GALEN NUR 242 MED-SURG EXAM 3
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which of the following provider orders should the nurse prioritize first?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Administer 50% Dextrose and Regular Insulin IV
C. Initiate continuous cardiac monitoring
D. Collect a repeat potassium specimen to verify results
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0) poses an immediate risk for life-
threatening dysrhythmias and cardiac arrest. Before administering medications to lower
potassium, the nurse must monitor the heart’s electrical activity.
2. Which assessment finding is most indicative of peritonitis in a patient receiving peritoneal
dialysis?
A. Hyperactive bowel sounds
B. Reports of mild abdominal cramping during inflow
,C. Effluent that appears cloudy or opaque
D. A dialysate outflow volume less than the inflow
Answer: C
Conceptual Explanation: Cloudy or opaque dialysate drainage is the earliest sign of
peritonitis. Other signs include fever, abdominal pain, and rebound tenderness.
3. A patient is diagnosed with Prerenal Acute Kidney Injury (AKI). Which of the following
conditions most likely contributed to this diagnosis?
A. Acute glomerulonephritis
B. Aminoglycoside antibiotic toxicity
C. Severe dehydration from excessive diuresis
D. Benign Prostatic Hyperplasia (BPH)
Answer: C
Conceptual Explanation: Prerenal AKI is caused by factors that reduce systemic
circulation, causing a decrease in renal blood flow (e.g., dehydration, heart failure, shock).
BPH is postrenal; aminoglycosides are intrarenal.
4. The nurse is caring for a patient with cirrhosis who has developed hepatic encephalopathy.
Which medication should the nurse anticipate administering to reduce serum ammonia
levels?
A. Lactulose
, B. Spironolactone
C. Propranolol
D. Vitamin K
Answer: A
Conceptual Explanation: Lactulose promotes the excretion of ammonia through the stool
by creating an acidic environment in the bowel that traps ammonia and acts as a laxative.
5. A patient with Acute Pancreatitis is NPO and has a nasogastric (NG) tube to low
intermittent suction. What is the primary rationale for this intervention?
A. To prevent the development of a paralytic ileus
B. To relieve nausea and vomiting symptoms
C. To provide a route for liquid medication administration
D. To reduce pancreatic enzyme secretion by resting the GI tract
Answer: D
Conceptual Explanation: Pancreatic enzymes are secreted in response to food or gastric
acid entering the duodenum. Staying NPO and using an NG tube to decompress the stomach
helps ‘rest’ the pancreas.
6. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.28, PaCO2 55,
HCO3 26. How should the nurse interpret these results?
A. Respiratory Acidosis, uncompensated
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which of the following provider orders should the nurse prioritize first?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Administer 50% Dextrose and Regular Insulin IV
C. Initiate continuous cardiac monitoring
D. Collect a repeat potassium specimen to verify results
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0) poses an immediate risk for life-
threatening dysrhythmias and cardiac arrest. Before administering medications to lower
potassium, the nurse must monitor the heart’s electrical activity.
2. Which assessment finding is most indicative of peritonitis in a patient receiving peritoneal
dialysis?
A. Hyperactive bowel sounds
B. Reports of mild abdominal cramping during inflow
,C. Effluent that appears cloudy or opaque
D. A dialysate outflow volume less than the inflow
Answer: C
Conceptual Explanation: Cloudy or opaque dialysate drainage is the earliest sign of
peritonitis. Other signs include fever, abdominal pain, and rebound tenderness.
3. A patient is diagnosed with Prerenal Acute Kidney Injury (AKI). Which of the following
conditions most likely contributed to this diagnosis?
A. Acute glomerulonephritis
B. Aminoglycoside antibiotic toxicity
C. Severe dehydration from excessive diuresis
D. Benign Prostatic Hyperplasia (BPH)
Answer: C
Conceptual Explanation: Prerenal AKI is caused by factors that reduce systemic
circulation, causing a decrease in renal blood flow (e.g., dehydration, heart failure, shock).
BPH is postrenal; aminoglycosides are intrarenal.
4. The nurse is caring for a patient with cirrhosis who has developed hepatic encephalopathy.
Which medication should the nurse anticipate administering to reduce serum ammonia
levels?
A. Lactulose
, B. Spironolactone
C. Propranolol
D. Vitamin K
Answer: A
Conceptual Explanation: Lactulose promotes the excretion of ammonia through the stool
by creating an acidic environment in the bowel that traps ammonia and acts as a laxative.
5. A patient with Acute Pancreatitis is NPO and has a nasogastric (NG) tube to low
intermittent suction. What is the primary rationale for this intervention?
A. To prevent the development of a paralytic ileus
B. To relieve nausea and vomiting symptoms
C. To provide a route for liquid medication administration
D. To reduce pancreatic enzyme secretion by resting the GI tract
Answer: D
Conceptual Explanation: Pancreatic enzymes are secreted in response to food or gastric
acid entering the duodenum. Staying NPO and using an NG tube to decompress the stomach
helps ‘rest’ the pancreas.
6. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.28, PaCO2 55,
HCO3 26. How should the nurse interpret these results?
A. Respiratory Acidosis, uncompensated
