NSG 3800 Exam 3 V2 | NSG 3800 Nursing Practice – Adult Health II |
Actual Q&A with Rationale (NSG3800 Exam 3) | Galen
1. A nurse is assessing a patient with suspected acute pancreatitis. Which laboratory result
would the nurse expect to be significantly elevated?
A. Serum Potassium
B. Serum Albumin
C. Serum Amylase
D. Hemoglobin
Answer: C
Rationale: Serum amylase and lipase are the primary diagnostic indicators for acute
pancreatitis. These enzymes leak into the bloodstream when pancreatic cells are damaged
or inflamed. Typically, amylase levels rise within hours of onset and stay elevated for
several days, providing a clear clinical picture of the inflammatory process.
2. A patient diagnosed with cirrhosis presents with increased confusion and asterixis. Which
medication should the nurse anticipate administering?
A. Spironolactone
B. Furosemide
C. Propranolol
D. Lactulose
Answer: D
Rationale: Lactulose is commonly prescribed to treat hepatic encephalopathy, which is
evidenced by confusion and asterixis. It works by drawing ammonia from the blood into
the colon so it can be excreted via bowel movements. The reduction of serum ammonia is
critical for improving neurological status in patients with severe liver dysfunction.
3. A client is in the diuretic phase of acute kidney injury (AKI). Which complication is the
highest priority for the nurse to monitor?
A. Hypervolemia
B. Metabolic Acidosis
C. Hypokalemia
D. Hypertension
Answer: C
,Rationale: During the diuretic phase of AKI, the kidneys begin to recover their ability to
excrete waste but cannot yet concentrate urine. This leads to massive fluid loss and
significant electrolyte depletion, particularly potassium and sodium. Monitoring for
hypokalemia is essential to prevent life-threatening cardiac dysrhythmias during this
recovery period.
4. A nurse is teaching a patient with Chronic Kidney Disease (CKD) about dietary restrictions.
Which food choice should the patient avoid due to high phosphorus levels?
A. Dairy products
B. Apples
C. White bread
D. White rice
Answer: A
Rationale: Dairy products, including milk, cheese, and yogurt, are very high in phosphorus
and must be limited in patients with CKD. As kidney function declines, phosphorus
accumulates in the blood, leading to bone disease and calcification of blood vessels.
Patients are often educated to take phosphate binders with meals to help manage these
levels.
5. Which clinical sign is an early indicator of a thyroid storm in a patient with
hyperthyroidism?
A. Bradycardia
B. Hypotension
C. Hyperthermia
D. Hyporeflexia
Answer: C
Rationale: Thyroid storm is an extreme state of hyperthyroidism characterized by a
sudden, severe worsening of symptoms. Tachycardia and high fever (hyperthermia) are the
most prominent early signs that require immediate intervention. Without rapid treatment,
the patient may progress to heart failure, pulmonary edema, and death.
6. A patient with Diabetic Ketoacidosis (DKA) is receiving intravenous insulin. The nurse notes
the blood glucose is now 240 mg/dL. What should the nurse do next?
A. Stop the insulin infusion immediately
B. Administer glucagon subcutaneously
C. Increase the insulin infusion rate
D. Change the IV fluid to include 5% dextrose
, Answer: D
Rationale: When blood glucose levels drop below 250 mg/dL in a patient with DKA,
dextrose is added to the IV fluids. This prevents a rapid drop in glucose levels which could
lead to cerebral edema. The insulin infusion is typically continued at a lower rate until the
metabolic acidosis is fully resolved and the anion gap is closed.
7. Which assessment finding would lead the nurse to suspect Diabetes Insipidus (DI) following
head trauma?
A. Specific gravity of 1.035
B. Serum sodium of 130 mEq/L
C. Urine output of 500 mL/hr
D. Increased weight gain
Answer: C
Rationale: Diabetes Insipidus is characterized by a deficiency of Antidiuretic Hormone
(ADH), resulting in the excretion of large volumes of dilute urine. A urine output as high as
500 mL/hr and low urine specific gravity (under 1.005) are classic diagnostic features.
Patients also experience severe thirst and high serum sodium due to significant free water
loss.
8. A patient with Cushing’s Syndrome is at high risk for which of the following complications?
A. Hypotension
B. Infection
C. Hyperkalemia
D. Hypoglycemia
Answer: B
Rationale: Cushing’s syndrome involves an excess of cortisol, which is a potent
immunosuppressant. This puts the patient at a significantly increased risk for infection and
impaired wound healing. The nurse must monitor for subtle signs of infection because the
typical inflammatory response may be blunted by high cortisol levels.
9. A client is admitted with Addisonian Crisis. Which electrolyte imbalance is most likely to
occur?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypocalcemia
Actual Q&A with Rationale (NSG3800 Exam 3) | Galen
1. A nurse is assessing a patient with suspected acute pancreatitis. Which laboratory result
would the nurse expect to be significantly elevated?
A. Serum Potassium
B. Serum Albumin
C. Serum Amylase
D. Hemoglobin
Answer: C
Rationale: Serum amylase and lipase are the primary diagnostic indicators for acute
pancreatitis. These enzymes leak into the bloodstream when pancreatic cells are damaged
or inflamed. Typically, amylase levels rise within hours of onset and stay elevated for
several days, providing a clear clinical picture of the inflammatory process.
2. A patient diagnosed with cirrhosis presents with increased confusion and asterixis. Which
medication should the nurse anticipate administering?
A. Spironolactone
B. Furosemide
C. Propranolol
D. Lactulose
Answer: D
Rationale: Lactulose is commonly prescribed to treat hepatic encephalopathy, which is
evidenced by confusion and asterixis. It works by drawing ammonia from the blood into
the colon so it can be excreted via bowel movements. The reduction of serum ammonia is
critical for improving neurological status in patients with severe liver dysfunction.
3. A client is in the diuretic phase of acute kidney injury (AKI). Which complication is the
highest priority for the nurse to monitor?
A. Hypervolemia
B. Metabolic Acidosis
C. Hypokalemia
D. Hypertension
Answer: C
,Rationale: During the diuretic phase of AKI, the kidneys begin to recover their ability to
excrete waste but cannot yet concentrate urine. This leads to massive fluid loss and
significant electrolyte depletion, particularly potassium and sodium. Monitoring for
hypokalemia is essential to prevent life-threatening cardiac dysrhythmias during this
recovery period.
4. A nurse is teaching a patient with Chronic Kidney Disease (CKD) about dietary restrictions.
Which food choice should the patient avoid due to high phosphorus levels?
A. Dairy products
B. Apples
C. White bread
D. White rice
Answer: A
Rationale: Dairy products, including milk, cheese, and yogurt, are very high in phosphorus
and must be limited in patients with CKD. As kidney function declines, phosphorus
accumulates in the blood, leading to bone disease and calcification of blood vessels.
Patients are often educated to take phosphate binders with meals to help manage these
levels.
5. Which clinical sign is an early indicator of a thyroid storm in a patient with
hyperthyroidism?
A. Bradycardia
B. Hypotension
C. Hyperthermia
D. Hyporeflexia
Answer: C
Rationale: Thyroid storm is an extreme state of hyperthyroidism characterized by a
sudden, severe worsening of symptoms. Tachycardia and high fever (hyperthermia) are the
most prominent early signs that require immediate intervention. Without rapid treatment,
the patient may progress to heart failure, pulmonary edema, and death.
6. A patient with Diabetic Ketoacidosis (DKA) is receiving intravenous insulin. The nurse notes
the blood glucose is now 240 mg/dL. What should the nurse do next?
A. Stop the insulin infusion immediately
B. Administer glucagon subcutaneously
C. Increase the insulin infusion rate
D. Change the IV fluid to include 5% dextrose
, Answer: D
Rationale: When blood glucose levels drop below 250 mg/dL in a patient with DKA,
dextrose is added to the IV fluids. This prevents a rapid drop in glucose levels which could
lead to cerebral edema. The insulin infusion is typically continued at a lower rate until the
metabolic acidosis is fully resolved and the anion gap is closed.
7. Which assessment finding would lead the nurse to suspect Diabetes Insipidus (DI) following
head trauma?
A. Specific gravity of 1.035
B. Serum sodium of 130 mEq/L
C. Urine output of 500 mL/hr
D. Increased weight gain
Answer: C
Rationale: Diabetes Insipidus is characterized by a deficiency of Antidiuretic Hormone
(ADH), resulting in the excretion of large volumes of dilute urine. A urine output as high as
500 mL/hr and low urine specific gravity (under 1.005) are classic diagnostic features.
Patients also experience severe thirst and high serum sodium due to significant free water
loss.
8. A patient with Cushing’s Syndrome is at high risk for which of the following complications?
A. Hypotension
B. Infection
C. Hyperkalemia
D. Hypoglycemia
Answer: B
Rationale: Cushing’s syndrome involves an excess of cortisol, which is a potent
immunosuppressant. This puts the patient at a significantly increased risk for infection and
impaired wound healing. The nurse must monitor for subtle signs of infection because the
typical inflammatory response may be blunted by high cortisol levels.
9. A client is admitted with Addisonian Crisis. Which electrolyte imbalance is most likely to
occur?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypocalcemia
