NURS 354 MEDICAL-SURGICAL
NURSING QUESTIONS AND ANSWERS
2026
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST-segment depression
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves. U waves and ST depression are associated with
hypokalemia.
2. A client is diagnosed with Metabolic Acidosis. Which respiratory pattern is the body likely
to exhibit as a compensatory mechanism?
A. Cheyne-Stokes respirations
B. Kussmaul respirations
,C. Bradypnea
D. Apneustic breathing
Answer: B
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that occur as the
body attempts to exhale excess CO2 to compensate for metabolic acidosis.
3. Which of the following findings is most characteristic of a patient experiencing Right-sided
Heart Failure?
A. Pulmonary crackles
B. Orthopnea
C. Pink frothy sputum
D. Jugular venous distention
Answer: D
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to jugular venous distention, peripheral edema, and hepatomegaly. Left-sided
failure leads to pulmonary symptoms.
4. A nurse is caring for a patient post-cholecystectomy. Which assessment finding should be
reported immediately as a sign of internal bleeding?
A. Pain level of 6/10 at the incision site
B. Absent bowel sounds in all quadrants
, C. Heart rate of 118 bpm and BP of 90/58 mmHg
D. Serosanguinous drainage on the dressing
Answer: C
Conceptual Explanation: Tachycardia and hypotension are classic late signs of
hypovolemic shock due to hemorrhage. The other findings are expected or less urgent post-
operatively.
5. What is the primary rationale for administering IV insulin in a patient with Diabetic
Ketoacidosis (DKA)?
A. To prevent hypoglycemia
B. To increase serum potassium levels
C. To stop the breakdown of fats into ketones
D. To promote fluid volume expansion
Answer: C
Conceptual Explanation: In DKA, the lack of insulin causes fat breakdown (lipolysis),
resulting in ketone production. Insulin stops this process and shifts the body back to
carbohydrate metabolism.
6. During a blood transfusion, a patient develops chills, lower back pain, and hypotension.
What is the nurse’s first action?
A. Slow the infusion rate
NURSING QUESTIONS AND ANSWERS
2026
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST-segment depression
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves. U waves and ST depression are associated with
hypokalemia.
2. A client is diagnosed with Metabolic Acidosis. Which respiratory pattern is the body likely
to exhibit as a compensatory mechanism?
A. Cheyne-Stokes respirations
B. Kussmaul respirations
,C. Bradypnea
D. Apneustic breathing
Answer: B
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that occur as the
body attempts to exhale excess CO2 to compensate for metabolic acidosis.
3. Which of the following findings is most characteristic of a patient experiencing Right-sided
Heart Failure?
A. Pulmonary crackles
B. Orthopnea
C. Pink frothy sputum
D. Jugular venous distention
Answer: D
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to jugular venous distention, peripheral edema, and hepatomegaly. Left-sided
failure leads to pulmonary symptoms.
4. A nurse is caring for a patient post-cholecystectomy. Which assessment finding should be
reported immediately as a sign of internal bleeding?
A. Pain level of 6/10 at the incision site
B. Absent bowel sounds in all quadrants
, C. Heart rate of 118 bpm and BP of 90/58 mmHg
D. Serosanguinous drainage on the dressing
Answer: C
Conceptual Explanation: Tachycardia and hypotension are classic late signs of
hypovolemic shock due to hemorrhage. The other findings are expected or less urgent post-
operatively.
5. What is the primary rationale for administering IV insulin in a patient with Diabetic
Ketoacidosis (DKA)?
A. To prevent hypoglycemia
B. To increase serum potassium levels
C. To stop the breakdown of fats into ketones
D. To promote fluid volume expansion
Answer: C
Conceptual Explanation: In DKA, the lack of insulin causes fat breakdown (lipolysis),
resulting in ketone production. Insulin stops this process and shifts the body back to
carbohydrate metabolism.
6. During a blood transfusion, a patient develops chills, lower back pain, and hypotension.
What is the nurse’s first action?
A. Slow the infusion rate
