NU 192 Exam 1 V1 | NU 192 Medical-
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 1) | Galen
1. A nurse is caring for a client with Diabetic Ketoacidosis (DKA). Which intravenous fluid
should the nurse anticipate the healthcare provider will prescribe once the blood glucose
level reaches 250 mg/dL?
A. 5% Dextrose in 0.45% Normal Saline
B. 0.45% Normal Saline
C. 0.9% Normal Saline
D. 3% Hypertonic Saline
Correct Answer: A
Explanation: When the blood glucose reaches 250 mg/dL, dextrose is added to the IV
solution to prevent a rapid drop in blood glucose that could lead to cerebral edema. The
nurse must monitor the client closely for signs of fluid overload during this transition. This
practice ensures that the blood sugar level stabilizes while the metabolic acidosis is still
being corrected.
2. A client is admitted with a diagnosis of thyroid storm. Which clinical manifestations should
the nurse expect to assess? Select all that apply.
A. Fever greater than 102°F (38.9°C)
,B. Severe tachycardia
C. Systolic hypertension
D. Agitation and restlessness
E. Bradycardia
F. Constipation
Correct Answer: A, B, C, D
Explanation: Thyroid storm is a life-threatening emergency characterized by a
hypermetabolic state. Clinical manifestations include high fever, extreme tachycardia,
hypertension, and altered mental status such as agitation or delirium. It is crucial for the
nurse to implement cooling measures and provide prescribed beta-blockers immediately.
3. The nurse is assessing a client with Cushing’s Syndrome. Which clinical finding is most
consistent with this diagnosis?
A. Trunkal obesity and moon face
B. Hypotension and hyperkalemia
C. Weight loss and hypoglycemia
D. Hyperpigmentation of the skin
Correct Answer: A
Explanation: Cushing’s Syndrome results from an excess of corticosteroids, specifically
cortisol. Classic physical signs include central obesity, a rounded ‘moon face,’ and a ‘buffalo
, hump’ on the back. The nurse should also monitor for associated complications such as
hyperglycemia and osteoporosis.
4. A client with Chronic Kidney Disease (CKD) is prescribed Sevelamer. The nurse understands
that the primary purpose of this medication is to:
A. Treat hyperkalemia
B. Correct metabolic acidosis
C. Lower serum phosphate levels
D. Stimulate red blood cell production
Correct Answer: C
Explanation: Sevelamer is a phosphate binder used in clients with CKD to prevent
phosphorus absorption from the GI tract. High phosphate levels can lead to secondary
hyperparathyroidism and bone disease in renal patients. This medication should be taken
with meals to be effective in binding the phosphorus in food.
5. A nurse is reviewing the laboratory results for a client with Acute Kidney Injury (AKI) in the
oliguric phase. Which findings are expected? Select all that apply.
A. Hyperkalemia
B. Hyponatremia
C. Elevated Creatinine
D. Hypokalemia
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 1) | Galen
1. A nurse is caring for a client with Diabetic Ketoacidosis (DKA). Which intravenous fluid
should the nurse anticipate the healthcare provider will prescribe once the blood glucose
level reaches 250 mg/dL?
A. 5% Dextrose in 0.45% Normal Saline
B. 0.45% Normal Saline
C. 0.9% Normal Saline
D. 3% Hypertonic Saline
Correct Answer: A
Explanation: When the blood glucose reaches 250 mg/dL, dextrose is added to the IV
solution to prevent a rapid drop in blood glucose that could lead to cerebral edema. The
nurse must monitor the client closely for signs of fluid overload during this transition. This
practice ensures that the blood sugar level stabilizes while the metabolic acidosis is still
being corrected.
2. A client is admitted with a diagnosis of thyroid storm. Which clinical manifestations should
the nurse expect to assess? Select all that apply.
A. Fever greater than 102°F (38.9°C)
,B. Severe tachycardia
C. Systolic hypertension
D. Agitation and restlessness
E. Bradycardia
F. Constipation
Correct Answer: A, B, C, D
Explanation: Thyroid storm is a life-threatening emergency characterized by a
hypermetabolic state. Clinical manifestations include high fever, extreme tachycardia,
hypertension, and altered mental status such as agitation or delirium. It is crucial for the
nurse to implement cooling measures and provide prescribed beta-blockers immediately.
3. The nurse is assessing a client with Cushing’s Syndrome. Which clinical finding is most
consistent with this diagnosis?
A. Trunkal obesity and moon face
B. Hypotension and hyperkalemia
C. Weight loss and hypoglycemia
D. Hyperpigmentation of the skin
Correct Answer: A
Explanation: Cushing’s Syndrome results from an excess of corticosteroids, specifically
cortisol. Classic physical signs include central obesity, a rounded ‘moon face,’ and a ‘buffalo
, hump’ on the back. The nurse should also monitor for associated complications such as
hyperglycemia and osteoporosis.
4. A client with Chronic Kidney Disease (CKD) is prescribed Sevelamer. The nurse understands
that the primary purpose of this medication is to:
A. Treat hyperkalemia
B. Correct metabolic acidosis
C. Lower serum phosphate levels
D. Stimulate red blood cell production
Correct Answer: C
Explanation: Sevelamer is a phosphate binder used in clients with CKD to prevent
phosphorus absorption from the GI tract. High phosphate levels can lead to secondary
hyperparathyroidism and bone disease in renal patients. This medication should be taken
with meals to be effective in binding the phosphorus in food.
5. A nurse is reviewing the laboratory results for a client with Acute Kidney Injury (AKI) in the
oliguric phase. Which findings are expected? Select all that apply.
A. Hyperkalemia
B. Hyponatremia
C. Elevated Creatinine
D. Hypokalemia
