NRSG 110 Exam 4 V1 | NRSG 110 Medical
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 4) | Ivy Tech
1. A nurse is assessing a patient with a history of COPD who is experiencing increased
dyspnea and productive cough. Which oxygen delivery method and flow rate is most
appropriate for this patient initially?
A. Simple face mask at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Partial rebreather at 8 L/min
D. Venturi mask at 50% FiO2
E. Nasal cannula at 2 L/min
Correct Answer: E
In patients with chronic obstructive pulmonary disease (COPD), the stimulus to breathe is
often a low arterial oxygen level rather than high carbon dioxide levels. Providing high
concentrations of oxygen can suppress this hypoxic drive, potentially leading to respiratory
hypoventilation or arrest. Therefore, the nurse should start with a low-flow device like a
nasal cannula to maintain adequate saturation without over-oxygenating.
,2. A patient arrives in the emergency department with partial-thickness burns to the entire
left arm and the anterior trunk. According to the Rule of Nines, what is the estimated
percentage of total body surface area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 9%
Correct Answer: A
According to the Rule of Nines, the entire arm accounts for 9% of the TBSA, and the
anterior trunk accounts for 18%. Adding these two areas together (9 + 18) results in a total
of 27%. Accurate TBSA estimation is critical for determining fluid resuscitation needs in
the burn patient.
3. A nurse is caring for a patient who has just undergone a thyroidectomy. The nurse
monitors the patient for which signs of hypocalcemia, indicating accidental removal of the
parathyroid glands?
A. Hypotension and bradycardia
B. Constipation and muscle weakness
C. Positive Chvostek’s and Trousseau’s signs
D. Polyuria and polydipsia
, Correct Answer: C
Accidental removal of the parathyroid glands during a thyroidectomy can result in a rapid
drop in serum calcium levels. Chvostek’s sign (facial twitching) and Trousseau’s sign
(carpal spasm) are classic clinical indicators of neuromuscular irritability due to
hypocalcemia. The nurse must have calcium gluconate available for emergency
administration if these signs appear.
4. The nurse is providing discharge education to a patient diagnosed with Gastroesophageal
Reflux Disease (GERD). Which instructions should be included in the teaching plan?
A. Eat three large meals a day to keep the stomach full.
B. Increase intake of caffeinated beverages.
C. Drink a glass of red wine with dinner to aid digestion.
D. Lie flat for 30 minutes after each meal.
E. Avoid eating within 3 hours of bedtime.
F. Wear tight-fitting clothing to support the abdomen.
Correct Answer: E
Eating close to bedtime increases the likelihood of gastric contents refluxing into the
esophagus while lying down. Patients with GERD should be taught to remain upright after
meals and consume smaller, more frequent meals. Avoiding triggers such as caffeine,
alcohol, and spicy foods is also essential for symptom management.
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 4) | Ivy Tech
1. A nurse is assessing a patient with a history of COPD who is experiencing increased
dyspnea and productive cough. Which oxygen delivery method and flow rate is most
appropriate for this patient initially?
A. Simple face mask at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Partial rebreather at 8 L/min
D. Venturi mask at 50% FiO2
E. Nasal cannula at 2 L/min
Correct Answer: E
In patients with chronic obstructive pulmonary disease (COPD), the stimulus to breathe is
often a low arterial oxygen level rather than high carbon dioxide levels. Providing high
concentrations of oxygen can suppress this hypoxic drive, potentially leading to respiratory
hypoventilation or arrest. Therefore, the nurse should start with a low-flow device like a
nasal cannula to maintain adequate saturation without over-oxygenating.
,2. A patient arrives in the emergency department with partial-thickness burns to the entire
left arm and the anterior trunk. According to the Rule of Nines, what is the estimated
percentage of total body surface area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 9%
Correct Answer: A
According to the Rule of Nines, the entire arm accounts for 9% of the TBSA, and the
anterior trunk accounts for 18%. Adding these two areas together (9 + 18) results in a total
of 27%. Accurate TBSA estimation is critical for determining fluid resuscitation needs in
the burn patient.
3. A nurse is caring for a patient who has just undergone a thyroidectomy. The nurse
monitors the patient for which signs of hypocalcemia, indicating accidental removal of the
parathyroid glands?
A. Hypotension and bradycardia
B. Constipation and muscle weakness
C. Positive Chvostek’s and Trousseau’s signs
D. Polyuria and polydipsia
, Correct Answer: C
Accidental removal of the parathyroid glands during a thyroidectomy can result in a rapid
drop in serum calcium levels. Chvostek’s sign (facial twitching) and Trousseau’s sign
(carpal spasm) are classic clinical indicators of neuromuscular irritability due to
hypocalcemia. The nurse must have calcium gluconate available for emergency
administration if these signs appear.
4. The nurse is providing discharge education to a patient diagnosed with Gastroesophageal
Reflux Disease (GERD). Which instructions should be included in the teaching plan?
A. Eat three large meals a day to keep the stomach full.
B. Increase intake of caffeinated beverages.
C. Drink a glass of red wine with dinner to aid digestion.
D. Lie flat for 30 minutes after each meal.
E. Avoid eating within 3 hours of bedtime.
F. Wear tight-fitting clothing to support the abdomen.
Correct Answer: E
Eating close to bedtime increases the likelihood of gastric contents refluxing into the
esophagus while lying down. Patients with GERD should be taught to remain upright after
meals and consume smaller, more frequent meals. Avoiding triggers such as caffeine,
alcohol, and spicy foods is also essential for symptom management.
