NUR 170 Medical-Surgical Nursing Exam 3 Study Guide 2026 Galen
College
1. A patient is admitted with a blood glucose level of 600 mg/dL and is
diagnosed with Diabetic Ketoacidosis (DKA). Which clinical finding is most
consistent with this diagnosis?
A. Bradycardia
B. Hypertension
C. Kussmaul respirations
D. Weight gain
Answer: C
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to blow off excess CO2 to compensate for metabolic acidosis in DKA.
2. A nurse is caring for a patient who had a thyroidectomy 6 hours ago. The
patient reports tingling in the fingers and around the mouth. Which action
should the nurse take first?
A. Check the patient’s blood pressure
B. Administer an analgesic
C. Assess for Trousseau’s sign
D. Encourage the patient to cough and deep breathe
Answer: C
Rationale: Tingling in the extremities and circumoral area are signs of hypocalcemia, a
potential complication of thyroid surgery if parathyroid glands are damaged. Trousseau’s
sign helps confirm this.
,3. Which laboratory value is the most accurate indicator of long-term blood
glucose control in a patient with Diabetes Mellitus?
A. Fasting plasma glucose
B. Postprandial glucose
C. Glycosylated hemoglobin (HbA1c)
D. Urine ketones
Answer: C
Rationale: HbA1c reflects average blood glucose levels over the past 2 to 3 months, making
it the gold standard for long-term monitoring.
4. A patient with Type 1 Diabetes is scheduled for surgery and is NPO. The nurse
should expect which modification to the insulin regimen?
A. Discontinue all insulin for 24 hours
B. Replace insulin with oral hypoglycemic agents
C. Give the full dose of rapid-acting insulin
D. Administer a reduced dose of intermediate or long-acting insulin
Answer: D
Rationale: Basal insulin is still needed to prevent DKA even when NPO, but the dose is
often adjusted or reduced. Rapid-acting insulin is typically held or given only as a
correction.
5. When teaching a patient with Cushing’s syndrome about their condition,
which physical characteristic should the nurse include?
A. Extreme weight loss
B. Bronze-colored skin
C. Exophthalmos
D. Buffalo hump and moon face
Answer: D
, Rationale: Cushing’s syndrome is characterized by excess cortisol, leading to fat
redistribution resulting in a buffalo hump, moon face, and truncal obesity.
6. A patient with Addison’s disease is being discharged. Which instruction is
most important for the nurse to provide?
A. Restrict sodium intake to 1 gram per day
B. Increase physical activity to maximum tolerance
C. Carry an emergency kit with injectable hydrocortisone
D. Stop taking steroids once symptoms improve
Answer: C
Rationale: Patients with Addison’s disease require lifelong hormone replacement and
must carry an emergency kit to treat Addisonian crisis brought on by stress.
7. A nurse is assessing a patient with Graves’ disease. Which finding is
expected?
A. Heat intolerance
B. Lethargy
C. Bradycardia
D. Cold intolerance
Answer: A
Rationale: Hyperthyroidism (Graves’ disease) increases metabolic rate, leading to
symptoms like heat intolerance, tachycardia, and weight loss.
8. A patient is diagnosed with Diabetes Insipidus. The nurse should monitor for
which clinical manifestation?
A. Excessive thirst (polydipsia)
B. High urine specific gravity
C. Fluid volume excess
D. Hypertension
Answer: A
College
1. A patient is admitted with a blood glucose level of 600 mg/dL and is
diagnosed with Diabetic Ketoacidosis (DKA). Which clinical finding is most
consistent with this diagnosis?
A. Bradycardia
B. Hypertension
C. Kussmaul respirations
D. Weight gain
Answer: C
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to blow off excess CO2 to compensate for metabolic acidosis in DKA.
2. A nurse is caring for a patient who had a thyroidectomy 6 hours ago. The
patient reports tingling in the fingers and around the mouth. Which action
should the nurse take first?
A. Check the patient’s blood pressure
B. Administer an analgesic
C. Assess for Trousseau’s sign
D. Encourage the patient to cough and deep breathe
Answer: C
Rationale: Tingling in the extremities and circumoral area are signs of hypocalcemia, a
potential complication of thyroid surgery if parathyroid glands are damaged. Trousseau’s
sign helps confirm this.
,3. Which laboratory value is the most accurate indicator of long-term blood
glucose control in a patient with Diabetes Mellitus?
A. Fasting plasma glucose
B. Postprandial glucose
C. Glycosylated hemoglobin (HbA1c)
D. Urine ketones
Answer: C
Rationale: HbA1c reflects average blood glucose levels over the past 2 to 3 months, making
it the gold standard for long-term monitoring.
4. A patient with Type 1 Diabetes is scheduled for surgery and is NPO. The nurse
should expect which modification to the insulin regimen?
A. Discontinue all insulin for 24 hours
B. Replace insulin with oral hypoglycemic agents
C. Give the full dose of rapid-acting insulin
D. Administer a reduced dose of intermediate or long-acting insulin
Answer: D
Rationale: Basal insulin is still needed to prevent DKA even when NPO, but the dose is
often adjusted or reduced. Rapid-acting insulin is typically held or given only as a
correction.
5. When teaching a patient with Cushing’s syndrome about their condition,
which physical characteristic should the nurse include?
A. Extreme weight loss
B. Bronze-colored skin
C. Exophthalmos
D. Buffalo hump and moon face
Answer: D
, Rationale: Cushing’s syndrome is characterized by excess cortisol, leading to fat
redistribution resulting in a buffalo hump, moon face, and truncal obesity.
6. A patient with Addison’s disease is being discharged. Which instruction is
most important for the nurse to provide?
A. Restrict sodium intake to 1 gram per day
B. Increase physical activity to maximum tolerance
C. Carry an emergency kit with injectable hydrocortisone
D. Stop taking steroids once symptoms improve
Answer: C
Rationale: Patients with Addison’s disease require lifelong hormone replacement and
must carry an emergency kit to treat Addisonian crisis brought on by stress.
7. A nurse is assessing a patient with Graves’ disease. Which finding is
expected?
A. Heat intolerance
B. Lethargy
C. Bradycardia
D. Cold intolerance
Answer: A
Rationale: Hyperthyroidism (Graves’ disease) increases metabolic rate, leading to
symptoms like heat intolerance, tachycardia, and weight loss.
8. A patient is diagnosed with Diabetes Insipidus. The nurse should monitor for
which clinical manifestation?
A. Excessive thirst (polydipsia)
B. High urine specific gravity
C. Fluid volume excess
D. Hypertension
Answer: A
