NU 185
Exam 4 Medical-Surgical Nursing II
Exam 4 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
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,NU 185 Exam 4 Medical-Surgical Nursing II 2026/2027 UPDATE – Galen
1. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which of the
following arterial blood gas results is most consistent with this diagnosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 23
C. pH 7.30, PaCO2 40, HCO3 18
D. pH 7.50, PaCO2 45, HCO3 32
Answer: C
Rationale: DKA causes metabolic acidosis due to the accumulation of ketones. pH < 7.35
and HCO3 < 22 indicate metabolic acidosis.
2. A nurse is assessing a patient who had a kidney transplant 48 hours ago. Which finding
requires immediate notification of the healthcare provider?
A. A sudden decrease in urine output
B. Tenderness over the graft site
C. Incisional pain rated 4/10
D. Serum creatinine of 1.2 mg/dL
Answer: A
, Rationale: Sudden oliguria or anuria after a kidney transplant is a sign of potential
rejection, thrombosis, or obstruction and is a medical emergency.
3. Which clinical manifestation is a hallmark sign of hepatic encephalopathy in a patient with
cirrhosis?
A. Caput medusae
B. Asterixis
C. Splenomegaly
D. Spider angiomas
Answer: B
Rationale: Asterixis, also known as ‘flapping tremors’ of the hands, is a classic sign of
hepatic encephalopathy due to elevated ammonia levels.
4. Using the Parkland formula, calculate the total fluid requirement for the first 24 hours for a
70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 8,400 mL
C. 22,400 mL
D. 11,200 mL
Answer: D
Rationale: Parkland formula: 4 mL x weight (kg) x % TBSA. So, 4 x 70 x 40 = 11,200 mL.
Exam 4 Medical-Surgical Nursing II
Exam 4 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Exam 4 Medical-Surgical Nursing II 2026/2027 UPDATE – Galen
1. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which of the
following arterial blood gas results is most consistent with this diagnosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 23
C. pH 7.30, PaCO2 40, HCO3 18
D. pH 7.50, PaCO2 45, HCO3 32
Answer: C
Rationale: DKA causes metabolic acidosis due to the accumulation of ketones. pH < 7.35
and HCO3 < 22 indicate metabolic acidosis.
2. A nurse is assessing a patient who had a kidney transplant 48 hours ago. Which finding
requires immediate notification of the healthcare provider?
A. A sudden decrease in urine output
B. Tenderness over the graft site
C. Incisional pain rated 4/10
D. Serum creatinine of 1.2 mg/dL
Answer: A
, Rationale: Sudden oliguria or anuria after a kidney transplant is a sign of potential
rejection, thrombosis, or obstruction and is a medical emergency.
3. Which clinical manifestation is a hallmark sign of hepatic encephalopathy in a patient with
cirrhosis?
A. Caput medusae
B. Asterixis
C. Splenomegaly
D. Spider angiomas
Answer: B
Rationale: Asterixis, also known as ‘flapping tremors’ of the hands, is a classic sign of
hepatic encephalopathy due to elevated ammonia levels.
4. Using the Parkland formula, calculate the total fluid requirement for the first 24 hours for a
70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 8,400 mL
C. 22,400 mL
D. 11,200 mL
Answer: D
Rationale: Parkland formula: 4 mL x weight (kg) x % TBSA. So, 4 x 70 x 40 = 11,200 mL.
