NUR 170 Exam 2 Med Surg 2026-2027 BANK QUESTIONS
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QUESTION 1
A patient with heart failure is prescribed furosemide. Which laboratory
value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of potassium. Hypokalemia is a significant adverse
effect and can precipitate cardiac dysrhythmias, especially in patients
taking digitalis. While sodium, calcium, and magnesium may be
affected, potassium monitoring is paramount due to the immediate risk
of arrhythmias.
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QUESTION 2
A client with chronic obstructive pulmonary disease has a nursing
diagnosis of ineffective airway clearance. Which intervention is most
appropriate?
A) Encourage pursed-lip breathing
B) Administer oxygen at 6 L/min via nasal cannula
C) Perform chest physiotherapy
D) Restrict fluid intake
Answer: C) Perform chest physiotherapy
Explanation: Chest physiotherapy, including percussion and vibration,
helps mobilize secretions, which is the primary goal for ineffective
airway clearance. Pursed-lip breathing helps with dyspnea but does not
clear airways. High-flow oxygen can suppress the hypoxic drive in COPD
patients, and fluid restriction would thicken secretions, making
clearance more difficult.
QUESTION 3
Which electrocardiogram change is characteristic of hyperkalemia?
A) Prolonged PR interval
B) Tall, peaked T waves
C) ST segment elevation
D) U waves
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Answer: B) Tall, peaked T waves
Explanation: Hyperkalemia produces characteristic tall, tented T waves
on the ECG. Prolonged PR interval is associated with hypokalemia or
first-degree heart block. ST segment elevation is seen in myocardial
injury. U waves are associated with hypokalemia.
QUESTION 4
A patient is admitted with acute pancreatitis. Which laboratory finding
is most specific for this diagnosis?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated blood urea nitrogen
D) Elevated white blood cell count
Answer: B) Elevated serum lipase
Explanation: Serum lipase is more specific and sensitive for acute
pancreatitis than amylase. Lipase remains elevated longer and is not
affected by other conditions like salivary gland disorders. Amylase can
be elevated in other abdominal conditions. BUN and WBC are
nonspecific.
QUESTION 5
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The nurse is caring for a patient with a nasogastric tube to low
continuous suction. Which electrolyte imbalance is most likely to
develop?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: B) Metabolic alkalosis
Explanation: Nasogastric suction removes gastric acid (hydrochloric
acid) from the stomach. This loss of hydrogen ions leads to a relative
increase in bicarbonate, causing metabolic alkalosis. Acidosis is less
likely because acid is being removed, not retained. Respiratory
imbalances are related to ventilation issues, not GI losses.
QUESTION 6
A patient receiving total parenteral nutrition complains of shortness of
breath and chest pain. The nurse notes the patient is tachycardic and
hypoxic. What is the priority action?
A) Slow the TPN infusion rate
B) Place the patient in Trendelenburg position
C) Turn off the TPN infusion and call for help
D) Obtain a stat serum glucose level