NU 185 Exam 3 Medical-Surgical Nursing II 2026 Galen College
1. A patient with cirrhosis has a high ammonia level and is exhibiting confusion.
Which medication should the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to lower ammonia levels in patients with hepatic
encephalopathy by promoting ammonia excretion through the stool.
2. The nurse is assessing a patient with acute pancreatitis. Which physical
finding is known as Cullen’s sign?
A. Pain with palpation of the RUQ
B. Bluish discoloration around the umbilicus
C. Bruising in the flank area
D. Pain when the foot is dorsiflexed
Answer: B
Rationale: Cullen’s sign is a superficial bluish discoloration around the umbilicus,
indicating intra-abdominal hemorrhage often associated with pancreatitis.
,3. A patient is admitted with suspected cholecystitis. Where does the patient
typically experience pain?
A. Left upper quadrant radiating to the back
B. Left lower quadrant radiating to the groin
C. Right upper quadrant radiating to the right shoulder
D. Periumbilical area radiating to the RLQ
Answer: C
Rationale: Cholecystitis pain is typically located in the RUQ and often radiates to the right
scapula or shoulder.
4. Following a liver biopsy, how should the nurse position the patient?
A. Supine with the head of the bed elevated 45 degrees
B. Left side-lying with a pillow under the abdomen
C. Right side-lying to provide pressure to the site
D. Prone with a small pillow under the diaphragm
Answer: C
Rationale: After a liver biopsy, the patient is placed on the right side to apply pressure to
the puncture site and prevent hemorrhage.
5. Which transmission-based precaution is necessary for a patient with Hepatitis
A?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation
D. Standard precautions (unless incontinent, then Contact)
Answer: D
Rationale: Hepatitis A is transmitted via the fecal-oral route. Standard precautions are
used, but if the patient is incontinent of stool, contact precautions are required.
, 6. A patient with diabetes insipidus (DI) is expected to have which of the
following lab findings?
A. Low urine specific gravity
B. Low serum sodium
C. High urine specific gravity
D. Elevated blood glucose
Answer: A
Rationale: DI results in a deficiency of ADH, leading to the excretion of large amounts of
dilute urine with a low specific gravity (usually < 1.005).
7. A patient is exhibiting Trousseau’s sign after a thyroidectomy. This is
indicative of which electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Trousseau’s sign (carpal spasm induced by inflating a BP cuff) is a classic sign of
hypocalcemia, often caused by accidental parathyroid gland removal during thyroid
surgery.
8. Which clinical manifestation is a hallmark of Cushing’s Syndrome?
A. Bronze skin pigmentation
B. Moon face and buffalo hump
C. Weight loss and hypotension
D. Exophthalmos
Answer: B
Rationale: Cushing’s Syndrome is characterized by cortisol excess, leading to adipose
tissue redistribution (moon face, buffalo hump, and trunkal obesity).
1. A patient with cirrhosis has a high ammonia level and is exhibiting confusion.
Which medication should the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to lower ammonia levels in patients with hepatic
encephalopathy by promoting ammonia excretion through the stool.
2. The nurse is assessing a patient with acute pancreatitis. Which physical
finding is known as Cullen’s sign?
A. Pain with palpation of the RUQ
B. Bluish discoloration around the umbilicus
C. Bruising in the flank area
D. Pain when the foot is dorsiflexed
Answer: B
Rationale: Cullen’s sign is a superficial bluish discoloration around the umbilicus,
indicating intra-abdominal hemorrhage often associated with pancreatitis.
,3. A patient is admitted with suspected cholecystitis. Where does the patient
typically experience pain?
A. Left upper quadrant radiating to the back
B. Left lower quadrant radiating to the groin
C. Right upper quadrant radiating to the right shoulder
D. Periumbilical area radiating to the RLQ
Answer: C
Rationale: Cholecystitis pain is typically located in the RUQ and often radiates to the right
scapula or shoulder.
4. Following a liver biopsy, how should the nurse position the patient?
A. Supine with the head of the bed elevated 45 degrees
B. Left side-lying with a pillow under the abdomen
C. Right side-lying to provide pressure to the site
D. Prone with a small pillow under the diaphragm
Answer: C
Rationale: After a liver biopsy, the patient is placed on the right side to apply pressure to
the puncture site and prevent hemorrhage.
5. Which transmission-based precaution is necessary for a patient with Hepatitis
A?
A. Airborne precautions
B. Droplet precautions
C. Protective isolation
D. Standard precautions (unless incontinent, then Contact)
Answer: D
Rationale: Hepatitis A is transmitted via the fecal-oral route. Standard precautions are
used, but if the patient is incontinent of stool, contact precautions are required.
, 6. A patient with diabetes insipidus (DI) is expected to have which of the
following lab findings?
A. Low urine specific gravity
B. Low serum sodium
C. High urine specific gravity
D. Elevated blood glucose
Answer: A
Rationale: DI results in a deficiency of ADH, leading to the excretion of large amounts of
dilute urine with a low specific gravity (usually < 1.005).
7. A patient is exhibiting Trousseau’s sign after a thyroidectomy. This is
indicative of which electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Trousseau’s sign (carpal spasm induced by inflating a BP cuff) is a classic sign of
hypocalcemia, often caused by accidental parathyroid gland removal during thyroid
surgery.
8. Which clinical manifestation is a hallmark of Cushing’s Syndrome?
A. Bronze skin pigmentation
B. Moon face and buffalo hump
C. Weight loss and hypotension
D. Exophthalmos
Answer: B
Rationale: Cushing’s Syndrome is characterized by cortisol excess, leading to adipose
tissue redistribution (moon face, buffalo hump, and trunkal obesity).
