NU 185 Medical-Surgical Nursing II Exam 4 Compreh… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Medical-Surgical Nursing II Exam 4 Comprehensive
Review 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 4 Compreh… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose of 750 mg/dL and is
receiving an intravenous insulin infusion. The nurse notes the blood glucose has dropped to
250 mg/dL. Which action should the nurse take next?
A. has a serum glucose of 750 mg/dL and is receiving an intravenous insulin infusion. The nurse
notes the blood glucose has dropped to 250 mg/dL. Which action should the nurse take next?
B. Stop the insulin infusion immediately.
C. Increase the insulin infusion rate to clear remaining ketones.
D. Administer 50 mL of 50% Dextrose (D50) IV push.
Answer: A
Rationale: When blood glucose levels reach 250 to 300 mg/dL in DKA, dextrose is added to the IV
fluids to prevent hypoglycemia and cerebral edema as the insulin continues to treat the ketosis. 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.
2. Which clinical finding is most characteristic of a patient experiencing Hyperosmolar
Hyperglycemic Syndrome (HHS) rather than DKA?
A. Presence of Kussmaul respirations.
B. Severe dehydration and high serum osmolality.
C. Serum bicarbonate level of 12 mEq/L.
D. Positive urine and serum ketones.
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia and profound dehydration without
significant ketosis or acidosis, resulting in much higher serum osmolality than DKA. 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. 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 4 Compreh… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). The nurse should anticipate which laboratory result?
A. Hematocrit 55%.
B. Serum osmolality 310 mOsm/kg.
C. Urine specific gravity 1.002.
D. Serum sodium 128 mEq/L.
Answer: D
Rationale: SIADH causes water retention leading to dilutional hyponatremia. Therefore, a low serum
sodium level is expected. Urine specific gravity would be high, not low. This knowledge supports safe
care and helps the nurse teach the client and family clearly and simply. Clear teaching improves
cooperation and reduces anxiety. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
4. A client with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
assessment finding indicates the medication is effective?
A. Increased weight and increased heart rate.
B. Decreased urine output and increased urine specific gravity.
C. Decreased thirst and increased serum sodium.
D. Increased urine output and clear urine color.
Answer: B
Rationale: Desmopressin is a synthetic form of ADH. Effectiveness is demonstrated by a decrease in
the massive urine output associated with DI and an increase in urine concentration (specific gravity).
Knowing the reason behind the correct answer makes it easier to rule out the wrong options quickly.
Look for the choice that protects the client and matches the priority need. 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.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Medical-Surgical Nursing II Exam 4 Comprehensive
Review 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 4 Compreh… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose of 750 mg/dL and is
receiving an intravenous insulin infusion. The nurse notes the blood glucose has dropped to
250 mg/dL. Which action should the nurse take next?
A. has a serum glucose of 750 mg/dL and is receiving an intravenous insulin infusion. The nurse
notes the blood glucose has dropped to 250 mg/dL. Which action should the nurse take next?
B. Stop the insulin infusion immediately.
C. Increase the insulin infusion rate to clear remaining ketones.
D. Administer 50 mL of 50% Dextrose (D50) IV push.
Answer: A
Rationale: When blood glucose levels reach 250 to 300 mg/dL in DKA, dextrose is added to the IV
fluids to prevent hypoglycemia and cerebral edema as the insulin continues to treat the ketosis. 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.
2. Which clinical finding is most characteristic of a patient experiencing Hyperosmolar
Hyperglycemic Syndrome (HHS) rather than DKA?
A. Presence of Kussmaul respirations.
B. Severe dehydration and high serum osmolality.
C. Serum bicarbonate level of 12 mEq/L.
D. Positive urine and serum ketones.
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia and profound dehydration without
significant ketosis or acidosis, resulting in much higher serum osmolality than DKA. 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. 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 4 Compreh… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). The nurse should anticipate which laboratory result?
A. Hematocrit 55%.
B. Serum osmolality 310 mOsm/kg.
C. Urine specific gravity 1.002.
D. Serum sodium 128 mEq/L.
Answer: D
Rationale: SIADH causes water retention leading to dilutional hyponatremia. Therefore, a low serum
sodium level is expected. Urine specific gravity would be high, not low. This knowledge supports safe
care and helps the nurse teach the client and family clearly and simply. Clear teaching improves
cooperation and reduces anxiety. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
4. A client with Diabetes Insipidus (DI) is receiving Desmopressin (DDAVP). Which
assessment finding indicates the medication is effective?
A. Increased weight and increased heart rate.
B. Decreased urine output and increased urine specific gravity.
C. Decreased thirst and increased serum sodium.
D. Increased urine output and clear urine color.
Answer: B
Rationale: Desmopressin is a synthetic form of ADH. Effectiveness is demonstrated by a decrease in
the massive urine output associated with DI and an increase in urine concentration (specific gravity).
Knowing the reason behind the correct answer makes it easier to rule out the wrong options quickly.
Look for the choice that protects the client and matches the priority need. 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.
Exam (Elaborations) • Detailed Rationales Page 3
