NSG223/NSG 223 Exam 1 V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A client is admitted with a suspected diagnosis of Acute Kidney Injury (AKI). Which
laboratory result should the nurse prioritize as the most sensitive indicator of renal function?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
C. Serum Creatinine
D. Urine Specific Gravity
Correct Answer: C
Rationale: Serum creatinine is the most sensitive and specific indicator of renal function
because it is a waste product of muscle metabolism that is almost entirely excreted by the
kidneys. While BUN can be affected by protein intake, dehydration, and fever, creatinine
levels remain relatively stable unless there is kidney damage. Monitoring daily trends in
creatinine is essential for identifying the progression or recovery of AKI.
2. The nurse is caring for a client with Chronic Kidney Disease (CKD) who has a potassium
level of 6.2 mEq/L. Which medication should the nurse anticipate administering to stabilize
the cardiac membrane?
A. Sodium Polystyrene Sulfonate
,B. Regular Insulin and Dextrose
C. Furosemide
D. Calcium Gluconate
Correct Answer: D
Rationale: Calcium gluconate is administered intravenously to protect the heart by
antagonizing the effects of hyperkalemia on the cardiac cell membrane. It does not lower
the serum potassium level but prevents life-threatening arrhythmias while other
treatments are initiated. This intervention is temporary and must be followed by therapies
that actually shift or remove potassium from the body.
3. A client receiving peritoneal dialysis reports that the outflow (effluent) is beginning to look
cloudy. What should be the nurse’s immediate action?
A. Increase the dwell time for the next cycle
B. Warm the dialysate to a higher temperature
C. Notify the healthcare provider and collect a sample for culture
D. Reposition the client to improve drainage
Correct Answer: C
Rationale: Cloudy dialysate drainage is the hallmark sign of peritonitis, which is a serious
complication of peritoneal dialysis. The nurse must act quickly to notify the provider and
, obtain a culture of the effluent to identify the causative organism. Delaying treatment can
lead to systemic sepsis and the need to discontinue the dialysis modality.
4. When assessing a client with Cushing’s Syndrome, which clinical manifestation should the
nurse expect to find?
A. Hypotension and weight loss
B. Truncal obesity and ‘moon face’
C. Hyperpigmentation of the skin
D. Persistent diarrhea and dehydration
Correct Answer: B
Rationale: Cushing’s Syndrome results from an excess of corticosteroids, leading to
characteristic physical changes like truncal obesity and a rounded face known as ‘moon
face.’ Clients also commonly exhibit a ‘buffalo hump’ on the neck and purple striae on the
abdomen. These changes are due to the redistribution of fat and the catabolic effects of
cortisol on protein and skin tissues.
5. A client is diagnosed with Addisonian Crisis. Which set of laboratory findings is most
consistent with this condition?
A. Hypoglycemia and Hyperkalemia
B. Hypernatremia and Hypokalemia
C. Hypercalcemia and Hypernatremia
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A client is admitted with a suspected diagnosis of Acute Kidney Injury (AKI). Which
laboratory result should the nurse prioritize as the most sensitive indicator of renal function?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
C. Serum Creatinine
D. Urine Specific Gravity
Correct Answer: C
Rationale: Serum creatinine is the most sensitive and specific indicator of renal function
because it is a waste product of muscle metabolism that is almost entirely excreted by the
kidneys. While BUN can be affected by protein intake, dehydration, and fever, creatinine
levels remain relatively stable unless there is kidney damage. Monitoring daily trends in
creatinine is essential for identifying the progression or recovery of AKI.
2. The nurse is caring for a client with Chronic Kidney Disease (CKD) who has a potassium
level of 6.2 mEq/L. Which medication should the nurse anticipate administering to stabilize
the cardiac membrane?
A. Sodium Polystyrene Sulfonate
,B. Regular Insulin and Dextrose
C. Furosemide
D. Calcium Gluconate
Correct Answer: D
Rationale: Calcium gluconate is administered intravenously to protect the heart by
antagonizing the effects of hyperkalemia on the cardiac cell membrane. It does not lower
the serum potassium level but prevents life-threatening arrhythmias while other
treatments are initiated. This intervention is temporary and must be followed by therapies
that actually shift or remove potassium from the body.
3. A client receiving peritoneal dialysis reports that the outflow (effluent) is beginning to look
cloudy. What should be the nurse’s immediate action?
A. Increase the dwell time for the next cycle
B. Warm the dialysate to a higher temperature
C. Notify the healthcare provider and collect a sample for culture
D. Reposition the client to improve drainage
Correct Answer: C
Rationale: Cloudy dialysate drainage is the hallmark sign of peritonitis, which is a serious
complication of peritoneal dialysis. The nurse must act quickly to notify the provider and
, obtain a culture of the effluent to identify the causative organism. Delaying treatment can
lead to systemic sepsis and the need to discontinue the dialysis modality.
4. When assessing a client with Cushing’s Syndrome, which clinical manifestation should the
nurse expect to find?
A. Hypotension and weight loss
B. Truncal obesity and ‘moon face’
C. Hyperpigmentation of the skin
D. Persistent diarrhea and dehydration
Correct Answer: B
Rationale: Cushing’s Syndrome results from an excess of corticosteroids, leading to
characteristic physical changes like truncal obesity and a rounded face known as ‘moon
face.’ Clients also commonly exhibit a ‘buffalo hump’ on the neck and purple striae on the
abdomen. These changes are due to the redistribution of fat and the catabolic effects of
cortisol on protein and skin tissues.
5. A client is diagnosed with Addisonian Crisis. Which set of laboratory findings is most
consistent with this condition?
A. Hypoglycemia and Hyperkalemia
B. Hypernatremia and Hypokalemia
C. Hypercalcemia and Hypernatremia
