NUR 257 - ADVANCED NURSING
CONCEPTS II COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT-GALEN.
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range, this is
uncompensated respiratory acidosis.
2. The nurse is caring for a patient with a potassium level of 6.4 mEq/L. Which ECG change
should the nurse monitor for most closely?
A. Tall, peaked T waves
B. Prolonged ST segment
,C. Prominent U waves
D. Inverted P waves
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T
waves, widened QRS complexes, and potentially cardiac arrest.
3. A patient with Chronic Kidney Disease (CKD) has a Glomerular Filtration Rate (GFR) of 25
mL/min. Which stage of CKD is this patient in?
A. Stage 2
B. Stage 4
C. Stage 3
D. Stage 5
Answer: B
Conceptual Explanation: Stage 4 CKD is defined as a severe decrease in GFR, ranging from
15 to 29 mL/min.
4. Which clinical manifestation is most characteristic of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Extreme thirst
B. Urine output of 500 mL/hr
C. Increased serum osmolality
, D. Serum sodium of 128 mEq/L
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia. Low serum sodium is a hallmark finding.
5. A patient is admitted with a suspected Addisonian Crisis. Which set of laboratory findings is
expected?
A. Hyperglycemia and Hypokalemia
B. Hypernatremia and Hypertension
C. Hyponatremia and Hyperkalemia
D. Hypocalcemia and Metabolic Alkalosis
Answer: C
Conceptual Explanation: Adrenal insufficiency (Addison’s) leads to low aldosterone,
causing the body to lose sodium (hyponatremia) and retain potassium (hyperkalemia).
6. A patient in the ICU has an ICP monitor showing a reading of 25 mmHg. Which action is the
priority?
A. Place the patient in Trendelenburg position
B. Encourage the patient to perform the Valsalva maneuver
C. Maintain the head of the bed at 30 degrees
D. Increase environmental stimuli to check for responsiveness
CONCEPTS II COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT-GALEN.
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range, this is
uncompensated respiratory acidosis.
2. The nurse is caring for a patient with a potassium level of 6.4 mEq/L. Which ECG change
should the nurse monitor for most closely?
A. Tall, peaked T waves
B. Prolonged ST segment
,C. Prominent U waves
D. Inverted P waves
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T
waves, widened QRS complexes, and potentially cardiac arrest.
3. A patient with Chronic Kidney Disease (CKD) has a Glomerular Filtration Rate (GFR) of 25
mL/min. Which stage of CKD is this patient in?
A. Stage 2
B. Stage 4
C. Stage 3
D. Stage 5
Answer: B
Conceptual Explanation: Stage 4 CKD is defined as a severe decrease in GFR, ranging from
15 to 29 mL/min.
4. Which clinical manifestation is most characteristic of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Extreme thirst
B. Urine output of 500 mL/hr
C. Increased serum osmolality
, D. Serum sodium of 128 mEq/L
Answer: D
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
retention and dilutional hyponatremia. Low serum sodium is a hallmark finding.
5. A patient is admitted with a suspected Addisonian Crisis. Which set of laboratory findings is
expected?
A. Hyperglycemia and Hypokalemia
B. Hypernatremia and Hypertension
C. Hyponatremia and Hyperkalemia
D. Hypocalcemia and Metabolic Alkalosis
Answer: C
Conceptual Explanation: Adrenal insufficiency (Addison’s) leads to low aldosterone,
causing the body to lose sodium (hyponatremia) and retain potassium (hyperkalemia).
6. A patient in the ICU has an ICP monitor showing a reading of 25 mmHg. Which action is the
priority?
A. Place the patient in Trendelenburg position
B. Encourage the patient to perform the Valsalva maneuver
C. Maintain the head of the bed at 30 degrees
D. Increase environmental stimuli to check for responsiveness
