NUR 253 EXAM 4 REVIEW QUESTIONS
& VERIFIED ANSWERS (A+
GUARANTEE) | GALEN COLLEGE OF
NURSING ()
1. A patient is admitted with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis, fully compensated
B. Metabolic Alkalosis, partially compensated
C. Respiratory Alkalosis, uncompensated
D. Respiratory Acidosis, partially compensated
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate, making it
partially compensated respiratory acidosis.
2. Which clinical finding is most characteristic of a patient in Diabetes Insipidus (DI)?
A. Urine specific gravity of 1.035
,B. Serum sodium of 128 mEq/L
C. Urine output of 500 mL/hr
D. High levels of Antidiuretic Hormone (ADH)
Answer: C
Conceptual Explanation: DI is characterized by a deficiency of ADH, leading to massive
polyuria (often >250 mL/hr) and low urine specific gravity, usually below 1.005.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate administration to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular Insulin and D50
D. Calcium Gluconate
Answer: D
Conceptual Explanation: While insulin and Kayexalate help lower potassium, Calcium
Gluconate is the priority to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
4. When caring for a patient with SIADH, which provider order should the nurse question?
A. Infusion of 0.45% Normal Saline at 125 mL/hr
, B. Administration of 3% Hypertonic Saline
C. Frequent neurological checks
D. Fluid restriction of 800 mL/24h
Answer: A
Conceptual Explanation: SIADH involves excessive water retention and hyponatremia.
Infusing hypotonic solutions like 0.45% NS would worsen the hyponatremia and cerebral
edema.
5. A patient is in the oliguric phase of Acute Kidney Injury (AKI). Which electrolyte
abnormality is the nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypermagnesemia
Answer: D
Conceptual Explanation: In AKI, the kidneys fail to excrete magnesium, potassium, and
phosphorus, leading to elevations in these electrolytes. Calcium is typically low in renal
failure.
& VERIFIED ANSWERS (A+
GUARANTEE) | GALEN COLLEGE OF
NURSING ()
1. A patient is admitted with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis, fully compensated
B. Metabolic Alkalosis, partially compensated
C. Respiratory Alkalosis, uncompensated
D. Respiratory Acidosis, partially compensated
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate, making it
partially compensated respiratory acidosis.
2. Which clinical finding is most characteristic of a patient in Diabetes Insipidus (DI)?
A. Urine specific gravity of 1.035
,B. Serum sodium of 128 mEq/L
C. Urine output of 500 mL/hr
D. High levels of Antidiuretic Hormone (ADH)
Answer: C
Conceptual Explanation: DI is characterized by a deficiency of ADH, leading to massive
polyuria (often >250 mL/hr) and low urine specific gravity, usually below 1.005.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate administration to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular Insulin and D50
D. Calcium Gluconate
Answer: D
Conceptual Explanation: While insulin and Kayexalate help lower potassium, Calcium
Gluconate is the priority to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
4. When caring for a patient with SIADH, which provider order should the nurse question?
A. Infusion of 0.45% Normal Saline at 125 mL/hr
, B. Administration of 3% Hypertonic Saline
C. Frequent neurological checks
D. Fluid restriction of 800 mL/24h
Answer: A
Conceptual Explanation: SIADH involves excessive water retention and hyponatremia.
Infusing hypotonic solutions like 0.45% NS would worsen the hyponatremia and cerebral
edema.
5. A patient is in the oliguric phase of Acute Kidney Injury (AKI). Which electrolyte
abnormality is the nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypermagnesemia
Answer: D
Conceptual Explanation: In AKI, the kidneys fail to excrete magnesium, potassium, and
phosphorus, leading to elevations in these electrolytes. Calcium is typically low in renal
failure.
