Page 1 of 182
Galen NUR 242 Exam 1 Med-Surg (Latest
) Questions And Answers,
Verified Answers ||Complete A+ Guide
1. A nurse is assessing a patient with hyponatremia (Na+
128 mEq/L). Which clinical manifestation is most
concerning?
A. Muscle cramps
B. Nausea and vomiting
C. Altered mental status
D. Dry mucous membranes
Answer: C – Altered mental status
Rationale: Severe hyponatremia causes cerebral edema,
leading to confusion, seizures, or coma. This is a medical
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emergency. Muscle cramps and nausea are early signs; dry
mucous membranes suggest dehydration, not hyponatremia.
2. A patient with heart failure has a potassium level of 2.9
mEq/L. Which ECG change does the nurse expect?
A. Peaked T waves
B. Prominent U wave
C. Wide QRS complex
D. Tall, narrow P wave
Answer: B – Prominent U wave
Rationale: Hypokalemia (K+ <3.5) causes U waves, flat T
waves, and ST depression. Peaked T waves occur in
hyperkalemia.
3. A patient is receiving IV furosemide. Which electrolyte
imbalance is the priority to monitor?
A. Hypernatremia
B. Hyperkalemia
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C. Hypokalemia
D. Hypercalcemia
Answer: C – Hypokalemia
Rationale: Loop diuretics (furosemide) increase potassium
excretion in the distal tubule, causing hypokalemia.
4. (SATA) A patient with hyperkalemia (K+ 6.8 mEq/L) is
admitted. Which interventions should the nurse anticipate?
(Select all that apply)
A. IV calcium gluconate
B. IV insulin and dextrose
C. Oral sodium polystyrene sulfonate (Kayexalate)
D. Low-potassium diet
E. IV potassium chloride
Answer: A, B, C, D
Rationale: Calcium gluconate stabilizes the cardiac membrane.
Insulin + dextrose shifts K+ into cells. Kayexalate removes K+
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via GI tract. Low-potassium diet prevents further increase. IV
potassium chloride would worsen hyperkalemia.
5. A post-op patient has a serum sodium of 155 mEq/L. The
nurse identifies this as:
A. Hyponatremia – fluid overload
B. Hypernatremia – water deficit
C. Hyperkalemia – cardiac risk
D. Hypocalcemia – tetany risk
Answer: B – Hypernatremia – water deficit
Rationale: Na+ >145 indicates hypernatremia, usually from
free water loss (e.g., NPO status, insensible losses).
6. Scenario: A 72-year-old patient is confused, has poor skin
turgor, and urine output of 20 mL/hr over 2 hours. Lab: Na+
150, BUN 48, creatinine 1.9. What is the priority action?
A. Administer hypotonic IV fluids
B. Restrict oral fluids
Galen NUR 242 Exam 1 Med-Surg (Latest
) Questions And Answers,
Verified Answers ||Complete A+ Guide
1. A nurse is assessing a patient with hyponatremia (Na+
128 mEq/L). Which clinical manifestation is most
concerning?
A. Muscle cramps
B. Nausea and vomiting
C. Altered mental status
D. Dry mucous membranes
Answer: C – Altered mental status
Rationale: Severe hyponatremia causes cerebral edema,
leading to confusion, seizures, or coma. This is a medical
,Page 2 of 182
emergency. Muscle cramps and nausea are early signs; dry
mucous membranes suggest dehydration, not hyponatremia.
2. A patient with heart failure has a potassium level of 2.9
mEq/L. Which ECG change does the nurse expect?
A. Peaked T waves
B. Prominent U wave
C. Wide QRS complex
D. Tall, narrow P wave
Answer: B – Prominent U wave
Rationale: Hypokalemia (K+ <3.5) causes U waves, flat T
waves, and ST depression. Peaked T waves occur in
hyperkalemia.
3. A patient is receiving IV furosemide. Which electrolyte
imbalance is the priority to monitor?
A. Hypernatremia
B. Hyperkalemia
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C. Hypokalemia
D. Hypercalcemia
Answer: C – Hypokalemia
Rationale: Loop diuretics (furosemide) increase potassium
excretion in the distal tubule, causing hypokalemia.
4. (SATA) A patient with hyperkalemia (K+ 6.8 mEq/L) is
admitted. Which interventions should the nurse anticipate?
(Select all that apply)
A. IV calcium gluconate
B. IV insulin and dextrose
C. Oral sodium polystyrene sulfonate (Kayexalate)
D. Low-potassium diet
E. IV potassium chloride
Answer: A, B, C, D
Rationale: Calcium gluconate stabilizes the cardiac membrane.
Insulin + dextrose shifts K+ into cells. Kayexalate removes K+
, Page 4 of 182
via GI tract. Low-potassium diet prevents further increase. IV
potassium chloride would worsen hyperkalemia.
5. A post-op patient has a serum sodium of 155 mEq/L. The
nurse identifies this as:
A. Hyponatremia – fluid overload
B. Hypernatremia – water deficit
C. Hyperkalemia – cardiac risk
D. Hypocalcemia – tetany risk
Answer: B – Hypernatremia – water deficit
Rationale: Na+ >145 indicates hypernatremia, usually from
free water loss (e.g., NPO status, insensible losses).
6. Scenario: A 72-year-old patient is confused, has poor skin
turgor, and urine output of 20 mL/hr over 2 hours. Lab: Na+
150, BUN 48, creatinine 1.9. What is the priority action?
A. Administer hypotonic IV fluids
B. Restrict oral fluids
