NR 324 Adult Health II - Exam 3 Practice Quiz 2026 |Chamberlain
College
1. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Sodium polystyrene sulfonate
B. Furosemide
C. Regular Insulin IV
D. Calcium gluconate
Answer: D
Rationale: Calcium gluconate is used in severe hyperkalemia to stabilize the myocardium
and prevent lethal arrhythmias, although it does not lower the potassium level itself.
2. Which clinical manifestation is most characteristic of the oliguric phase of
Acute Kidney Injury (AKI)?
A. Hypokalemia
B. Metabolic alkalosis
C. Reduced urine output less than 400 mL/day
D. Fluid volume deficit
Answer: C
Rationale: The oliguric phase is defined by a urine output of less than 400 mL in 24 hours,
often accompanied by fluid retention and electrolyte imbalances.
,3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result is consistent with this diagnosis?
A. Hypernatremia
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH causes water retention, leading to dilutional hyponatremia (sodium <
135 mEq/L) and low serum osmolality.
4. The nurse is caring for a patient with Diabetes Insipidus (DI). Which
intervention is a priority?
A. Restricting fluid intake
B. Administering insulin
C. Monitoring for signs of fluid overload
D. Administering Vasopressin as ordered
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH. Vasopressin or
Desmopressin replaces the missing hormone to reduce urine output.
5. A patient with cirrhosis and esophageal varices is vomiting large amounts of
bright red blood. Which action should the nurse take first?
A. Administer a dose of Lactulose
B. Check the patient’s albumin level
C. Insert a Foley catheter
D. Assess the airway and prepare for suctioning
Answer: D
Rationale: Hemorrhage from esophageal varices is a life-threatening emergency.
Maintaining a patent airway and preventing aspiration is the immediate priority.
, 6. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Elevated Serum Amylase
B. Elevated Serum Lipase
C. Decreased WBC count
D. Decreased Blood Glucose
Answer: B
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to pancreatic tissue damage.
7. A patient in Diabetic Ketoacidosis (DKA) is receiving an insulin drip. When the
blood glucose level reaches 250 mg/dL, what change should the nurse
anticipate?
A. Switching the IV fluid to include 5% dextrose
B. Stopping the insulin infusion
C. Administering IV glucagon
D. Increasing the insulin drip rate
Answer: A
Rationale: Dextrose is added to IV fluids when glucose levels drop to 250 mg/dL to
prevent hypoglycemia and cerebral edema while continuing insulin to resolve ketosis.
8. What is the primary difference between DKA and Hyperosmolar
Hyperglycemic Syndrome (HHS)?
A. HHS results in significant ketoacidosis
B. DKA occurs only in Type 2 Diabetes
C. DKA does not cause dehydration
D. HHS typically has higher blood glucose levels and no ketosis
Answer: D
Rationale: HHS involves enough insulin to prevent ketosis but not enough to control
hyperglycemia, leading to extreme dehydration and very high glucose levels.
College
1. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Sodium polystyrene sulfonate
B. Furosemide
C. Regular Insulin IV
D. Calcium gluconate
Answer: D
Rationale: Calcium gluconate is used in severe hyperkalemia to stabilize the myocardium
and prevent lethal arrhythmias, although it does not lower the potassium level itself.
2. Which clinical manifestation is most characteristic of the oliguric phase of
Acute Kidney Injury (AKI)?
A. Hypokalemia
B. Metabolic alkalosis
C. Reduced urine output less than 400 mL/day
D. Fluid volume deficit
Answer: C
Rationale: The oliguric phase is defined by a urine output of less than 400 mL in 24 hours,
often accompanied by fluid retention and electrolyte imbalances.
,3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory result is consistent with this diagnosis?
A. Hypernatremia
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 128 mEq/L
Answer: D
Rationale: SIADH causes water retention, leading to dilutional hyponatremia (sodium <
135 mEq/L) and low serum osmolality.
4. The nurse is caring for a patient with Diabetes Insipidus (DI). Which
intervention is a priority?
A. Restricting fluid intake
B. Administering insulin
C. Monitoring for signs of fluid overload
D. Administering Vasopressin as ordered
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH. Vasopressin or
Desmopressin replaces the missing hormone to reduce urine output.
5. A patient with cirrhosis and esophageal varices is vomiting large amounts of
bright red blood. Which action should the nurse take first?
A. Administer a dose of Lactulose
B. Check the patient’s albumin level
C. Insert a Foley catheter
D. Assess the airway and prepare for suctioning
Answer: D
Rationale: Hemorrhage from esophageal varices is a life-threatening emergency.
Maintaining a patent airway and preventing aspiration is the immediate priority.
, 6. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Elevated Serum Amylase
B. Elevated Serum Lipase
C. Decreased WBC count
D. Decreased Blood Glucose
Answer: B
Rationale: While both amylase and lipase rise in pancreatitis, lipase stays elevated longer
and is more specific to pancreatic tissue damage.
7. A patient in Diabetic Ketoacidosis (DKA) is receiving an insulin drip. When the
blood glucose level reaches 250 mg/dL, what change should the nurse
anticipate?
A. Switching the IV fluid to include 5% dextrose
B. Stopping the insulin infusion
C. Administering IV glucagon
D. Increasing the insulin drip rate
Answer: A
Rationale: Dextrose is added to IV fluids when glucose levels drop to 250 mg/dL to
prevent hypoglycemia and cerebral edema while continuing insulin to resolve ketosis.
8. What is the primary difference between DKA and Hyperosmolar
Hyperglycemic Syndrome (HHS)?
A. HHS results in significant ketoacidosis
B. DKA occurs only in Type 2 Diabetes
C. DKA does not cause dehydration
D. HHS typically has higher blood glucose levels and no ketosis
Answer: D
Rationale: HHS involves enough insulin to prevent ketosis but not enough to control
hyperglycemia, leading to extreme dehydration and very high glucose levels.
