NU 185 Exam 1: Medical-Surgical Nursing II Study Quiz 2026 Galen
College
1. A patient’s ABG results are pH 7.28, PaCO2 55 mm Hg, and HCO3 24 mEq/L.
Which acid-base imbalance does the nurse identify?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
2. Which electrolyte imbalance is most associated with the presence of
Trousseau’s sign and Chvostek’s sign?
A. Hypomagnesemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Rationale: Hypocalcemia increases neuromuscular excitability, leading to positive
Trousseau’s (carpal spasm with BP cuff) and Chvostek’s (facial twitching) signs.
,3. When administering intravenous potassium chloride (KCl), which action by
the nurse is essential for safety?
A. Administering via IV push over 1 minute
B. Restricting fluid intake during the infusion
C. Ensuring the infusion rate does not exceed 10 mEq/hour
D. Using a 25-gauge needle for peripheral access
Answer: C
Rationale: Potassium should never be given IV push as it causes cardiac arrest. It must be
diluted and infused slowly, typically not exceeding 10 mEq/hr in a med-surg setting.
4. A preoperative patient is prescribed midazolam. What is the primary purpose
of this medication?
A. To reduce gastric acid secretion
B. To prevent postoperative infection
C. To provide sedation and reduce anxiety
D. To prevent intraoperative bradycardia
Answer: C
Rationale: Midazolam is a benzodiazepine used preoperatively for its sedative and
amnestic effects to reduce patient anxiety.
5. Which task is the primary responsibility of the scrub nurse in the operating
room?
A. Documenting the nursing care plan
B. Handing sterile instruments to the surgeon
C. Assessing the patient’s level of consciousness
D. Coordinating the transport of the patient to PACU
Answer: B
Rationale: The scrub nurse maintains the sterile field and assists the surgeon by passing
instruments and supplies.
, 6. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse monitor for most closely?
A. Increased thirst and dry mucous membranes
B. Hyperreflexia and muscle twitching
C. Constipation and decreased bowel sounds
D. Confusion and seizures
Answer: D
Rationale: Hyponatremia (Sodium < 135) causes water to move into cells, including brain
cells, leading to cerebral edema, confusion, and potential seizures.
7. What is the priority nursing intervention for a patient exhibiting signs of
Malignant Hyperthermia during surgery?
A. Applying warm blankets to the patient
B. Increasing the concentration of inhalation anesthetics
C. Administering intravenous Dantrolene
D. Administering IV calcium gluconate
Answer: C
Rationale: Dantrolene is the specific skeletal muscle relaxant used to treat the metabolic
crisis of Malignant Hyperthermia.
8. A patient with COPD has a pH of 7.33, PaCO2 of 50, and HCO3 of 30. How
would the nurse interpret this ABG?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Normal ABG for a COPD patient
Answer: C
College
1. A patient’s ABG results are pH 7.28, PaCO2 55 mm Hg, and HCO3 24 mEq/L.
Which acid-base imbalance does the nurse identify?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
2. Which electrolyte imbalance is most associated with the presence of
Trousseau’s sign and Chvostek’s sign?
A. Hypomagnesemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Rationale: Hypocalcemia increases neuromuscular excitability, leading to positive
Trousseau’s (carpal spasm with BP cuff) and Chvostek’s (facial twitching) signs.
,3. When administering intravenous potassium chloride (KCl), which action by
the nurse is essential for safety?
A. Administering via IV push over 1 minute
B. Restricting fluid intake during the infusion
C. Ensuring the infusion rate does not exceed 10 mEq/hour
D. Using a 25-gauge needle for peripheral access
Answer: C
Rationale: Potassium should never be given IV push as it causes cardiac arrest. It must be
diluted and infused slowly, typically not exceeding 10 mEq/hr in a med-surg setting.
4. A preoperative patient is prescribed midazolam. What is the primary purpose
of this medication?
A. To reduce gastric acid secretion
B. To prevent postoperative infection
C. To provide sedation and reduce anxiety
D. To prevent intraoperative bradycardia
Answer: C
Rationale: Midazolam is a benzodiazepine used preoperatively for its sedative and
amnestic effects to reduce patient anxiety.
5. Which task is the primary responsibility of the scrub nurse in the operating
room?
A. Documenting the nursing care plan
B. Handing sterile instruments to the surgeon
C. Assessing the patient’s level of consciousness
D. Coordinating the transport of the patient to PACU
Answer: B
Rationale: The scrub nurse maintains the sterile field and assists the surgeon by passing
instruments and supplies.
, 6. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse monitor for most closely?
A. Increased thirst and dry mucous membranes
B. Hyperreflexia and muscle twitching
C. Constipation and decreased bowel sounds
D. Confusion and seizures
Answer: D
Rationale: Hyponatremia (Sodium < 135) causes water to move into cells, including brain
cells, leading to cerebral edema, confusion, and potential seizures.
7. What is the priority nursing intervention for a patient exhibiting signs of
Malignant Hyperthermia during surgery?
A. Applying warm blankets to the patient
B. Increasing the concentration of inhalation anesthetics
C. Administering intravenous Dantrolene
D. Administering IV calcium gluconate
Answer: C
Rationale: Dantrolene is the specific skeletal muscle relaxant used to treat the metabolic
crisis of Malignant Hyperthermia.
8. A patient with COPD has a pH of 7.33, PaCO2 of 50, and HCO3 of 30. How
would the nurse interpret this ABG?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Normal ABG for a COPD patient
Answer: C
