NUR 242 MED-SURG EXAM 3 -
ADVANCED ASSESSMENT AND
MANAGEMENT QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with Diabetic Ketoacidosis (DKA) is receiving a continuous insulin infusion. The
most recent potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Continue the insulin infusion as ordered and recheck the level in 2 hours.
B. Stop the insulin infusion and notify the healthcare provider immediately.
C. Administer a potassium supplement as ordered before continuing insulin.
D. Increase the IV fluid rate to dilute the serum glucose levels.
Answer: B
Conceptual Explanation: Insulin shifts potassium into the cells. If the potassium is already
low (below 3.3 mEq/L), continuing insulin can lead to life-threatening hypokalemia. The
infusion should be held until potassium is replaced.
,2. A client is diagnosed with Pheochromocytoma. Which assessment finding is most critical
for the nurse to monitor?
A. Hyperglycemia and weight loss
B. Hypotension and bradycardia
C. Abdominal pain and constipation
D. Severe headache and hypertension
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The hallmark symptoms are severe hypertension, pounding headache,
and tachycardia due to excessive epinephrine and norepinephrine.
3. A patient in the diuretic phase of Acute Kidney Injury (AKI) is producing 4 liters of urine per
day. Which electrolyte imbalance is the highest priority for the nurse to monitor?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypernatremia
D. Hypokalemia
Answer: D
, Conceptual Explanation: In the diuretic phase of AKI, the kidneys begin to excrete large
volumes of fluid, but the tubules cannot yet concentrate urine. This leads to massive loss of
fluids and electrolytes, particularly potassium and sodium.
4. Which laboratory result is the most sensitive indicator of acute pancreatitis?
A. Serum Amylase
B. Serum Calcium
C. White Blood Cell Count
D. Serum Lipase
Answer: D
Conceptual Explanation: Serum lipase is more specific and remains elevated longer than
amylase in cases of acute pancreatitis, making it a better diagnostic marker.
5. A patient with Chronic Kidney Disease (CKD) has a serum potassium of 6.8 mEq/L and EKG
changes including peaked T waves. Which medication should the nurse anticipate
administering first to protect the heart?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate (Kayexalate)
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Answer: A
ADVANCED ASSESSMENT AND
MANAGEMENT QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with Diabetic Ketoacidosis (DKA) is receiving a continuous insulin infusion. The
most recent potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Continue the insulin infusion as ordered and recheck the level in 2 hours.
B. Stop the insulin infusion and notify the healthcare provider immediately.
C. Administer a potassium supplement as ordered before continuing insulin.
D. Increase the IV fluid rate to dilute the serum glucose levels.
Answer: B
Conceptual Explanation: Insulin shifts potassium into the cells. If the potassium is already
low (below 3.3 mEq/L), continuing insulin can lead to life-threatening hypokalemia. The
infusion should be held until potassium is replaced.
,2. A client is diagnosed with Pheochromocytoma. Which assessment finding is most critical
for the nurse to monitor?
A. Hyperglycemia and weight loss
B. Hypotension and bradycardia
C. Abdominal pain and constipation
D. Severe headache and hypertension
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The hallmark symptoms are severe hypertension, pounding headache,
and tachycardia due to excessive epinephrine and norepinephrine.
3. A patient in the diuretic phase of Acute Kidney Injury (AKI) is producing 4 liters of urine per
day. Which electrolyte imbalance is the highest priority for the nurse to monitor?
A. Hypermagnesemia
B. Hyperkalemia
C. Hypernatremia
D. Hypokalemia
Answer: D
, Conceptual Explanation: In the diuretic phase of AKI, the kidneys begin to excrete large
volumes of fluid, but the tubules cannot yet concentrate urine. This leads to massive loss of
fluids and electrolytes, particularly potassium and sodium.
4. Which laboratory result is the most sensitive indicator of acute pancreatitis?
A. Serum Amylase
B. Serum Calcium
C. White Blood Cell Count
D. Serum Lipase
Answer: D
Conceptual Explanation: Serum lipase is more specific and remains elevated longer than
amylase in cases of acute pancreatitis, making it a better diagnostic marker.
5. A patient with Chronic Kidney Disease (CKD) has a serum potassium of 6.8 mEq/L and EKG
changes including peaked T waves. Which medication should the nurse anticipate
administering first to protect the heart?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate (Kayexalate)
C. Regular Insulin and Dextrose
D. Furosemide (Lasix)
Answer: A
