NSG223/NSG 223 Exam 1 V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A nurse is reviewing the arterial blood gas (ABG) results for a patient with chronic
obstructive pulmonary disease (COPD). The results are: pH 7.28, PaCO2 55 mmHg, and HCO3
28 mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis, fully compensated
B. Metabolic alkalosis, partially compensated
C. Respiratory alkalosis, uncompensated
D. Respiratory acidosis, partially compensated
Correct Answer: D
Rationale: The pH of 7.28 indicates acidosis because it is below the normal range of 7.35 to
7.45. The PaCO2 is elevated at 55 mmHg, which points toward a respiratory cause for the
acidosis. Since the HCO3 is also elevated at 28 mEq/L, it suggests the kidneys are
attempting to compensate, though the pH has not yet returned to normal.
2. A patient with a history of heart failure presents with a potassium level of 2.8 mEq/L.
Which EKG change should the nurse expect to see?
A. Tall, peaked T waves
B. Presence of U waves
,C. Widened QRS complexes
D. Shortened QT interval
Correct Answer: B
Rationale: Hypokalemia, defined as a potassium level below 3.5 mEq/L, often manifests as
specific EKG changes such as U waves and flattened T waves. Tall, peaked T waves are
conversely associated with hyperkalemia rather than hypokalemia. Nurses must monitor
these patients closely for life-threatening arrhythmias associated with low potassium
levels.
3. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention (JVD)
B. Peripheral edema in the lower extremities
C. Hepatomegaly and abdominal girth increase
D. Crackles auscultated in the lung bases
Correct Answer: D
Rationale: Left-sided heart failure leads to pulmonary congestion because the left ventricle
cannot effectively pump blood into the systemic circulation. This results in fluid backing up
into the lungs, which manifests as crackles, dyspnea, and orthopnea. Signs like JVD and
peripheral edema are more characteristic of right-sided heart failure where blood backs up
into the systemic venous system.
, 4. A nurse is caring for a patient who is 24 hours post-operative following a total hip
arthroplasty. The patient suddenly develops sharp chest pain and shortness of breath. What
is the nurse’s priority action?
A. Apply supplemental oxygen and notify the rapid response team
B. Administer the ordered PRN pain medication
C. Encourage the patient to use the incentive spirometer
D. Check the surgical site for signs of hemorrhage
Correct Answer: A
Rationale: The sudden onset of chest pain and shortness of breath in a post-operative
patient is highly suggestive of a pulmonary embolism. Oxygen administration is the
immediate priority to stabilize the patient’s respiratory status while seeking urgent
medical intervention. Delaying care for pain meds or incentive spirometry could result in
fatal respiratory or cardiac arrest.
5. The nurse is providing education to a patient newly diagnosed with hypertension who is
starting lisinopril. Which side effect should the patient be instructed to report immediately?
A. Mild dizziness when standing up quickly
B. A frequent, dry, hacking cough
C. Increased frequency of urination
D. A slight decrease in appetite
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A nurse is reviewing the arterial blood gas (ABG) results for a patient with chronic
obstructive pulmonary disease (COPD). The results are: pH 7.28, PaCO2 55 mmHg, and HCO3
28 mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis, fully compensated
B. Metabolic alkalosis, partially compensated
C. Respiratory alkalosis, uncompensated
D. Respiratory acidosis, partially compensated
Correct Answer: D
Rationale: The pH of 7.28 indicates acidosis because it is below the normal range of 7.35 to
7.45. The PaCO2 is elevated at 55 mmHg, which points toward a respiratory cause for the
acidosis. Since the HCO3 is also elevated at 28 mEq/L, it suggests the kidneys are
attempting to compensate, though the pH has not yet returned to normal.
2. A patient with a history of heart failure presents with a potassium level of 2.8 mEq/L.
Which EKG change should the nurse expect to see?
A. Tall, peaked T waves
B. Presence of U waves
,C. Widened QRS complexes
D. Shortened QT interval
Correct Answer: B
Rationale: Hypokalemia, defined as a potassium level below 3.5 mEq/L, often manifests as
specific EKG changes such as U waves and flattened T waves. Tall, peaked T waves are
conversely associated with hyperkalemia rather than hypokalemia. Nurses must monitor
these patients closely for life-threatening arrhythmias associated with low potassium
levels.
3. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention (JVD)
B. Peripheral edema in the lower extremities
C. Hepatomegaly and abdominal girth increase
D. Crackles auscultated in the lung bases
Correct Answer: D
Rationale: Left-sided heart failure leads to pulmonary congestion because the left ventricle
cannot effectively pump blood into the systemic circulation. This results in fluid backing up
into the lungs, which manifests as crackles, dyspnea, and orthopnea. Signs like JVD and
peripheral edema are more characteristic of right-sided heart failure where blood backs up
into the systemic venous system.
, 4. A nurse is caring for a patient who is 24 hours post-operative following a total hip
arthroplasty. The patient suddenly develops sharp chest pain and shortness of breath. What
is the nurse’s priority action?
A. Apply supplemental oxygen and notify the rapid response team
B. Administer the ordered PRN pain medication
C. Encourage the patient to use the incentive spirometer
D. Check the surgical site for signs of hemorrhage
Correct Answer: A
Rationale: The sudden onset of chest pain and shortness of breath in a post-operative
patient is highly suggestive of a pulmonary embolism. Oxygen administration is the
immediate priority to stabilize the patient’s respiratory status while seeking urgent
medical intervention. Delaying care for pain meds or incentive spirometry could result in
fatal respiratory or cardiac arrest.
5. The nurse is providing education to a patient newly diagnosed with hypertension who is
starting lisinopril. Which side effect should the patient be instructed to report immediately?
A. Mild dizziness when standing up quickly
B. A frequent, dry, hacking cough
C. Increased frequency of urination
D. A slight decrease in appetite
