NUR 253 FINAL EXAM REVIEW (2026 /
2027) QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING
1. A patient presents with a pH of 7.28, a PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
with a normal HCO3 indicates the primary cause is respiratory, leading to respiratory
acidosis.
,2. When assessing a patient with chronic kidney disease (CKD), the nurse notes peaked T-
waves on the EKG. Which electrolyte imbalance is most likely?
A. Hypocalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
Answer: C
Conceptual Explanation: Hyperkalemia (high potassium) causes characteristic EKG
changes including peaked T-waves, which can progress to cardiac arrest if untreated.
3. A client is prescribed Digoxin 0.25mg PO daily. Which assessment finding should lead the
nurse to withhold the medication and notify the provider?
A. Blood pressure of 140/90 mmHg
B. Heart rate of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.5 mEq/L
Answer: B
Conceptual Explanation: Digoxin is a cardiac glycoside that slows heart rate. It should be
withheld if the heart rate is less than 60 bpm in adults to prevent bradycardia.
, 4. Which clinical manifestation is a hallmark sign of Diabetic Ketoacidosis (DKA) but not
typically found in Hyperosmolar Hyperglycemic State (HHS)?
A. Extreme dehydration
B. Kussmaul respirations
C. Blood glucose > 600 mg/dL
D. Altered mental status
Answer: B
Conceptual Explanation: Kussmaul respirations (rapid, deep breathing) are a
compensatory mechanism for metabolic acidosis caused by ketones in DKA. HHS typically
lacks significant ketosis.
5. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. What is the priority action?
A. Assess for Chvostek’s sign
B. Administer an analgesic for post-op pain
C. Check the surgical dressing for bleeding
D. Encourage the patient to cough and deep breathe
Answer: A
2027) QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING
1. A patient presents with a pH of 7.28, a PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
with a normal HCO3 indicates the primary cause is respiratory, leading to respiratory
acidosis.
,2. When assessing a patient with chronic kidney disease (CKD), the nurse notes peaked T-
waves on the EKG. Which electrolyte imbalance is most likely?
A. Hypocalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
Answer: C
Conceptual Explanation: Hyperkalemia (high potassium) causes characteristic EKG
changes including peaked T-waves, which can progress to cardiac arrest if untreated.
3. A client is prescribed Digoxin 0.25mg PO daily. Which assessment finding should lead the
nurse to withhold the medication and notify the provider?
A. Blood pressure of 140/90 mmHg
B. Heart rate of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.5 mEq/L
Answer: B
Conceptual Explanation: Digoxin is a cardiac glycoside that slows heart rate. It should be
withheld if the heart rate is less than 60 bpm in adults to prevent bradycardia.
, 4. Which clinical manifestation is a hallmark sign of Diabetic Ketoacidosis (DKA) but not
typically found in Hyperosmolar Hyperglycemic State (HHS)?
A. Extreme dehydration
B. Kussmaul respirations
C. Blood glucose > 600 mg/dL
D. Altered mental status
Answer: B
Conceptual Explanation: Kussmaul respirations (rapid, deep breathing) are a
compensatory mechanism for metabolic acidosis caused by ketones in DKA. HHS typically
lacks significant ketosis.
5. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. What is the priority action?
A. Assess for Chvostek’s sign
B. Administer an analgesic for post-op pain
C. Check the surgical dressing for bleeding
D. Encourage the patient to cough and deep breathe
Answer: A
