NUR 3300 Exam 2 V1 | NUR 3300 Nursing
Practice II | Q&A with Rationale (NUR3300
Exam 2) | William Paterson University
1. A nurse is preparing a patient for an elective surgical procedure. Which of the following is
the primary responsibility of the nurse regarding informed consent?
A. Witnessing the patient’s signature on the consent form.
B. Providing a detailed explanation of the risks and benefits of the surgery.
C. Determining which surgical approach is most appropriate for the patient.
D. Obtaining the final verbal consent immediately before anesthesia induction.
Answer: A
Rationale: The nurse’s legal role in informed consent is to witness the signature and
ensure the patient is competent to sign. It is the surgeon’s responsibility to explain the
procedure, risks, and alternatives to the patient. If the nurse notes that the patient does not
understand the procedure, the surgeon must be notified to provide further clarification.
2. A postoperative patient has a heart rate of 115 bpm, a blood pressure of 90/58 mmHg, and
a urine output of 20 mL/hr. Which complication should the nurse suspect first?
A. Incipient pulmonary embolism.
B. Malignant hyperthermia.
C. Postoperative paralytic ileus.
,D. Hypovolemic shock.
Answer: D
Rationale: Tachycardia, hypotension, and decreased urine output are classic clinical
manifestations of hypovolemic shock in a surgical patient. Low urine output indicates poor
renal perfusion, often resulting from blood loss or dehydration during surgery. Immediate
intervention with fluid resuscitation and notification of the surgical team is essential.
3. During a respiratory assessment, the nurse notes the patient is using accessory muscles to
breathe and has a barrel-shaped chest. Which chronic condition does this most likely
indicate?
A. Emphysema.
B. Pulmonary Fibrosis.
C. Acute Bronchitis.
D. Pneumothorax.
Answer: A
Rationale: A barrel chest is a clinical sign of chronic hyperinflation of the lungs, which is
most characteristic of emphysema. This condition leads to the destruction of alveoli and
loss of lung elasticity, trapping air inside the chest cavity. Nursing care focuses on
improving oxygenation and teaching pursed-lip breathing techniques.
, 4. Which arterial blood gas (ABG) result is most consistent with a patient experiencing
prolonged vomiting?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L
C. pH 7.32, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 25 mmHg, HCO3 22 mEq/L
Answer: B
Rationale: Prolonged vomiting leads to the loss of gastric hydrochloric acid, which results
in metabolic alkalosis. This state is characterized by an elevated pH (greater than 7.45) and
an elevated bicarbonate level (greater than 26 mEq/L). The nurse should monitor the
patient for hypokalemia and provide intravenous fluid replacement.
5. A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A. Serum potassium level.
B. Serum sodium level.
C. Serum calcium level.
D. Serum phosphorus level.
Answer: A
Practice II | Q&A with Rationale (NUR3300
Exam 2) | William Paterson University
1. A nurse is preparing a patient for an elective surgical procedure. Which of the following is
the primary responsibility of the nurse regarding informed consent?
A. Witnessing the patient’s signature on the consent form.
B. Providing a detailed explanation of the risks and benefits of the surgery.
C. Determining which surgical approach is most appropriate for the patient.
D. Obtaining the final verbal consent immediately before anesthesia induction.
Answer: A
Rationale: The nurse’s legal role in informed consent is to witness the signature and
ensure the patient is competent to sign. It is the surgeon’s responsibility to explain the
procedure, risks, and alternatives to the patient. If the nurse notes that the patient does not
understand the procedure, the surgeon must be notified to provide further clarification.
2. A postoperative patient has a heart rate of 115 bpm, a blood pressure of 90/58 mmHg, and
a urine output of 20 mL/hr. Which complication should the nurse suspect first?
A. Incipient pulmonary embolism.
B. Malignant hyperthermia.
C. Postoperative paralytic ileus.
,D. Hypovolemic shock.
Answer: D
Rationale: Tachycardia, hypotension, and decreased urine output are classic clinical
manifestations of hypovolemic shock in a surgical patient. Low urine output indicates poor
renal perfusion, often resulting from blood loss or dehydration during surgery. Immediate
intervention with fluid resuscitation and notification of the surgical team is essential.
3. During a respiratory assessment, the nurse notes the patient is using accessory muscles to
breathe and has a barrel-shaped chest. Which chronic condition does this most likely
indicate?
A. Emphysema.
B. Pulmonary Fibrosis.
C. Acute Bronchitis.
D. Pneumothorax.
Answer: A
Rationale: A barrel chest is a clinical sign of chronic hyperinflation of the lungs, which is
most characteristic of emphysema. This condition leads to the destruction of alveoli and
loss of lung elasticity, trapping air inside the chest cavity. Nursing care focuses on
improving oxygenation and teaching pursed-lip breathing techniques.
, 4. Which arterial blood gas (ABG) result is most consistent with a patient experiencing
prolonged vomiting?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L
C. pH 7.32, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 25 mmHg, HCO3 22 mEq/L
Answer: B
Rationale: Prolonged vomiting leads to the loss of gastric hydrochloric acid, which results
in metabolic alkalosis. This state is characterized by an elevated pH (greater than 7.45) and
an elevated bicarbonate level (greater than 26 mEq/L). The nurse should monitor the
patient for hypokalemia and provide intravenous fluid replacement.
5. A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A. Serum potassium level.
B. Serum sodium level.
C. Serum calcium level.
D. Serum phosphorus level.
Answer: A
