,Galen NSG 4100 Exam 2 | Nursing Practice – Adult
Health III (2026) Actual Q&A PDF
1. A client with SIADH is at risk for hyponatremia. Which assessment finding
should the nurse monitor for first?
A) Polyuria and increased thirst
B) Confusion and seizure activity
C) Hypotension and tachycardia
D) Muscle cramps and hyperreflexia
Correct Answer: Confusion and seizure activity
Rationale: Hyponatremia in SIADH causes cerebral edema, leading to
neurological symptoms. Confusion, lethargy, and seizures are the most
immediate life-threatening complications. Polyuria indicates diabetes insipidus;
hypotension and cramps are less specific.
2. The nurse is reviewing the laboratory results for a client with suspected
Addison's disease. Which set of findings is most characteristic?
A) Hypernatremia, hypokalemia, hypoglycemia
B) Hyponatremia, hyperkalemia, hypotension
C) Hypercalcemia, hypophosphatemia, hypertension
D) Hyponatremia, hypokalemia, hyperglycemia
Correct Answer: Hyponatremia, hyperkalemia, hypotension
,Rationale: Aldosterone deficiency leads to sodium loss (hyponatremia),
potassium retention (hyperkalemia), and water loss causing hypotension.
Cortisol deficiency also contributes to hypoglycemia. The other patterns
describe Cushing's syndrome or hyperparathyroidism.
3. A client after a transsphenoidal hypophysectomy reports clear nasal drainage
that tests positive for glucose. What is the nurse's priority action?
A) Document the finding as normal postoperative drainage
B) Administer prescribed antibiotic
C) Reposition the client flat to reduce leakage
D) Notify the healthcare provider of a possible CSF leak
Correct Answer: Notify the healthcare provider of a possible CSF leak
Rationale: Clear, glucose-positive nasal drainage indicates a cerebrospinal fluid
leak, a serious complication after transsphenoidal surgery. The provider must be
notified immediately for intervention. Elevating the head of bed, not lying flat,
is used to decrease pressure.
4. A client with diabetic ketoacidosis has a serum potassium of 5.9 mEq/L. After
starting an insulin infusion, the nurse should anticipate which intervention?
A) Administration of sodium polystyrene sulfonate
B) Initiation of cardiac monitoring for hyperkalemia
C) Potassium replacement as levels drop due to intracellular shifts
D) Restriction of all oral and IV fluids
Correct Answer: Potassium replacement as levels drop due to intracellular shifts
, Rationale: Insulin drives potassium into cells, causing a rapid drop in serum
potassium despite total body depletion. Replacement is essential once urine
output is established. Cardiac monitoring is continuous; Kayexalate is not given
if levels are falling.
5. A client with chronic pancreatitis is admitted with severe abdominal pain.
Which laboratory finding is most specific for pancreatitis?
A) Elevated serum amylase only
B) Markedly elevated serum lipase
C) Increased alanine aminotransferase (ALT)
D) Hyperglycemia and glucosuria
Correct Answer: Markedly elevated serum lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
pancreatitis. Amylase can be elevated in other conditions. Liver enzymes may be
elevated if gallstones are the cause, but lipase is the most specific marker for
the pancreas.
6. The nurse is assessing a client with cirrhosis and portal hypertension. Which
finding is a direct consequence of the portal hypertension?
A) Asterixis and fetor hepaticus
B) Esophageal varices and ascites
C) Jaundice and pruritus
D) Hepatorenal syndrome
Health III (2026) Actual Q&A PDF
1. A client with SIADH is at risk for hyponatremia. Which assessment finding
should the nurse monitor for first?
A) Polyuria and increased thirst
B) Confusion and seizure activity
C) Hypotension and tachycardia
D) Muscle cramps and hyperreflexia
Correct Answer: Confusion and seizure activity
Rationale: Hyponatremia in SIADH causes cerebral edema, leading to
neurological symptoms. Confusion, lethargy, and seizures are the most
immediate life-threatening complications. Polyuria indicates diabetes insipidus;
hypotension and cramps are less specific.
2. The nurse is reviewing the laboratory results for a client with suspected
Addison's disease. Which set of findings is most characteristic?
A) Hypernatremia, hypokalemia, hypoglycemia
B) Hyponatremia, hyperkalemia, hypotension
C) Hypercalcemia, hypophosphatemia, hypertension
D) Hyponatremia, hypokalemia, hyperglycemia
Correct Answer: Hyponatremia, hyperkalemia, hypotension
,Rationale: Aldosterone deficiency leads to sodium loss (hyponatremia),
potassium retention (hyperkalemia), and water loss causing hypotension.
Cortisol deficiency also contributes to hypoglycemia. The other patterns
describe Cushing's syndrome or hyperparathyroidism.
3. A client after a transsphenoidal hypophysectomy reports clear nasal drainage
that tests positive for glucose. What is the nurse's priority action?
A) Document the finding as normal postoperative drainage
B) Administer prescribed antibiotic
C) Reposition the client flat to reduce leakage
D) Notify the healthcare provider of a possible CSF leak
Correct Answer: Notify the healthcare provider of a possible CSF leak
Rationale: Clear, glucose-positive nasal drainage indicates a cerebrospinal fluid
leak, a serious complication after transsphenoidal surgery. The provider must be
notified immediately for intervention. Elevating the head of bed, not lying flat,
is used to decrease pressure.
4. A client with diabetic ketoacidosis has a serum potassium of 5.9 mEq/L. After
starting an insulin infusion, the nurse should anticipate which intervention?
A) Administration of sodium polystyrene sulfonate
B) Initiation of cardiac monitoring for hyperkalemia
C) Potassium replacement as levels drop due to intracellular shifts
D) Restriction of all oral and IV fluids
Correct Answer: Potassium replacement as levels drop due to intracellular shifts
, Rationale: Insulin drives potassium into cells, causing a rapid drop in serum
potassium despite total body depletion. Replacement is essential once urine
output is established. Cardiac monitoring is continuous; Kayexalate is not given
if levels are falling.
5. A client with chronic pancreatitis is admitted with severe abdominal pain.
Which laboratory finding is most specific for pancreatitis?
A) Elevated serum amylase only
B) Markedly elevated serum lipase
C) Increased alanine aminotransferase (ALT)
D) Hyperglycemia and glucosuria
Correct Answer: Markedly elevated serum lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
pancreatitis. Amylase can be elevated in other conditions. Liver enzymes may be
elevated if gallstones are the cause, but lipase is the most specific marker for
the pancreas.
6. The nurse is assessing a client with cirrhosis and portal hypertension. Which
finding is a direct consequence of the portal hypertension?
A) Asterixis and fetor hepaticus
B) Esophageal varices and ascites
C) Jaundice and pruritus
D) Hepatorenal syndrome
