NUR 425 Exam 2: Acute & Chronic Health Disruptions In
Adults II V2 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with SIADH is experiencing a serum sodium level of 120 mEq/L. Which nursing intervention is
the highest priority?
A. Encouraging increased fluid intake
B. Administering IV 0.45% normal saline
C. Implementing seizure precautions
D. Administering a rapid bolus of D5W
Ans: C
Explanation: Severe hyponatremia places the patient at significant risk for cerebral edema and seizures.
Implementing seizure precautions is a critical safety measure when sodium levels drop below 125
mEq/L. Fluid restriction is typically required rather than encouraging intake for these patients. Rapid
correction of sodium must be avoided to prevent central pontine myelinolysis. Monitoring neurological
status is the primary nursing responsibility in acute SIADH management.
2. Which clinical manifestation should the nurse expect in a patient diagnosed with Diabetes Insipidus (DI)?
A. High urine osmolality
B. Low urine specific gravity
C. Weight gain and edema
D. Decreased serum sodium
Ans: B
,Explanation: Diabetes Insipidus is characterized by a deficiency of ADH resulting in the inability to
concentrate urine. This leads to a low urine specific gravity, typically less than 1.005. Patients will also
experience high serum osmolality and hypernatremia due to excessive water loss. Polyuria and
polydipsia are the hallmark symptoms seen in clinical practice. The nurse must monitor for signs of
dehydration and hypovolemic shock in these patients.
3. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which electrolyte abnormality is most
likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Ans: A
Explanation: During the oliguric phase of AKI, the kidneys are unable to excrete potassium effectively.
This leads to hyperkalemia, which can cause life-threatening cardiac arrhythmias. The nurse should
monitor the ECG for peaked T-waves and widened QRS complexes. Dietary restrictions of potassium and
avoiding potassium-sparing diuretics are standard interventions. Proper monitoring of intake and output
is essential during this critical phase of injury.
4. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a high phosphorus level. Which
medication will the nurse administer?
A. Calcium carbonate
B. Furosemide
C. Spironolactone
, D. Regular insulin
Ans: A
Explanation: Calcium carbonate acts as a phosphate binder when taken with meals in patients with CKD.
It binds to dietary phosphorus in the GI tract to prevent its absorption into the bloodstream. Reducing
serum phosphorus helps prevent secondary hyperparathyroidism and renal osteodystrophy. The nurse
must instruct the patient to take this medication with food for maximum effectiveness. Constipation is a
common side effect that the nurse should monitor and manage.
5. During the diuretic phase of AKI, what is the nurse’s primary concern for the patient?
A. Fluid volume overload
B. Hypernatremia
C. Metabolic acidosis
D. Dehydration and hypokalemia
Ans: D
Explanation: In the diuretic phase, the kidneys begin to recover but cannot yet concentrate urine,
leading to massive fluid loss. Patients can lose several liters of urine per day, risking severe dehydration
and hypotension. Electrolytes such as potassium are also lost in the urine, necessitating close monitoring.
The nurse must ensure adequate fluid replacement to maintain hemodynamic stability. This phase
signifies that the nephrons are recovering but are still not fully functional.
6. A patient is undergoing peritoneal dialysis. The nurse notes that the returned dialysate is cloudy. What
should the nurse do first?
A. Document the finding as normal
B. Slow the infusion rate
Adults II V2 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with SIADH is experiencing a serum sodium level of 120 mEq/L. Which nursing intervention is
the highest priority?
A. Encouraging increased fluid intake
B. Administering IV 0.45% normal saline
C. Implementing seizure precautions
D. Administering a rapid bolus of D5W
Ans: C
Explanation: Severe hyponatremia places the patient at significant risk for cerebral edema and seizures.
Implementing seizure precautions is a critical safety measure when sodium levels drop below 125
mEq/L. Fluid restriction is typically required rather than encouraging intake for these patients. Rapid
correction of sodium must be avoided to prevent central pontine myelinolysis. Monitoring neurological
status is the primary nursing responsibility in acute SIADH management.
2. Which clinical manifestation should the nurse expect in a patient diagnosed with Diabetes Insipidus (DI)?
A. High urine osmolality
B. Low urine specific gravity
C. Weight gain and edema
D. Decreased serum sodium
Ans: B
,Explanation: Diabetes Insipidus is characterized by a deficiency of ADH resulting in the inability to
concentrate urine. This leads to a low urine specific gravity, typically less than 1.005. Patients will also
experience high serum osmolality and hypernatremia due to excessive water loss. Polyuria and
polydipsia are the hallmark symptoms seen in clinical practice. The nurse must monitor for signs of
dehydration and hypovolemic shock in these patients.
3. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which electrolyte abnormality is most
likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Ans: A
Explanation: During the oliguric phase of AKI, the kidneys are unable to excrete potassium effectively.
This leads to hyperkalemia, which can cause life-threatening cardiac arrhythmias. The nurse should
monitor the ECG for peaked T-waves and widened QRS complexes. Dietary restrictions of potassium and
avoiding potassium-sparing diuretics are standard interventions. Proper monitoring of intake and output
is essential during this critical phase of injury.
4. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a high phosphorus level. Which
medication will the nurse administer?
A. Calcium carbonate
B. Furosemide
C. Spironolactone
, D. Regular insulin
Ans: A
Explanation: Calcium carbonate acts as a phosphate binder when taken with meals in patients with CKD.
It binds to dietary phosphorus in the GI tract to prevent its absorption into the bloodstream. Reducing
serum phosphorus helps prevent secondary hyperparathyroidism and renal osteodystrophy. The nurse
must instruct the patient to take this medication with food for maximum effectiveness. Constipation is a
common side effect that the nurse should monitor and manage.
5. During the diuretic phase of AKI, what is the nurse’s primary concern for the patient?
A. Fluid volume overload
B. Hypernatremia
C. Metabolic acidosis
D. Dehydration and hypokalemia
Ans: D
Explanation: In the diuretic phase, the kidneys begin to recover but cannot yet concentrate urine,
leading to massive fluid loss. Patients can lose several liters of urine per day, risking severe dehydration
and hypotension. Electrolytes such as potassium are also lost in the urine, necessitating close monitoring.
The nurse must ensure adequate fluid replacement to maintain hemodynamic stability. This phase
signifies that the nephrons are recovering but are still not fully functional.
6. A patient is undergoing peritoneal dialysis. The nurse notes that the returned dialysate is cloudy. What
should the nurse do first?
A. Document the finding as normal
B. Slow the infusion rate
