NRSG 110 Exam 4 V2 | NRSG 110 Medical Surgical
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 4) | Ivy Tech
1. A nurse is teaching a client about the proper sequence for mixing Regular and NPH insulin.
Which instruction is correct?
A. Draw up the NPH insulin first, followed by the Regular insulin.
B. Draw up the Regular insulin first, then draw up the NPH insulin.
C. Inject air into the Regular vial first, then inject air into the NPH vial.
D. Mix the two insulins in a single vial and store them for up to one week.
Correct Answer: B
Explanation: Regular insulin is ‘clear’ and NPH is ‘cloudy,’ and the clear insulin must
always be drawn first to prevent contamination of the short-acting vial. The procedure
involves injecting air into NPH, then air into Regular, drawing Regular, and finally drawing
NPH. This practice ensures that the rapid-acting properties of the Regular insulin are not
compromised by NPH particles.
2. A patient is diagnosed with Acute Kidney Injury (AKI). The nurse notes that the patient’s
urine output has decreased to 300 mL/day and the serum creatinine is rising. Which phase of
AKI is the patient currently experiencing?
A. Oliguric Phase
B. Diuretic Phase
,C. Recovery Phase
D. Onset Phase
E. Post-renal Phase
Correct Answer: A
Explanation: The oliguric phase is characterized by a urine output of less than 400
mL/day and a significant rise in serum creatinine and BUN levels. This stage represents the
period where metabolic wastes accumulate because the kidneys are unable to filter
effectively. Nursing care during this phase focuses on monitoring for fluid volume overload
and electrolyte imbalances.
3. A client with Graves’ disease is admitted to the medical-surgical unit. Which clinical
manifestation should the nurse expect to observe?
A. Bradycardia and weight gain
B. Exophthalmos and heat intolerance
C. Cold intolerance and lethargy
D. Periorbital edema and dry skin
Correct Answer: B
Explanation: Graves’ disease is a form of hyperthyroidism which accelerates the body’s
metabolism, leading to heat intolerance and weight loss despite increased appetite.
Exophthalmos, or bulging of the eyes, is a classic sign specific to Graves’ disease due to
, tissue swelling behind the eyes. Nurses should provide eye care, such as lubricant drops, to
prevent corneal abrasion in these patients.
4. Which electrolyte imbalance is most commonly associated with a positive Chvostek’s sign
in a post-thyroidectomy patient?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypercalcemia
Correct Answer: C
Explanation: Hypocalcemia occurs if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Chvostek’s sign involves tapping the facial nerve, which
causes a twitch if calcium levels are low. The nurse must have calcium gluconate readily
available for emergency intravenous administration.
5. A patient with Chronic Kidney Disease (CKD) is prescribed Sevelamer. What is the primary
purpose of this medication?
A. To bind dietary phosphorus in the GI tract
B. To stimulate red blood cell production
C. To lower blood pressure
D. To increase calcium absorption from the gut
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 4) | Ivy Tech
1. A nurse is teaching a client about the proper sequence for mixing Regular and NPH insulin.
Which instruction is correct?
A. Draw up the NPH insulin first, followed by the Regular insulin.
B. Draw up the Regular insulin first, then draw up the NPH insulin.
C. Inject air into the Regular vial first, then inject air into the NPH vial.
D. Mix the two insulins in a single vial and store them for up to one week.
Correct Answer: B
Explanation: Regular insulin is ‘clear’ and NPH is ‘cloudy,’ and the clear insulin must
always be drawn first to prevent contamination of the short-acting vial. The procedure
involves injecting air into NPH, then air into Regular, drawing Regular, and finally drawing
NPH. This practice ensures that the rapid-acting properties of the Regular insulin are not
compromised by NPH particles.
2. A patient is diagnosed with Acute Kidney Injury (AKI). The nurse notes that the patient’s
urine output has decreased to 300 mL/day and the serum creatinine is rising. Which phase of
AKI is the patient currently experiencing?
A. Oliguric Phase
B. Diuretic Phase
,C. Recovery Phase
D. Onset Phase
E. Post-renal Phase
Correct Answer: A
Explanation: The oliguric phase is characterized by a urine output of less than 400
mL/day and a significant rise in serum creatinine and BUN levels. This stage represents the
period where metabolic wastes accumulate because the kidneys are unable to filter
effectively. Nursing care during this phase focuses on monitoring for fluid volume overload
and electrolyte imbalances.
3. A client with Graves’ disease is admitted to the medical-surgical unit. Which clinical
manifestation should the nurse expect to observe?
A. Bradycardia and weight gain
B. Exophthalmos and heat intolerance
C. Cold intolerance and lethargy
D. Periorbital edema and dry skin
Correct Answer: B
Explanation: Graves’ disease is a form of hyperthyroidism which accelerates the body’s
metabolism, leading to heat intolerance and weight loss despite increased appetite.
Exophthalmos, or bulging of the eyes, is a classic sign specific to Graves’ disease due to
, tissue swelling behind the eyes. Nurses should provide eye care, such as lubricant drops, to
prevent corneal abrasion in these patients.
4. Which electrolyte imbalance is most commonly associated with a positive Chvostek’s sign
in a post-thyroidectomy patient?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypercalcemia
Correct Answer: C
Explanation: Hypocalcemia occurs if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Chvostek’s sign involves tapping the facial nerve, which
causes a twitch if calcium levels are low. The nurse must have calcium gluconate readily
available for emergency intravenous administration.
5. A patient with Chronic Kidney Disease (CKD) is prescribed Sevelamer. What is the primary
purpose of this medication?
A. To bind dietary phosphorus in the GI tract
B. To stimulate red blood cell production
C. To lower blood pressure
D. To increase calcium absorption from the gut
