NU 185
Exam 3 Medical-Surgical Nursing II (2026)
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
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,NU 185 Exam 3 Medical-Surgical Nursing II (2026) UPDATED – Galen
1. A patient is admitted with a suspected diagnosis of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result should the nurse prioritize?
A. Serum osmolality 300 mOsm/kg
B. Serum potassium 5.2 mEq/L
C. Serum sodium 118 mEq/L
D. Urine specific gravity 1.005
Answer: C
Rationale: SIADH causes excessive water retention leading to dilutional hyponatremia. A
sodium level of 118 mEq/L is critically low and places the patient at high risk for seizures
and cerebral edema.
2. The nurse is caring for a patient in the acute phase of an Addisonian crisis. Which
medication is the priority for administration?
A. IV Hydrocortisone sodium succinate
B. Oral fludrocortisone
C. Regular insulin
D. Potassium chloride IV
, Answer: A
Rationale: Addisonian crisis is a life-threatening emergency caused by acute adrenal
insufficiency. Immediate IV replacement of glucocorticoids (Hydrocortisone) is essential to
restore vascular tone and prevent shock.
3. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). The nurse
notes a potassium level of 3.3 mEq/L. What is the most appropriate action by the nurse?
A. Notify the provider and ensure potassium replacement is initiated before or with insulin.
B. Begin the insulin drip as ordered immediately.
C. Administer a bolus of 50% Dextrose.
D. Place the patient on a cardiac monitor and reassess in 2 hours.
Answer: A
Rationale: Insulin causes potassium to shift into the cells, which will further drop the
serum potassium level. If insulin is started when the patient is already hypokalemic, it can
lead to fatal arrhythmias.
4. Which clinical manifestation is a hallmark sign of a patient experiencing a Thyroid Storm?
A. Bradycardia and hypotension
B. Constipation and weight gain
C. Severe hyperthermia and tachycardia
D. Hypercalcemia and lethargy
Exam 3 Medical-Surgical Nursing II (2026)
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Exam 3 Medical-Surgical Nursing II (2026) UPDATED – Galen
1. A patient is admitted with a suspected diagnosis of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH). Which laboratory result should the nurse prioritize?
A. Serum osmolality 300 mOsm/kg
B. Serum potassium 5.2 mEq/L
C. Serum sodium 118 mEq/L
D. Urine specific gravity 1.005
Answer: C
Rationale: SIADH causes excessive water retention leading to dilutional hyponatremia. A
sodium level of 118 mEq/L is critically low and places the patient at high risk for seizures
and cerebral edema.
2. The nurse is caring for a patient in the acute phase of an Addisonian crisis. Which
medication is the priority for administration?
A. IV Hydrocortisone sodium succinate
B. Oral fludrocortisone
C. Regular insulin
D. Potassium chloride IV
, Answer: A
Rationale: Addisonian crisis is a life-threatening emergency caused by acute adrenal
insufficiency. Immediate IV replacement of glucocorticoids (Hydrocortisone) is essential to
restore vascular tone and prevent shock.
3. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). The nurse
notes a potassium level of 3.3 mEq/L. What is the most appropriate action by the nurse?
A. Notify the provider and ensure potassium replacement is initiated before or with insulin.
B. Begin the insulin drip as ordered immediately.
C. Administer a bolus of 50% Dextrose.
D. Place the patient on a cardiac monitor and reassess in 2 hours.
Answer: A
Rationale: Insulin causes potassium to shift into the cells, which will further drop the
serum potassium level. If insulin is started when the patient is already hypokalemic, it can
lead to fatal arrhythmias.
4. Which clinical manifestation is a hallmark sign of a patient experiencing a Thyroid Storm?
A. Bradycardia and hypotension
B. Constipation and weight gain
C. Severe hyperthermia and tachycardia
D. Hypercalcemia and lethargy
