,NUR 170 Exam 3 | Concepts of Medical-Surgical
Nursing (2026) Q&A | Galen College
1. A client with type 1 diabetes is admitted with diabetic ketoacidosis. Which
intervention is the priority?
A) Administer IV regular insulin bolus
B) Initiate 0.9% normal saline infusion
C) Obtain serum potassium level
D) Administer sodium bicarbonate
Correct Answer: Initiate 0.9% normal saline infusion
Rationale: Fluid resuscitation with isotonic saline is the initial priority to correct
hypovolemia, improve tissue perfusion, and lower blood glucose. Insulin follows
fluids, and potassium is monitored but not first.
2. A client with heart failure is started on furosemide. Which finding indicates a
therapeutic response?
A) Decreased urine output
B) Weight gain of 1 kg in 24 hours
C) Weight loss of 1 kg in 24 hours
D) Increased jugular vein distention
Correct Answer: Weight loss of 1 kg in 24 hours
,Rationale: Furosemide promotes diuresis, resulting in fluid loss and weight
reduction. A weight loss of 1 kg corresponds to approximately 1 liter of fluid
removal, indicating effective therapy.
3. A client with diabetic ketoacidosis has a potassium of 5.9 mEq/L before
treatment. After starting insulin and IV fluids, which change is expected?
A) Hypokalemia due to intracellular shift
B) Hyperkalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: Hypokalemia due to intracellular shift
Rationale: Insulin drives potassium into cells, lowering serum potassium despite
total body depletion. Potassium replacement is initiated once levels drop and
urine output is adequate.
4. A client asks about the purpose of HbA1c testing. The nurse explains that it
reflects average blood glucose over what period?
A) 24 hours
B) 1 week
C) 1 month
D) 2 to 3 months
Correct Answer: 2 to 3 months
, Rationale: HbA1c measures the percentage of glycated hemoglobin, reflecting
average blood glucose over the lifespan of a red blood cell, approximately 2 to 3
months. It is used to assess long-term control.
5. A client with angina reports chest pain. What is the nurse's first action?
A) Administer morphine
B) Give sublingual nitroglycerin
C) Obtain 12‑lead ECG
D) Call the provider
Correct Answer: Give sublingual nitroglycerin
Rationale: Nitroglycerin is the first-line drug for acute angina. It dilates coronary
arteries and reduces myocardial oxygen demand. Pain assessment and ECG
follow.
6. A client with diabetes has a blood glucose of 60 mg/dL and is diaphoretic.
What is the priority action?
A) Give 4 ounces of orange juice
B) Administer glucagon IM
C) Call the rapid response team
D) Start IV dextrose 50%
Correct Answer: Give 4 ounces of orange juice
Nursing (2026) Q&A | Galen College
1. A client with type 1 diabetes is admitted with diabetic ketoacidosis. Which
intervention is the priority?
A) Administer IV regular insulin bolus
B) Initiate 0.9% normal saline infusion
C) Obtain serum potassium level
D) Administer sodium bicarbonate
Correct Answer: Initiate 0.9% normal saline infusion
Rationale: Fluid resuscitation with isotonic saline is the initial priority to correct
hypovolemia, improve tissue perfusion, and lower blood glucose. Insulin follows
fluids, and potassium is monitored but not first.
2. A client with heart failure is started on furosemide. Which finding indicates a
therapeutic response?
A) Decreased urine output
B) Weight gain of 1 kg in 24 hours
C) Weight loss of 1 kg in 24 hours
D) Increased jugular vein distention
Correct Answer: Weight loss of 1 kg in 24 hours
,Rationale: Furosemide promotes diuresis, resulting in fluid loss and weight
reduction. A weight loss of 1 kg corresponds to approximately 1 liter of fluid
removal, indicating effective therapy.
3. A client with diabetic ketoacidosis has a potassium of 5.9 mEq/L before
treatment. After starting insulin and IV fluids, which change is expected?
A) Hypokalemia due to intracellular shift
B) Hyperkalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: Hypokalemia due to intracellular shift
Rationale: Insulin drives potassium into cells, lowering serum potassium despite
total body depletion. Potassium replacement is initiated once levels drop and
urine output is adequate.
4. A client asks about the purpose of HbA1c testing. The nurse explains that it
reflects average blood glucose over what period?
A) 24 hours
B) 1 week
C) 1 month
D) 2 to 3 months
Correct Answer: 2 to 3 months
, Rationale: HbA1c measures the percentage of glycated hemoglobin, reflecting
average blood glucose over the lifespan of a red blood cell, approximately 2 to 3
months. It is used to assess long-term control.
5. A client with angina reports chest pain. What is the nurse's first action?
A) Administer morphine
B) Give sublingual nitroglycerin
C) Obtain 12‑lead ECG
D) Call the provider
Correct Answer: Give sublingual nitroglycerin
Rationale: Nitroglycerin is the first-line drug for acute angina. It dilates coronary
arteries and reduces myocardial oxygen demand. Pain assessment and ECG
follow.
6. A client with diabetes has a blood glucose of 60 mg/dL and is diaphoretic.
What is the priority action?
A) Give 4 ounces of orange juice
B) Administer glucagon IM
C) Call the rapid response team
D) Start IV dextrose 50%
Correct Answer: Give 4 ounces of orange juice
