NU 185 Exam 3: Medical-Surgical Nursing II 2025 Galen College
1. A patient with Type 1 Diabetes presents with a blood glucose of 600 mg/dL,
ketones in the urine, and Kussmaul respirations. Which condition is the patient
likely experiencing?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperosmolar Hyperglycemic Syndrome (HHS)
D. Somogyi Effect
Answer: A
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis, often
presenting with Kussmaul respirations and fruity breath.
2. Which clinical manifestation is a hallmark sign of Grave’s Disease
(Hyperthyroidism)?
A. Weight gain
B. Bradycardia
C. Exophthalmos
D. Cold intolerance
Answer: C
Rationale: Exophthalmos (bulging eyes) is a classic finding in Grave’s disease due to
edema in the extraocular muscles and increased fatty tissue behind the eye.
,3. A nurse is caring for a patient with Addison’s disease. Which electrolyte
imbalance should the nurse monitor for?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypercalcemia
Answer: C
Rationale: Addison’s disease involves a lack of aldosterone, leading to sodium loss
(hyponatremia) and potassium retention (hyperkalemia).
4. What is the priority nursing intervention for a patient in a Myxedema Coma?
A. Administering rapid IV insulin
B. Applying cooling blankets
C. Maintaining a patent airway
D. Restricting oral fluids
Answer: C
Rationale: Myxedema coma is a life-threatening complication of hypothyroidism.
Maintaining an airway and respiratory support is the highest priority.
5. A patient with Cushing’s Syndrome is likely to exhibit which physical
characteristic?
A. Truncal obesity and buffalo hump
B. Sunken cheeks and weight loss
C. Bronze-colored skin
D. Hypotension
Answer: A
Rationale: Cushing’s syndrome results from excess cortisol, leading to fat redistribution
such as a buffalo hump, moon face, and truncal obesity.
, 6. Which medication should be held for 48 hours after a patient receives IV
contrast for a CT scan to prevent AKI?
A. Metformin
B. Lisinopril
C. Furosemide
D. Atorvastatin
Answer: A
Rationale: Metformin can interact with contrast media and lead to lactic acidosis; it must
be held prior to and for 48 hours after the procedure until renal function is confirmed.
7. A patient with Chronic Kidney Disease (CKD) has a high phosphorus level.
Which medication does the nurse expect to administer?
A. Epoetin Alfa
B. Spironolactone
C. Calcium Acetate (PhosLo)
D. Magnesium Hydroxide
Answer: C
Rationale: Phosphate binders like Calcium Acetate are given with meals to bind
phosphorus in the gut and prevent absorption in CKD patients.
8. During the oliguric phase of Acute Kidney Injury (AKI), the nurse should
monitor for which fluid-related complication?
A. Dehydration
B. Hypotension
C. Hypervolemia
D. Hypokalemia
Answer: C
Rationale: In the oliguric phase, urine output decreases significantly, leading to fluid
retention and hypervolemia (edema, hypertension).
1. A patient with Type 1 Diabetes presents with a blood glucose of 600 mg/dL,
ketones in the urine, and Kussmaul respirations. Which condition is the patient
likely experiencing?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperosmolar Hyperglycemic Syndrome (HHS)
D. Somogyi Effect
Answer: A
Rationale: DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis, often
presenting with Kussmaul respirations and fruity breath.
2. Which clinical manifestation is a hallmark sign of Grave’s Disease
(Hyperthyroidism)?
A. Weight gain
B. Bradycardia
C. Exophthalmos
D. Cold intolerance
Answer: C
Rationale: Exophthalmos (bulging eyes) is a classic finding in Grave’s disease due to
edema in the extraocular muscles and increased fatty tissue behind the eye.
,3. A nurse is caring for a patient with Addison’s disease. Which electrolyte
imbalance should the nurse monitor for?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypercalcemia
Answer: C
Rationale: Addison’s disease involves a lack of aldosterone, leading to sodium loss
(hyponatremia) and potassium retention (hyperkalemia).
4. What is the priority nursing intervention for a patient in a Myxedema Coma?
A. Administering rapid IV insulin
B. Applying cooling blankets
C. Maintaining a patent airway
D. Restricting oral fluids
Answer: C
Rationale: Myxedema coma is a life-threatening complication of hypothyroidism.
Maintaining an airway and respiratory support is the highest priority.
5. A patient with Cushing’s Syndrome is likely to exhibit which physical
characteristic?
A. Truncal obesity and buffalo hump
B. Sunken cheeks and weight loss
C. Bronze-colored skin
D. Hypotension
Answer: A
Rationale: Cushing’s syndrome results from excess cortisol, leading to fat redistribution
such as a buffalo hump, moon face, and truncal obesity.
, 6. Which medication should be held for 48 hours after a patient receives IV
contrast for a CT scan to prevent AKI?
A. Metformin
B. Lisinopril
C. Furosemide
D. Atorvastatin
Answer: A
Rationale: Metformin can interact with contrast media and lead to lactic acidosis; it must
be held prior to and for 48 hours after the procedure until renal function is confirmed.
7. A patient with Chronic Kidney Disease (CKD) has a high phosphorus level.
Which medication does the nurse expect to administer?
A. Epoetin Alfa
B. Spironolactone
C. Calcium Acetate (PhosLo)
D. Magnesium Hydroxide
Answer: C
Rationale: Phosphate binders like Calcium Acetate are given with meals to bind
phosphorus in the gut and prevent absorption in CKD patients.
8. During the oliguric phase of Acute Kidney Injury (AKI), the nurse should
monitor for which fluid-related complication?
A. Dehydration
B. Hypotension
C. Hypervolemia
D. Hypokalemia
Answer: C
Rationale: In the oliguric phase, urine output decreases significantly, leading to fluid
retention and hypervolemia (edema, hypertension).
