NUR 242 EXAM 3 - MED-SURG NURSING
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer first to protect the heart from
arrhythmias?
A. Sodium polystyrene sulfonate
B. Insulin and Dextrose 50%
C. Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial cell membrane to prevent life-threatening arrhythmias associated with severe
hyperkalemia.
2. Which clinical manifestation is a hallmark sign of Dialysis Disequilibrium Syndrome (DDS)
following a patient’s first hemodialysis session?
A. Hypotension and bradycardia
B. Hyperthermia and tachycardia
,C. Severe muscle cramps and itching
D. Headache, nausea, and confusion
Answer: D
Conceptual Explanation: DDS is caused by the rapid removal of urea from the blood while
it remains in the brain, creating an osmotic gradient that leads to cerebral edema. Common
signs include headache, confusion, and vomiting.
3. A patient with Chronic Kidney Disease (CKD) presents with a hemoglobin of 8.2 g/dL. Which
pathophysiological mechanism is primarily responsible for this finding?
A. Chronic gastrointestinal bleeding
B. Iron deficiency due to dietary restrictions
C. Shortened lifespan of red blood cells due to uremia
D. Inadequate production of erythropoietin by the kidneys
Answer: D
Conceptual Explanation: The kidneys produce erythropoietin, which stimulates RBC
production. In CKD, decreased kidney function leads to decreased erythropoietin and
subsequent anemia.
4. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, which finding
indicates the site is patent?
A. Absence of a thrill upon palpation
, B. Presence of a bruit and a palpable thrill
C. A high-pitched whistling sound on auscultation
D. Coolness and pallor distal to the site
Answer: B
Conceptual Explanation: A functional AV fistula should have a palpable thrill (vibration)
and an audible bruit (swishing sound), indicating adequate blood flow.
5. A patient in the oliguric phase of AKI has a 24-hour urine output of 350 mL. What is the
priority nursing intervention regarding fluid management?
A. Limit fluid intake to 400-600 mL plus the previous day’s output
B. Encourage oral fluids to stimulate kidney function
C. Administer aggressive IV boluses of Normal Saline
D. Monitor for signs of hypovolemia and dehydration
Answer: A
Conceptual Explanation: In the oliguric phase, fluid overload is a major risk. Fluid
restriction is calculated by adding the previous day’s output plus estimated insensible
losses (usually 500-600 mL).
6. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which
laboratory result most distinguishes DKA from Hyperosmolar Hyperglycemic State (HHS)?
A. Blood glucose of 550 mg/dL
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer first to protect the heart from
arrhythmias?
A. Sodium polystyrene sulfonate
B. Insulin and Dextrose 50%
C. Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial cell membrane to prevent life-threatening arrhythmias associated with severe
hyperkalemia.
2. Which clinical manifestation is a hallmark sign of Dialysis Disequilibrium Syndrome (DDS)
following a patient’s first hemodialysis session?
A. Hypotension and bradycardia
B. Hyperthermia and tachycardia
,C. Severe muscle cramps and itching
D. Headache, nausea, and confusion
Answer: D
Conceptual Explanation: DDS is caused by the rapid removal of urea from the blood while
it remains in the brain, creating an osmotic gradient that leads to cerebral edema. Common
signs include headache, confusion, and vomiting.
3. A patient with Chronic Kidney Disease (CKD) presents with a hemoglobin of 8.2 g/dL. Which
pathophysiological mechanism is primarily responsible for this finding?
A. Chronic gastrointestinal bleeding
B. Iron deficiency due to dietary restrictions
C. Shortened lifespan of red blood cells due to uremia
D. Inadequate production of erythropoietin by the kidneys
Answer: D
Conceptual Explanation: The kidneys produce erythropoietin, which stimulates RBC
production. In CKD, decreased kidney function leads to decreased erythropoietin and
subsequent anemia.
4. When assessing a patient’s arteriovenous (AV) fistula for hemodialysis, which finding
indicates the site is patent?
A. Absence of a thrill upon palpation
, B. Presence of a bruit and a palpable thrill
C. A high-pitched whistling sound on auscultation
D. Coolness and pallor distal to the site
Answer: B
Conceptual Explanation: A functional AV fistula should have a palpable thrill (vibration)
and an audible bruit (swishing sound), indicating adequate blood flow.
5. A patient in the oliguric phase of AKI has a 24-hour urine output of 350 mL. What is the
priority nursing intervention regarding fluid management?
A. Limit fluid intake to 400-600 mL plus the previous day’s output
B. Encourage oral fluids to stimulate kidney function
C. Administer aggressive IV boluses of Normal Saline
D. Monitor for signs of hypovolemia and dehydration
Answer: A
Conceptual Explanation: In the oliguric phase, fluid overload is a major risk. Fluid
restriction is calculated by adding the previous day’s output plus estimated insensible
losses (usually 500-600 mL).
6. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which
laboratory result most distinguishes DKA from Hyperosmolar Hyperglycemic State (HHS)?
A. Blood glucose of 550 mg/dL
