NU 170 EXAM 4 ADVANCED CLINICAL
CONCEPTS QUESTIONS AND ANSWERS
WITH VERIFIED SOLUTIONS 2026/2027
UPDATE. GALEN
1. A patient’s ABG results are pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L. Which
physiological process is most likely occurring?
A. Partially compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Fully compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
Answer: B
Conceptual Explanation: The pH is acidic (below 7.35) and the PaCO2 is high (above 45),
indicating respiratory acidosis. Since the HCO3 is within the normal range (22-26), the
kidneys have not yet begun to compensate.
,2. A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and tall peaked
T waves on the EKG. Which medication should the nurse prioritize first?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Conceptual Explanation: While insulin and sodium polystyrene sulfonate lower
potassium, calcium gluconate is administered first to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
3. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which finding should the nurse expect?
A. Increased serum osmolality
B. Urine specific gravity 1.002
C. Serum sodium 128 mEq/L
D. Excessive thirst and polyuria
Answer: C
, Conceptual Explanation: SIADH causes water retention leading to dilutional
hyponatremia (sodium < 135). Urine specific gravity would be high (> 1.030) due to
concentrated urine.
4. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. What is the nurse’s
priority action?
A. Prepare for fluid bolus administration
B. Place the patient in High-Fowler’s position
C. Administer a prescribed diuretic
D. Check for signs of right-sided heart failure
Answer: A
Conceptual Explanation: A normal CVP is 2-8 mmHg. A low CVP indicates hypovolemia or
decreased preload, necessitating fluid resuscitation.
5. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which outcome indicates
the medication is effective?
A. Increase in urine specific gravity
B. Weight loss of 2 kg in 24 hours
C. Serum sodium of 150 mEq/L
D. Increased heart rate
Answer: A
CONCEPTS QUESTIONS AND ANSWERS
WITH VERIFIED SOLUTIONS 2026/2027
UPDATE. GALEN
1. A patient’s ABG results are pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L. Which
physiological process is most likely occurring?
A. Partially compensated respiratory acidosis
B. Uncompensated respiratory acidosis
C. Fully compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
Answer: B
Conceptual Explanation: The pH is acidic (below 7.35) and the PaCO2 is high (above 45),
indicating respiratory acidosis. Since the HCO3 is within the normal range (22-26), the
kidneys have not yet begun to compensate.
,2. A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and tall peaked
T waves on the EKG. Which medication should the nurse prioritize first?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Conceptual Explanation: While insulin and sodium polystyrene sulfonate lower
potassium, calcium gluconate is administered first to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
3. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which finding should the nurse expect?
A. Increased serum osmolality
B. Urine specific gravity 1.002
C. Serum sodium 128 mEq/L
D. Excessive thirst and polyuria
Answer: C
, Conceptual Explanation: SIADH causes water retention leading to dilutional
hyponatremia (sodium < 135). Urine specific gravity would be high (> 1.030) due to
concentrated urine.
4. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. What is the nurse’s
priority action?
A. Prepare for fluid bolus administration
B. Place the patient in High-Fowler’s position
C. Administer a prescribed diuretic
D. Check for signs of right-sided heart failure
Answer: A
Conceptual Explanation: A normal CVP is 2-8 mmHg. A low CVP indicates hypovolemia or
decreased preload, necessitating fluid resuscitation.
5. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which outcome indicates
the medication is effective?
A. Increase in urine specific gravity
B. Weight loss of 2 kg in 24 hours
C. Serum sodium of 150 mEq/L
D. Increased heart rate
Answer: A
