NUR 3250 MED-SURG EXAM 4 -
COMPREHENSIVE REVIEW |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. A patient is admitted with a blood glucose of 900 mg/dL, a pH of 7.38, and a serum
osmolarity of 350 mOsm/L. Which condition should the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemic Unawareness
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: HHS is characterized by extreme hyperglycemia (>600 mg/dL)
and high serum osmolarity without the significant acidosis or ketosis seen in DKA.
,2. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication is the priority to stabilize the cardiac membrane?
A. Calcium Gluconate
B. Regular Insulin and Dextrose
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Furosemide (Lasix)
Answer: A
Conceptual Explanation: Calcium Gluconate does not lower potassium but is
administered first to stabilize the cardiac muscle and prevent life-threatening arrhythmias.
3. Which clinical manifestation is a hallmark sign of a Thyroid Storm?
A. Bradycardia and hypothermia
B. Hyperthermia and severe tachycardia
C. Weight gain and lethargy
D. Hypotension and bradypnea
Answer: B
Conceptual Explanation: Thyroid storm is a medical emergency characterized by extreme
hypermetabolism, resulting in high fever (hyperthermia), tachycardia, and hypertension.
, 4. A patient with Diabetes Insipidus (DI) is receiving Vasopressin. Which finding indicates the
medication is effective?
A. Increased urine output
B. Decreased urine specific gravity
C. Increased urine specific gravity
D. Decreased serum sodium
Answer: C
Conceptual Explanation: Vasopressin acts as ADH. Effectiveness is shown by a decrease in
urine output and an increase in the concentration (specific gravity) of the urine.
5. A patient with HIV has a CD4+ T-cell count of 150 cells/mm3. How should the nurse classify
this stage of the infection?
A. Stage 3: AIDS
B. Stage 2: Chronic Infection
C. Stage 1: Acute Infection
D. Stage 0: Early Infection
Answer: A
Conceptual Explanation: According to the CDC, an individual with HIV is diagnosed with
AIDS (Stage 3) when the CD4+ count drops below 200 cells/mm3.
COMPREHENSIVE REVIEW |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. A patient is admitted with a blood glucose of 900 mg/dL, a pH of 7.38, and a serum
osmolarity of 350 mOsm/L. Which condition should the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemic Unawareness
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: HHS is characterized by extreme hyperglycemia (>600 mg/dL)
and high serum osmolarity without the significant acidosis or ketosis seen in DKA.
,2. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication is the priority to stabilize the cardiac membrane?
A. Calcium Gluconate
B. Regular Insulin and Dextrose
C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Furosemide (Lasix)
Answer: A
Conceptual Explanation: Calcium Gluconate does not lower potassium but is
administered first to stabilize the cardiac muscle and prevent life-threatening arrhythmias.
3. Which clinical manifestation is a hallmark sign of a Thyroid Storm?
A. Bradycardia and hypothermia
B. Hyperthermia and severe tachycardia
C. Weight gain and lethargy
D. Hypotension and bradypnea
Answer: B
Conceptual Explanation: Thyroid storm is a medical emergency characterized by extreme
hypermetabolism, resulting in high fever (hyperthermia), tachycardia, and hypertension.
, 4. A patient with Diabetes Insipidus (DI) is receiving Vasopressin. Which finding indicates the
medication is effective?
A. Increased urine output
B. Decreased urine specific gravity
C. Increased urine specific gravity
D. Decreased serum sodium
Answer: C
Conceptual Explanation: Vasopressin acts as ADH. Effectiveness is shown by a decrease in
urine output and an increase in the concentration (specific gravity) of the urine.
5. A patient with HIV has a CD4+ T-cell count of 150 cells/mm3. How should the nurse classify
this stage of the infection?
A. Stage 3: AIDS
B. Stage 2: Chronic Infection
C. Stage 1: Acute Infection
D. Stage 0: Early Infection
Answer: A
Conceptual Explanation: According to the CDC, an individual with HIV is diagnosed with
AIDS (Stage 3) when the CD4+ count drops below 200 cells/mm3.
