NURl 170/l NUR170l Examl 1l –l Conceptsl
ofl Medical-l Surgicall Nursingl Guide|l
Galenl
(Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Hypocalcemial
Answer:
Causes-l Inadequatel intake,l malabsorption,l calciuml loss,
Inadequatel intake:l Calciuml andl Vitl D
Malabsorption:l Post-menopausall women,l diseasesl thatl affectl thel smalll bowel,l drugsl
(anticonvulsants)
Calciuml Loss:l Loopl Diuretics
Others:l Renall failure,l hypoparathyroidism,l lowl magnesium,l multiplel bloodl transfusions,l
alkalosis,l lowl albuminl levels
S/S:l Anxiety,l irritability,l confusion,l paresthesial (l numbness/tingling)l ofl toes,l fingers,l
face,l aroundl mouth,l SEVEREl musclel cramping,l Trousseau'sl andl Chvostek'sl signs,l
increasedl DTR's,l alkalosis
Worstl Casel Scenario:l Seizures,l highl riskl forl fractures
Treatment:l Calcium/Vitaminl Dl supplements;l ifl acutel orl symptomaticl IVl calciuml
gluconatel orl IVl calciuml chloride
Nursingl implications:l Ifl atl highl r/fl hypocalcemia,l assessl carefullyl forl s/s,l VS,l patentl
IV,l assessl forl Chvostek'sl andl Trousseau'sl signs,l monitorl labsl (espl afterl multiplel
transfusions),l teachl aboutl dietaryl sourcesl ofl calcium
Q:l Hyperkalemial
Answer:
Cause-l drugs,l notl enoughl excreted,l crushl injury
Tool muchl intake:l Increasedl dietaryl intake,l saltl substitutes,l potassiuml supplements
Donatedl blood
Drugs:l K-sparingl diuretics,l ACE-I's,l ARBS,l NSAIDS
Notl enoughl excreted:l Renall failure
,Crushl injury:l Intracellularl Kl released
S/S:l Cardiacl arrhythmias,l Musclel weaknessl (whichl mayl leadl tol flaccidl paralysis),l
increasedl GIl motility,l decreasedl DTR's,l acidosis
Worstl casel scenario:l Lifel threateningl cardiacl arrhythmias/cardiacl arrest
Treatment:l Potassiuml restrictedl diet;l ifl critical/symptomaticl willl requirel drugl therapyl
(suchl as?)CBIGKD,l furosemide-l diureticsl tol depletel K
Nursingl implications:l Cardiacl monitoring,l frequentl labs,l VS,l monitorl forl hypoglycemial
ifl insulinl IVPl given
Q:l Hypokalemial
Answer:
Causes:l Notl enoughl in,l tool muchl out,l depletingl drugs,l medicall conditions
Notl enoughl in:l Inadequatel K+l intake
Tool muchl out:l GIl fluidl losses
Depletingl drugs:l Diuretics,l corticosteroids,l insulin,l excessivel laxativel use,l albuterol
S/S:l Cardiacl arrhythmias,l legl crampsl (hallmark),l musclel weakness,l decreasedl GIl
motilityl (decreasedl BS,l constipation,l N/V),l decreasedl DTR's,l musclel weakness,l alkalosis
Worstl casel scenario:l Lifel threateningl cardiacl arrhythmias/Cardiacl arrest!
**Hypokalemial mayl potentiatel digl toxicity**
Treatment:l Increasel dietaryl intakel ofl potassium,l Kl supplementation.l Givel IVl potassiuml
SLOWLY!!!
Nursingl implications:l Frequentl VS,l cardiacl monitoring,l patentl IV,l monitorl labsl (recheckl
afterl supplementation),l NEVERl givel potassiuml IVPl orl bolus
Q:l Hypernatremial
Answer:
Cause-l Dehydrationl (l waterl loss),
S/S:l Restlessnessl orl agitation,l anorexia,l N/V,l weakness,l lethargy,l confusion,l cravel water.l
Pulsel ratel isl increasedl inl patientsl withl hypernatremial andl hypovolemia
Worstl casel scenario:l Decreasedl LOC,l seizures,l coma
Treatment:l Fluids!l PO/IV;l Isotonicl salinel (0.9%)l andl dextrosel 5%l inl 0.45%l sodiuml
chloridel arel mostl oftenl prescribed.
Nursingl implications:l Frequentl VS,l Monitorl neurologicl statusl (assesl mentall status),l
Seizure/falll precautions,l strictl I/O's,l assessl skin/MM,l orall care,l monitorl labs
, Q:l Hyponatremial
Answer:
Hyponatremial causes:l Duel tol sodiuml loss,l waterl gain,l orl inadequatel intake
Sodiuml loss:l Drugs---Diuretics,l Anticonvulsants,l SSRI's
Waterl Gain:l CHF,l SIADH,l polydipsia
S/S-Common:l Headache,l irritability,l disorientation/confusion,l tired,l abdominall cramping,l
musclel twitching/weakness,l cravel salt
Worstl casel scenariol (criticall low):Psychosis,l seizures,l ataxia,l airwayl issues>l musclel
twitching/weakness.
Stupor/coma
Treatment:
Mild:l Fluidl restrictionl (safest),l orall sodiuml supplements
Critical:l Hypertonicl (3%)l saline---CORRECTl SLOWLY!!!!!
Nursingl implications:l Monitorl neurologicl status,l Seizure/Falll Precautions,l Strictl I/O's,l
implementl fluidl restriction,l monitorl labs
Q:l ironl deficencyl anemial
Answer:
lackl ofl ironl inl thel RBC
Q:l ironl defienciencyl anemial riskl factorsl
Answer:
women
lowl blood
poorl ironl intake
poorl absorption
Q:l ironl deficiencyl expectedl findingsl
Answer:
Pica
ofl Medical-l Surgicall Nursingl Guide|l
Galenl
(Latestl 2026/l 2027l Update)l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Hypocalcemial
Answer:
Causes-l Inadequatel intake,l malabsorption,l calciuml loss,
Inadequatel intake:l Calciuml andl Vitl D
Malabsorption:l Post-menopausall women,l diseasesl thatl affectl thel smalll bowel,l drugsl
(anticonvulsants)
Calciuml Loss:l Loopl Diuretics
Others:l Renall failure,l hypoparathyroidism,l lowl magnesium,l multiplel bloodl transfusions,l
alkalosis,l lowl albuminl levels
S/S:l Anxiety,l irritability,l confusion,l paresthesial (l numbness/tingling)l ofl toes,l fingers,l
face,l aroundl mouth,l SEVEREl musclel cramping,l Trousseau'sl andl Chvostek'sl signs,l
increasedl DTR's,l alkalosis
Worstl Casel Scenario:l Seizures,l highl riskl forl fractures
Treatment:l Calcium/Vitaminl Dl supplements;l ifl acutel orl symptomaticl IVl calciuml
gluconatel orl IVl calciuml chloride
Nursingl implications:l Ifl atl highl r/fl hypocalcemia,l assessl carefullyl forl s/s,l VS,l patentl
IV,l assessl forl Chvostek'sl andl Trousseau'sl signs,l monitorl labsl (espl afterl multiplel
transfusions),l teachl aboutl dietaryl sourcesl ofl calcium
Q:l Hyperkalemial
Answer:
Cause-l drugs,l notl enoughl excreted,l crushl injury
Tool muchl intake:l Increasedl dietaryl intake,l saltl substitutes,l potassiuml supplements
Donatedl blood
Drugs:l K-sparingl diuretics,l ACE-I's,l ARBS,l NSAIDS
Notl enoughl excreted:l Renall failure
,Crushl injury:l Intracellularl Kl released
S/S:l Cardiacl arrhythmias,l Musclel weaknessl (whichl mayl leadl tol flaccidl paralysis),l
increasedl GIl motility,l decreasedl DTR's,l acidosis
Worstl casel scenario:l Lifel threateningl cardiacl arrhythmias/cardiacl arrest
Treatment:l Potassiuml restrictedl diet;l ifl critical/symptomaticl willl requirel drugl therapyl
(suchl as?)CBIGKD,l furosemide-l diureticsl tol depletel K
Nursingl implications:l Cardiacl monitoring,l frequentl labs,l VS,l monitorl forl hypoglycemial
ifl insulinl IVPl given
Q:l Hypokalemial
Answer:
Causes:l Notl enoughl in,l tool muchl out,l depletingl drugs,l medicall conditions
Notl enoughl in:l Inadequatel K+l intake
Tool muchl out:l GIl fluidl losses
Depletingl drugs:l Diuretics,l corticosteroids,l insulin,l excessivel laxativel use,l albuterol
S/S:l Cardiacl arrhythmias,l legl crampsl (hallmark),l musclel weakness,l decreasedl GIl
motilityl (decreasedl BS,l constipation,l N/V),l decreasedl DTR's,l musclel weakness,l alkalosis
Worstl casel scenario:l Lifel threateningl cardiacl arrhythmias/Cardiacl arrest!
**Hypokalemial mayl potentiatel digl toxicity**
Treatment:l Increasel dietaryl intakel ofl potassium,l Kl supplementation.l Givel IVl potassiuml
SLOWLY!!!
Nursingl implications:l Frequentl VS,l cardiacl monitoring,l patentl IV,l monitorl labsl (recheckl
afterl supplementation),l NEVERl givel potassiuml IVPl orl bolus
Q:l Hypernatremial
Answer:
Cause-l Dehydrationl (l waterl loss),
S/S:l Restlessnessl orl agitation,l anorexia,l N/V,l weakness,l lethargy,l confusion,l cravel water.l
Pulsel ratel isl increasedl inl patientsl withl hypernatremial andl hypovolemia
Worstl casel scenario:l Decreasedl LOC,l seizures,l coma
Treatment:l Fluids!l PO/IV;l Isotonicl salinel (0.9%)l andl dextrosel 5%l inl 0.45%l sodiuml
chloridel arel mostl oftenl prescribed.
Nursingl implications:l Frequentl VS,l Monitorl neurologicl statusl (assesl mentall status),l
Seizure/falll precautions,l strictl I/O's,l assessl skin/MM,l orall care,l monitorl labs
, Q:l Hyponatremial
Answer:
Hyponatremial causes:l Duel tol sodiuml loss,l waterl gain,l orl inadequatel intake
Sodiuml loss:l Drugs---Diuretics,l Anticonvulsants,l SSRI's
Waterl Gain:l CHF,l SIADH,l polydipsia
S/S-Common:l Headache,l irritability,l disorientation/confusion,l tired,l abdominall cramping,l
musclel twitching/weakness,l cravel salt
Worstl casel scenariol (criticall low):Psychosis,l seizures,l ataxia,l airwayl issues>l musclel
twitching/weakness.
Stupor/coma
Treatment:
Mild:l Fluidl restrictionl (safest),l orall sodiuml supplements
Critical:l Hypertonicl (3%)l saline---CORRECTl SLOWLY!!!!!
Nursingl implications:l Monitorl neurologicl status,l Seizure/Falll Precautions,l Strictl I/O's,l
implementl fluidl restriction,l monitorl labs
Q:l ironl deficencyl anemial
Answer:
lackl ofl ironl inl thel RBC
Q:l ironl defienciencyl anemial riskl factorsl
Answer:
women
lowl blood
poorl ironl intake
poorl absorption
Q:l ironl deficiencyl expectedl findingsl
Answer:
Pica
