NRSG 201 Exam 1 V3 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A nurse is reviewing the arterial blood gas (ABG) results for a client with COPD. The results
are: pH 7.30, PaCO2 55 mm Hg, and HCO3 26 mEq/L. How should the nurse interpret these
findings?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Answer: D
The pH of 7.30 indicates acidosis because it is below the normal range of 7.35 to 7.45. The
PaCO2 is elevated at 55 mm Hg, which is the primary cause of the acidic pH in a client with
COPD. The bicarbonate level is within normal limits, suggesting that no compensation has
occurred yet.
2. A client is admitted with a serum sodium level of 128 mEq/L. Which nursing intervention is
a priority for this client?
A. Implementing seizure precautions
B. Encouraging increased fluid intake
,C. Administering a diuretic
D. Providing a low-salt diet
Correct Answer: A
Hyponatremia, defined as a sodium level below 135 mEq/L, can lead to cerebral edema
and increased intracranial pressure. Clients with severe hyponatremia are at a high risk for
developing seizures or falling into a coma. Ensuring a safe environment with seizure
precautions is the most critical immediate nursing action.
3. Which of the following EKG changes is most characteristic of a client experiencing
hyperkalemia?
A. Tall peaked T waves
B. ST segment depression
C. Prominent U waves
D. Shortened PR interval
Correct Answer: A
Hyperkalemia affects the repolarization phase of the cardiac cycle, leading to the classic
sign of tall, peaked T waves. As potassium levels continue to rise, the QRS complex may
widen and lead to cardiac arrest. Prompt recognition of these EKG changes is essential for
preventing lethal arrhythmias.
, 4. A preoperative nurse is assessing a client before surgery. Which statement by the client
requires immediate notification of the surgeon?
A. ‘I am very nervous about having this procedure done today.’
B. ‘I haven’t taken my daily multivitamin in three days.’
C. ‘I had a small cup of coffee with cream two hours ago.’
D. ‘I have a history of seasonal allergies and hay fever.’
Correct Answer: C
The client must remain NPO (nothing by mouth) for a specified period before surgery to
prevent the risk of aspiration under anesthesia. Consuming coffee with cream violates NPO
status and significantly increases the risk of pulmonary complications. The surgeon and
anesthesiologist must be notified to determine if the surgery should be delayed or
rescheduled.
5. During the postoperative period, a nurse notes that a client’s surgical wound has
eviscerated. What is the nurse’s first action?
A. Attempt to push the protruding organs back into the abdomen
B. Place the client in a high-Fowler’s position
C. Cover the wound with sterile saline-soaked dressings
D. Leave the room to call the surgeon immediately
Correct Answer: C
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A nurse is reviewing the arterial blood gas (ABG) results for a client with COPD. The results
are: pH 7.30, PaCO2 55 mm Hg, and HCO3 26 mEq/L. How should the nurse interpret these
findings?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Answer: D
The pH of 7.30 indicates acidosis because it is below the normal range of 7.35 to 7.45. The
PaCO2 is elevated at 55 mm Hg, which is the primary cause of the acidic pH in a client with
COPD. The bicarbonate level is within normal limits, suggesting that no compensation has
occurred yet.
2. A client is admitted with a serum sodium level of 128 mEq/L. Which nursing intervention is
a priority for this client?
A. Implementing seizure precautions
B. Encouraging increased fluid intake
,C. Administering a diuretic
D. Providing a low-salt diet
Correct Answer: A
Hyponatremia, defined as a sodium level below 135 mEq/L, can lead to cerebral edema
and increased intracranial pressure. Clients with severe hyponatremia are at a high risk for
developing seizures or falling into a coma. Ensuring a safe environment with seizure
precautions is the most critical immediate nursing action.
3. Which of the following EKG changes is most characteristic of a client experiencing
hyperkalemia?
A. Tall peaked T waves
B. ST segment depression
C. Prominent U waves
D. Shortened PR interval
Correct Answer: A
Hyperkalemia affects the repolarization phase of the cardiac cycle, leading to the classic
sign of tall, peaked T waves. As potassium levels continue to rise, the QRS complex may
widen and lead to cardiac arrest. Prompt recognition of these EKG changes is essential for
preventing lethal arrhythmias.
, 4. A preoperative nurse is assessing a client before surgery. Which statement by the client
requires immediate notification of the surgeon?
A. ‘I am very nervous about having this procedure done today.’
B. ‘I haven’t taken my daily multivitamin in three days.’
C. ‘I had a small cup of coffee with cream two hours ago.’
D. ‘I have a history of seasonal allergies and hay fever.’
Correct Answer: C
The client must remain NPO (nothing by mouth) for a specified period before surgery to
prevent the risk of aspiration under anesthesia. Consuming coffee with cream violates NPO
status and significantly increases the risk of pulmonary complications. The surgeon and
anesthesiologist must be notified to determine if the surgery should be delayed or
rescheduled.
5. During the postoperative period, a nurse notes that a client’s surgical wound has
eviscerated. What is the nurse’s first action?
A. Attempt to push the protruding organs back into the abdomen
B. Place the client in a high-Fowler’s position
C. Cover the wound with sterile saline-soaked dressings
D. Leave the room to call the surgeon immediately
Correct Answer: C
