,NU 185 Exam 3 | Medical-Surgical II | Questions &
Verified Answers | 2026 Edition | Galen College
1. Which of the following best describes the most common cause of acute tubular necrosis?
A) Prolonged renal ischemia
B) Allergic interstitial nephritis
C) Acute glomerulonephritis
D) Polycystic kidney disease
Correct Answer: Prolonged renal ischemia
Rationale: Acute tubular necrosis is primarily caused by ischemia (prerenal) or nephrotoxic agents that
directly damage tubular cells. Ischemia from hypotension or hypovolemia is the most frequent cause.
Glomerulonephritis and interstitial nephritis affect other renal structures.
2. The nurse is reviewing laboratory data for a patient with chronic kidney disease. Which value best
reflects renal function?
A) Serum glucose
B) Serum creatinine and glomerular filtration rate
C) Alanine aminotransferase
D) White blood cell count
Correct Answer: Serum creatinine and glomerular filtration rate
Rationale: Creatinine is a waste product filtered by the kidneys; elevated levels indicate impaired
function. GFR estimates the rate of filtration. Glucose, liver enzymes, and WBC do not directly measure
renal function.
3. When teaching a patient with diabetes insipidus about desmopressin therapy, which statement
indicates a need for further instruction?
A) “I will take this medication as a nasal spray.”
,B) “I should monitor my fluid intake carefully.”
C) “I can drink as much water as I want while on this medication.”
D) “I will report headache or confusion to my provider.”
Correct Answer: “I can drink as much water as I want while on this medication.”
Rationale: Desmopressin is an antidiuretic hormone analog that causes water reabsorption. Excessive
fluid intake while taking it can lead to water intoxication and severe hyponatremia. Fluid intake must be
regulated.
4. A patient with cirrhosis develops esophageal varices. This complication results from which
pathophysiologic change?
A) Decreased portal blood flow
B) Increased hepatic synthesis
C) Biliary obstruction
D) Portal hypertension
Correct Answer: Portal hypertension
Rationale: Cirrhosis obstructs portal blood flow, increasing pressure in the portal venous system. This
leads to the development of collateral vessels, including esophageal varices, which are prone to rupture
and life-threatening hemorrhage.
5. The nurse is caring for a patient with acute pancreatitis. Which laboratory finding is most specific for
this condition?
A) Elevated serum lipase
B) Decreased white blood cell count
C) Elevated serum amylase only
D) Elevated serum potassium
Correct Answer: Elevated serum lipase
, Rationale: Lipase is produced primarily by the pancreas and remains elevated longer than amylase,
making it more specific for pancreatitis. Amylase can also rise from other causes. WBC is often elevated,
not decreased.
6. In providing dietary teaching to a patient with cholecystitis, which statement indicates
understanding?
A) “I will eat a high-fat diet to stimulate bile flow.”
B) “I will avoid fatty foods to prevent gallbladder attacks.”
C) “I will increase my intake of whole milk.”
D) “I will eat large meals to prevent gallstones.”
Correct Answer: “I will avoid fatty foods to prevent gallbladder attacks.”
Rationale: Fatty foods stimulate gallbladder contraction, which can worsen pain and cause an attack in
cholecystitis. A low-fat diet is recommended. High-fat meals and large portions increase symptoms.
7. The nurse is assessing a patient with a T-tube after cholecystectomy. The drainage is dark green and
measures 500 mL in 24 hours. What should the nurse do?
A) Clamp the tube
B) Notify the provider
C) Document the expected finding
D) Irrigate the tube
Correct Answer: Document the expected finding
Rationale: T-tube drainage of 300–500 mL of dark green bile per day is normal in the early postoperative
period. The amount decreases as bile begins to flow into the duodenum. No further intervention is
needed.
8. The nurse is caring for a patient with a Sengstaken-Blakemore tube. What is the priority nursing
action?
Verified Answers | 2026 Edition | Galen College
1. Which of the following best describes the most common cause of acute tubular necrosis?
A) Prolonged renal ischemia
B) Allergic interstitial nephritis
C) Acute glomerulonephritis
D) Polycystic kidney disease
Correct Answer: Prolonged renal ischemia
Rationale: Acute tubular necrosis is primarily caused by ischemia (prerenal) or nephrotoxic agents that
directly damage tubular cells. Ischemia from hypotension or hypovolemia is the most frequent cause.
Glomerulonephritis and interstitial nephritis affect other renal structures.
2. The nurse is reviewing laboratory data for a patient with chronic kidney disease. Which value best
reflects renal function?
A) Serum glucose
B) Serum creatinine and glomerular filtration rate
C) Alanine aminotransferase
D) White blood cell count
Correct Answer: Serum creatinine and glomerular filtration rate
Rationale: Creatinine is a waste product filtered by the kidneys; elevated levels indicate impaired
function. GFR estimates the rate of filtration. Glucose, liver enzymes, and WBC do not directly measure
renal function.
3. When teaching a patient with diabetes insipidus about desmopressin therapy, which statement
indicates a need for further instruction?
A) “I will take this medication as a nasal spray.”
,B) “I should monitor my fluid intake carefully.”
C) “I can drink as much water as I want while on this medication.”
D) “I will report headache or confusion to my provider.”
Correct Answer: “I can drink as much water as I want while on this medication.”
Rationale: Desmopressin is an antidiuretic hormone analog that causes water reabsorption. Excessive
fluid intake while taking it can lead to water intoxication and severe hyponatremia. Fluid intake must be
regulated.
4. A patient with cirrhosis develops esophageal varices. This complication results from which
pathophysiologic change?
A) Decreased portal blood flow
B) Increased hepatic synthesis
C) Biliary obstruction
D) Portal hypertension
Correct Answer: Portal hypertension
Rationale: Cirrhosis obstructs portal blood flow, increasing pressure in the portal venous system. This
leads to the development of collateral vessels, including esophageal varices, which are prone to rupture
and life-threatening hemorrhage.
5. The nurse is caring for a patient with acute pancreatitis. Which laboratory finding is most specific for
this condition?
A) Elevated serum lipase
B) Decreased white blood cell count
C) Elevated serum amylase only
D) Elevated serum potassium
Correct Answer: Elevated serum lipase
, Rationale: Lipase is produced primarily by the pancreas and remains elevated longer than amylase,
making it more specific for pancreatitis. Amylase can also rise from other causes. WBC is often elevated,
not decreased.
6. In providing dietary teaching to a patient with cholecystitis, which statement indicates
understanding?
A) “I will eat a high-fat diet to stimulate bile flow.”
B) “I will avoid fatty foods to prevent gallbladder attacks.”
C) “I will increase my intake of whole milk.”
D) “I will eat large meals to prevent gallstones.”
Correct Answer: “I will avoid fatty foods to prevent gallbladder attacks.”
Rationale: Fatty foods stimulate gallbladder contraction, which can worsen pain and cause an attack in
cholecystitis. A low-fat diet is recommended. High-fat meals and large portions increase symptoms.
7. The nurse is assessing a patient with a T-tube after cholecystectomy. The drainage is dark green and
measures 500 mL in 24 hours. What should the nurse do?
A) Clamp the tube
B) Notify the provider
C) Document the expected finding
D) Irrigate the tube
Correct Answer: Document the expected finding
Rationale: T-tube drainage of 300–500 mL of dark green bile per day is normal in the early postoperative
period. The amount decreases as bile begins to flow into the duodenum. No further intervention is
needed.
8. The nurse is caring for a patient with a Sengstaken-Blakemore tube. What is the priority nursing
action?
