PNR 201/PNR201 Exam 2 V2 | Medical-
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient who is 24 hours postoperative. The patient reports sudden
chest pain and shortness of breath. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Hypovolemic shock
C. Atelectasis
D. Pneumonia
Correct Answer: A
Expert Explanation: Sudden onset of chest pain and dyspnea in a postoperative patient
are classic indicators of a pulmonary embolism. This condition occurs when a blood clot,
often from a deep vein thrombosis, travels to the lungs and obstructs blood flow. The nurse
must prioritize oxygen administration and notify the provider immediately to prevent
cardiac arrest.
2. Which laboratory value is most indicative of a patient experiencing fluid volume deficit?
A. Urine specific gravity 1.010
B. Sodium 138 mEq/L
C. BUN 12 mg/dL
,D. Hematocrit 55%
Correct Answer: D
Expert Explanation: A hematocrit of 55% is elevated, which often indicates
hemoconcentration due to a loss of fluid volume. When the liquid part of the blood
decreases, the ratio of red blood cells to total volume increases. The nurse should assess
the patient for other signs of dehydration such as poor skin turgor and dry mucous
membranes.
3. The nurse is preparing to administer potassium chloride (KCl) intravenously to a patient
with a potassium level of 3.0 mEq/L. Which action is essential for safety?
A. Administer the medication via IV push over 2 minutes.
B. Dilute the KCl in 50 mL of 0.9% Normal Saline.
C. Restrict fluid intake while the infusion is running.
D. Ensure the infusion rate does not exceed 10 mEq/hr.
Correct Answer: D
Expert Explanation: Intravenous potassium must never be given by IV push because it can
cause immediate cardiac arrest. The standard safe infusion rate for a peripheral line is
typically no more than 10 mEq per hour to prevent irritation and cardiac complications.
Continuous cardiac monitoring is often required for patients receiving high concentrations
of potassium replacement.
, 4. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula. Which flow rate is typically most appropriate for this patient?
A. 6 to 10 L/min
B. 1 to 2 L/min
C. 10 to 15 L/min
D. 5 to 8 L/min
Correct Answer: B
Expert Explanation: Patients with COPD often rely on a hypoxic drive to breathe, meaning
low oxygen levels stimulate their respiratory effort. Administering high concentrations of
oxygen can suppress this drive and lead to respiratory failure or CO2 narcosis. Therefore,
low-flow oxygen, usually 1 to 2 liters per minute, is the safest starting point for these
patients.
5. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte imbalance is the nurse
screening for?
A. Hyperkalemia
B. Hypermagnesemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: D
Surgical Nursing Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient who is 24 hours postoperative. The patient reports sudden
chest pain and shortness of breath. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Hypovolemic shock
C. Atelectasis
D. Pneumonia
Correct Answer: A
Expert Explanation: Sudden onset of chest pain and dyspnea in a postoperative patient
are classic indicators of a pulmonary embolism. This condition occurs when a blood clot,
often from a deep vein thrombosis, travels to the lungs and obstructs blood flow. The nurse
must prioritize oxygen administration and notify the provider immediately to prevent
cardiac arrest.
2. Which laboratory value is most indicative of a patient experiencing fluid volume deficit?
A. Urine specific gravity 1.010
B. Sodium 138 mEq/L
C. BUN 12 mg/dL
,D. Hematocrit 55%
Correct Answer: D
Expert Explanation: A hematocrit of 55% is elevated, which often indicates
hemoconcentration due to a loss of fluid volume. When the liquid part of the blood
decreases, the ratio of red blood cells to total volume increases. The nurse should assess
the patient for other signs of dehydration such as poor skin turgor and dry mucous
membranes.
3. The nurse is preparing to administer potassium chloride (KCl) intravenously to a patient
with a potassium level of 3.0 mEq/L. Which action is essential for safety?
A. Administer the medication via IV push over 2 minutes.
B. Dilute the KCl in 50 mL of 0.9% Normal Saline.
C. Restrict fluid intake while the infusion is running.
D. Ensure the infusion rate does not exceed 10 mEq/hr.
Correct Answer: D
Expert Explanation: Intravenous potassium must never be given by IV push because it can
cause immediate cardiac arrest. The standard safe infusion rate for a peripheral line is
typically no more than 10 mEq per hour to prevent irritation and cardiac complications.
Continuous cardiac monitoring is often required for patients receiving high concentrations
of potassium replacement.
, 4. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula. Which flow rate is typically most appropriate for this patient?
A. 6 to 10 L/min
B. 1 to 2 L/min
C. 10 to 15 L/min
D. 5 to 8 L/min
Correct Answer: B
Expert Explanation: Patients with COPD often rely on a hypoxic drive to breathe, meaning
low oxygen levels stimulate their respiratory effort. Administering high concentrations of
oxygen can suppress this drive and lead to respiratory failure or CO2 narcosis. Therefore,
low-flow oxygen, usually 1 to 2 liters per minute, is the safest starting point for these
patients.
5. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte imbalance is the nurse
screening for?
A. Hyperkalemia
B. Hypermagnesemia
C. Hyponatremia
D. Hypocalcemia
Correct Answer: D
