,NU 157/NU157 Exam 3 – Medical-Surgical Nursing
I-A – Actual Q&A (GCN) (Updated PDF)
1. A patient with a small bowel obstruction has abdominal distention and
nausea. What is the priority nursing intervention?
A) Insert a nasogastric tube to decompress the bowel
B) Administer an antiemetic
C) Encourage oral fluids
D) Notify the healthcare provider
Correct Answer: A) Insert a nasogastric tube to decompress the bowel
Rationale: NG tube decompression relieves pressure and reduces the risk of
perforation in small bowel obstruction. Oral fluids are withheld, and antiemetics
may be used later. Provider notification follows but decompression is the
priority.
2. A patient with nephrotic syndrome would most likely exhibit which finding?
A) Smoky or cola-colored urine
B) Periorbital edema
C) Hypertension
D) Oliguria
Correct Answer: B) Periorbital edema
,Rationale: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia,
and edema. Periorbital edema is a classic early finding. Smoky urine is more
typical of glomerulonephritis.
3. A patient with diabetes has a blood glucose of 450 mg/dL, serum ketones
positive, and arterial pH of 7.25. The nurse recognizes this as:
A) Hyperglycemic hyperosmolar state
B) Hypoglycemia
C) Diabetic ketoacidosis
D) Lactic acidosis
Correct Answer: C) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic
acidosis with a pH below 7.3. HHS has severe hyperglycemia without significant
ketosis or acidosis. Hypoglycemia and lactic acidosis do not fit the findings.
4. A patient on furosemide should be monitored for which electrolyte
imbalance?
A) Hyperkalemia
B) Hyponatremia
C) Hypercalcemia
D) Hypokalemia
Correct Answer: D) Hypokalemia
, Rationale: Furosemide is a loop diuretic that promotes potassium excretion,
causing hypokalemia. Hypokalemia increases the risk of dysrhythmias and
digoxin toxicity.
5. Which finding indicates digoxin toxicity?
A) Yellow-green halos around lights
B) Hypertension
C) Hyperglycemia
D) Polyuria
Correct Answer: A) Yellow-green halos around lights
Rationale: Visual disturbances, especially yellow-green halos, are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, and bradycardia. The
medication should be held and the provider notified.
6. Which insulin has an onset of 5–15 minutes and a peak of 1 hour?
A) NPH
B) Lispro
C) Regular
D) Glargine
Correct Answer: B) Lispro
Rationale: Lispro is rapid-acting with an onset of 5–15 minutes and a peak of
about 1 hour. It is given around mealtime. NPH and glargine have longer onsets.
I-A – Actual Q&A (GCN) (Updated PDF)
1. A patient with a small bowel obstruction has abdominal distention and
nausea. What is the priority nursing intervention?
A) Insert a nasogastric tube to decompress the bowel
B) Administer an antiemetic
C) Encourage oral fluids
D) Notify the healthcare provider
Correct Answer: A) Insert a nasogastric tube to decompress the bowel
Rationale: NG tube decompression relieves pressure and reduces the risk of
perforation in small bowel obstruction. Oral fluids are withheld, and antiemetics
may be used later. Provider notification follows but decompression is the
priority.
2. A patient with nephrotic syndrome would most likely exhibit which finding?
A) Smoky or cola-colored urine
B) Periorbital edema
C) Hypertension
D) Oliguria
Correct Answer: B) Periorbital edema
,Rationale: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia,
and edema. Periorbital edema is a classic early finding. Smoky urine is more
typical of glomerulonephritis.
3. A patient with diabetes has a blood glucose of 450 mg/dL, serum ketones
positive, and arterial pH of 7.25. The nurse recognizes this as:
A) Hyperglycemic hyperosmolar state
B) Hypoglycemia
C) Diabetic ketoacidosis
D) Lactic acidosis
Correct Answer: C) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic
acidosis with a pH below 7.3. HHS has severe hyperglycemia without significant
ketosis or acidosis. Hypoglycemia and lactic acidosis do not fit the findings.
4. A patient on furosemide should be monitored for which electrolyte
imbalance?
A) Hyperkalemia
B) Hyponatremia
C) Hypercalcemia
D) Hypokalemia
Correct Answer: D) Hypokalemia
, Rationale: Furosemide is a loop diuretic that promotes potassium excretion,
causing hypokalemia. Hypokalemia increases the risk of dysrhythmias and
digoxin toxicity.
5. Which finding indicates digoxin toxicity?
A) Yellow-green halos around lights
B) Hypertension
C) Hyperglycemia
D) Polyuria
Correct Answer: A) Yellow-green halos around lights
Rationale: Visual disturbances, especially yellow-green halos, are classic signs of
digoxin toxicity. Other signs include nausea, vomiting, and bradycardia. The
medication should be held and the provider notified.
6. Which insulin has an onset of 5–15 minutes and a peak of 1 hour?
A) NPH
B) Lispro
C) Regular
D) Glargine
Correct Answer: B) Lispro
Rationale: Lispro is rapid-acting with an onset of 5–15 minutes and a peak of
about 1 hour. It is given around mealtime. NPH and glargine have longer onsets.
