NUR 253 EXAM 3 - ADVANCED
MEDICAL-SURGICAL NURSING
QUESTIONS & ANSWERS (VERIFIED
ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient with cirrhosis is experiencing hepatic encephalopathy. The nurse notes a flapping
tremor of the hands when the patient extends their arms. How should the nurse document
this finding?
A. Fetor hepaticus
B. Asterixis
C. Caput medusae
D. Palmar erythema
Answer: B
Conceptual Explanation: Asterixis is a classic sign of hepatic encephalopathy
characterized by a coarse flapping tremor of the hands when extended.
,2. Which laboratory value is most indicative of acute pancreatitis?
A. Elevated serum bilirubin
B. Elevated serum amylase and lipase
C. Decreased serum calcium
D. Elevated white blood cell count
Answer: B
Conceptual Explanation: Serum amylase and lipase are the primary biochemical markers
for acute pancreatitis; lipase is more specific to the pancreas.
3. A client with Addison’s disease is admitted with a blood pressure of 80/45 mmHg and a
potassium level of 6.2 mEq/L. Which medication should the nurse anticipate administering
first?
A. Spironolactone
B. Potassium chloride
C. Oral fludrocortisone
D. Hydrocortisone IV
Answer: D
Conceptual Explanation: In an Addisonian crisis, rapid replacement of glucocorticoids
(Hydrocortisone) and fluids is vital to restore blood pressure and electrolyte balance.
, 4. A patient is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation is the
nurse most likely to observe?
A. Serum sodium of 128 mEq/L
B. Urine specific gravity of 1.002
C. Weight gain and edema
D. Hypertension
Answer: B
Conceptual Explanation: DI involves a deficiency in ADH, leading to massive diuresis of
dilute urine, typically resulting in a very low urine specific gravity (less than 1.005).
5. What is the priority assessment for a patient immediately following a thyroidectomy?
A. Monitoring for Chvostek’s sign
B. Assessing for laryngeal nerve damage and airway patency
C. Checking the posterior surgical dressing for bleeding
D. Measuring thyroid stimulating hormone (TSH) levels
Answer: B
Conceptual Explanation: Post-thyroidectomy, the highest priority is airway maintenance
due to the risk of edema or hematoma near the trachea.
MEDICAL-SURGICAL NURSING
QUESTIONS & ANSWERS (VERIFIED
ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient with cirrhosis is experiencing hepatic encephalopathy. The nurse notes a flapping
tremor of the hands when the patient extends their arms. How should the nurse document
this finding?
A. Fetor hepaticus
B. Asterixis
C. Caput medusae
D. Palmar erythema
Answer: B
Conceptual Explanation: Asterixis is a classic sign of hepatic encephalopathy
characterized by a coarse flapping tremor of the hands when extended.
,2. Which laboratory value is most indicative of acute pancreatitis?
A. Elevated serum bilirubin
B. Elevated serum amylase and lipase
C. Decreased serum calcium
D. Elevated white blood cell count
Answer: B
Conceptual Explanation: Serum amylase and lipase are the primary biochemical markers
for acute pancreatitis; lipase is more specific to the pancreas.
3. A client with Addison’s disease is admitted with a blood pressure of 80/45 mmHg and a
potassium level of 6.2 mEq/L. Which medication should the nurse anticipate administering
first?
A. Spironolactone
B. Potassium chloride
C. Oral fludrocortisone
D. Hydrocortisone IV
Answer: D
Conceptual Explanation: In an Addisonian crisis, rapid replacement of glucocorticoids
(Hydrocortisone) and fluids is vital to restore blood pressure and electrolyte balance.
, 4. A patient is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation is the
nurse most likely to observe?
A. Serum sodium of 128 mEq/L
B. Urine specific gravity of 1.002
C. Weight gain and edema
D. Hypertension
Answer: B
Conceptual Explanation: DI involves a deficiency in ADH, leading to massive diuresis of
dilute urine, typically resulting in a very low urine specific gravity (less than 1.005).
5. What is the priority assessment for a patient immediately following a thyroidectomy?
A. Monitoring for Chvostek’s sign
B. Assessing for laryngeal nerve damage and airway patency
C. Checking the posterior surgical dressing for bleeding
D. Measuring thyroid stimulating hormone (TSH) levels
Answer: B
Conceptual Explanation: Post-thyroidectomy, the highest priority is airway maintenance
due to the risk of edema or hematoma near the trachea.
