NU 185 EXAM 4 (GALEN) NEWEST 2026/ 2027 ACTUAL
EXAM TEST BANK| NU185 MEDICAL-SURGICAL
NURSING II EXAM 4 REVIEW WITH COMPLETE 400
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
A patient with chronic kidney disease (CKD) is told to follow a renal
diet. Which suggestion is correct? - ANSWER - Low protein (or protein
limited depending on stage), potassium restriction as indicated
Which is the most important nursing action when assessing a newly
created AV fistula for hemodialysis? - ANSWER - Auscultate for bruit
and palpate for thrill; avoid blood pressures/venipuncture in that arm
A patient with peritoneal dialysis develops cloudy outflow and
abdominal pain and fever. The nurse suspects: - ANSWER - Peritonitis
— notify provider and start per protocol (culture and antibiotics)
A patient with diabetes mellitus and a blood glucose of 48 mg/dL is
lethargic. Which is best immediate action? - ANSWER - Give 4 oz
orange juice if able to swallow safely (conscious & able) or IV dextrose
if not safe
A patient has SIADH secondary to small-cell lung cancer. The nurse
expects: - ANSWER - Oliguria, hyponatremia, and weight gain without
edema (dilutional)
pg. 1
,Which finding best suggests diabetic ketoacidosis (DKA) rather than
hyperosmolar hyperglycemic state? - ANSWER - Presence of ketones,
metabolic acidosis, and fruity breath
A nurse teaching a patient about radiation therapy for head/neck cancer
should include which side effect? - ANSWER - Nausea/Vomiting,
fatigue, and localized hair loss in the treatment field
During a dexamethasone suppression test, what is the usual nursing
instruction? - ANSWER - Draw blood sample in the morning after
overnight dexamethasone
A patient who had a transsphenoidal hypophysectomy (pituitary surgery)
is post-op. Which sign requires immediate attention? - ANSWER - Clear
nasal drainage that tests positive for glucose (CSF leak)
A patient with acute kidney injury (AKI) has rising BUN and creatinine
and decreased urine output. The nurse anticipates which order to
evaluate renal perfusion? - ANSWER - Creatinine clearance
measurement and monitor urine output hourly
A patient with chronic renal failure is scheduled for hemodialysis this
morning. Which medication order is the nurse likely to hold? -
ANSWER - Lisinopril (BP med) due to risk of intra-dialytic hypotension
pg. 2
,A client in alcohol withdrawal is agitated and at risk of falling. Nursing
priority: - ANSWER - Pad side rails and maintain safety with frequent
assessment
A patient with retinal detachment is being prepared for surgery. Which
position is commonly used pre-op to minimize further detachment? -
ANSWER - Lie with head in position recommended (often reclined or
affected-eye dependent per surgeon) and avoid activities that increase
A patient diagnosed with SIADH has hyponatremia and crackles on
auscultation. Which action is appropriate per chart? - ANSWER -
Administer IV normal saline cautiously and fluid restriction; follow
orders to correct sodium carefully to avoid osmotic demyelination
A patient with ESRD (end-stage renal disease) is being assessed. The
nurse should expect which respiratory finding? - ANSWER - Crackles
and pulmonary edema if fluid overload — listen q4h as status can
change
A patient with SIADH is at risk for water intoxication. Which chart
finding supports that? - ANSWER - Confusion, headache, decreased
serum sodium, and crackles may be present if overloaded
The nurse is caring for a patient after kidney transplant. Which report
requires immediate notification to the transplant team? - ANSWER -
pg. 3
, Sore throat and fever — possible infection and opportunistic infections
in immunosuppressed patient
Which nursing finding suggests the medication treatment for DI
(desmopressin) is therapeutic? - ANSWER - Decreased urine output
A patient with diabetes is at increased risk for infection for what reason?
- ANSWER - Hyperglycemia impairs neutrophil function and wound
healing.
DM ↑ risk for infection bc ↑ glucose
A patient with pheochromocytoma undergoes surgery to remove the
tumor. Prior to surgery, the nurse expects which preop medication? -
ANSWER - Beta-blocker and alpha-blockade as ordered to control BP
and prevent intraoperative hypertensive crisis
A patient with bladder cancer will have which possible urinary diversion
procedure? - ANSWER - Ileal conduit (urostomy) — urine drains into an
external appliance using a segment of ileum
A renal transplant patient is taught to report which early sign of
rejection? - ANSWER - Fever, malaise, and localized tenderness over
the graft site — report immediately
pg. 4
EXAM TEST BANK| NU185 MEDICAL-SURGICAL
NURSING II EXAM 4 REVIEW WITH COMPLETE 400
REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
A patient with chronic kidney disease (CKD) is told to follow a renal
diet. Which suggestion is correct? - ANSWER - Low protein (or protein
limited depending on stage), potassium restriction as indicated
Which is the most important nursing action when assessing a newly
created AV fistula for hemodialysis? - ANSWER - Auscultate for bruit
and palpate for thrill; avoid blood pressures/venipuncture in that arm
A patient with peritoneal dialysis develops cloudy outflow and
abdominal pain and fever. The nurse suspects: - ANSWER - Peritonitis
— notify provider and start per protocol (culture and antibiotics)
A patient with diabetes mellitus and a blood glucose of 48 mg/dL is
lethargic. Which is best immediate action? - ANSWER - Give 4 oz
orange juice if able to swallow safely (conscious & able) or IV dextrose
if not safe
A patient has SIADH secondary to small-cell lung cancer. The nurse
expects: - ANSWER - Oliguria, hyponatremia, and weight gain without
edema (dilutional)
pg. 1
,Which finding best suggests diabetic ketoacidosis (DKA) rather than
hyperosmolar hyperglycemic state? - ANSWER - Presence of ketones,
metabolic acidosis, and fruity breath
A nurse teaching a patient about radiation therapy for head/neck cancer
should include which side effect? - ANSWER - Nausea/Vomiting,
fatigue, and localized hair loss in the treatment field
During a dexamethasone suppression test, what is the usual nursing
instruction? - ANSWER - Draw blood sample in the morning after
overnight dexamethasone
A patient who had a transsphenoidal hypophysectomy (pituitary surgery)
is post-op. Which sign requires immediate attention? - ANSWER - Clear
nasal drainage that tests positive for glucose (CSF leak)
A patient with acute kidney injury (AKI) has rising BUN and creatinine
and decreased urine output. The nurse anticipates which order to
evaluate renal perfusion? - ANSWER - Creatinine clearance
measurement and monitor urine output hourly
A patient with chronic renal failure is scheduled for hemodialysis this
morning. Which medication order is the nurse likely to hold? -
ANSWER - Lisinopril (BP med) due to risk of intra-dialytic hypotension
pg. 2
,A client in alcohol withdrawal is agitated and at risk of falling. Nursing
priority: - ANSWER - Pad side rails and maintain safety with frequent
assessment
A patient with retinal detachment is being prepared for surgery. Which
position is commonly used pre-op to minimize further detachment? -
ANSWER - Lie with head in position recommended (often reclined or
affected-eye dependent per surgeon) and avoid activities that increase
A patient diagnosed with SIADH has hyponatremia and crackles on
auscultation. Which action is appropriate per chart? - ANSWER -
Administer IV normal saline cautiously and fluid restriction; follow
orders to correct sodium carefully to avoid osmotic demyelination
A patient with ESRD (end-stage renal disease) is being assessed. The
nurse should expect which respiratory finding? - ANSWER - Crackles
and pulmonary edema if fluid overload — listen q4h as status can
change
A patient with SIADH is at risk for water intoxication. Which chart
finding supports that? - ANSWER - Confusion, headache, decreased
serum sodium, and crackles may be present if overloaded
The nurse is caring for a patient after kidney transplant. Which report
requires immediate notification to the transplant team? - ANSWER -
pg. 3
, Sore throat and fever — possible infection and opportunistic infections
in immunosuppressed patient
Which nursing finding suggests the medication treatment for DI
(desmopressin) is therapeutic? - ANSWER - Decreased urine output
A patient with diabetes is at increased risk for infection for what reason?
- ANSWER - Hyperglycemia impairs neutrophil function and wound
healing.
DM ↑ risk for infection bc ↑ glucose
A patient with pheochromocytoma undergoes surgery to remove the
tumor. Prior to surgery, the nurse expects which preop medication? -
ANSWER - Beta-blocker and alpha-blockade as ordered to control BP
and prevent intraoperative hypertensive crisis
A patient with bladder cancer will have which possible urinary diversion
procedure? - ANSWER - Ileal conduit (urostomy) — urine drains into an
external appliance using a segment of ileum
A renal transplant patient is taught to report which early sign of
rejection? - ANSWER - Fever, malaise, and localized tenderness over
the graft site — report immediately
pg. 4
