NSG 3250 Exam 4 V2 | NSG 3250 Adult
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following laboratory
findings should the nurse expect to observe?
A. Blood glucose 250 mg/dL and bicarbonate 12 mEq/L
B. Blood glucose 800 mg/dL and pH 7.45
C. Blood glucose 110 mg/dL and positive ketones
D. Blood glucose 400 mg/dL and bicarbonate 26 mEq/L
Answer: A
Rationale: DKA is characterized by hyperglycemia, metabolic acidosis, and ketosis. A
bicarbonate level of 12 mEq/L indicates metabolic acidosis, which is a hallmark finding in
this condition. The glucose level is typically above 250 mg/dL but not as extreme as in
HHNS.
2. Which nursing intervention is the priority for a client diagnosed with Myxedema Coma?
A. Providing a high-calorie diet
B. Applying cooling blankets
C. Administering oral levothyroxine
D. Maintaining a patent airway
,Answer: D
Rationale: Myxedema coma is a life-threatening emergency caused by severe
hypothyroidism, leading to respiratory failure and cardiovascular collapse. Maintaining a
patent airway is the priority intervention to ensure adequate oxygenation. Supportive care,
including IV levothyroxine and warming, is also critical but follows airway management.
3. A client with Chronic Kidney Disease (CKD) has a potassium level of 6.4 mEq/L. Which
medication should the nurse anticipate administering to protect the heart?
A. Sodium Polystyrene Sulfonate
B. Regular Insulin IV
C. Calcium Gluconate IV
D. Furosemide
Answer: C
Rationale: Calcium gluconate is administered in cases of severe hyperkalemia to stabilize
the myocardial cell membrane and prevent arrhythmias. While insulin and sodium
polystyrene sulfonate help lower potassium levels, they do not provide immediate cardiac
protection. The nurse must monitor the ECG continuously during administration.
4. A nurse is teaching a client with Addison’s disease about their medication regimen. Which
statement by the client indicates a need for further teaching?
A. I will wear a medical alert bracelet at all times.
B. I need to increase my dose during periods of high stress.
, C. I should skip my dose if I feel nauseated.
D. I will keep an emergency injection kit with me.
Answer: C
Rationale: Clients with Addison’s disease must never skip doses of corticosteroids as it can
precipitate an Addisonian crisis. During illness or stress, the dosage typically needs to be
increased rather than decreased. Medical alert identification is essential for safety in
emergencies.
5. A client is 4 hours post-thyroidectomy. The nurse notes the client has developed a hoarse
voice and is complaining of tingling in the fingers. What is the nurse’s priority action?
A. Reassure the client hoarseness is normal
B. Administer a cough suppressant
C. Check for Chvostek’s sign
D. Encourage the client to drink hot tea
Answer: C
Rationale: Tingling in the fingers post-thyroidectomy suggests hypocalcemia, which can
occur if the parathyroid glands are damaged. The nurse should assess for Chvostek’s sign
(facial twitching) or Trousseau’s sign to confirm neuromuscular irritability. Prompt
identification is necessary to prevent tetany and laryngospasm.
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following laboratory
findings should the nurse expect to observe?
A. Blood glucose 250 mg/dL and bicarbonate 12 mEq/L
B. Blood glucose 800 mg/dL and pH 7.45
C. Blood glucose 110 mg/dL and positive ketones
D. Blood glucose 400 mg/dL and bicarbonate 26 mEq/L
Answer: A
Rationale: DKA is characterized by hyperglycemia, metabolic acidosis, and ketosis. A
bicarbonate level of 12 mEq/L indicates metabolic acidosis, which is a hallmark finding in
this condition. The glucose level is typically above 250 mg/dL but not as extreme as in
HHNS.
2. Which nursing intervention is the priority for a client diagnosed with Myxedema Coma?
A. Providing a high-calorie diet
B. Applying cooling blankets
C. Administering oral levothyroxine
D. Maintaining a patent airway
,Answer: D
Rationale: Myxedema coma is a life-threatening emergency caused by severe
hypothyroidism, leading to respiratory failure and cardiovascular collapse. Maintaining a
patent airway is the priority intervention to ensure adequate oxygenation. Supportive care,
including IV levothyroxine and warming, is also critical but follows airway management.
3. A client with Chronic Kidney Disease (CKD) has a potassium level of 6.4 mEq/L. Which
medication should the nurse anticipate administering to protect the heart?
A. Sodium Polystyrene Sulfonate
B. Regular Insulin IV
C. Calcium Gluconate IV
D. Furosemide
Answer: C
Rationale: Calcium gluconate is administered in cases of severe hyperkalemia to stabilize
the myocardial cell membrane and prevent arrhythmias. While insulin and sodium
polystyrene sulfonate help lower potassium levels, they do not provide immediate cardiac
protection. The nurse must monitor the ECG continuously during administration.
4. A nurse is teaching a client with Addison’s disease about their medication regimen. Which
statement by the client indicates a need for further teaching?
A. I will wear a medical alert bracelet at all times.
B. I need to increase my dose during periods of high stress.
, C. I should skip my dose if I feel nauseated.
D. I will keep an emergency injection kit with me.
Answer: C
Rationale: Clients with Addison’s disease must never skip doses of corticosteroids as it can
precipitate an Addisonian crisis. During illness or stress, the dosage typically needs to be
increased rather than decreased. Medical alert identification is essential for safety in
emergencies.
5. A client is 4 hours post-thyroidectomy. The nurse notes the client has developed a hoarse
voice and is complaining of tingling in the fingers. What is the nurse’s priority action?
A. Reassure the client hoarseness is normal
B. Administer a cough suppressant
C. Check for Chvostek’s sign
D. Encourage the client to drink hot tea
Answer: C
Rationale: Tingling in the fingers post-thyroidectomy suggests hypocalcemia, which can
occur if the parathyroid glands are damaged. The nurse should assess for Chvostek’s sign
(facial twitching) or Trousseau’s sign to confirm neuromuscular irritability. Prompt
identification is necessary to prevent tetany and laryngospasm.
