NUR 210 ADVANCED MED-SURG EXAM
4 QUESTIONS AND ANSWERS 2026/2027
1. A patient is admitted with a suspected diagnosis of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result would the nurse expect to find?
A. Hypokalemia
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 120 mEq/L
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia. A serum sodium of 120 mEq/L is characteristic. The
serum osmolality would be low, and urine specific gravity would be high.
2. A patient with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
assessment finding indicates the medication is effective?
A. Increased serum sodium
B. Decreased urine specific gravity
C. Increased pulse rate
,D. Decreased urine output
Answer: D
Conceptual Explanation: Desmopressin is a synthetic form of ADH. Effectiveness is
indicated by decreased urine output and increased urine specific gravity as the kidneys
retain more water.
3. In the management of Diabetic Ketoacidosis (DKA), which intervention is the absolute
priority during the first hour of treatment?
A. Intravenous insulin bolus
B. Bicarbonate infusion for pH < 7.0
C. Potassium replacement
D. 0.9% Normal Saline rapid infusion
Answer: D
Conceptual Explanation: Fluid resuscitation is the first priority in DKA to restore
circulatory volume and perfusion. Insulin is typically started after fluid resuscitation has
begun.
4. A patient with Hyperosmolar Hyperglycemic State (HHS) differs from DKA in that HHS
typically presents with:
A. Kussmaul respirations
B. Positive ketones in the urine
, C. A blood glucose level exceeding 600 mg/dL
D. Metabolic acidosis
Answer: C
Conceptual Explanation: HHS is characterized by extreme hyperglycemia (often >600
mg/dL) and profound dehydration without the significant ketoacidosis or Kussmaul
respirations seen in DKA.
5. Which clinical manifestation is considered a medical emergency in a patient with Grave’s
Disease?
A. Hyperthermia and tachycardia
B. Exophthalmos
C. Weight loss of 5 lbs
D. Pretibial myxedema
Answer: A
Conceptual Explanation: Hyperthermia (fever) and severe tachycardia are signs of
Thyroid Storm (thyrotoxic crisis), a life-threatening complication of hyperthyroidism.
6. Following a thyroidectomy, a patient develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse have available?
A. Potassium chloride
B. Levothyroxine
4 QUESTIONS AND ANSWERS 2026/2027
1. A patient is admitted with a suspected diagnosis of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result would the nurse expect to find?
A. Hypokalemia
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 120 mEq/L
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia. A serum sodium of 120 mEq/L is characteristic. The
serum osmolality would be low, and urine specific gravity would be high.
2. A patient with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
assessment finding indicates the medication is effective?
A. Increased serum sodium
B. Decreased urine specific gravity
C. Increased pulse rate
,D. Decreased urine output
Answer: D
Conceptual Explanation: Desmopressin is a synthetic form of ADH. Effectiveness is
indicated by decreased urine output and increased urine specific gravity as the kidneys
retain more water.
3. In the management of Diabetic Ketoacidosis (DKA), which intervention is the absolute
priority during the first hour of treatment?
A. Intravenous insulin bolus
B. Bicarbonate infusion for pH < 7.0
C. Potassium replacement
D. 0.9% Normal Saline rapid infusion
Answer: D
Conceptual Explanation: Fluid resuscitation is the first priority in DKA to restore
circulatory volume and perfusion. Insulin is typically started after fluid resuscitation has
begun.
4. A patient with Hyperosmolar Hyperglycemic State (HHS) differs from DKA in that HHS
typically presents with:
A. Kussmaul respirations
B. Positive ketones in the urine
, C. A blood glucose level exceeding 600 mg/dL
D. Metabolic acidosis
Answer: C
Conceptual Explanation: HHS is characterized by extreme hyperglycemia (often >600
mg/dL) and profound dehydration without the significant ketoacidosis or Kussmaul
respirations seen in DKA.
5. Which clinical manifestation is considered a medical emergency in a patient with Grave’s
Disease?
A. Hyperthermia and tachycardia
B. Exophthalmos
C. Weight loss of 5 lbs
D. Pretibial myxedema
Answer: A
Conceptual Explanation: Hyperthermia (fever) and severe tachycardia are signs of
Thyroid Storm (thyrotoxic crisis), a life-threatening complication of hyperthyroidism.
6. Following a thyroidectomy, a patient develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse have available?
A. Potassium chloride
B. Levothyroxine
