreme state of hyperthyroidism. Key
features include severe tachycardia, hyperthermia (fever), systolic hypertension, and
agitation/delirium.
3. A patient with Chronic Kidney Disease (CKD) receives Sevelamer. What is the primary
purpose of this medication?
A. To decrease serum phosphorus levels
B. To increase serum calcium levels
C. To stimulate erythropoietin production
D. To lower systemic blood pressure
Answer: A
Conceptual Explanation: Sevelamer is a phosphate binder used in CKD to prevent
phosphorus absorption from food, as the kidneys can no longer effectively excrete it.
4. A patient is admitted with suspected Diabetic Ketoacidosis (DKA). Which arterial blood gas
result is most consistent with this diagnosis?
A. pH 7.48, PaCO2 48, HCO3 28
, B. pH 7.28, PaCO2 30, HCO3 16
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.25, PaCO2 50, HCO3 24
Answer: B
Conceptual Explanation: DKA results in metabolic acidosis with respiratory
compensation (Kussmaul breathing). Option A shows a low pH and low bicarbonate,
indicating metabolic acidosis, with a low PaCO2 suggesting partial compensation.
5. The nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. Which action is the priority?
A. Check the patient’s temperature
B. Assess for Chvostek’s sign
C. Administer a dose of levothyroxine
D. Encourage the patient to cough and deep breathe
Answer: B
Conceptual Explanation: Tingling (paresthesia) after a thyroidectomy suggests
hypocalcemia due to accidental parathyroid gland removal or damage. Assessing
Chvostek’s sign helps confirm tetany.
ADVANCED NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) is in the diuretic phase. Which finding is the nurse
most concerned about?
A. Urine output of 4 L/day
B. Serum potassium of 6.2 mEq/L
C. Serum sodium of 128 mEq/L
D. Blood Pressure of 150/90 mmHg
Answer: C
Conceptual Explanation: In the diuretic phase of AKI, the patient loses massive amounts
of water and electrolytes. Hyponatremia and hypokalemia are common risks due to
dilution and loss; however, severe hyponatremia (128) can lead to seizures and
neurological collapse, making it a critical concern alongside the risk of dehydration.
2. Which clinical manifestation should the nurse anticipate in a patient experiencing a Thyroid
Storm?
A. Bradycardia and constipation
,B. Hypoventilation and cold intolerance
C. Hyperthermia and systolic hypertension
D. Lethargy and muffled heart sounds
Answer: C
Conceptual Explanation: Thyroid storm is an extreme state of hyperthyroidism. Key
features include severe tachycardia, hyperthermia (fever), systolic hypertension, and
agitation/delirium.
3. A patient with Chronic Kidney Disease (CKD) receives Sevelamer. What is the primary
purpose of this medication?
A. To decrease serum phosphorus levels
B. To increase serum calcium levels
C. To stimulate erythropoietin production
D. To lower systemic blood pressure
Answer: A
Conceptual Explanation: Sevelamer is a phosphate binder used in CKD to prevent
phosphorus absorption from food, as the kidneys can no longer effectively excrete it.
4. A patient is admitted with suspected Diabetic Ketoacidosis (DKA). Which arterial blood gas
result is most consistent with this diagnosis?
A. pH 7.48, PaCO2 48, HCO3 28
, B. pH 7.28, PaCO2 30, HCO3 16
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.25, PaCO2 50, HCO3 24
Answer: B
Conceptual Explanation: DKA results in metabolic acidosis with respiratory
compensation (Kussmaul breathing). Option A shows a low pH and low bicarbonate,
indicating metabolic acidosis, with a low PaCO2 suggesting partial compensation.
5. The nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. Which action is the priority?
A. Check the patient’s temperature
B. Assess for Chvostek’s sign
C. Administer a dose of levothyroxine
D. Encourage the patient to cough and deep breathe
Answer: B
Conceptual Explanation: Tingling (paresthesia) after a thyroidectomy suggests
hypocalcemia due to accidental parathyroid gland removal or damage. Assessing
Chvostek’s sign helps confirm tetany.
