NUR 3463 Exam 3: Adult Health Acute Care
Verified & Updated Questions and Answers -
Rasmussen University
1. A patient with acute kidney injury (AKI) has a serum potassium level of 6.8
mEq/L. Which prescribed medication should the nurse prioritize?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Calcium gluconate IV
D. Lisinopril
Answer: C
Explanation: Calcium gluconate is used to stabilize the myocardium and prevent lethal
dysrhythmias in the presence of severe hyperkalemia.
2. Which clinical finding is most characteristic of the oliguric phase of acute
kidney injury?
A. Urine output of 2 liters per day
B. Metabolic alkalosis
C. Serum creatinine level decrease
D. Fixed urine specific gravity of 1.010
Answer: D
Explanation: A fixed urine specific gravity of 1.010 indicates that the kidneys have lost the
ability to concentrate urine, which is common in the oliguric phase.
,3. A nurse is caring for a patient with liver cirrhosis who is confused and has
asterixis. Which lab result explains these findings?
A. Decreased serum bilirubin
B. Elevated serum ammonia
C. Elevated serum albumin
D. Decreased prothrombin time
Answer: B
Explanation: Elevated ammonia levels cross the blood-brain barrier, causing hepatic
encephalopathy, characterized by confusion and asterixis (flapping tremors).
4. A patient is admitted with suspected acute pancreatitis. Which laboratory
result is most specific to this diagnosis?
A. Elevated serum amylase
B. Decreased white blood cell count
C. Elevated serum lipase
D. Elevated serum calcium
Answer: C
Explanation: Serum lipase is more specific to the pancreas than amylase and remains
elevated for a longer period.
5. The nurse is providing education to a patient with chronic kidney disease
(CKD). Which dietary restriction should be emphasized?
A. Increased fluid intake
B. High phosphorus foods
C. Low protein, low potassium
D. High sodium intake
Answer: C
Explanation: CKD patients require protein restriction to reduce nitrogenous waste and
potassium restriction to prevent hyperkalemia.
, 6. A patient in the ICU has a blood pressure of 80/40 mmHg, a heart rate of 124
bpm, and warm, flushed skin. Which type of shock does the nurse suspect?
A. Hypovolemic shock
B. Septic shock (Early/Hyperdynamic phase)
C. Cardiogenic shock
D. Neurogenic shock
Answer: B
Explanation: Septic shock is unique in its early stage due to vasodilation, resulting in
warm, flushed skin and high cardiac output before progressing.
7. What is the primary goal of lactulose administration in a patient with
cirrhosis?
A. To treat constipation
B. To reduce portal hypertension
C. To increase serum potassium levels
D. To promote ammonia excretion via stool
Answer: D
Explanation: Lactulose traps ammonia in the gut and acts as an osmotic laxative to expel it
from the body, treating hepatic encephalopathy.
8. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 450 mg/dL
and is receiving an insulin drip. What is the priority nursing action when the
glucose reaches 250 mg/dL?
A. Add 5% dextrose to the IV fluids
B. Stop the insulin infusion immediately
C. Administer glucagon
D. Increase the insulin drip rate
Answer: A
Verified & Updated Questions and Answers -
Rasmussen University
1. A patient with acute kidney injury (AKI) has a serum potassium level of 6.8
mEq/L. Which prescribed medication should the nurse prioritize?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Calcium gluconate IV
D. Lisinopril
Answer: C
Explanation: Calcium gluconate is used to stabilize the myocardium and prevent lethal
dysrhythmias in the presence of severe hyperkalemia.
2. Which clinical finding is most characteristic of the oliguric phase of acute
kidney injury?
A. Urine output of 2 liters per day
B. Metabolic alkalosis
C. Serum creatinine level decrease
D. Fixed urine specific gravity of 1.010
Answer: D
Explanation: A fixed urine specific gravity of 1.010 indicates that the kidneys have lost the
ability to concentrate urine, which is common in the oliguric phase.
,3. A nurse is caring for a patient with liver cirrhosis who is confused and has
asterixis. Which lab result explains these findings?
A. Decreased serum bilirubin
B. Elevated serum ammonia
C. Elevated serum albumin
D. Decreased prothrombin time
Answer: B
Explanation: Elevated ammonia levels cross the blood-brain barrier, causing hepatic
encephalopathy, characterized by confusion and asterixis (flapping tremors).
4. A patient is admitted with suspected acute pancreatitis. Which laboratory
result is most specific to this diagnosis?
A. Elevated serum amylase
B. Decreased white blood cell count
C. Elevated serum lipase
D. Elevated serum calcium
Answer: C
Explanation: Serum lipase is more specific to the pancreas than amylase and remains
elevated for a longer period.
5. The nurse is providing education to a patient with chronic kidney disease
(CKD). Which dietary restriction should be emphasized?
A. Increased fluid intake
B. High phosphorus foods
C. Low protein, low potassium
D. High sodium intake
Answer: C
Explanation: CKD patients require protein restriction to reduce nitrogenous waste and
potassium restriction to prevent hyperkalemia.
, 6. A patient in the ICU has a blood pressure of 80/40 mmHg, a heart rate of 124
bpm, and warm, flushed skin. Which type of shock does the nurse suspect?
A. Hypovolemic shock
B. Septic shock (Early/Hyperdynamic phase)
C. Cardiogenic shock
D. Neurogenic shock
Answer: B
Explanation: Septic shock is unique in its early stage due to vasodilation, resulting in
warm, flushed skin and high cardiac output before progressing.
7. What is the primary goal of lactulose administration in a patient with
cirrhosis?
A. To treat constipation
B. To reduce portal hypertension
C. To increase serum potassium levels
D. To promote ammonia excretion via stool
Answer: D
Explanation: Lactulose traps ammonia in the gut and acts as an osmotic laxative to expel it
from the body, treating hepatic encephalopathy.
8. A patient with Diabetic Ketoacidosis (DKA) has a blood glucose of 450 mg/dL
and is receiving an insulin drip. What is the priority nursing action when the
glucose reaches 250 mg/dL?
A. Add 5% dextrose to the IV fluids
B. Stop the insulin infusion immediately
C. Administer glucagon
D. Increase the insulin drip rate
Answer: A
