NURS 201 Quiz 2 V2 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 2) | West Coast
University
1. A nurse is caring for a postoperative patient who reports sudden chest pain and shortness
of breath. Which of the following complications should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Hypovolemic shock
D. Pneumonia
Answer: B
Rationale: Sudden onset of chest pain and dyspnea in a postoperative patient are hallmark
signs of a pulmonary embolism. This condition is a medical emergency caused by a blood
clot migrating to the pulmonary vasculature. The nurse must immediately assess oxygen
saturation and notify the rapid response team to prevent cardiovascular collapse.
2. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG change should
the nurse expect to observe?
A. Prominent U waves
B. Tall peaked T waves
,C. ST segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, significantly
affects cardiac conduction and often presents with tall peaked T waves. As potassium levels
continue to rise, the QRS complex may widen, eventually leading to cardiac arrest.
Immediate intervention with calcium gluconate or insulin with glucose is necessary to
stabilize the myocardium and shift potassium into the cells.
3. Which clinical manifestation is most characteristic of hypocalcemia?
A. Constipation
B. Depressed deep tendon reflexes
C. Shortened QT interval
D. Positive Chvostek’s sign
Answer: D
Rationale: Hypocalcemia increases neuromuscular irritability, leading to signs such as
Chvostek’s sign, which is a facial twitch elicited by tapping the facial nerve. Other
symptoms include Trousseau’s sign, tetany, and muscle cramps. Nurses must monitor these
patients closely for laryngeal spasms, which can compromise the airway.
, 4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Metabolic acidosis
B. Uncompensated respiratory acidosis
C. Compensated respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Rationale: The pH of 7.30 indicates acidosis, while the elevated PaCO2 of 55 mmHg points
to a respiratory cause. Since the bicarbonate level (HCO3) is within the normal range of 22-
26 mEq/L, no compensation has occurred yet. This pattern is typical in patients with
hypoventilation or acute respiratory failure.
5. Which of the following is a primary nursing responsibility during the preoperative phase?
A. Verifying that the informed consent is signed
B. Performing the surgical incision
C. Administering general anesthesia
D. Suturing the wound
Answer: A
Rationale: The nurse’s role in informed consent is to witness the patient’s signature and
verify that the patient understands the procedure explained by the surgeon. If the patient
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 2) | West Coast
University
1. A nurse is caring for a postoperative patient who reports sudden chest pain and shortness
of breath. Which of the following complications should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Hypovolemic shock
D. Pneumonia
Answer: B
Rationale: Sudden onset of chest pain and dyspnea in a postoperative patient are hallmark
signs of a pulmonary embolism. This condition is a medical emergency caused by a blood
clot migrating to the pulmonary vasculature. The nurse must immediately assess oxygen
saturation and notify the rapid response team to prevent cardiovascular collapse.
2. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG change should
the nurse expect to observe?
A. Prominent U waves
B. Tall peaked T waves
,C. ST segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, significantly
affects cardiac conduction and often presents with tall peaked T waves. As potassium levels
continue to rise, the QRS complex may widen, eventually leading to cardiac arrest.
Immediate intervention with calcium gluconate or insulin with glucose is necessary to
stabilize the myocardium and shift potassium into the cells.
3. Which clinical manifestation is most characteristic of hypocalcemia?
A. Constipation
B. Depressed deep tendon reflexes
C. Shortened QT interval
D. Positive Chvostek’s sign
Answer: D
Rationale: Hypocalcemia increases neuromuscular irritability, leading to signs such as
Chvostek’s sign, which is a facial twitch elicited by tapping the facial nerve. Other
symptoms include Trousseau’s sign, tetany, and muscle cramps. Nurses must monitor these
patients closely for laryngeal spasms, which can compromise the airway.
, 4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Metabolic acidosis
B. Uncompensated respiratory acidosis
C. Compensated respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Rationale: The pH of 7.30 indicates acidosis, while the elevated PaCO2 of 55 mmHg points
to a respiratory cause. Since the bicarbonate level (HCO3) is within the normal range of 22-
26 mEq/L, no compensation has occurred yet. This pattern is typical in patients with
hypoventilation or acute respiratory failure.
5. Which of the following is a primary nursing responsibility during the preoperative phase?
A. Verifying that the informed consent is signed
B. Performing the surgical incision
C. Administering general anesthesia
D. Suturing the wound
Answer: A
Rationale: The nurse’s role in informed consent is to witness the patient’s signature and
verify that the patient understands the procedure explained by the surgeon. If the patient
