NURS 201 Medical-Surgical Nursing Exam 3 - Promoting Wellness 2026
|WCU
1. A patient with Diabetic Ketoacidosis (DKA) is receiving an IV insulin infusion.
Which laboratory value should the nurse monitor most closely to prevent life-
threatening complications?
A. Serum Calcium
B. Serum Sodium
C. Serum Potassium
D. Serum Creatinine
Answer: C
Rationale: Insulin causes potassium to move into the cells, which can lead to severe
hypokalemia and cardiac arrhythmias. Close monitoring of potassium levels is vital during
DKA treatment.
2. A client is diagnosed with SIADH. Which of the following nursing
interventions is the highest priority?
A. Encourage fluid intake to 3L/day
B. Administer loop diuretics as ordered
C. Measure abdominal girth daily
D. Implement seizure precautions
Answer: D
Rationale: SIADH leads to dilutional hyponatremia. Low sodium levels (typically below
120-125 mEq/L) put the patient at high risk for cerebral edema and seizures.
,3. Which clinical manifestation would a nurse expect to find in a client with a
history of Addison’s disease who is experiencing an Addisonian Crisis?
A. Hypertension and hypervolemia
B. Hyperglycemia and moon face
C. Profound hypotension and tachycardia
D. Bradycardia and peripheral edema
Answer: C
Rationale: Addisonian crisis is an acute adrenal insufficiency characterized by circulatory
collapse, profound hypotension, and signs of shock due to a lack of cortisol and
aldosterone.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering to
stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Regular Insulin with D50
D. Furosemide
Answer: B
Rationale: While insulin and Kayexalate help lower potassium, Calcium Gluconate is
administered first in severe hyperkalemia to protect the heart from arrhythmias by
stabilizing the myocardial membrane.
, 5. A nurse is caring for a patient post-thyroidectomy. The patient reports
numbness and tingling around the mouth. What is the nurse’s priority action?
A. Check for Trousseau’s sign
B. Assess the patient’s voice quality
C. Administer a dose of levothyroxine
D. Check the surgical dressing for bleeding
Answer: A
Rationale: Paresthesia around the mouth suggests hypocalcemia, often caused by
accidental damage to the parathyroid glands during a thyroidectomy. Trousseau’s sign
helps confirm this electrolyte imbalance.
6. Which arterial blood gas (ABG) result is consistent with a patient experiencing
prolonged vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting causes loss of gastric acid (HCl), leading to Metabolic Alkalosis,
characterized by an elevated pH (>7.45) and elevated Bicarbonate (>26).
7. A client with Cirrhosis is scheduled for a paracentesis. What should the nurse
instruct the client to do immediately before the procedure?
A. Drink 1 liter of water
B. Assume a prone position
C. Empty their bladder
D. Maintain NPO status for 8 hours
Answer: C
|WCU
1. A patient with Diabetic Ketoacidosis (DKA) is receiving an IV insulin infusion.
Which laboratory value should the nurse monitor most closely to prevent life-
threatening complications?
A. Serum Calcium
B. Serum Sodium
C. Serum Potassium
D. Serum Creatinine
Answer: C
Rationale: Insulin causes potassium to move into the cells, which can lead to severe
hypokalemia and cardiac arrhythmias. Close monitoring of potassium levels is vital during
DKA treatment.
2. A client is diagnosed with SIADH. Which of the following nursing
interventions is the highest priority?
A. Encourage fluid intake to 3L/day
B. Administer loop diuretics as ordered
C. Measure abdominal girth daily
D. Implement seizure precautions
Answer: D
Rationale: SIADH leads to dilutional hyponatremia. Low sodium levels (typically below
120-125 mEq/L) put the patient at high risk for cerebral edema and seizures.
,3. Which clinical manifestation would a nurse expect to find in a client with a
history of Addison’s disease who is experiencing an Addisonian Crisis?
A. Hypertension and hypervolemia
B. Hyperglycemia and moon face
C. Profound hypotension and tachycardia
D. Bradycardia and peripheral edema
Answer: C
Rationale: Addisonian crisis is an acute adrenal insufficiency characterized by circulatory
collapse, profound hypotension, and signs of shock due to a lack of cortisol and
aldosterone.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of
6.8 mEq/L. Which medication should the nurse anticipate administering to
stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Regular Insulin with D50
D. Furosemide
Answer: B
Rationale: While insulin and Kayexalate help lower potassium, Calcium Gluconate is
administered first in severe hyperkalemia to protect the heart from arrhythmias by
stabilizing the myocardial membrane.
, 5. A nurse is caring for a patient post-thyroidectomy. The patient reports
numbness and tingling around the mouth. What is the nurse’s priority action?
A. Check for Trousseau’s sign
B. Assess the patient’s voice quality
C. Administer a dose of levothyroxine
D. Check the surgical dressing for bleeding
Answer: A
Rationale: Paresthesia around the mouth suggests hypocalcemia, often caused by
accidental damage to the parathyroid glands during a thyroidectomy. Trousseau’s sign
helps confirm this electrolyte imbalance.
6. Which arterial blood gas (ABG) result is consistent with a patient experiencing
prolonged vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting causes loss of gastric acid (HCl), leading to Metabolic Alkalosis,
characterized by an elevated pH (>7.45) and elevated Bicarbonate (>26).
7. A client with Cirrhosis is scheduled for a paracentesis. What should the nurse
instruct the client to do immediately before the procedure?
A. Drink 1 liter of water
B. Assume a prone position
C. Empty their bladder
D. Maintain NPO status for 8 hours
Answer: C
