NUR 253 EXAM 3 COMPREHENSIVE
REVIEW QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING (2026/2027)
1. A patient with Type 1 Diabetes presents with fruity breath, Kussmaul respirations, and a
blood glucose of 580 mg/dL. Which acid-base imbalance is most likely present?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: Diabetic Ketoacidosis (DKA) results in the accumulation of
ketones, which are acidic, leading to a decrease in serum pH and bicarbonate, characteristic
of metabolic acidosis. Kussmaul respirations are a compensatory mechanism to blow off
CO2.
,2. Which of the following clinical manifestations is a hallmark sign of Syndrome of
Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum osmolality 310 mOsm/kg
B. Serum sodium 128 mEq/L
C. Urine specific gravity 1.002
D. Polyuria and polydipsia
Answer: B
Conceptual Explanation: SIADH involves excessive ADH, causing water retention and
dilutional hyponatremia. A serum sodium of 128 mEq/L (normal 135-145) reflects this
hemodilution.
3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte abnormality should be the nurse’s highest priority?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
, Conceptual Explanation: During the oliguric phase of AKI, the kidneys are unable to
excrete potassium, leading to hyperkalemia, which can cause life-threatening cardiac
arrhythmias.
4. A patient diagnosed with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
finding indicates the medication is effective?
A. Increased serum sodium
B. Decreased urine specific gravity
C. Decreased urine output
D. Weight loss of 2 kg in 24 hours
Answer: C
Conceptual Explanation: DDAVP is a synthetic form of ADH. In DI, patients have excessive
dilute urine output; therefore, effective treatment will lead to increased water reabsorption
and decreased urine volume.
5. Which assessment finding in a patient with a spinal cord injury at T4 suggests the
development of Autonomic Dysreflexia?
A. Flaccid paralysis below the level of injury
B. Tachycardia and hypotension
C. Pounding headache and BP 210/110
D. Cool, dry skin above the level of injury
REVIEW QUESTIONS & VERIFIED
ANSWERS (A+ GUARANTEE) | GALEN
COLLEGE OF NURSING (2026/2027)
1. A patient with Type 1 Diabetes presents with fruity breath, Kussmaul respirations, and a
blood glucose of 580 mg/dL. Which acid-base imbalance is most likely present?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: Diabetic Ketoacidosis (DKA) results in the accumulation of
ketones, which are acidic, leading to a decrease in serum pH and bicarbonate, characteristic
of metabolic acidosis. Kussmaul respirations are a compensatory mechanism to blow off
CO2.
,2. Which of the following clinical manifestations is a hallmark sign of Syndrome of
Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum osmolality 310 mOsm/kg
B. Serum sodium 128 mEq/L
C. Urine specific gravity 1.002
D. Polyuria and polydipsia
Answer: B
Conceptual Explanation: SIADH involves excessive ADH, causing water retention and
dilutional hyponatremia. A serum sodium of 128 mEq/L (normal 135-145) reflects this
hemodilution.
3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte abnormality should be the nurse’s highest priority?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
, Conceptual Explanation: During the oliguric phase of AKI, the kidneys are unable to
excrete potassium, leading to hyperkalemia, which can cause life-threatening cardiac
arrhythmias.
4. A patient diagnosed with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
finding indicates the medication is effective?
A. Increased serum sodium
B. Decreased urine specific gravity
C. Decreased urine output
D. Weight loss of 2 kg in 24 hours
Answer: C
Conceptual Explanation: DDAVP is a synthetic form of ADH. In DI, patients have excessive
dilute urine output; therefore, effective treatment will lead to increased water reabsorption
and decreased urine volume.
5. Which assessment finding in a patient with a spinal cord injury at T4 suggests the
development of Autonomic Dysreflexia?
A. Flaccid paralysis below the level of injury
B. Tachycardia and hypotension
C. Pounding headache and BP 210/110
D. Cool, dry skin above the level of injury
