GALEN NUR 242 MED-SURG EXAM 3 -
COMPREHENSIVE ADVANCED
NURSING TEST QUESTIONS AND
ANSWERS
1. A patient is admitted with a suspected Addisonian Crisis. Which of the following physician
orders should the nurse prioritize first?
A. Administering IV Hydrocortisone
B. Obtaining a STAT serum potassium level
C. Initiating rapid IV infusion of 0.9% Normal Saline
D. Administering Oral Fludrocortisone
Answer: C
Conceptual Explanation: In an Addisonian crisis, the most immediate life-threatening
issue is circulatory collapse due to severe dehydration and hypotension. Restoring volume
with 0.9% NS is the top priority, followed by steroid replacement.
2. Which lab finding is most consistent with a diagnosis of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Serum Sodium 152 mEq/L and Urine Specific Gravity 1.002
B. Serum Sodium 128 mEq/L and Urine Specific Gravity 1.035
,C. Serum Osmolality 310 mOsm/kg and Urine Osmolality 100 mOsm/kg
D. Serum Potassium 5.8 mEq/L and Urine Specific Gravity 1.010
Answer: B
Conceptual Explanation: SIADH is characterized by excessive water retention, leading to
dilutional hyponatremia (Low Serum Na) and highly concentrated urine (High Urine
Specific Gravity).
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L and
shows peaked T-waves on the EKG. Which medication should be administered first to protect
the heart?
A. Calcium Gluconate IV
B. Regular Insulin and D50W
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Sodium Bicarbonate
Answer: A
Conceptual Explanation: Calcium Gluconate does not lower potassium, but it stabilizes
the myocardial cell membrane to prevent lethal arrhythmias. It is the first priority in
symptomatic hyperkalemia.
, 4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. What is the nurse’s next action?
A. Assess the surgical site for bleeding
B. Check for Trousseau’s sign and notify the provider
C. Administer a dose of Levothyroxine
D. Increase the IV fluid rate
Answer: B
Conceptual Explanation: Tingling (paresthesia) is a sign of hypocalcemia, often caused by
accidental damage to the parathyroid glands during a thyroidectomy. Trousseau’s and
Chvostek’s signs are clinical indicators.
5. Which assessment finding in a patient with Acute Kidney Injury (AKI) suggests the cause is
‘Intrarenal’?
A. Recent treatment with IV Aminoglycoside antibiotics
B. History of benign prostatic hyperplasia (BPH)
C. Hypotension following a massive hemorrhage
D. Cardiac output of 2.5 L/min
Answer: A
COMPREHENSIVE ADVANCED
NURSING TEST QUESTIONS AND
ANSWERS
1. A patient is admitted with a suspected Addisonian Crisis. Which of the following physician
orders should the nurse prioritize first?
A. Administering IV Hydrocortisone
B. Obtaining a STAT serum potassium level
C. Initiating rapid IV infusion of 0.9% Normal Saline
D. Administering Oral Fludrocortisone
Answer: C
Conceptual Explanation: In an Addisonian crisis, the most immediate life-threatening
issue is circulatory collapse due to severe dehydration and hypotension. Restoring volume
with 0.9% NS is the top priority, followed by steroid replacement.
2. Which lab finding is most consistent with a diagnosis of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Serum Sodium 152 mEq/L and Urine Specific Gravity 1.002
B. Serum Sodium 128 mEq/L and Urine Specific Gravity 1.035
,C. Serum Osmolality 310 mOsm/kg and Urine Osmolality 100 mOsm/kg
D. Serum Potassium 5.8 mEq/L and Urine Specific Gravity 1.010
Answer: B
Conceptual Explanation: SIADH is characterized by excessive water retention, leading to
dilutional hyponatremia (Low Serum Na) and highly concentrated urine (High Urine
Specific Gravity).
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L and
shows peaked T-waves on the EKG. Which medication should be administered first to protect
the heart?
A. Calcium Gluconate IV
B. Regular Insulin and D50W
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Sodium Bicarbonate
Answer: A
Conceptual Explanation: Calcium Gluconate does not lower potassium, but it stabilizes
the myocardial cell membrane to prevent lethal arrhythmias. It is the first priority in
symptomatic hyperkalemia.
, 4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. What is the nurse’s next action?
A. Assess the surgical site for bleeding
B. Check for Trousseau’s sign and notify the provider
C. Administer a dose of Levothyroxine
D. Increase the IV fluid rate
Answer: B
Conceptual Explanation: Tingling (paresthesia) is a sign of hypocalcemia, often caused by
accidental damage to the parathyroid glands during a thyroidectomy. Trousseau’s and
Chvostek’s signs are clinical indicators.
5. Which assessment finding in a patient with Acute Kidney Injury (AKI) suggests the cause is
‘Intrarenal’?
A. Recent treatment with IV Aminoglycoside antibiotics
B. History of benign prostatic hyperplasia (BPH)
C. Hypotension following a massive hemorrhage
D. Cardiac output of 2.5 L/min
Answer: A
