HONDROS NUR 212 EXAM 2/ 300 ACTUAL QUESTIONS
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
Each of the 300 items presents a unique clinical scenario, distinct medication,
specific nursing intervention, or a different pathophysiological aspect. Even
when questions address the same broad disease (such as Acute Kidney Injury,
Parkinson's, or chemotherapy), each one tests a separate and non-identical
detail—covering different phases, drug actions, lab values, complications, or
priority actions. The content spans renal, neurological, oncological,
gastrointestinal, and ophthalmic nursing, ensuring complete and non-
repetitive coverage of the NUR 212 Exam 2 material.
1. A patient with acute kidney injury has a serum potassium level of 6.8 mEq/L.
Which medication does the nurse anticipate administering to help lower this level?
A) Calcium gluconate
B) Sodium polystyrene sulfonate
C) Regular insulin with dextrose
D) Furosemide
Answer: B
Rationale: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange resin
that works in the gastrointestinal tract to exchange sodium ions for potassium ions,
promoting potassium excretion in the stool. This is the definitive treatment to
actually remove excess potassium from the body. Calcium gluconate is given to
protect the heart by raising the threshold for dysrhythmias but does not lower
potassium levels. Insulin with dextrose shifts potassium into cells temporarily but
does not remove it from the body. Furosemide is a loop diuretic that can help
excrete potassium but is not the primary treatment for severe hyperkalemia in a
patient with acute kidney injury, as the kidneys are not functioning optimally.
2. A patient is receiving chemotherapy and reports severe mouth pain with visible
ulcerations. Which nursing intervention is a priority?
A) Encourage the patient to use a firm-bristled toothbrush to clean the lesions.
B) Provide a diet consisting of hot, spicy, and highly acidic foods.
C) Offer soft, bland foods and cool liquids to reduce discomfort.
,D) Apply lemon-glycerin swabs to clean the mouth.
Answer: C
Rationale: Stomatitis is a common side effect of chemotherapy that causes painful
inflammation and ulceration of the oral mucosa. Offering soft, bland foods and
cool liquids helps minimize irritation and discomfort. The patient should use a soft-
bristled toothbrush to prevent further trauma to the gums. Hot, spicy, and acidic
foods will exacerbate pain and should be avoided. Lemon-glycerin swabs can dry
out and irritate the oral mucosa further, so they are not recommended.
3. A nurse is assessing a patient with a suspected diagnosis of myasthenia gravis.
Which clinical manifestation is characteristic of this condition?
A) Muscle rigidity and resting tremors
B) Involuntary choreiform movements
C) Weakness that improves with rest and worsens with exercise
D) Asymmetric muscle weakness with hyperreflexia
Answer: C
Rationale: Myasthenia gravis is characterized by fluctuating weakness of voluntary
muscles that typically worsens with activity and improves with rest. Muscle
rigidity and resting tremors are more characteristic of Parkinson's disease.
Involuntary choreiform movements are seen in Huntington's disease. Asymmetric
muscle weakness with hyperreflexia is more consistent with a stroke or other upper
motor neuron lesion, not myasthenia gravis which typically presents with
symmetrical weakness.
4. A patient in the oliguric phase of acute kidney injury has a urine output of 200
mL over 24 hours. What is the primary concern for this patient?
A) Fluid volume overload and hyperkalemia
B) Dehydration and hypovolemia
C) Hypokalemia and metabolic alkalosis
D) Excessive urine output leading to electrolyte loss
Answer: A
Rationale: The oliguric phase of acute kidney injury is characterized by a urine
output of less than 400 mL/day. This results in the retention of fluid and waste
products, leading to fluid volume overload, hypertension, edema, and life-
threatening hyperkalemia. The patient is not at risk for dehydration or
hypovolemia. Hypokalemia and metabolic alkalosis are not typical findings;
instead, the patient is at risk for hyperkalemia and metabolic acidosis due to the
kidneys' inability to excrete waste.
,5. A patient with chronic kidney disease is prescribed a phosphate binder. The
nurse should instruct the patient to take this medication at what time?
A) With meals
B) On an empty stomach
C) At bedtime
D) Before breakfast
Answer: A
Rationale: Phosphate binders are taken with meals to bind dietary phosphate in the
gastrointestinal tract, preventing its absorption and helping to control
hyperphosphatemia in patients with chronic kidney disease. Taking it on an empty
stomach or at other times would not effectively reduce phosphate absorption from
food. The timing with meals is crucial for the medication to be most effective.
6. A patient with Parkinson's disease is taking carbidopa-levodopa. Which side
effect is most concerning and should be reported to the healthcare provider
immediately?
A) Dyskinesia and mental status changes
B) Mild nausea and vomiting
C) Darkening of urine and sweat
D) Orthostatic hypotension
Answer: A
Rationale: Carbidopa-levodopa, the most effective drug for Parkinson's disease,
has serious side effects. Dyskinesia (involuntary movements) and significant
mental status changes, including confusion, hallucinations, and psychosis, are
significant side effects that require immediate medical attention. While nausea,
vomiting, darkening of secretions, and orthostatic hypotension are also side effects
of this medication, they are often manageable and not as immediately life-
threatening or severe as the neuropsychiatric and movement effects.
7. A patient with cancer is experiencing cachexia. Which dietary intervention is
most appropriate?
A) Low-calorie, low-protein diet to reduce tumor growth
B) High-calorie, high-protein diet
C) Clear liquid diet to rest the gastrointestinal tract
D) A diet with no carbohydrates to starve the cancer cells
Answer: B
Rationale: Cachexia is a wasting syndrome characterized by severe weight loss,
muscle atrophy, and malnutrition commonly seen in cancer patients. A high-
calorie, high-protein diet is essential to counteract this, support immune function,
, and maintain muscle mass. The other options are inappropriate and could worsen
the patient's nutritional status and overall condition.
8. A patient is diagnosed with a benign tumor. Which characteristic would the
nurse expect to find?
A) Rapid growth and invasion of surrounding tissue
B) Irregular shape, immobile, and hard on palpation
C) Slow growth, encapsulated, and rarely fatal
D) Metastasis to distant organs
Answer: C
Rationale: Benign tumors are characterized by slow, steady growth. They remain
localized and are contained within a capsule, which prevents them from invading
surrounding tissues. They are rarely fatal and do not metastasize. The other options
describe characteristics of malignant tumors.
9. A patient is being treated for glaucoma with timolol eye drops. Which
assessment finding is a priority for the nurse to report?
A) The patient's heart rate has decreased to 55 beats per minute.
B) The patient complains of a mild burning sensation after instilling the drops.
C) The patient's vision is slightly blurred immediately after application.
D) The patient is experiencing a headache.
Answer: A
Rationale: Timolol is a beta-blocker. Systemic absorption can occur, leading to
bradycardia, hypotension, and bronchospasm. A heart rate of 55 beats per minute is
bradycardic and should be reported to the healthcare provider. A mild burning
sensation, temporary blurred vision, and headache are localized or common side
effects that are not as critical as a systemic cardiovascular effect.
10. The nurse is evaluating a patient's understanding of cancer prevention. Which
statement indicates a need for further teaching regarding primary prevention?
A) "I will use sunscreen with an SPF of 30 every day."
B) "I have scheduled my annual mammogram for next month."
C) "I am going to start a smoking cessation program this week."
D) "I plan to eat more fruits and vegetables and exercise regularly."
Answer: B
Rationale: Primary prevention aims to prevent disease from occurring in the first
place through lifestyle changes, such as sun protection, smoking cessation, and a
healthy diet. Scheduling a mammogram is an example of secondary prevention,
which involves early detection of disease through screening.
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
Each of the 300 items presents a unique clinical scenario, distinct medication,
specific nursing intervention, or a different pathophysiological aspect. Even
when questions address the same broad disease (such as Acute Kidney Injury,
Parkinson's, or chemotherapy), each one tests a separate and non-identical
detail—covering different phases, drug actions, lab values, complications, or
priority actions. The content spans renal, neurological, oncological,
gastrointestinal, and ophthalmic nursing, ensuring complete and non-
repetitive coverage of the NUR 212 Exam 2 material.
1. A patient with acute kidney injury has a serum potassium level of 6.8 mEq/L.
Which medication does the nurse anticipate administering to help lower this level?
A) Calcium gluconate
B) Sodium polystyrene sulfonate
C) Regular insulin with dextrose
D) Furosemide
Answer: B
Rationale: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange resin
that works in the gastrointestinal tract to exchange sodium ions for potassium ions,
promoting potassium excretion in the stool. This is the definitive treatment to
actually remove excess potassium from the body. Calcium gluconate is given to
protect the heart by raising the threshold for dysrhythmias but does not lower
potassium levels. Insulin with dextrose shifts potassium into cells temporarily but
does not remove it from the body. Furosemide is a loop diuretic that can help
excrete potassium but is not the primary treatment for severe hyperkalemia in a
patient with acute kidney injury, as the kidneys are not functioning optimally.
2. A patient is receiving chemotherapy and reports severe mouth pain with visible
ulcerations. Which nursing intervention is a priority?
A) Encourage the patient to use a firm-bristled toothbrush to clean the lesions.
B) Provide a diet consisting of hot, spicy, and highly acidic foods.
C) Offer soft, bland foods and cool liquids to reduce discomfort.
,D) Apply lemon-glycerin swabs to clean the mouth.
Answer: C
Rationale: Stomatitis is a common side effect of chemotherapy that causes painful
inflammation and ulceration of the oral mucosa. Offering soft, bland foods and
cool liquids helps minimize irritation and discomfort. The patient should use a soft-
bristled toothbrush to prevent further trauma to the gums. Hot, spicy, and acidic
foods will exacerbate pain and should be avoided. Lemon-glycerin swabs can dry
out and irritate the oral mucosa further, so they are not recommended.
3. A nurse is assessing a patient with a suspected diagnosis of myasthenia gravis.
Which clinical manifestation is characteristic of this condition?
A) Muscle rigidity and resting tremors
B) Involuntary choreiform movements
C) Weakness that improves with rest and worsens with exercise
D) Asymmetric muscle weakness with hyperreflexia
Answer: C
Rationale: Myasthenia gravis is characterized by fluctuating weakness of voluntary
muscles that typically worsens with activity and improves with rest. Muscle
rigidity and resting tremors are more characteristic of Parkinson's disease.
Involuntary choreiform movements are seen in Huntington's disease. Asymmetric
muscle weakness with hyperreflexia is more consistent with a stroke or other upper
motor neuron lesion, not myasthenia gravis which typically presents with
symmetrical weakness.
4. A patient in the oliguric phase of acute kidney injury has a urine output of 200
mL over 24 hours. What is the primary concern for this patient?
A) Fluid volume overload and hyperkalemia
B) Dehydration and hypovolemia
C) Hypokalemia and metabolic alkalosis
D) Excessive urine output leading to electrolyte loss
Answer: A
Rationale: The oliguric phase of acute kidney injury is characterized by a urine
output of less than 400 mL/day. This results in the retention of fluid and waste
products, leading to fluid volume overload, hypertension, edema, and life-
threatening hyperkalemia. The patient is not at risk for dehydration or
hypovolemia. Hypokalemia and metabolic alkalosis are not typical findings;
instead, the patient is at risk for hyperkalemia and metabolic acidosis due to the
kidneys' inability to excrete waste.
,5. A patient with chronic kidney disease is prescribed a phosphate binder. The
nurse should instruct the patient to take this medication at what time?
A) With meals
B) On an empty stomach
C) At bedtime
D) Before breakfast
Answer: A
Rationale: Phosphate binders are taken with meals to bind dietary phosphate in the
gastrointestinal tract, preventing its absorption and helping to control
hyperphosphatemia in patients with chronic kidney disease. Taking it on an empty
stomach or at other times would not effectively reduce phosphate absorption from
food. The timing with meals is crucial for the medication to be most effective.
6. A patient with Parkinson's disease is taking carbidopa-levodopa. Which side
effect is most concerning and should be reported to the healthcare provider
immediately?
A) Dyskinesia and mental status changes
B) Mild nausea and vomiting
C) Darkening of urine and sweat
D) Orthostatic hypotension
Answer: A
Rationale: Carbidopa-levodopa, the most effective drug for Parkinson's disease,
has serious side effects. Dyskinesia (involuntary movements) and significant
mental status changes, including confusion, hallucinations, and psychosis, are
significant side effects that require immediate medical attention. While nausea,
vomiting, darkening of secretions, and orthostatic hypotension are also side effects
of this medication, they are often manageable and not as immediately life-
threatening or severe as the neuropsychiatric and movement effects.
7. A patient with cancer is experiencing cachexia. Which dietary intervention is
most appropriate?
A) Low-calorie, low-protein diet to reduce tumor growth
B) High-calorie, high-protein diet
C) Clear liquid diet to rest the gastrointestinal tract
D) A diet with no carbohydrates to starve the cancer cells
Answer: B
Rationale: Cachexia is a wasting syndrome characterized by severe weight loss,
muscle atrophy, and malnutrition commonly seen in cancer patients. A high-
calorie, high-protein diet is essential to counteract this, support immune function,
, and maintain muscle mass. The other options are inappropriate and could worsen
the patient's nutritional status and overall condition.
8. A patient is diagnosed with a benign tumor. Which characteristic would the
nurse expect to find?
A) Rapid growth and invasion of surrounding tissue
B) Irregular shape, immobile, and hard on palpation
C) Slow growth, encapsulated, and rarely fatal
D) Metastasis to distant organs
Answer: C
Rationale: Benign tumors are characterized by slow, steady growth. They remain
localized and are contained within a capsule, which prevents them from invading
surrounding tissues. They are rarely fatal and do not metastasize. The other options
describe characteristics of malignant tumors.
9. A patient is being treated for glaucoma with timolol eye drops. Which
assessment finding is a priority for the nurse to report?
A) The patient's heart rate has decreased to 55 beats per minute.
B) The patient complains of a mild burning sensation after instilling the drops.
C) The patient's vision is slightly blurred immediately after application.
D) The patient is experiencing a headache.
Answer: A
Rationale: Timolol is a beta-blocker. Systemic absorption can occur, leading to
bradycardia, hypotension, and bronchospasm. A heart rate of 55 beats per minute is
bradycardic and should be reported to the healthcare provider. A mild burning
sensation, temporary blurred vision, and headache are localized or common side
effects that are not as critical as a systemic cardiovascular effect.
10. The nurse is evaluating a patient's understanding of cancer prevention. Which
statement indicates a need for further teaching regarding primary prevention?
A) "I will use sunscreen with an SPF of 30 every day."
B) "I have scheduled my annual mammogram for next month."
C) "I am going to start a smoking cessation program this week."
D) "I plan to eat more fruits and vegetables and exercise regularly."
Answer: B
Rationale: Primary prevention aims to prevent disease from occurring in the first
place through lifestyle changes, such as sun protection, smoking cessation, and a
healthy diet. Scheduling a mammogram is an example of secondary prevention,
which involves early detection of disease through screening.
