NUR 170 Exam 3: Med Surg - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with cirrhosis presents with increased confusion and asterixis. Which medication should the
nurse anticipate administering to reduce serum ammonia levels?
A. Spironolactone
B. Lactulose
C. Furosemide
D. Propranolol
Correct Answer: B
Rationale: Lactulose is the primary medication used to treat hepatic encephalopathy by promoting the
excretion of ammonia through the stool. It works by acidifying the colon contents which traps ammonia
and allows it to be expelled via a laxative effect. The nurse should monitor the patient for several soft
bowel movements daily to ensure the medication is effective. Reducing ammonia levels is critical to
improving the patient’s cognitive function and neurological status. This intervention directly addresses
the physiological cause of hepatic encephalopathy in liver failure patients.
2. A nurse is caring for a patient with Chronic Kidney Disease (CKD). Which dietary instruction is most
appropriate for this patient to manage their condition?
A. Limit intake of high-protein and high-potassium foods
B. Use salt substitutes to season food
C. Increase intake of dairy products for calcium
D. Increase fluid intake to at least 3 liters per day
,Correct Answer: A
Rationale: Chronic Kidney Disease requires strict management of electrolytes and metabolic waste
products that the kidneys can no longer filter. High-protein diets are restricted because they increase
nitrogenous waste which places more stress on the remaining nephrons. Potassium must be limited to
prevent life-threatening cardiac arrhythmias that occur when levels become too high. Salt substitutes
should be avoided because they often contain high amounts of potassium. These dietary modifications
are essential for slowing the progression of renal failure and maintaining homeostasis.
3. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood glucose level of 42 mg/dL.
What is the priority nursing action?
A. Administer 15 grams of oral glucose gel
B. Provide 4 ounces of orange juice
C. Administer Glucagon subcutaneously or IM
D. Encourage the patient to eat a complex carbohydrate snack
Correct Answer: C
Rationale: In an unconscious patient with severe hypoglycemia, the oral route is contraindicated due to
the risk of aspiration. Glucagon is the emergency treatment of choice to rapidly mobilize glucose from
liver stores when IV access is not immediately available. Once the patient regains consciousness and can
swallow safely, they should be provided with a source of carbohydrates. The nurse must re-check blood
glucose levels frequently to ensure they return to a safe range. This immediate action is vital to prevent
permanent neurological damage or death from hypoglycemia.
4. Which clinical manifestation is most characteristic of a patient experiencing Cushing’s Syndrome?
A. Truncal obesity and a ‘buffalo hump’
, B. Weight loss and hypotension
C. Hyperpigmentation of the skin
D. Heat intolerance and tachycardia
Correct Answer: A
Rationale: Cushing’s Syndrome is caused by an excess of cortisol which leads to distinct physical changes
in the body. Truncal obesity, a ‘buffalo hump’ on the neck, and a moon-shaped face are hallmark signs of
this endocrine disorder. Patients also frequently experience thin skin, purple striae, and muscle wasting
in the extremities. These symptoms result from the altered metabolism of fats, proteins, and
carbohydrates under high cortisol levels. Nursing care focuses on monitoring for complications like
hypertension, hyperglycemia, and increased infection risk.
5. A nurse is assessing a patient with acute pancreatitis. Which laboratory result would the nurse expect to
find elevated?
A. Serum Calcium
B. Serum Potassium
C. Serum Hemoglobin
D. Serum Amylase
Correct Answer: D
Rationale: Acute pancreatitis involves the inflammation of the pancreas leading to the premature
activation of digestive enzymes. Serum amylase and lipase are released into the bloodstream and are the
primary diagnostic indicators of this condition. Amylase levels usually rise within hours of the onset of
symptoms and stay elevated for several days. Conversely, serum calcium levels often decrease in severe
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with cirrhosis presents with increased confusion and asterixis. Which medication should the
nurse anticipate administering to reduce serum ammonia levels?
A. Spironolactone
B. Lactulose
C. Furosemide
D. Propranolol
Correct Answer: B
Rationale: Lactulose is the primary medication used to treat hepatic encephalopathy by promoting the
excretion of ammonia through the stool. It works by acidifying the colon contents which traps ammonia
and allows it to be expelled via a laxative effect. The nurse should monitor the patient for several soft
bowel movements daily to ensure the medication is effective. Reducing ammonia levels is critical to
improving the patient’s cognitive function and neurological status. This intervention directly addresses
the physiological cause of hepatic encephalopathy in liver failure patients.
2. A nurse is caring for a patient with Chronic Kidney Disease (CKD). Which dietary instruction is most
appropriate for this patient to manage their condition?
A. Limit intake of high-protein and high-potassium foods
B. Use salt substitutes to season food
C. Increase intake of dairy products for calcium
D. Increase fluid intake to at least 3 liters per day
,Correct Answer: A
Rationale: Chronic Kidney Disease requires strict management of electrolytes and metabolic waste
products that the kidneys can no longer filter. High-protein diets are restricted because they increase
nitrogenous waste which places more stress on the remaining nephrons. Potassium must be limited to
prevent life-threatening cardiac arrhythmias that occur when levels become too high. Salt substitutes
should be avoided because they often contain high amounts of potassium. These dietary modifications
are essential for slowing the progression of renal failure and maintaining homeostasis.
3. A patient with Type 1 Diabetes Mellitus is found unconscious with a blood glucose level of 42 mg/dL.
What is the priority nursing action?
A. Administer 15 grams of oral glucose gel
B. Provide 4 ounces of orange juice
C. Administer Glucagon subcutaneously or IM
D. Encourage the patient to eat a complex carbohydrate snack
Correct Answer: C
Rationale: In an unconscious patient with severe hypoglycemia, the oral route is contraindicated due to
the risk of aspiration. Glucagon is the emergency treatment of choice to rapidly mobilize glucose from
liver stores when IV access is not immediately available. Once the patient regains consciousness and can
swallow safely, they should be provided with a source of carbohydrates. The nurse must re-check blood
glucose levels frequently to ensure they return to a safe range. This immediate action is vital to prevent
permanent neurological damage or death from hypoglycemia.
4. Which clinical manifestation is most characteristic of a patient experiencing Cushing’s Syndrome?
A. Truncal obesity and a ‘buffalo hump’
, B. Weight loss and hypotension
C. Hyperpigmentation of the skin
D. Heat intolerance and tachycardia
Correct Answer: A
Rationale: Cushing’s Syndrome is caused by an excess of cortisol which leads to distinct physical changes
in the body. Truncal obesity, a ‘buffalo hump’ on the neck, and a moon-shaped face are hallmark signs of
this endocrine disorder. Patients also frequently experience thin skin, purple striae, and muscle wasting
in the extremities. These symptoms result from the altered metabolism of fats, proteins, and
carbohydrates under high cortisol levels. Nursing care focuses on monitoring for complications like
hypertension, hyperglycemia, and increased infection risk.
5. A nurse is assessing a patient with acute pancreatitis. Which laboratory result would the nurse expect to
find elevated?
A. Serum Calcium
B. Serum Potassium
C. Serum Hemoglobin
D. Serum Amylase
Correct Answer: D
Rationale: Acute pancreatitis involves the inflammation of the pancreas leading to the premature
activation of digestive enzymes. Serum amylase and lipase are released into the bloodstream and are the
primary diagnostic indicators of this condition. Amylase levels usually rise within hours of the onset of
symptoms and stay elevated for several days. Conversely, serum calcium levels often decrease in severe
