Exam 1: NUR 201 Medical-Surgical Nursing I
2026/2027 |Newly Released| Fortis College
50 Questions & Answers |Grade A+
100% Correct Rationales | Complete Guide
Guaranteed Pass
Q1: A 68-year-old male is admitted with a serum potassium of 2.8 mEq/L. He is receiving
furosemide 40 mg daily for heart failure. Which ECG change is most consistent with this
patient's electrolyte imbalance?
A. Peaked T-waves and widened QRS complex
B. Flattened T-waves, ST depression, and prominent U-waves
C. Shortened QT interval and bradycardia
D. Prolonged PR interval and tall peaked P-waves
Correct Answer: B
Rationale: Correct because hypokalemia (potassium <3.5 mEq/L) characteristically produces
flattened T-waves, ST-segment depression, and prominent U-waves on ECG due to delayed
ventricular repolarization. This patient's loop diuretic (furosemide) promotes renal potassium
wasting, making hypokalemia the most likely disorder. The priority nursing action includes
cardiac monitoring and initiating oral or IV potassium replacement per provider orders while
monitoring for dysrhythmias.
Q2: A nurse is caring for a postoperative patient on POD #2 who suddenly develops dyspnea,
tachycardia, and chest pain. The patient had a total knee arthroplasty 48 hours ago. Which
complication should the nurse suspect first?
A. Atelectasis
B. Wound dehiscence
C. Pulmonary embolism
D. Surgical site infection
,Correct Answer: D
Rationale: Correct because the sudden onset of dyspnea, chest pain, and tachycardia in a
postoperative patient with recent orthopedic surgery is the classic triad for pulmonary
embolism (PE), a critical complication of deep vein thrombosis (DVT). Orthopedic surgery carries
a massive risk for DVT due to Virchow's triad (stasis, vessel injury, hypercoagulability). The
priority nursing action is to administer supplemental oxygen, activate the rapid response team,
and prepare for anticoagulation therapy while maintaining hemodynamic support.
Q3: A nurse is preparing a 72-year-old female for an elective cholecystectomy. Which action by
the nurse best verifies that informed consent has been properly obtained?
A. The nurse asks the patient to sign the consent form after the surgeon has explained the
procedure
B. The nurse witnesses the patient's signature and confirms the patient can explain the
procedure in her own words
C. The nurse explains the risks and benefits of the surgery to the patient and family
D. The nurse obtains the patient's signature on the consent form before the surgeon arrives
Correct Answer: A
Rationale: Correct because informed consent is a legal requirement that must be obtained by
the physician (surgeon) who will perform the procedure; the nurse's role is to witness the
signature and verify patient understanding through teach-back methods. The nurse must ensure
the patient is able to explain the procedure, risks, and alternatives in her own words without
coercion before witnessing the signature. This protects both patient autonomy and the surgical
team from liability while confirming the patient possesses decision-making capacity.
Q4: A patient with chronic kidney disease presents with perioral numbness, muscle cramps, and
a positive Chvostek's sign. Which electrolyte imbalance is most likely?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: C
Rationale: Correct because hypocalcemia (calcium <8.5 mg/dL) manifests with neuromuscular
irritability including perioral and digital paresthesias, muscle cramps, and positive Chvostek's
, sign (facial muscle twitching when tapping the facial nerve). Chronic kidney disease impairs
vitamin D activation and phosphate excretion, both of which reduce ionized calcium levels. The
priority nursing interventions include seizure precautions, ECG monitoring for prolonged QT
interval, and administration of IV calcium gluconate for severe symptomatic hypocalcemia per
provider orders.
Q5: A nurse is caring for a patient in the PACU who is difficult to arouse with shallow
respirations at 8 breaths/minute following morphine administration. Which is the priority
nursing action?
A. Administer naloxone immediately
B. Apply supplemental oxygen and prepare to administer naloxone
C. Stimulate the patient and encourage deep breathing
D. Increase the IV fluid rate to promote drug metabolism
Correct Answer: D
Rationale: Correct because the patient is exhibiting signs of opioid-induced respiratory
depression (shallow respirations, decreased level of consciousness), which is a life-threatening
complication requiring immediate airway management and reversal of the opioid effect. The
nurse must first apply supplemental oxygen to maintain adequate oxygenation while preparing
to administer naloxone, an opioid antagonist that reverses respiratory depression. Continuous
monitoring of respiratory status, oxygen saturation, and level of consciousness is essential
following naloxone administration due to the risk of recurrent sedation as the naloxone wears
off before the morphine.
Q6: A patient is admitted with a serum sodium of 128 mEq/L. The patient is alert but reports a
headache and mild confusion. Which nursing intervention is most appropriate for this patient?
A. Implement fluid restriction and monitor neurological status closely
B. Administer 3% hypertonic saline immediately
C. Encourage oral fluid intake to correct the deficit
D. Initiate seizure precautions and prepare for rapid sodium correction
Correct Answer: A
Rationale: Correct because this patient has mild to moderate hyponatremia (sodium 128
mEq/L) with neurological symptoms but is not in severe crisis, making fluid restriction the
appropriate initial intervention if the patient is hypervolemic or euvolemic. The nurse must
2026/2027 |Newly Released| Fortis College
50 Questions & Answers |Grade A+
100% Correct Rationales | Complete Guide
Guaranteed Pass
Q1: A 68-year-old male is admitted with a serum potassium of 2.8 mEq/L. He is receiving
furosemide 40 mg daily for heart failure. Which ECG change is most consistent with this
patient's electrolyte imbalance?
A. Peaked T-waves and widened QRS complex
B. Flattened T-waves, ST depression, and prominent U-waves
C. Shortened QT interval and bradycardia
D. Prolonged PR interval and tall peaked P-waves
Correct Answer: B
Rationale: Correct because hypokalemia (potassium <3.5 mEq/L) characteristically produces
flattened T-waves, ST-segment depression, and prominent U-waves on ECG due to delayed
ventricular repolarization. This patient's loop diuretic (furosemide) promotes renal potassium
wasting, making hypokalemia the most likely disorder. The priority nursing action includes
cardiac monitoring and initiating oral or IV potassium replacement per provider orders while
monitoring for dysrhythmias.
Q2: A nurse is caring for a postoperative patient on POD #2 who suddenly develops dyspnea,
tachycardia, and chest pain. The patient had a total knee arthroplasty 48 hours ago. Which
complication should the nurse suspect first?
A. Atelectasis
B. Wound dehiscence
C. Pulmonary embolism
D. Surgical site infection
,Correct Answer: D
Rationale: Correct because the sudden onset of dyspnea, chest pain, and tachycardia in a
postoperative patient with recent orthopedic surgery is the classic triad for pulmonary
embolism (PE), a critical complication of deep vein thrombosis (DVT). Orthopedic surgery carries
a massive risk for DVT due to Virchow's triad (stasis, vessel injury, hypercoagulability). The
priority nursing action is to administer supplemental oxygen, activate the rapid response team,
and prepare for anticoagulation therapy while maintaining hemodynamic support.
Q3: A nurse is preparing a 72-year-old female for an elective cholecystectomy. Which action by
the nurse best verifies that informed consent has been properly obtained?
A. The nurse asks the patient to sign the consent form after the surgeon has explained the
procedure
B. The nurse witnesses the patient's signature and confirms the patient can explain the
procedure in her own words
C. The nurse explains the risks and benefits of the surgery to the patient and family
D. The nurse obtains the patient's signature on the consent form before the surgeon arrives
Correct Answer: A
Rationale: Correct because informed consent is a legal requirement that must be obtained by
the physician (surgeon) who will perform the procedure; the nurse's role is to witness the
signature and verify patient understanding through teach-back methods. The nurse must ensure
the patient is able to explain the procedure, risks, and alternatives in her own words without
coercion before witnessing the signature. This protects both patient autonomy and the surgical
team from liability while confirming the patient possesses decision-making capacity.
Q4: A patient with chronic kidney disease presents with perioral numbness, muscle cramps, and
a positive Chvostek's sign. Which electrolyte imbalance is most likely?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: C
Rationale: Correct because hypocalcemia (calcium <8.5 mg/dL) manifests with neuromuscular
irritability including perioral and digital paresthesias, muscle cramps, and positive Chvostek's
, sign (facial muscle twitching when tapping the facial nerve). Chronic kidney disease impairs
vitamin D activation and phosphate excretion, both of which reduce ionized calcium levels. The
priority nursing interventions include seizure precautions, ECG monitoring for prolonged QT
interval, and administration of IV calcium gluconate for severe symptomatic hypocalcemia per
provider orders.
Q5: A nurse is caring for a patient in the PACU who is difficult to arouse with shallow
respirations at 8 breaths/minute following morphine administration. Which is the priority
nursing action?
A. Administer naloxone immediately
B. Apply supplemental oxygen and prepare to administer naloxone
C. Stimulate the patient and encourage deep breathing
D. Increase the IV fluid rate to promote drug metabolism
Correct Answer: D
Rationale: Correct because the patient is exhibiting signs of opioid-induced respiratory
depression (shallow respirations, decreased level of consciousness), which is a life-threatening
complication requiring immediate airway management and reversal of the opioid effect. The
nurse must first apply supplemental oxygen to maintain adequate oxygenation while preparing
to administer naloxone, an opioid antagonist that reverses respiratory depression. Continuous
monitoring of respiratory status, oxygen saturation, and level of consciousness is essential
following naloxone administration due to the risk of recurrent sedation as the naloxone wears
off before the morphine.
Q6: A patient is admitted with a serum sodium of 128 mEq/L. The patient is alert but reports a
headache and mild confusion. Which nursing intervention is most appropriate for this patient?
A. Implement fluid restriction and monitor neurological status closely
B. Administer 3% hypertonic saline immediately
C. Encourage oral fluid intake to correct the deficit
D. Initiate seizure precautions and prepare for rapid sodium correction
Correct Answer: A
Rationale: Correct because this patient has mild to moderate hyponatremia (sodium 128
mEq/L) with neurological symptoms but is not in severe crisis, making fluid restriction the
appropriate initial intervention if the patient is hypervolemic or euvolemic. The nurse must
