NSG 3250 Exam 4 V3 | NSG 3250 Adult
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A client with type 1 diabetes mellitus is admitted to the emergency department with a
blood glucose of 560 mg/dL and positive serum ketones. Which physiological process best
explains the development of metabolic acidosis in this patient?
A. Retention of bicarbonate by the kidneys to compensate for hyperglycemia.
B. Increased production of lactic acid due to anaerobic metabolism.
C. Excessive breakdown of fatty acids for energy resulting in ketone body production.
D. Hyperventilation causing a decrease in serum carbon dioxide levels.
Answer: C
Rationale: In type 1 diabetes, an absolute lack of insulin prevents glucose from entering
the cells for energy. To compensate, the body breaks down fats, leading to the production
of acidic ketone bodies. This accumulation of ketones causes a drop in serum pH, resulting
in diabetic ketoacidosis.
2. The nurse is caring for a patient who underwent a total thyroidectomy 12 hours ago. The
patient reports numbness and tingling in their fingertips and around their mouth. What is the
priority nursing action?
A. Administer an oral calcium supplement as ordered.
,B. Check for Trousseau’s and Chvostek’s signs.
C. Notify the provider and prepare for intravenous calcium gluconate administration.
D. Reassure the patient that these are normal post-operative sensations.
Answer: C
Rationale: Numbness and tingling are early signs of hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during surgery. Hypocalcemia is
a medical emergency because it can lead to laryngospasm and seizures. The nurse must
immediately notify the provider and ensure that IV calcium gluconate is readily available at
the bedside.
3. A client diagnosed with Cushing’s syndrome is being monitored by the nurse. Which
assessment finding is most consistent with this diagnosis?
A. Postural hypotension and weight loss.
B. Hyperpigmentation of the skin and low blood glucose.
C. Elevated serum potassium and decreased serum sodium.
D. Trunkal obesity, buffalo hump, and purple striae on the abdomen.
Answer: D
Rationale: Cushing’s syndrome results from an excess of corticosteroids, particularly
glucocorticoids. Classic manifestations include a round ‘moon face,’ trunkal obesity with
, thin extremities, and a ‘buffalo hump’ on the upper back. The skin often becomes thin and
fragile, resulting in the characteristic purple striae on the abdomen or thighs.
4. The nurse provides education to a patient newly diagnosed with Addison’s disease. Which
instruction should be included regarding medication management?
A. Increase the dosage of corticosteroids during periods of high stress or illness.
B. Stop taking the medication immediately if weight gain occurs.
C. Take the medication only when feeling weak or dizzy.
D. Limit sodium intake to prevent fluid retention.
Answer: A
Rationale: Patients with Addison’s disease require lifelong hormone replacement therapy.
During times of physical or emotional stress, the body normally produces more cortisol,
which these patients cannot do. Therefore, they must increase their steroid dosage to
prevent an Addisonian crisis, which is a life-threatening adrenal insufficiency.
5. Which laboratory value should the nurse prioritize when monitoring a client with Acute
Pancreatitis?
A. Hemoglobin and Hematocrit.
B. Serum Amylase and Lipase.
C. Serum Potassium and Sodium.
D. Blood Urea Nitrogen and Creatinine.
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Exam 4)
1. A client with type 1 diabetes mellitus is admitted to the emergency department with a
blood glucose of 560 mg/dL and positive serum ketones. Which physiological process best
explains the development of metabolic acidosis in this patient?
A. Retention of bicarbonate by the kidneys to compensate for hyperglycemia.
B. Increased production of lactic acid due to anaerobic metabolism.
C. Excessive breakdown of fatty acids for energy resulting in ketone body production.
D. Hyperventilation causing a decrease in serum carbon dioxide levels.
Answer: C
Rationale: In type 1 diabetes, an absolute lack of insulin prevents glucose from entering
the cells for energy. To compensate, the body breaks down fats, leading to the production
of acidic ketone bodies. This accumulation of ketones causes a drop in serum pH, resulting
in diabetic ketoacidosis.
2. The nurse is caring for a patient who underwent a total thyroidectomy 12 hours ago. The
patient reports numbness and tingling in their fingertips and around their mouth. What is the
priority nursing action?
A. Administer an oral calcium supplement as ordered.
,B. Check for Trousseau’s and Chvostek’s signs.
C. Notify the provider and prepare for intravenous calcium gluconate administration.
D. Reassure the patient that these are normal post-operative sensations.
Answer: C
Rationale: Numbness and tingling are early signs of hypocalcemia, which can occur if the
parathyroid glands are accidentally damaged or removed during surgery. Hypocalcemia is
a medical emergency because it can lead to laryngospasm and seizures. The nurse must
immediately notify the provider and ensure that IV calcium gluconate is readily available at
the bedside.
3. A client diagnosed with Cushing’s syndrome is being monitored by the nurse. Which
assessment finding is most consistent with this diagnosis?
A. Postural hypotension and weight loss.
B. Hyperpigmentation of the skin and low blood glucose.
C. Elevated serum potassium and decreased serum sodium.
D. Trunkal obesity, buffalo hump, and purple striae on the abdomen.
Answer: D
Rationale: Cushing’s syndrome results from an excess of corticosteroids, particularly
glucocorticoids. Classic manifestations include a round ‘moon face,’ trunkal obesity with
, thin extremities, and a ‘buffalo hump’ on the upper back. The skin often becomes thin and
fragile, resulting in the characteristic purple striae on the abdomen or thighs.
4. The nurse provides education to a patient newly diagnosed with Addison’s disease. Which
instruction should be included regarding medication management?
A. Increase the dosage of corticosteroids during periods of high stress or illness.
B. Stop taking the medication immediately if weight gain occurs.
C. Take the medication only when feeling weak or dizzy.
D. Limit sodium intake to prevent fluid retention.
Answer: A
Rationale: Patients with Addison’s disease require lifelong hormone replacement therapy.
During times of physical or emotional stress, the body normally produces more cortisol,
which these patients cannot do. Therefore, they must increase their steroid dosage to
prevent an Addisonian crisis, which is a life-threatening adrenal insufficiency.
5. Which laboratory value should the nurse prioritize when monitoring a client with Acute
Pancreatitis?
A. Hemoglobin and Hematocrit.
B. Serum Amylase and Lipase.
C. Serum Potassium and Sodium.
D. Blood Urea Nitrogen and Creatinine.
