NU 185 Exam 2 | Medical-Surgical Nursing II | (2026) Study Guide
Galen College
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is found
unresponsive. The fingerstick glucose is 48 mg/dL. Which action should the
nurse take first?
A. Administer 15g of oral glucose gel
B. Administer 1 mg of glucagon intramuscularly
C. Provide 4 ounces of orange juice
D. Recheck the blood glucose in 15 minutes
Answer: B
Rationale: Because the client is unresponsive and cannot swallow safely, intramuscular
glucagon or IV dextrose is the priority to raise blood glucose quickly.
2. Which laboratory value is the most reliable indicator of long-term glycemic
control in a client with diabetes?
A. Fasting blood glucose
B. Postprandial glucose
C. Urine ketones
D. Glycosylated hemoglobin (HbA1c)
Answer: D
Rationale: HbA1c reflects average blood glucose levels over the previous 2 to 3 months by
measuring the amount of glucose attached to hemoglobin.
,3. A client is diagnosed with Diabetic Ketoacidosis (DKA). Which clinical
manifestation should the nurse expect to find?
A. Bradycardia
B. Kussmaul respirations
C. Increased blood pressure
D. Peripheral edema
Answer: B
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to compensate for metabolic acidosis by blowing off CO2.
4. The nurse is educating a client starting Metformin. Which instruction is most
important regarding diagnostic tests?
A. Take the medication with a high-fat meal
B. Stop the medication 48 hours before and after any procedure using iodine contrast dye
C. Monitor for weight gain as a common side effect
D. Limit fluid intake to 1 liter per day
Answer: B
Rationale: Metformin must be held before and after contrast dye to prevent acute renal
failure and lactic acidosis.
5. A client with Hyperosmolar Hyperglycemic State (HHS) is admitted. What is
the primary difference between HHS and DKA?
A. HHS involves significant ketosis
B. HHS is characterized by extreme hyperglycemia without significant ketosis
C. DKA occurs primarily in Type 2 Diabetes
D. DKA has a higher mortality rate than HHS
Answer: B
Rationale: HHS usually occurs in Type 2 diabetics who have enough insulin to prevent
ketosis but not enough to prevent severe hyperglycemia and dehydration.
, 6. Which insulin type has the quickest onset of action and should be given when
the tray is in front of the client?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin lispro
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered immediately before eating.
7. A nurse is caring for a client post-thyroidectomy. Which piece of equipment is
most critical to have at the bedside?
A. Tracheostomy tray
B. Incentive spirometer
C. Heating pad
D. Sequential compression devices
Answer: A
Rationale: Post-thyroidectomy carries a risk of airway obstruction due to edema or
hematoma; a tracheostomy tray must be available for emergencies.
8. A client presents with a ‘butterfly rash’ across the nose and cheeks. Which
condition does the nurse suspect?
A. Rheumatoid arthritis
B. Systemic Lupus Erythematosus (SLE)
C. Scleroderma
D. Psoriasis
Answer: B
Rationale: The butterfly rash (malar rash) is a classic hallmark sign of Systemic Lupus
Erythematosus.
Galen College
1. A nurse is caring for a client with Type 1 Diabetes Mellitus who is found
unresponsive. The fingerstick glucose is 48 mg/dL. Which action should the
nurse take first?
A. Administer 15g of oral glucose gel
B. Administer 1 mg of glucagon intramuscularly
C. Provide 4 ounces of orange juice
D. Recheck the blood glucose in 15 minutes
Answer: B
Rationale: Because the client is unresponsive and cannot swallow safely, intramuscular
glucagon or IV dextrose is the priority to raise blood glucose quickly.
2. Which laboratory value is the most reliable indicator of long-term glycemic
control in a client with diabetes?
A. Fasting blood glucose
B. Postprandial glucose
C. Urine ketones
D. Glycosylated hemoglobin (HbA1c)
Answer: D
Rationale: HbA1c reflects average blood glucose levels over the previous 2 to 3 months by
measuring the amount of glucose attached to hemoglobin.
,3. A client is diagnosed with Diabetic Ketoacidosis (DKA). Which clinical
manifestation should the nurse expect to find?
A. Bradycardia
B. Kussmaul respirations
C. Increased blood pressure
D. Peripheral edema
Answer: B
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to compensate for metabolic acidosis by blowing off CO2.
4. The nurse is educating a client starting Metformin. Which instruction is most
important regarding diagnostic tests?
A. Take the medication with a high-fat meal
B. Stop the medication 48 hours before and after any procedure using iodine contrast dye
C. Monitor for weight gain as a common side effect
D. Limit fluid intake to 1 liter per day
Answer: B
Rationale: Metformin must be held before and after contrast dye to prevent acute renal
failure and lactic acidosis.
5. A client with Hyperosmolar Hyperglycemic State (HHS) is admitted. What is
the primary difference between HHS and DKA?
A. HHS involves significant ketosis
B. HHS is characterized by extreme hyperglycemia without significant ketosis
C. DKA occurs primarily in Type 2 Diabetes
D. DKA has a higher mortality rate than HHS
Answer: B
Rationale: HHS usually occurs in Type 2 diabetics who have enough insulin to prevent
ketosis but not enough to prevent severe hyperglycemia and dehydration.
, 6. Which insulin type has the quickest onset of action and should be given when
the tray is in front of the client?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin lispro
Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered immediately before eating.
7. A nurse is caring for a client post-thyroidectomy. Which piece of equipment is
most critical to have at the bedside?
A. Tracheostomy tray
B. Incentive spirometer
C. Heating pad
D. Sequential compression devices
Answer: A
Rationale: Post-thyroidectomy carries a risk of airway obstruction due to edema or
hematoma; a tracheostomy tray must be available for emergencies.
8. A client presents with a ‘butterfly rash’ across the nose and cheeks. Which
condition does the nurse suspect?
A. Rheumatoid arthritis
B. Systemic Lupus Erythematosus (SLE)
C. Scleroderma
D. Psoriasis
Answer: B
Rationale: The butterfly rash (malar rash) is a classic hallmark sign of Systemic Lupus
Erythematosus.
