GALEN NUR 242 MED-SURG EXAM 3:
COMPREHENSIVE RENAL AND
ENDOCRINE ASSESSMENT QUESTIONS
AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
prescribed intervention should the nurse implement first to protect the patient from life-
threatening arrhythmias?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally.
B. Administer regular insulin and 50% dextrose intravenously.
C. Prepare the patient for urgent hemodialysis.
D. Administer intravenous calcium gluconate.
Answer: D
Conceptual Explanation: While insulin/dextrose and dialysis lower potassium,
intravenous calcium gluconate is the priority to stabilize the myocardial cell membrane and
prevent lethal arrhythmias in the setting of severe hyperkalemia.
2. Which clinical manifestation would the nurse expect to find in a patient diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Dilutional hyponatremia and fluid retention.
,B. Low urine specific gravity and polyuria.
C. Increased serum osmolality and hypernatremia.
D. Weight loss and clinical signs of dehydration.
Answer: A
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
reabsorption in the kidneys, which results in dilutional hyponatremia, high urine specific
gravity, and fluid volume excess.
3. A patient is in the diuretic phase of Acute Kidney Injury (AKI). Which complication is the
highest priority for the nurse to monitor?
A. Hypovolemia and electrolyte imbalance.
B. Metabolic acidosis.
C. Hypervolemia and pulmonary edema.
D. Acute nephrolithiasis.
Answer: A
Conceptual Explanation: During the diuretic phase, the kidneys can excrete waste but
cannot concentrate urine. This leads to massive fluid loss (up to 5L/day), putting the
patient at risk for dehydration and hypokalemia.
, 4. A patient presents with a ‘moon face,’ truncal obesity, and a ‘buffalo hump.’ Which
laboratory result is most consistent with these findings?
A. Hypercortisolism.
B. Hyperkalemia.
C. Hypoglycemia.
D. Hyponatremia.
Answer: A
Conceptual Explanation: These are classic signs of Cushing’s Syndrome, which is caused
by an excess of corticosteroids, particularly cortisol.
5. A patient post-Transurethral Resection of the Prostate (TURP) is receiving Continuous
Bladder Irrigation (CBI). The nurse notes the return is bright red with numerous clots. What is
the nurse’s priority action?
A. Manually irrigate the catheter with 30 mL of sterile saline.
B. Stop the irrigation and notify the surgeon.
C. Decrease the rate to prevent bladder spasms.
D. Increase the rate of the irrigation flow.
Answer: D
COMPREHENSIVE RENAL AND
ENDOCRINE ASSESSMENT QUESTIONS
AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
prescribed intervention should the nurse implement first to protect the patient from life-
threatening arrhythmias?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally.
B. Administer regular insulin and 50% dextrose intravenously.
C. Prepare the patient for urgent hemodialysis.
D. Administer intravenous calcium gluconate.
Answer: D
Conceptual Explanation: While insulin/dextrose and dialysis lower potassium,
intravenous calcium gluconate is the priority to stabilize the myocardial cell membrane and
prevent lethal arrhythmias in the setting of severe hyperkalemia.
2. Which clinical manifestation would the nurse expect to find in a patient diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Dilutional hyponatremia and fluid retention.
,B. Low urine specific gravity and polyuria.
C. Increased serum osmolality and hypernatremia.
D. Weight loss and clinical signs of dehydration.
Answer: A
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
reabsorption in the kidneys, which results in dilutional hyponatremia, high urine specific
gravity, and fluid volume excess.
3. A patient is in the diuretic phase of Acute Kidney Injury (AKI). Which complication is the
highest priority for the nurse to monitor?
A. Hypovolemia and electrolyte imbalance.
B. Metabolic acidosis.
C. Hypervolemia and pulmonary edema.
D. Acute nephrolithiasis.
Answer: A
Conceptual Explanation: During the diuretic phase, the kidneys can excrete waste but
cannot concentrate urine. This leads to massive fluid loss (up to 5L/day), putting the
patient at risk for dehydration and hypokalemia.
, 4. A patient presents with a ‘moon face,’ truncal obesity, and a ‘buffalo hump.’ Which
laboratory result is most consistent with these findings?
A. Hypercortisolism.
B. Hyperkalemia.
C. Hypoglycemia.
D. Hyponatremia.
Answer: A
Conceptual Explanation: These are classic signs of Cushing’s Syndrome, which is caused
by an excess of corticosteroids, particularly cortisol.
5. A patient post-Transurethral Resection of the Prostate (TURP) is receiving Continuous
Bladder Irrigation (CBI). The nurse notes the return is bright red with numerous clots. What is
the nurse’s priority action?
A. Manually irrigate the catheter with 30 mL of sterile saline.
B. Stop the irrigation and notify the surgeon.
C. Decrease the rate to prevent bladder spasms.
D. Increase the rate of the irrigation flow.
Answer: D
