NRSG 110 Exam 3 V2 | NRSG 110 Medical Surgical
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 3) | Ivy Tech
1. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a serum
potassium level of 6.2 mEq/L. Which medication should the nurse anticipate administering to
promote the excretion of potassium through the stool?
A. Sodium bicarbonate
B. Regular insulin IV
C. Calcium gluconate
D. Sodium polystyrene sulfonate
Correct Answer: D
Explanation: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange resin that
works in the bowel to exchange sodium for potassium, allowing potassium to be excreted
in the feces. This is a common treatment for hyperkalemia in patients with renal failure
who cannot filter potassium effectively. The nurse must monitor for bowel sounds and
potential constipation or bowel necrosis while the patient is receiving this medication.
2. A patient is admitted to the emergency department with suspected Addisonian Crisis.
Which clinical manifestations should the nurse expect to observe in this patient?
A. Hypotension, tachycardia, and hyponatremia
B. Hypertension and hypernatremia
,C. Weight gain and moon face
D. Bradypnea and hyperglycemia
E. Exophthalmos and tremors
Correct Answer: A
Explanation: Addisonian crisis is a life-threatening emergency caused by a severe
deficiency of cortisol and aldosterone. Clinical signs include profound hypotension due to
fluid loss, tachycardia as a compensatory mechanism, and electrolyte imbalances like
hyponatremia and hyperkalemia. Immediate intervention with IV fluids and high-dose
glucocorticoids is required to prevent circulatory collapse.
3. A nurse is providing discharge education to a patient newly diagnosed with
Hypothyroidism and prescribed levothyroxine. What is the most important instruction
regarding the administration of this medication?
A. Take the medication with a full meal to avoid GI upset.
B. Only take the medication when symptoms of fatigue occur.
C. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
D. Double the dose if a day of treatment is missed.
Correct Answer: C
Explanation: Levothyroxine absorption is significantly affected by the presence of food
and other medications in the stomach. Taking it consistently in the morning on an empty
,stomach ensures optimal bioavailability and stable therapeutic levels. The nurse should
also emphasize that this is typically a lifelong therapy and should not be discontinued
without medical supervision.
4. A patient with a history of cirrhosis is hospitalized with hepatic encephalopathy. The nurse
notes the patient has flapping tremors of the hands. How should the nurse document this
finding?
A. Trousseau’s sign
B. Chvostek’s sign
C. Asterixis
D. Ascites
Correct Answer: C
Explanation: Asterixis is a characteristic ‘flapping’ tremor of the hands and wrists that
occurs when the patient extends their arms and dorsiflexes the wrists. It is a sign of
worsening hepatic encephalopathy due to the accumulation of ammonia in the blood. The
nurse should monitor ammonia levels and the patient’s neurological status closely to
evaluate the effectiveness of treatments like lactulose.
5. A nurse is assessing a patient following a total thyroidectomy. Which of the following
findings would indicate a complication related to parathyroid gland injury?
A. Hoarseness of the voice
B. Weight gain
, C. Hyperglycemia
D. Polyuria
E. Positive Trousseau’s sign
F. Lethargy
Correct Answer: E
Explanation: Accidental removal or damage to the parathyroid glands during a
thyroidectomy can lead to hypocalcemia. A positive Trousseau’s sign (carpal spasm
induced by inflating a blood pressure cuff) indicates neuromuscular irritability due to low
calcium levels. The nurse must keep calcium gluconate at the bedside for emergency
administration if tetany occurs.
6. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which arterial
blood gas (ABG) result is most consistent with this diagnosis?
A. pH 7.48, PaCO2 35, HCO3 28
B. pH 7.35, PaCO2 45, HCO3 24
C. pH 7.28, PaCO2 30, HCO3 14
D. pH 7.55, PaCO2 25, HCO3 22
Correct Answer: C
Explanation: DKA results in metabolic acidosis due to the accumulation of ketones, which
are acidic byproducts of fat metabolism. The ABG shows a low pH (acidosis) and a low
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 3) | Ivy Tech
1. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a serum
potassium level of 6.2 mEq/L. Which medication should the nurse anticipate administering to
promote the excretion of potassium through the stool?
A. Sodium bicarbonate
B. Regular insulin IV
C. Calcium gluconate
D. Sodium polystyrene sulfonate
Correct Answer: D
Explanation: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange resin that
works in the bowel to exchange sodium for potassium, allowing potassium to be excreted
in the feces. This is a common treatment for hyperkalemia in patients with renal failure
who cannot filter potassium effectively. The nurse must monitor for bowel sounds and
potential constipation or bowel necrosis while the patient is receiving this medication.
2. A patient is admitted to the emergency department with suspected Addisonian Crisis.
Which clinical manifestations should the nurse expect to observe in this patient?
A. Hypotension, tachycardia, and hyponatremia
B. Hypertension and hypernatremia
,C. Weight gain and moon face
D. Bradypnea and hyperglycemia
E. Exophthalmos and tremors
Correct Answer: A
Explanation: Addisonian crisis is a life-threatening emergency caused by a severe
deficiency of cortisol and aldosterone. Clinical signs include profound hypotension due to
fluid loss, tachycardia as a compensatory mechanism, and electrolyte imbalances like
hyponatremia and hyperkalemia. Immediate intervention with IV fluids and high-dose
glucocorticoids is required to prevent circulatory collapse.
3. A nurse is providing discharge education to a patient newly diagnosed with
Hypothyroidism and prescribed levothyroxine. What is the most important instruction
regarding the administration of this medication?
A. Take the medication with a full meal to avoid GI upset.
B. Only take the medication when symptoms of fatigue occur.
C. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
D. Double the dose if a day of treatment is missed.
Correct Answer: C
Explanation: Levothyroxine absorption is significantly affected by the presence of food
and other medications in the stomach. Taking it consistently in the morning on an empty
,stomach ensures optimal bioavailability and stable therapeutic levels. The nurse should
also emphasize that this is typically a lifelong therapy and should not be discontinued
without medical supervision.
4. A patient with a history of cirrhosis is hospitalized with hepatic encephalopathy. The nurse
notes the patient has flapping tremors of the hands. How should the nurse document this
finding?
A. Trousseau’s sign
B. Chvostek’s sign
C. Asterixis
D. Ascites
Correct Answer: C
Explanation: Asterixis is a characteristic ‘flapping’ tremor of the hands and wrists that
occurs when the patient extends their arms and dorsiflexes the wrists. It is a sign of
worsening hepatic encephalopathy due to the accumulation of ammonia in the blood. The
nurse should monitor ammonia levels and the patient’s neurological status closely to
evaluate the effectiveness of treatments like lactulose.
5. A nurse is assessing a patient following a total thyroidectomy. Which of the following
findings would indicate a complication related to parathyroid gland injury?
A. Hoarseness of the voice
B. Weight gain
, C. Hyperglycemia
D. Polyuria
E. Positive Trousseau’s sign
F. Lethargy
Correct Answer: E
Explanation: Accidental removal or damage to the parathyroid glands during a
thyroidectomy can lead to hypocalcemia. A positive Trousseau’s sign (carpal spasm
induced by inflating a blood pressure cuff) indicates neuromuscular irritability due to low
calcium levels. The nurse must keep calcium gluconate at the bedside for emergency
administration if tetany occurs.
6. A patient with Type 1 Diabetes is admitted with Diabetic Ketoacidosis (DKA). Which arterial
blood gas (ABG) result is most consistent with this diagnosis?
A. pH 7.48, PaCO2 35, HCO3 28
B. pH 7.35, PaCO2 45, HCO3 24
C. pH 7.28, PaCO2 30, HCO3 14
D. pH 7.55, PaCO2 25, HCO3 22
Correct Answer: C
Explanation: DKA results in metabolic acidosis due to the accumulation of ketones, which
are acidic byproducts of fat metabolism. The ABG shows a low pH (acidosis) and a low
