NSG 3850 ADVANCED MEDICAL-
SURGICAL NURSING EXAM 3 GALEN
COLLEGE OF NURSING (U.S.) |
COMPLETE VERIFIED ANSWERS
2026/2027
1. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) presents with a
serum sodium level of 118 mEq/L. Which nursing intervention is the highest priority?
A. Encouraging increased oral fluid intake
B. Administering a rapid bolus of 0.45% normal saline
C. Implementing seizure precautions and limiting fluid intake
D. Preparing the patient for an immediate hemodialysis session
Answer: C
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) in SIADH puts the
patient at high risk for cerebral edema and seizures. Fluid restriction is the primary
treatment, and safety precautions are vital.
2. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Diabetes Insipidus (DI)?
A. Urine specific gravity of 1.035
,B. Weight gain and peripheral edema
C. High levels of antidiuretic hormone in the blood
D. Excessive thirst and urine output of 10 liters per day
Answer: D
Conceptual Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to massive polyuria (large volumes of dilute urine) and intense polydipsia.
3. A patient is admitted in an Addisonian Crisis. Which laboratory result would the nurse most
likely observe?
A. Serum Potassium 6.2 mEq/L and Serum Sodium 128 mEq/L
B. Serum Glucose 250 mg/dL and Serum Sodium 150 mEq/L
C. Serum Calcium 7.5 mg/dL and Magnesium 1.2 mEq/L
D. Serum Potassium 3.2 mEq/L and Serum Sodium 145 mEq/L
Answer: A
Conceptual Explanation: Addisonian crisis (adrenal insufficiency) leads to hyponatremia
and hyperkalemia due to the lack of aldosterone, which normally retains sodium and
excretes potassium.
4. A patient with Cushing’s Syndrome is being monitored for complications. Which finding
suggests the patient is experiencing a common metabolic complication of this disorder?
A. Hypokalemia
, B. Hypoglycemia
C. Hypotension
D. Weight loss
Answer: A
Conceptual Explanation: Excess cortisol in Cushing’s Syndrome has mineralocorticoid
effects, leading to sodium retention and potassium depletion (hypokalemia), along with
hypertension and hyperglycemia.
5. The nurse is caring for a patient following a thyroidectomy. The patient reports tingling in
the fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s temperature for signs of thyroid storm
B. Encourage the patient to cough and deep breathe
C. Administer a dose of levothyroxine as ordered
D. Assess for Chvostek’s sign and notify the provider
Answer: D
Conceptual Explanation: Tingling (paresthesia) is a sign of hypocalcemia, often caused by
accidental damage to the parathyroid glands during thyroidectomy. Chvostek’s sign
confirms neuromuscular irritability.
SURGICAL NURSING EXAM 3 GALEN
COLLEGE OF NURSING (U.S.) |
COMPLETE VERIFIED ANSWERS
2026/2027
1. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) presents with a
serum sodium level of 118 mEq/L. Which nursing intervention is the highest priority?
A. Encouraging increased oral fluid intake
B. Administering a rapid bolus of 0.45% normal saline
C. Implementing seizure precautions and limiting fluid intake
D. Preparing the patient for an immediate hemodialysis session
Answer: C
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) in SIADH puts the
patient at high risk for cerebral edema and seizures. Fluid restriction is the primary
treatment, and safety precautions are vital.
2. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Diabetes Insipidus (DI)?
A. Urine specific gravity of 1.035
,B. Weight gain and peripheral edema
C. High levels of antidiuretic hormone in the blood
D. Excessive thirst and urine output of 10 liters per day
Answer: D
Conceptual Explanation: Diabetes Insipidus is characterized by a deficiency of ADH,
leading to massive polyuria (large volumes of dilute urine) and intense polydipsia.
3. A patient is admitted in an Addisonian Crisis. Which laboratory result would the nurse most
likely observe?
A. Serum Potassium 6.2 mEq/L and Serum Sodium 128 mEq/L
B. Serum Glucose 250 mg/dL and Serum Sodium 150 mEq/L
C. Serum Calcium 7.5 mg/dL and Magnesium 1.2 mEq/L
D. Serum Potassium 3.2 mEq/L and Serum Sodium 145 mEq/L
Answer: A
Conceptual Explanation: Addisonian crisis (adrenal insufficiency) leads to hyponatremia
and hyperkalemia due to the lack of aldosterone, which normally retains sodium and
excretes potassium.
4. A patient with Cushing’s Syndrome is being monitored for complications. Which finding
suggests the patient is experiencing a common metabolic complication of this disorder?
A. Hypokalemia
, B. Hypoglycemia
C. Hypotension
D. Weight loss
Answer: A
Conceptual Explanation: Excess cortisol in Cushing’s Syndrome has mineralocorticoid
effects, leading to sodium retention and potassium depletion (hypokalemia), along with
hypertension and hyperglycemia.
5. The nurse is caring for a patient following a thyroidectomy. The patient reports tingling in
the fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s temperature for signs of thyroid storm
B. Encourage the patient to cough and deep breathe
C. Administer a dose of levothyroxine as ordered
D. Assess for Chvostek’s sign and notify the provider
Answer: D
Conceptual Explanation: Tingling (paresthesia) is a sign of hypocalcemia, often caused by
accidental damage to the parathyroid glands during thyroidectomy. Chvostek’s sign
confirms neuromuscular irritability.
