NUR 242 PRACTICE EXAM 4
(ADVANCED MEDICAL-SURGICAL
NURSING) QUESTIONS & VERIFIED
ANSWERS | GALEN COLLEGE (A+
GUARANTEE)
1. A patient with Acute Kidney Injury (AKI) enters the oliguric phase. Which laboratory finding
should the nurse anticipate as the most critical to report immediately?
A. Serum Creatinine of 2.1 mg/dL
B. BUN of 45 mg/dL
C. Serum Potassium of 6.8 mEq/L
D. Serum Sodium of 132 mEq/L
Answer: C
Conceptual Explanation: Hyperkalemia (Potassium > 6.0 mEq/L) is the most life-
threatening complication of the oliguric phase in AKI due to the risk of lethal cardiac
arrhythmias.
2. A client is diagnosed with Cushing’s Syndrome. Which of the following clinical
manifestations is the nurse most likely to observe?
A. Weight loss and hypotension
,B. Hyperpigmentation and hyperkalemia
C. Tachycardia and heat intolerance
D. Truncal obesity and moon face
Answer: D
Conceptual Explanation: Cushing’s syndrome is characterized by excess cortisol, leading
to fat redistribution (truncal obesity, moon face, buffalo hump) and skin thinning.
3. A patient presents with Diabetic Ketoacidosis (DKA). Which acid-base imbalance is
expected?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: D
Conceptual Explanation: In DKA, the breakdown of fats into ketones leads to an
accumulation of metabolic acids, resulting in metabolic acidosis with an increased anion
gap.
4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. What is the priority nursing action?
A. Administer a dose of levothyroxine
, B. Check the surgical dressing for bleeding
C. Assess for Chvostek’s sign
D. Encourage the patient to cough and deep breathe
Answer: C
Conceptual Explanation: Tingling indicates hypocalcemia, likely due to accidental
parathyroid damage. Assessing for Chvostek’s or Trousseau’s sign confirms neuromuscular
irritability before notifying the provider.
5. Which assessment finding in a patient with Cirrhosis indicates the development of Hepatic
Encephalopathy?
A. Asterixis
B. Ascites
C. Spider angiomas
D. Splenomegaly
Answer: A
Conceptual Explanation: Asterixis, or ‘flapping tremor,’ is a hallmark sign of hepatic
encephalopathy caused by high ammonia levels affecting the central nervous system.
6. A client with Chronic Kidney Disease (CKD) is prescribed Erythropoietin (Epogen). What is
the primary goal of this therapy?
A. Decrease serum phosphate
(ADVANCED MEDICAL-SURGICAL
NURSING) QUESTIONS & VERIFIED
ANSWERS | GALEN COLLEGE (A+
GUARANTEE)
1. A patient with Acute Kidney Injury (AKI) enters the oliguric phase. Which laboratory finding
should the nurse anticipate as the most critical to report immediately?
A. Serum Creatinine of 2.1 mg/dL
B. BUN of 45 mg/dL
C. Serum Potassium of 6.8 mEq/L
D. Serum Sodium of 132 mEq/L
Answer: C
Conceptual Explanation: Hyperkalemia (Potassium > 6.0 mEq/L) is the most life-
threatening complication of the oliguric phase in AKI due to the risk of lethal cardiac
arrhythmias.
2. A client is diagnosed with Cushing’s Syndrome. Which of the following clinical
manifestations is the nurse most likely to observe?
A. Weight loss and hypotension
,B. Hyperpigmentation and hyperkalemia
C. Tachycardia and heat intolerance
D. Truncal obesity and moon face
Answer: D
Conceptual Explanation: Cushing’s syndrome is characterized by excess cortisol, leading
to fat redistribution (truncal obesity, moon face, buffalo hump) and skin thinning.
3. A patient presents with Diabetic Ketoacidosis (DKA). Which acid-base imbalance is
expected?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: D
Conceptual Explanation: In DKA, the breakdown of fats into ketones leads to an
accumulation of metabolic acids, resulting in metabolic acidosis with an increased anion
gap.
4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. What is the priority nursing action?
A. Administer a dose of levothyroxine
, B. Check the surgical dressing for bleeding
C. Assess for Chvostek’s sign
D. Encourage the patient to cough and deep breathe
Answer: C
Conceptual Explanation: Tingling indicates hypocalcemia, likely due to accidental
parathyroid damage. Assessing for Chvostek’s or Trousseau’s sign confirms neuromuscular
irritability before notifying the provider.
5. Which assessment finding in a patient with Cirrhosis indicates the development of Hepatic
Encephalopathy?
A. Asterixis
B. Ascites
C. Spider angiomas
D. Splenomegaly
Answer: A
Conceptual Explanation: Asterixis, or ‘flapping tremor,’ is a hallmark sign of hepatic
encephalopathy caused by high ammonia levels affecting the central nervous system.
6. A client with Chronic Kidney Disease (CKD) is prescribed Erythropoietin (Epogen). What is
the primary goal of this therapy?
A. Decrease serum phosphate
