NU 155 EXAM 4 MEDICAL-SURGICAL
NURSING QUESTIONS & ANSWERS
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COLLEGE OF NURSING
1. A patient with Diabetic Ketoacidosis (DKA) is receiving IV insulin and normal saline. The
nurse notes the blood glucose has dropped to 250 mg/dL. Which action should the nurse take
next?
A. Discontinue the insulin infusion immediately.
B. Administer 15g of oral fast-acting carbohydrates.
C. Increase the insulin infusion rate to prevent rebound hyperglycemia.
D. Change the IV fluid to 5% dextrose in 0.45% normal saline.
Answer: D
Conceptual Explanation: When blood glucose levels reach approximately 250 mg/dL in
DKA, dextrose is added to the IV fluids to prevent hypoglycemia and cerebral edema as the
insulin continues to resolve the ketosis.
2. A nurse is caring for a patient who is 12 hours post-thyroidectomy. The patient reports
numbness and tingling in their fingertips. What is the priority nursing action?
A. Check the surgical dressing for hemorrhage.
,B. Encourage the patient to cough and deep breathe.
C. Administer the prescribed levothyroxine.
D. Assess for Chvostek’s sign and notify the provider.
Answer: D
Conceptual Explanation: Numbness and tingling (paresthesia) are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during thyroid surgery. Chvostek’s sign is a clinical indicator of hypocalcemia.
3. Which clinical manifestation would a nurse expect to see in a patient experiencing
Hyperosmolar Hyperglycemic Syndrome (HHS) but not in DKA?
A. Kussmaul respirations
B. Severe dehydration
C. Positive urine ketones
D. Blood glucose > 600 mg/dL
Answer: D
Conceptual Explanation: HHS is characterized by extremely high glucose levels (>600
mg/dL) and a lack of significant ketosis, whereas DKA involves lower glucose levels
(typically 300-500) and metabolic acidosis with Kussmaul breaths.
, 4. A patient with Addison’s disease is admitted for an elective surgery. Which medication
order does the nurse anticipate being most critical during the perioperative period?
A. Oral potassium supplements
B. Broad-spectrum antibiotics
C. Intravenous hydrocortisone
D. Continuous insulin infusion
Answer: C
Conceptual Explanation: Patients with adrenal insufficiency (Addison’s) cannot produce
enough cortisol to handle the stress of surgery. Supplemental IV hydrocortisone is required
to prevent an Addisonian crisis.
5. A patient with Cushing’s syndrome is at risk for which electrolyte imbalance?
A. Hyperkalemia and hyponatremia
B. Hypocalcemia and hypermagnesemia
C. Hypercalcemia and hypophosphatemia
D. Hypokalemia and hypernatremia
Answer: D
Conceptual Explanation: Excessive glucocorticoids and mineralocorticoids in Cushing’s
syndrome lead to sodium retention (hypernatremia) and potassium excretion
(hypokalemia).
NURSING QUESTIONS & ANSWERS
100% GUARANTEE PASS | GALEN
COLLEGE OF NURSING
1. A patient with Diabetic Ketoacidosis (DKA) is receiving IV insulin and normal saline. The
nurse notes the blood glucose has dropped to 250 mg/dL. Which action should the nurse take
next?
A. Discontinue the insulin infusion immediately.
B. Administer 15g of oral fast-acting carbohydrates.
C. Increase the insulin infusion rate to prevent rebound hyperglycemia.
D. Change the IV fluid to 5% dextrose in 0.45% normal saline.
Answer: D
Conceptual Explanation: When blood glucose levels reach approximately 250 mg/dL in
DKA, dextrose is added to the IV fluids to prevent hypoglycemia and cerebral edema as the
insulin continues to resolve the ketosis.
2. A nurse is caring for a patient who is 12 hours post-thyroidectomy. The patient reports
numbness and tingling in their fingertips. What is the priority nursing action?
A. Check the surgical dressing for hemorrhage.
,B. Encourage the patient to cough and deep breathe.
C. Administer the prescribed levothyroxine.
D. Assess for Chvostek’s sign and notify the provider.
Answer: D
Conceptual Explanation: Numbness and tingling (paresthesia) are early signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during thyroid surgery. Chvostek’s sign is a clinical indicator of hypocalcemia.
3. Which clinical manifestation would a nurse expect to see in a patient experiencing
Hyperosmolar Hyperglycemic Syndrome (HHS) but not in DKA?
A. Kussmaul respirations
B. Severe dehydration
C. Positive urine ketones
D. Blood glucose > 600 mg/dL
Answer: D
Conceptual Explanation: HHS is characterized by extremely high glucose levels (>600
mg/dL) and a lack of significant ketosis, whereas DKA involves lower glucose levels
(typically 300-500) and metabolic acidosis with Kussmaul breaths.
, 4. A patient with Addison’s disease is admitted for an elective surgery. Which medication
order does the nurse anticipate being most critical during the perioperative period?
A. Oral potassium supplements
B. Broad-spectrum antibiotics
C. Intravenous hydrocortisone
D. Continuous insulin infusion
Answer: C
Conceptual Explanation: Patients with adrenal insufficiency (Addison’s) cannot produce
enough cortisol to handle the stress of surgery. Supplemental IV hydrocortisone is required
to prevent an Addisonian crisis.
5. A patient with Cushing’s syndrome is at risk for which electrolyte imbalance?
A. Hyperkalemia and hyponatremia
B. Hypocalcemia and hypermagnesemia
C. Hypercalcemia and hypophosphatemia
D. Hypokalemia and hypernatremia
Answer: D
Conceptual Explanation: Excessive glucocorticoids and mineralocorticoids in Cushing’s
syndrome lead to sodium retention (hypernatremia) and potassium excretion
(hypokalemia).
