NUR 390 Exam 3 V2 | NUR 390 Nursing Care of the
Adult I | Actual Q&A with Rationale (NUR390 Exam
3) | Concordia
1. A client is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which of the following
laboratory findings should the nurse expect?
A. Blood glucose 250 mg/dL, pH 7.38, HCO3 24 mEq/L
B. Blood glucose 800 mg/dL, pH 7.45, HCO3 28 mEq/L
C. Blood glucose 450 mg/dL, pH 7.25, HCO3 14 mEq/L
D. Blood glucose 110 mg/dL, pH 7.30, HCO3 22 mEq/L
Correct Answer: C
Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and low
bicarbonate levels. A blood glucose over 250 mg/dL accompanied by a pH below 7.35 and
HCO3 below 18 mEq/L confirms the diagnosis. These findings reflect the body’s inability to
utilize glucose, leading to the breakdown of fats and subsequent ketone production.
2. A nurse is caring for a client post-thyroidectomy. The nurse notes the client is experiencing
numbness and tingling in the fingers and around the mouth. Which action should the nurse
take first?
A. Check the client’s blood pressure.
B. Assess for Chvostek’s or Trousseau’s sign.
,C. Administer a prescribed analgesic.
D. Encourage the client to cough and deep breathe.
Correct Answer: B
Explanation: Numbness and tingling following a thyroidectomy suggest hypocalcemia,
which can occur if the parathyroid glands were accidentally damaged or removed. The
nurse must assess for neuromuscular irritability using Chvostek’s or Trousseau’s signs to
confirm this complication. Early detection of hypocalcemia is vital to prevent tetany and
respiratory distress.
3. The nurse is providing discharge teaching to a client with Addison’s disease. Which
instruction is most important to include?
A. Follow a low-sodium, high-potassium diet.
B. Stop taking steroids once symptoms improve.
C. Carry a medical alert identification at all times.
D. Limit fluid intake to 1500 mL per day.
Correct Answer: C
Explanation: Addison’s disease requires lifelong hormone replacement therapy, and
patients are at risk for life-threatening Addisonian crisis during periods of stress. Carrying
medical alert identification ensures that emergency responders are aware of the need for
glucocorticoids if the client is incapacitated. The nurse must emphasize that medication
should never be abruptly discontinued to avoid adrenal insufficiency.
, 4. Which clinical manifestation would the nurse expect to find in a client with Grave’s
disease? (Select All That Apply)
A. Exophthalmos
B. Bradycardia
C. Heat intolerance
D. Weight gain
E. Tachycardia
Correct Answer: A, C, E
Explanation: Grave’s disease is a form of hyperthyroidism which accelerates metabolic
processes. Manifestations include exophthalmos (bulging eyes), heat intolerance, and
tachycardia due to the excess thyroid hormone. Bradycardia and weight gain are typically
associated with hypothyroidism rather than hyperthyroidism.
5. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse be prepared to administer immediately to protect the
heart?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium gluconate
D. Epoetin alfa
Adult I | Actual Q&A with Rationale (NUR390 Exam
3) | Concordia
1. A client is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which of the following
laboratory findings should the nurse expect?
A. Blood glucose 250 mg/dL, pH 7.38, HCO3 24 mEq/L
B. Blood glucose 800 mg/dL, pH 7.45, HCO3 28 mEq/L
C. Blood glucose 450 mg/dL, pH 7.25, HCO3 14 mEq/L
D. Blood glucose 110 mg/dL, pH 7.30, HCO3 22 mEq/L
Correct Answer: C
Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and low
bicarbonate levels. A blood glucose over 250 mg/dL accompanied by a pH below 7.35 and
HCO3 below 18 mEq/L confirms the diagnosis. These findings reflect the body’s inability to
utilize glucose, leading to the breakdown of fats and subsequent ketone production.
2. A nurse is caring for a client post-thyroidectomy. The nurse notes the client is experiencing
numbness and tingling in the fingers and around the mouth. Which action should the nurse
take first?
A. Check the client’s blood pressure.
B. Assess for Chvostek’s or Trousseau’s sign.
,C. Administer a prescribed analgesic.
D. Encourage the client to cough and deep breathe.
Correct Answer: B
Explanation: Numbness and tingling following a thyroidectomy suggest hypocalcemia,
which can occur if the parathyroid glands were accidentally damaged or removed. The
nurse must assess for neuromuscular irritability using Chvostek’s or Trousseau’s signs to
confirm this complication. Early detection of hypocalcemia is vital to prevent tetany and
respiratory distress.
3. The nurse is providing discharge teaching to a client with Addison’s disease. Which
instruction is most important to include?
A. Follow a low-sodium, high-potassium diet.
B. Stop taking steroids once symptoms improve.
C. Carry a medical alert identification at all times.
D. Limit fluid intake to 1500 mL per day.
Correct Answer: C
Explanation: Addison’s disease requires lifelong hormone replacement therapy, and
patients are at risk for life-threatening Addisonian crisis during periods of stress. Carrying
medical alert identification ensures that emergency responders are aware of the need for
glucocorticoids if the client is incapacitated. The nurse must emphasize that medication
should never be abruptly discontinued to avoid adrenal insufficiency.
, 4. Which clinical manifestation would the nurse expect to find in a client with Grave’s
disease? (Select All That Apply)
A. Exophthalmos
B. Bradycardia
C. Heat intolerance
D. Weight gain
E. Tachycardia
Correct Answer: A, C, E
Explanation: Grave’s disease is a form of hyperthyroidism which accelerates metabolic
processes. Manifestations include exophthalmos (bulging eyes), heat intolerance, and
tachycardia due to the excess thyroid hormone. Bradycardia and weight gain are typically
associated with hypothyroidism rather than hyperthyroidism.
5. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse be prepared to administer immediately to protect the
heart?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium gluconate
D. Epoetin alfa
