NUR242 Exam 2 V1 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This exam preparation resource focuses on gastrointestinal disorders, renal conditions, and
endocrine nursing care in adult patients. The material is designed to strengthen understanding
of pathophysiology, nursing interventions, and evidence-based management strategies used in
medical-surgical nursing.
The questions included in this version closely mirror the style and complexity of actual nursing
exams. Detailed expert explanations are included to improve clinical reasoning and patient
management skills.
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The Exam Covers:
• Gastrointestinal disorders
• Renal and urinary system disorders
• Diabetes mellitus management
• Endocrine nursing care
• Nutritional support in adults
• Fluid replacement therapy
• Nursing assessment findings
• Adult elimination disorders
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1. A patient with liver cirrhosis presents with a serum ammonia level of 110 mcg/dL. Which
medication should the nurse anticipate administering to reduce this level?
A. Spironolactone
B. Vitamin K
C. Furosemide
,D. Lactulose
Correct Answer: D
Expert Explanation: Lactulose is used in patients with cirrhosis to promote the excretion
of ammonia through the stool. It works by acidifying the colon, which converts ammonia
into ammonium, a non-absorbable ion. This prevents hepatic encephalopathy, which is a
key priority in patients with high ammonia levels.
2. A client is diagnosed with acute pancreatitis. Which laboratory result is most specific in
confirming this diagnosis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Increased white blood cell count
D. Decreased serum calcium
Correct Answer: B
Expert Explanation: Serum lipase is more specific to the pancreas than amylase and
remains elevated for a longer period. While amylase rises early, it can also be elevated in
other conditions like mumps or intestinal obstruction. Lipase elevation is a hallmark
diagnostic finding for acute pancreatitis.
3. The nurse is caring for a patient with Cushing’s syndrome. Which clinical manifestation is
the nurse most likely to observe?
A. Postural hypotension
, B. Truncal obesity and moon face
C. Weight loss and cachexia
D. Hyperpigmentation of the skin
Correct Answer: B
Expert Explanation: Cushing’s syndrome is caused by excessive cortisol, leading to a
redistribution of fat resulting in truncal obesity, a ‘buffalo hump,’ and a ‘moon face.’
Hyperpigmentation is more characteristic of Addison’s disease. Monitoring for
hyperglycemia and hypertension is also vital in Cushing’s care.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL and positive
ketones in the urine. What is the priority nursing intervention?
A. Administering 50% Dextrose IV
B. Starting an IV infusion of 0.9% Normal Saline
C. Administering subcutaneous long-acting insulin
D. Encouraging the patient to drink orange juice
Correct Answer: B
Expert Explanation: The initial priority in Diabetic Ketoacidosis (DKA) is fluid
resuscitation with isotonic saline to restore circulatory volume and renal perfusion. Once
fluids are initiated, an insulin drip is started to lower glucose. Dextrose is only added once
glucose levels drop to about 250 mg/dL.
Q&A | Galen College of Nursing
────────────────────────────────────
This exam preparation resource focuses on gastrointestinal disorders, renal conditions, and
endocrine nursing care in adult patients. The material is designed to strengthen understanding
of pathophysiology, nursing interventions, and evidence-based management strategies used in
medical-surgical nursing.
The questions included in this version closely mirror the style and complexity of actual nursing
exams. Detailed expert explanations are included to improve clinical reasoning and patient
management skills.
════════════════════════════════════
The Exam Covers:
• Gastrointestinal disorders
• Renal and urinary system disorders
• Diabetes mellitus management
• Endocrine nursing care
• Nutritional support in adults
• Fluid replacement therapy
• Nursing assessment findings
• Adult elimination disorders
════════════════════════════════════
1. A patient with liver cirrhosis presents with a serum ammonia level of 110 mcg/dL. Which
medication should the nurse anticipate administering to reduce this level?
A. Spironolactone
B. Vitamin K
C. Furosemide
,D. Lactulose
Correct Answer: D
Expert Explanation: Lactulose is used in patients with cirrhosis to promote the excretion
of ammonia through the stool. It works by acidifying the colon, which converts ammonia
into ammonium, a non-absorbable ion. This prevents hepatic encephalopathy, which is a
key priority in patients with high ammonia levels.
2. A client is diagnosed with acute pancreatitis. Which laboratory result is most specific in
confirming this diagnosis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Increased white blood cell count
D. Decreased serum calcium
Correct Answer: B
Expert Explanation: Serum lipase is more specific to the pancreas than amylase and
remains elevated for a longer period. While amylase rises early, it can also be elevated in
other conditions like mumps or intestinal obstruction. Lipase elevation is a hallmark
diagnostic finding for acute pancreatitis.
3. The nurse is caring for a patient with Cushing’s syndrome. Which clinical manifestation is
the nurse most likely to observe?
A. Postural hypotension
, B. Truncal obesity and moon face
C. Weight loss and cachexia
D. Hyperpigmentation of the skin
Correct Answer: B
Expert Explanation: Cushing’s syndrome is caused by excessive cortisol, leading to a
redistribution of fat resulting in truncal obesity, a ‘buffalo hump,’ and a ‘moon face.’
Hyperpigmentation is more characteristic of Addison’s disease. Monitoring for
hyperglycemia and hypertension is also vital in Cushing’s care.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL and positive
ketones in the urine. What is the priority nursing intervention?
A. Administering 50% Dextrose IV
B. Starting an IV infusion of 0.9% Normal Saline
C. Administering subcutaneous long-acting insulin
D. Encouraging the patient to drink orange juice
Correct Answer: B
Expert Explanation: The initial priority in Diabetic Ketoacidosis (DKA) is fluid
resuscitation with isotonic saline to restore circulatory volume and renal perfusion. Once
fluids are initiated, an insulin drip is started to lower glucose. Dextrose is only added once
glucose levels drop to about 250 mg/dL.
