NU 185 Exam 2 | Medical-Surgical Nursing II | Galen Study Guide 2026
Galen College
1. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA).
Which of the following laboratory findings is most consistent with this
diagnosis?
A. Blood glucose 800 mg/dL, pH 7.45, negative ketones
B. Blood glucose 250 mg/dL, pH 7.28, positive ketones
C. Blood glucose 110 mg/dL, pH 7.35, bicarbonate 24 mEq/L
D. Blood glucose 600 mg/dL, pH 7.30, negative ketones
Answer: B
Rationale: DKA is characterized by hyperglycemia (usually >250), metabolic acidosis (pH
<7.30), and the presence of ketones in the blood and urine.
2. The nurse is caring for a patient with Hyperosmolar Hyperglycemic Syndrome
(HHS). What is the primary priority in the initial management of this patient?
A. Administering bicarbonate to correct acidosis
B. Administration of long-acting insulin
C. Fluid replacement with 0.9% Normal Saline
D. Initiating a potassium drip immediately
Answer: C
Rationale: The primary concern in HHS is severe dehydration. Fluid resuscitation is the
first priority to restore circulatory volume.
,3. A patient is scheduled for a CT scan with IV contrast. Which medication must
be held for 48 hours after the procedure to prevent renal failure?
A. Metformin
B. Furosemide
C. Lisinopril
D. Atorvastatin
Answer: A
Rationale: Metformin must be held before and for 48 hours after contrast studies to
prevent the risk of lactic acidosis if renal impairment occurs.
4. A patient presents with a Trousseau’s sign. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Trousseau’s sign (carpal spasm induced by inflating a BP cuff) and Chvostek’s
sign are classic indicators of hypocalcemia.
5. Which clinical manifestation is expected in a patient diagnosed with Cushing’s
Syndrome?
A. Weight loss and hypotension
B. Moon face and truncal obesity
C. Hyperpigmentation of the skin
D. Decreased blood glucose levels
Answer: B
Rationale: Cushing’s Syndrome involves an excess of cortisol, leading to truncal obesity,
moon face, and a buffalo hump.
, 6. A patient with Addison’s disease is being discharged. What is the most
important teaching point regarding their medication?
A. Take the medication only when feeling stressed
B. Stop the medication if you gain weight
C. Never abruptly discontinue the steroids
D. The medication should be taken on an empty stomach
Answer: C
Rationale: Abruptly stopping steroids in a patient with Addison’s can trigger an
Addisonian Crisis, which is a life-threatening emergency.
7. Which assessment finding is a hallmark sign of Diabetes Insipidus (DI)?
A. High urine specific gravity
B. Severe fluid volume excess
C. Large amounts of dilute urine
D. Hypotension and bradycardia
Answer: C
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria of very
dilute urine (low specific gravity).
8. A patient with SIADH is likely to exhibit which of the following electrolyte
patterns?
A. Hypernatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: D
Rationale: SIADH causes excessive water retention, which dilutes the blood, leading to
dilutional hyponatremia.
Galen College
1. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA).
Which of the following laboratory findings is most consistent with this
diagnosis?
A. Blood glucose 800 mg/dL, pH 7.45, negative ketones
B. Blood glucose 250 mg/dL, pH 7.28, positive ketones
C. Blood glucose 110 mg/dL, pH 7.35, bicarbonate 24 mEq/L
D. Blood glucose 600 mg/dL, pH 7.30, negative ketones
Answer: B
Rationale: DKA is characterized by hyperglycemia (usually >250), metabolic acidosis (pH
<7.30), and the presence of ketones in the blood and urine.
2. The nurse is caring for a patient with Hyperosmolar Hyperglycemic Syndrome
(HHS). What is the primary priority in the initial management of this patient?
A. Administering bicarbonate to correct acidosis
B. Administration of long-acting insulin
C. Fluid replacement with 0.9% Normal Saline
D. Initiating a potassium drip immediately
Answer: C
Rationale: The primary concern in HHS is severe dehydration. Fluid resuscitation is the
first priority to restore circulatory volume.
,3. A patient is scheduled for a CT scan with IV contrast. Which medication must
be held for 48 hours after the procedure to prevent renal failure?
A. Metformin
B. Furosemide
C. Lisinopril
D. Atorvastatin
Answer: A
Rationale: Metformin must be held before and for 48 hours after contrast studies to
prevent the risk of lactic acidosis if renal impairment occurs.
4. A patient presents with a Trousseau’s sign. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Trousseau’s sign (carpal spasm induced by inflating a BP cuff) and Chvostek’s
sign are classic indicators of hypocalcemia.
5. Which clinical manifestation is expected in a patient diagnosed with Cushing’s
Syndrome?
A. Weight loss and hypotension
B. Moon face and truncal obesity
C. Hyperpigmentation of the skin
D. Decreased blood glucose levels
Answer: B
Rationale: Cushing’s Syndrome involves an excess of cortisol, leading to truncal obesity,
moon face, and a buffalo hump.
, 6. A patient with Addison’s disease is being discharged. What is the most
important teaching point regarding their medication?
A. Take the medication only when feeling stressed
B. Stop the medication if you gain weight
C. Never abruptly discontinue the steroids
D. The medication should be taken on an empty stomach
Answer: C
Rationale: Abruptly stopping steroids in a patient with Addison’s can trigger an
Addisonian Crisis, which is a life-threatening emergency.
7. Which assessment finding is a hallmark sign of Diabetes Insipidus (DI)?
A. High urine specific gravity
B. Severe fluid volume excess
C. Large amounts of dilute urine
D. Hypotension and bradycardia
Answer: C
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria of very
dilute urine (low specific gravity).
8. A patient with SIADH is likely to exhibit which of the following electrolyte
patterns?
A. Hypernatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: D
Rationale: SIADH causes excessive water retention, which dilutes the blood, leading to
dilutional hyponatremia.
