NUR 253 FINAL EXAM
COMPREHENSIVE REVIEW QUESTIONS
& ANSWERS (VERIFIED ANSWERS)
WITH EXPERT EXPLANATIONS | 2026 –
2027 UPDATE (PDF) GALEN COLLEGE
OF NURSING
1. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 850 mg/dL. Which order
should the nurse prioritize first?
A. Intravenous administration of 10 units of regular insulin
B. Infusion of 0.9% normal saline at 1000 mL/hr
C. Potassium replacement protocol initiation
D. Hourly fingerstick glucose monitoring
Answer: B
Conceptual Explanation: Fluid resuscitation is the immediate priority in DKA to restore
circulatory volume and renal perfusion before insulin administration.
,2. Which clinical manifestation is a hallmark sign of Hyperosmolar Hyperglycemic Syndrome
(HHS) that distinguishes it from DKA?
A. Kussmaul respirations
B. Absence of significant ketosis
C. Fruity breath odor
D. Metabolic acidosis
Answer: B
Conceptual Explanation: HHS is characterized by profound hyperglycemia and
dehydration without the significant ketoacidosis seen in DKA.
3. Interpret the following ABG: pH 7.30, PaCO2 55, HCO3 28.
A. Uncompensated respiratory acidosis
B. Partially compensated metabolic acidosis
C. Fully compensated metabolic alkalosis
D. Partially compensated respiratory acidosis
Answer: D
Conceptual Explanation: The pH is acidic, PaCO2 is high (acidic), and HCO3 is high
(basic/compensating). Because the pH is not within normal range, it is partially
compensated.
, 4. A patient’s Central Venous Pressure (CVP) is measured at 1 mmHg. What is the nurse’s
primary concern?
A. Fluid volume overload
B. Right-sided heart failure
C. Cardiac tamponade
D. Hypovolemia
Answer: D
Conceptual Explanation: Normal CVP is 2-8 mmHg. A low CVP (1 mmHg) indicates
reduced venous return and hypovolemia.
5. Which hemodynamic parameter is the best indicator of left ventricular end-diastolic
pressure (LVEDP)?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Central Venous Pressure (CVP)
C. Mean Arterial Pressure (MAP)
D. Cardiac Output (CO)
Answer: A
Conceptual Explanation: PAWP (or PCWP) reflects left atrial pressure and is the clinical
surrogate for left ventricular end-diastolic pressure.
COMPREHENSIVE REVIEW QUESTIONS
& ANSWERS (VERIFIED ANSWERS)
WITH EXPERT EXPLANATIONS | 2026 –
2027 UPDATE (PDF) GALEN COLLEGE
OF NURSING
1. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 850 mg/dL. Which order
should the nurse prioritize first?
A. Intravenous administration of 10 units of regular insulin
B. Infusion of 0.9% normal saline at 1000 mL/hr
C. Potassium replacement protocol initiation
D. Hourly fingerstick glucose monitoring
Answer: B
Conceptual Explanation: Fluid resuscitation is the immediate priority in DKA to restore
circulatory volume and renal perfusion before insulin administration.
,2. Which clinical manifestation is a hallmark sign of Hyperosmolar Hyperglycemic Syndrome
(HHS) that distinguishes it from DKA?
A. Kussmaul respirations
B. Absence of significant ketosis
C. Fruity breath odor
D. Metabolic acidosis
Answer: B
Conceptual Explanation: HHS is characterized by profound hyperglycemia and
dehydration without the significant ketoacidosis seen in DKA.
3. Interpret the following ABG: pH 7.30, PaCO2 55, HCO3 28.
A. Uncompensated respiratory acidosis
B. Partially compensated metabolic acidosis
C. Fully compensated metabolic alkalosis
D. Partially compensated respiratory acidosis
Answer: D
Conceptual Explanation: The pH is acidic, PaCO2 is high (acidic), and HCO3 is high
(basic/compensating). Because the pH is not within normal range, it is partially
compensated.
, 4. A patient’s Central Venous Pressure (CVP) is measured at 1 mmHg. What is the nurse’s
primary concern?
A. Fluid volume overload
B. Right-sided heart failure
C. Cardiac tamponade
D. Hypovolemia
Answer: D
Conceptual Explanation: Normal CVP is 2-8 mmHg. A low CVP (1 mmHg) indicates
reduced venous return and hypovolemia.
5. Which hemodynamic parameter is the best indicator of left ventricular end-diastolic
pressure (LVEDP)?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Central Venous Pressure (CVP)
C. Mean Arterial Pressure (MAP)
D. Cardiac Output (CO)
Answer: A
Conceptual Explanation: PAWP (or PCWP) reflects left atrial pressure and is the clinical
surrogate for left ventricular end-diastolic pressure.
