NURS 201 | Medical-Surgical Nursing - Module Exam 3 (Week 9) 2026
|WCU
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L and the ECG shows tall, peaked T-waves. Which medication should the
nurse expect to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate
B. IV Regular Insulin and Dextrose
C. Calcium Gluconate
D. Furosemide
Answer: C
Rationale: Calcium gluconate does not lower potassium but antagonizes the membrane
effect of hyperkalemia on the heart, preventing lethal arrhythmias. This is the priority
intervention for cardiac stability.
2. A nurse is caring for a patient post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the
nurse perform next?
A. Assess for Chvostek’s sign
B. Check for Homans sign
C. Monitor for Babinski reflex
D. Assess for rebound tenderness
Answer: A
Rationale: Tingling in the extremities (paresthesia) after thyroid surgery suggests
hypocalcemia due to accidental parathyroid gland removal. Chvostek’s sign is a clinical
indicator of hypocalcemia.
,3. A patient with Chronic Kidney Disease (CKD) is receiving Epoetin Alfa. Which
laboratory result indicates the medication is achieving its therapeutic goal?
A. Decreased serum creatinine
B. Increased Hematocrit and Hemoglobin
C. Decreased Phosphorus level
D. Increased Serum Albumin
Answer: B
Rationale: Epoetin Alfa stimulates erythropoiesis in patients with CKD who lack
endogenous erythropoietin; success is measured by rising H&H levels.
4. Which clinical manifestation is most characteristic of Diabetic Ketoacidosis
(DKA) but NOT typically found in Hyperosmolar Hyperglycemic State (HHS)?
A. Kussmaul respirations
B. Blood glucose over 600 mg/dL
C. Severe dehydration
D. Altered mental status
Answer: A
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to compensate for metabolic acidosis (ketosis), which is present in DKA but usually absent
in HHS.
5. A patient with SIADH is experiencing a serum sodium level of 118 mEq/L.
Which provider order should the nurse clarify?
A. Fluid restriction of 800 mL/day
B. Encouraging oral water intake of 2000 mL/day
C. Daily weights
D. Administration of 3% Hypertonic Saline
Answer: B
, Rationale: SIADH involves excessive ADH leading to water retention and dilutional
hyponatremia. Increasing oral water intake would worsen the hyponatremia and is
contraindicated.
6. A patient is admitted with an Addisonian Crisis. Which set of laboratory
findings is the nurse most likely to observe?
A. Hyperglycemia and Hypokalemia
B. Hyponatremia and Hyperkalemia
C. Hypernatremia and Hypertension
D. Hypocalcemia and Metabolic Alkalosis
Answer: B
Rationale: Addison’s disease involves a lack of aldosterone, leading to sodium loss
(hyponatremia) and potassium retention (hyperkalemia), along with hypotension and
hypoglycemia.
7. Which dietary instruction is essential for a patient with Chronic Kidney
Disease (CKD) who is NOT yet on dialysis?
A. Restrict dietary phosphorus and potassium
B. Increase intake of protein to 2.0 g/kg/day
C. Follow a high-sodium diet to prevent hypotension
D. Drink at least 4 liters of water daily
Answer: A
Rationale: Pre-dialysis CKD patients must restrict phosphorus (to prevent bone disease)
and potassium (to prevent arrhythmias) as the kidneys cannot efficiently excrete these.
|WCU
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8
mEq/L and the ECG shows tall, peaked T-waves. Which medication should the
nurse expect to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate
B. IV Regular Insulin and Dextrose
C. Calcium Gluconate
D. Furosemide
Answer: C
Rationale: Calcium gluconate does not lower potassium but antagonizes the membrane
effect of hyperkalemia on the heart, preventing lethal arrhythmias. This is the priority
intervention for cardiac stability.
2. A nurse is caring for a patient post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the
nurse perform next?
A. Assess for Chvostek’s sign
B. Check for Homans sign
C. Monitor for Babinski reflex
D. Assess for rebound tenderness
Answer: A
Rationale: Tingling in the extremities (paresthesia) after thyroid surgery suggests
hypocalcemia due to accidental parathyroid gland removal. Chvostek’s sign is a clinical
indicator of hypocalcemia.
,3. A patient with Chronic Kidney Disease (CKD) is receiving Epoetin Alfa. Which
laboratory result indicates the medication is achieving its therapeutic goal?
A. Decreased serum creatinine
B. Increased Hematocrit and Hemoglobin
C. Decreased Phosphorus level
D. Increased Serum Albumin
Answer: B
Rationale: Epoetin Alfa stimulates erythropoiesis in patients with CKD who lack
endogenous erythropoietin; success is measured by rising H&H levels.
4. Which clinical manifestation is most characteristic of Diabetic Ketoacidosis
(DKA) but NOT typically found in Hyperosmolar Hyperglycemic State (HHS)?
A. Kussmaul respirations
B. Blood glucose over 600 mg/dL
C. Severe dehydration
D. Altered mental status
Answer: A
Rationale: Kussmaul respirations are deep, rapid breaths that occur as the body attempts
to compensate for metabolic acidosis (ketosis), which is present in DKA but usually absent
in HHS.
5. A patient with SIADH is experiencing a serum sodium level of 118 mEq/L.
Which provider order should the nurse clarify?
A. Fluid restriction of 800 mL/day
B. Encouraging oral water intake of 2000 mL/day
C. Daily weights
D. Administration of 3% Hypertonic Saline
Answer: B
, Rationale: SIADH involves excessive ADH leading to water retention and dilutional
hyponatremia. Increasing oral water intake would worsen the hyponatremia and is
contraindicated.
6. A patient is admitted with an Addisonian Crisis. Which set of laboratory
findings is the nurse most likely to observe?
A. Hyperglycemia and Hypokalemia
B. Hyponatremia and Hyperkalemia
C. Hypernatremia and Hypertension
D. Hypocalcemia and Metabolic Alkalosis
Answer: B
Rationale: Addison’s disease involves a lack of aldosterone, leading to sodium loss
(hyponatremia) and potassium retention (hyperkalemia), along with hypotension and
hypoglycemia.
7. Which dietary instruction is essential for a patient with Chronic Kidney
Disease (CKD) who is NOT yet on dialysis?
A. Restrict dietary phosphorus and potassium
B. Increase intake of protein to 2.0 g/kg/day
C. Follow a high-sodium diet to prevent hypotension
D. Drink at least 4 liters of water daily
Answer: A
Rationale: Pre-dialysis CKD patients must restrict phosphorus (to prevent bone disease)
and potassium (to prevent arrhythmias) as the kidneys cannot efficiently excrete these.
