NUR 242 EXAM 5 - ADVANCED MED-
SURG NURSING QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A patient with Diabetic Ketoacidosis (DKA) is receiving a continuous intravenous infusion of
regular insulin. The nurse notes the serum potassium level is 3.4 mEq/L. Which action should
the nurse take first?
A. Increase the insulin infusion rate to resolve acidosis faster.
B. Continue the insulin infusion and recheck the level in 4 hours.
C. Notify the healthcare provider and prepare to administer potassium replacement.
D. Administer a dose of IV furosemide to prevent fluid overload.
Answer: C
Conceptual Explanation: Insulin causes potassium to move into the cells, further lowering
serum potassium. If the level is already low (3.4 mEq/L), starting or continuing insulin can
cause life-threatening hypokalemia. Potassium must be replaced before or during insulin
therapy.
,2. A patient is admitted with a suspected pheochromocytoma. Which assessment finding is
most characteristic of this condition?
A. Persistent hypotension and bradycardia.
B. Profound lethargy and cold intolerance.
C. Moon face, truncal obesity, and buffalo hump.
D. Severe headache, diaphoresis, and palpitations.
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The classic triad of symptoms includes severe headache, palpitations, and
profuse sweating, often accompanied by hypertension.
3. A nurse is caring for a patient in the emergent phase of a 40% total body surface area
(TBSA) burn. The patient’s urine output is 20 mL/hr and is dark red/maroon. What is the
priority nursing intervention?
A. Apply topical silver sulfadiazine to the burn wounds.
B. Decrease the IV fluid rate to prevent heart failure.
C. Increase the rate of IV fluid administration.
D. Administer an immediate dose of intravenous morphine.
Answer: C
, Conceptual Explanation: Dark red/maroon urine in a burn patient indicates
myoglobinuria due to muscle damage. This can lead to acute tubular necrosis. The priority
is to increase IV fluids to maintain a urine output of 75-100 mL/hr to flush the kidneys.
4. Which clinical manifestation would the nurse expect to find in a patient experiencing an
Addisonian Crisis?
A. Hypernatremia and hypokalemia.
B. Hypotension, tachycardia, and hyponatremia.
C. Hypertension and hyperglycemia.
D. Increased alertness and bounding pulses.
Answer: B
Conceptual Explanation: Addisonian crisis is an acute adrenal insufficiency characterized
by profound hypotension (from volume depletion), hyponatremia, hyperkalemia, and
hypoglycemia. Tachycardia occurs as a compensatory mechanism for low blood pressure.
5. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) has a serum
sodium of 118 mEq/L. Which complication is the nurse most concerned about?
A. Cardiac dysrhythmias.
B. Tetany and positive Trousseau’s sign.
C. Hypovolemic shock.
D. Seizures and cerebral edema.
SURG NURSING QUESTIONS &
ANSWERS 100% GUARANTEE PASS
1. A patient with Diabetic Ketoacidosis (DKA) is receiving a continuous intravenous infusion of
regular insulin. The nurse notes the serum potassium level is 3.4 mEq/L. Which action should
the nurse take first?
A. Increase the insulin infusion rate to resolve acidosis faster.
B. Continue the insulin infusion and recheck the level in 4 hours.
C. Notify the healthcare provider and prepare to administer potassium replacement.
D. Administer a dose of IV furosemide to prevent fluid overload.
Answer: C
Conceptual Explanation: Insulin causes potassium to move into the cells, further lowering
serum potassium. If the level is already low (3.4 mEq/L), starting or continuing insulin can
cause life-threatening hypokalemia. Potassium must be replaced before or during insulin
therapy.
,2. A patient is admitted with a suspected pheochromocytoma. Which assessment finding is
most characteristic of this condition?
A. Persistent hypotension and bradycardia.
B. Profound lethargy and cold intolerance.
C. Moon face, truncal obesity, and buffalo hump.
D. Severe headache, diaphoresis, and palpitations.
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The classic triad of symptoms includes severe headache, palpitations, and
profuse sweating, often accompanied by hypertension.
3. A nurse is caring for a patient in the emergent phase of a 40% total body surface area
(TBSA) burn. The patient’s urine output is 20 mL/hr and is dark red/maroon. What is the
priority nursing intervention?
A. Apply topical silver sulfadiazine to the burn wounds.
B. Decrease the IV fluid rate to prevent heart failure.
C. Increase the rate of IV fluid administration.
D. Administer an immediate dose of intravenous morphine.
Answer: C
, Conceptual Explanation: Dark red/maroon urine in a burn patient indicates
myoglobinuria due to muscle damage. This can lead to acute tubular necrosis. The priority
is to increase IV fluids to maintain a urine output of 75-100 mL/hr to flush the kidneys.
4. Which clinical manifestation would the nurse expect to find in a patient experiencing an
Addisonian Crisis?
A. Hypernatremia and hypokalemia.
B. Hypotension, tachycardia, and hyponatremia.
C. Hypertension and hyperglycemia.
D. Increased alertness and bounding pulses.
Answer: B
Conceptual Explanation: Addisonian crisis is an acute adrenal insufficiency characterized
by profound hypotension (from volume depletion), hyponatremia, hyperkalemia, and
hypoglycemia. Tachycardia occurs as a compensatory mechanism for low blood pressure.
5. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) has a serum
sodium of 118 mEq/L. Which complication is the nurse most concerned about?
A. Cardiac dysrhythmias.
B. Tetany and positive Trousseau’s sign.
C. Hypovolemic shock.
D. Seizures and cerebral edema.
