HERZING UNIVERSITY
NSG 523 MEDICAL-SURGICAL NURSING I – EXAM 1
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES |100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A patient with diabetic ketoacidosis (DKA) has a serum potassiumlevel
of 5.9 mEq/L on admission. Which interpretation by the nurse is most
accurate?
A. The patient is experiencing total body potassium excess
B. Potassium shifting from the intracellular to extracellular space
C. Renal failure is the primary cause of the potassium elevation
D. Potassium replacement therapy should be initiated immediately
,Correct Answer: B
Rationale:
In DKA, acidosis causes hydrogen ions to move into cells, forcing
potassium into the extracellular space. Although serum
potassiumappears elevated, total body potassium is usually depleted due
to osmotic diuresis.
Question 2
A postoperative patient has an oxygen saturation of 89% on room air;
shallow respirations, and is difficult to arouse. What is the nurse’s
priority action?
A. Apply a warning blanket
B. Encourage incentive spirometry
C. Perform a focused respiratory assessment
D. Administer prescribed opioid reversal agent
,Correct Answer: C
Rationale:
Using the ABC framework, airway and breathing take priority. A
focused respiratory assessment is required before initiating interventions
to determine cause, severity, and appropriate response.
Question 3
Which arterial blood gas (ABG) values indicate metabolic acidosis?
A. pH 7.32, PaCO₂ 48 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L
C. pH 7.31, PaCO₂ 36 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.44, PaCO₂ 40 mmHg, HCO₃⁻ 26 mEq/L
Correct Answer: C
Rationale: A low pH with decreased bicarbonate indicates metabolic
acidosis. PaCO₂ is within normal range, suggesting little or no
respiratory compensation.
, Question 4
A nurse notes tall, peaked T waves on telemetry in a patient receiving
potassium chloride infusion. What is the most appropriate nursing
action?
A. Slow the infusion rate
B. Stop the infusion and notify the provider
C. Obtain a repeat potassium level in 4 hours
D. Document the finding as expected
Correct Answer: B
Rationale: Tall, peaked T waves indicate hyperkalemia, a life-
threatening condition. Potassium administration must be stopped
immediately and the provider notified.
Question 5
A patient with vomiting and diarrhea presents with hypotension,
tachycardia, and dry mucous membranes. Which IV fluid is most
appropriate initially?
A. 0.45% normal saline
B. 3% hypertonic saline
C. Lactated Ringers’
NSG 523 MEDICAL-SURGICAL NURSING I – EXAM 1
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES |100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A patient with diabetic ketoacidosis (DKA) has a serum potassiumlevel
of 5.9 mEq/L on admission. Which interpretation by the nurse is most
accurate?
A. The patient is experiencing total body potassium excess
B. Potassium shifting from the intracellular to extracellular space
C. Renal failure is the primary cause of the potassium elevation
D. Potassium replacement therapy should be initiated immediately
,Correct Answer: B
Rationale:
In DKA, acidosis causes hydrogen ions to move into cells, forcing
potassium into the extracellular space. Although serum
potassiumappears elevated, total body potassium is usually depleted due
to osmotic diuresis.
Question 2
A postoperative patient has an oxygen saturation of 89% on room air;
shallow respirations, and is difficult to arouse. What is the nurse’s
priority action?
A. Apply a warning blanket
B. Encourage incentive spirometry
C. Perform a focused respiratory assessment
D. Administer prescribed opioid reversal agent
,Correct Answer: C
Rationale:
Using the ABC framework, airway and breathing take priority. A
focused respiratory assessment is required before initiating interventions
to determine cause, severity, and appropriate response.
Question 3
Which arterial blood gas (ABG) values indicate metabolic acidosis?
A. pH 7.32, PaCO₂ 48 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 30 mmHg, HCO₃⁻ 22 mEq/L
C. pH 7.31, PaCO₂ 36 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.44, PaCO₂ 40 mmHg, HCO₃⁻ 26 mEq/L
Correct Answer: C
Rationale: A low pH with decreased bicarbonate indicates metabolic
acidosis. PaCO₂ is within normal range, suggesting little or no
respiratory compensation.
, Question 4
A nurse notes tall, peaked T waves on telemetry in a patient receiving
potassium chloride infusion. What is the most appropriate nursing
action?
A. Slow the infusion rate
B. Stop the infusion and notify the provider
C. Obtain a repeat potassium level in 4 hours
D. Document the finding as expected
Correct Answer: B
Rationale: Tall, peaked T waves indicate hyperkalemia, a life-
threatening condition. Potassium administration must be stopped
immediately and the provider notified.
Question 5
A patient with vomiting and diarrhea presents with hypotension,
tachycardia, and dry mucous membranes. Which IV fluid is most
appropriate initially?
A. 0.45% normal saline
B. 3% hypertonic saline
C. Lactated Ringers’
