NU 185 Medical-Surgical Nursing II - Exam 3 Advan… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Medical-Surgical Nursing II - Exam 3 Advanced
Concepts 2026/2027 UPDATE |Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NU 185 Medical-Surgical Nursing II - Exam 3 Advan… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Diabetic Ketoacidosis (DKA) is receiving an insulin drip. The nurse notes
the blood glucose has dropped from 450 mg/dL to 230 mg/dL in the last two hours. Which
action should the nurse take next?
A. is receiving an insulin drip. The nurse notes the blood glucose has dropped from 450 mg/dL to 230
mg/dL in the last two hours. Which action should the nurse take next?
B. Increase the insulin infusion rate.
C. Change the IV fluid to include 5% dextrose.
D. Administer 1 mg of glucagon subcutaneously.
Answer: C
Rationale: When blood glucose levels approach 250 mg/dL in DKA, dextrose is added to the IV fluids
to prevent hypoglycemia and a rapid drop in serum osmolality, which could lead to cerebral edema.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Clear understanding of this
concept improves both test performance and everyday clinical judgment. Practice applying it to short
case scenarios to lock the idea in place.
2. A patient with acute pancreatitis reports increased pain and the nurse observes a bluish
discoloration around the umbilicus. How should the nurse document this finding?
A. Cullen’s sign
B. Murphy’s sign
C. Turner’s sign
D. Chvostek’s sign
Answer: A
Rationale: Cullen’s sign is a bluish discoloration of the periumbilical area, indicating retroperitoneal
hemorrhage associated with severe pancreatitis. This is important because the nurse must choose the
action that keeps the client safest while still meeting their basic needs. Always think about safety first
when answering these questions. Remembering this point will help you decide the best nursing action
when similar questions appear on the exam. Link the answer to the client’s current condition and risk
level.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Medical-Surgical Nursing II - Exam 3 Advan… 2026/2027 • Verified • Assured Grade A+
3. A patient with cirrhosis and esophageal varices is being treated for hepatic
encephalopathy. Which laboratory value indicates that lactulose is achieving the desired
therapeutic effect?
A. Decreased serum ammonia levels
B. Decreased serum bilirubin
C. Increased serum albumin
D. Decreased Prothrombin Time (PT)
Answer: A
Rationale: Lactulose works by promoting the excretion of ammonia in the stool, thereby lowering
serum ammonia levels and improving the neurological status of patients with hepatic encephalopathy.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Exam questions often test
whether you can pick the most practical and safe choice for the client in real situations. Focus on what
the nurse can actually do right now.
4. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which of
the following electrolyte imbalances is the nurse most likely to observe?
A. Hypokalemia and hypernatremia
B. Hypocalcemia and hypophosphatemia
C. Hyperkalemia and hyponatremia
D. Hypermagnesemia and hypokalemia
Answer: C
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia. Hyponatremia occurs due to water retention and the kidneys’ inability to conserve
sodium. Clear understanding of this concept improves both test performance and everyday clinical
judgment. Practice applying it to short case scenarios to lock the idea in place. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Medical-Surgical Nursing II - Exam 3 Advanced
Concepts 2026/2027 UPDATE |Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NU 185 Medical-Surgical Nursing II - Exam 3 Advan… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Diabetic Ketoacidosis (DKA) is receiving an insulin drip. The nurse notes
the blood glucose has dropped from 450 mg/dL to 230 mg/dL in the last two hours. Which
action should the nurse take next?
A. is receiving an insulin drip. The nurse notes the blood glucose has dropped from 450 mg/dL to 230
mg/dL in the last two hours. Which action should the nurse take next?
B. Increase the insulin infusion rate.
C. Change the IV fluid to include 5% dextrose.
D. Administer 1 mg of glucagon subcutaneously.
Answer: C
Rationale: When blood glucose levels approach 250 mg/dL in DKA, dextrose is added to the IV fluids
to prevent hypoglycemia and a rapid drop in serum osmolality, which could lead to cerebral edema.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Clear understanding of this
concept improves both test performance and everyday clinical judgment. Practice applying it to short
case scenarios to lock the idea in place.
2. A patient with acute pancreatitis reports increased pain and the nurse observes a bluish
discoloration around the umbilicus. How should the nurse document this finding?
A. Cullen’s sign
B. Murphy’s sign
C. Turner’s sign
D. Chvostek’s sign
Answer: A
Rationale: Cullen’s sign is a bluish discoloration of the periumbilical area, indicating retroperitoneal
hemorrhage associated with severe pancreatitis. This is important because the nurse must choose the
action that keeps the client safest while still meeting their basic needs. Always think about safety first
when answering these questions. Remembering this point will help you decide the best nursing action
when similar questions appear on the exam. Link the answer to the client’s current condition and risk
level.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Medical-Surgical Nursing II - Exam 3 Advan… 2026/2027 • Verified • Assured Grade A+
3. A patient with cirrhosis and esophageal varices is being treated for hepatic
encephalopathy. Which laboratory value indicates that lactulose is achieving the desired
therapeutic effect?
A. Decreased serum ammonia levels
B. Decreased serum bilirubin
C. Increased serum albumin
D. Decreased Prothrombin Time (PT)
Answer: A
Rationale: Lactulose works by promoting the excretion of ammonia in the stool, thereby lowering
serum ammonia levels and improving the neurological status of patients with hepatic encephalopathy.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Exam questions often test
whether you can pick the most practical and safe choice for the client in real situations. Focus on what
the nurse can actually do right now.
4. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which of
the following electrolyte imbalances is the nurse most likely to observe?
A. Hypokalemia and hypernatremia
B. Hypocalcemia and hypophosphatemia
C. Hyperkalemia and hyponatremia
D. Hypermagnesemia and hypokalemia
Answer: C
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia. Hyponatremia occurs due to water retention and the kidneys’ inability to conserve
sodium. Clear understanding of this concept improves both test performance and everyday clinical
judgment. Practice applying it to short case scenarios to lock the idea in place. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 3
