NUR 265 Exam 3: Nur Med Surg - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with cirrhosis is prescribed lactulose. Which finding indicates that the medication is achieving
the desired therapeutic effect?
A. Improvement in mental status
B. Decrease in abdominal girth
C. Increase in serum potassium levels
D. Reduction in peripheral edema
Correct Answer: A
Rationale: Lactulose is administered to patients with cirrhosis to lower high ammonia levels. High
ammonia levels contribute to hepatic encephalopathy, which causes confusion and altered mental status.
The medication works by trapping ammonia in the gut and expelling it through bowel movements.
Therefore, improved cognition and orientation indicate that the treatment is successful. Nurses must
monitor the frequency of stools to ensure the medication is effective without causing severe dehydration.
2. A nurse is caring for a patient who just underwent a liver biopsy. Which nursing intervention is the
priority for this patient?
A. Place the patient in a high-Fowler position
B. Position the patient on their right side
C. Encourage the patient to cough and deep breathe
D. Administer a dose of prescribed anticoagulants
Correct Answer: B
,Rationale: The priority intervention after a liver biopsy is to prevent hemorrhage by applying pressure
to the site. Positioning the patient on their right side uses the body’s weight to compress the liver against
the chest wall. This position should be maintained for several hours to ensure hemostasis. The nurse
must also monitor vital signs frequently for symptoms of internal bleeding, such as tachycardia and
hypotension. Education should focus on avoiding strenuous activity for several days following the
procedure.
3. Which laboratory result is the most specific indicator for a diagnosis of acute pancreatitis?
A. Elevated serum amylase
B. Decreased serum calcium
C. Elevated serum lipase
D. Increased white blood cell count
Correct Answer: C
Rationale: Serum lipase is more specific than amylase because it stays elevated longer and is primarily
produced by the pancreas. While amylase rises early, it can return to normal within 24 to 72 hours. In
contrast, lipase levels can remain high for up to two weeks during an acute episode. Low calcium levels
may occur but are more indicative of the severity and prognosis rather than the initial diagnosis. Nurses
should monitor these enzymes to track the patient’s recovery and response to therapy.
4. A patient is admitted with Acute Kidney Injury (AKI) due to severe dehydration. Which category of AKI
does this represent?
A. Intrarenal
B. Prerenal
C. Postrenal
, D. Chronic renal failure
Correct Answer: B
Rationale: Prerenal AKI is caused by conditions that reduce blood flow to the kidneys, such as
hypovolemia or heart failure. Dehydration leads to decreased renal perfusion, which prevents the
kidneys from filtering blood effectively. This type of injury is often reversible if the underlying cause is
treated promptly with fluid resuscitation. If left untreated, prerenal conditions can lead to permanent
intrarenal damage. The nurse should prioritize monitoring blood pressure and urine output in these
patients.
5. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L. Which medication
should the nurse anticipate administering?
A. Erythropoietin
B. Sodium polystyrene sulfonate
C. Furosemide
D. Calcium carbonate
Correct Answer: B
Rationale: Sodium polystyrene sulfonate, also known as Kayexalate, is used to treat hyperkalemia by
exchanging sodium ions for potassium ions in the intestine. A potassium level of 6.8 mEq/L is critically
high and poses a risk for life-threatening cardiac arrhythmias. The nurse must assess bowel sounds
before administration because the drug can cause intestinal necrosis if the gut is not mobile. Continuous
cardiac monitoring is essential for any patient with significant electrolyte imbalances. The nurse should
also prepare the patient for potential emergency dialysis if levels do not decrease.
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with cirrhosis is prescribed lactulose. Which finding indicates that the medication is achieving
the desired therapeutic effect?
A. Improvement in mental status
B. Decrease in abdominal girth
C. Increase in serum potassium levels
D. Reduction in peripheral edema
Correct Answer: A
Rationale: Lactulose is administered to patients with cirrhosis to lower high ammonia levels. High
ammonia levels contribute to hepatic encephalopathy, which causes confusion and altered mental status.
The medication works by trapping ammonia in the gut and expelling it through bowel movements.
Therefore, improved cognition and orientation indicate that the treatment is successful. Nurses must
monitor the frequency of stools to ensure the medication is effective without causing severe dehydration.
2. A nurse is caring for a patient who just underwent a liver biopsy. Which nursing intervention is the
priority for this patient?
A. Place the patient in a high-Fowler position
B. Position the patient on their right side
C. Encourage the patient to cough and deep breathe
D. Administer a dose of prescribed anticoagulants
Correct Answer: B
,Rationale: The priority intervention after a liver biopsy is to prevent hemorrhage by applying pressure
to the site. Positioning the patient on their right side uses the body’s weight to compress the liver against
the chest wall. This position should be maintained for several hours to ensure hemostasis. The nurse
must also monitor vital signs frequently for symptoms of internal bleeding, such as tachycardia and
hypotension. Education should focus on avoiding strenuous activity for several days following the
procedure.
3. Which laboratory result is the most specific indicator for a diagnosis of acute pancreatitis?
A. Elevated serum amylase
B. Decreased serum calcium
C. Elevated serum lipase
D. Increased white blood cell count
Correct Answer: C
Rationale: Serum lipase is more specific than amylase because it stays elevated longer and is primarily
produced by the pancreas. While amylase rises early, it can return to normal within 24 to 72 hours. In
contrast, lipase levels can remain high for up to two weeks during an acute episode. Low calcium levels
may occur but are more indicative of the severity and prognosis rather than the initial diagnosis. Nurses
should monitor these enzymes to track the patient’s recovery and response to therapy.
4. A patient is admitted with Acute Kidney Injury (AKI) due to severe dehydration. Which category of AKI
does this represent?
A. Intrarenal
B. Prerenal
C. Postrenal
, D. Chronic renal failure
Correct Answer: B
Rationale: Prerenal AKI is caused by conditions that reduce blood flow to the kidneys, such as
hypovolemia or heart failure. Dehydration leads to decreased renal perfusion, which prevents the
kidneys from filtering blood effectively. This type of injury is often reversible if the underlying cause is
treated promptly with fluid resuscitation. If left untreated, prerenal conditions can lead to permanent
intrarenal damage. The nurse should prioritize monitoring blood pressure and urine output in these
patients.
5. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L. Which medication
should the nurse anticipate administering?
A. Erythropoietin
B. Sodium polystyrene sulfonate
C. Furosemide
D. Calcium carbonate
Correct Answer: B
Rationale: Sodium polystyrene sulfonate, also known as Kayexalate, is used to treat hyperkalemia by
exchanging sodium ions for potassium ions in the intestine. A potassium level of 6.8 mEq/L is critically
high and poses a risk for life-threatening cardiac arrhythmias. The nurse must assess bowel sounds
before administration because the drug can cause intestinal necrosis if the gut is not mobile. Continuous
cardiac monitoring is essential for any patient with significant electrolyte imbalances. The nurse should
also prepare the patient for potential emergency dialysis if levels do not decrease.
