NUR 209 MEDICAL SURGICAL NURSING
II - EXAM 2 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient with chronic heart failure presents with peripheral edema, jugular venous
distention, and abdominal girth increase. Which condition does the nurse suspect?
A. Right-sided heart failure
B. Left-sided heart failure
C. Pulmonary edema
D. Mitral valve stenosis
Answer: A
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
peripheral edema, JVD, and ascites.
2. Which arterial blood gas (ABG) result is most consistent with a patient experiencing a
severe asthma attack and early respiratory distress?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
C. pH 7.35, PaCO2 40 mmHg, HCO3 22 mEq/L
,D. pH 7.25, PaCO2 35 mmHg, HCO3 18 mEq/L
Answer: A
Conceptual Explanation: Early asthma attacks often cause hyperventilation, leading to
respiratory alkalosis (high pH, low PaCO2).
3. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer for immediate stabilization of the cardiac
membrane?
A. Calcium gluconate
B. Furosemide
C. Sodium polystyrene sulfonate
D. Regular insulin and D50
Answer: A
Conceptual Explanation: Calcium gluconate is used in hyperkalemia to protect the heart
from arrhythmias by stabilizing the myocardial cell membrane.
4. A patient in the ICU is on a ventilator. The high-pressure alarm sounds. What is the nurse’s
priority action?
A. Check for a disconnected tube
B. Assess the patient’s oxygen saturation and breath sounds
C. Increase the oxygen concentration (FiO2)
, D. Call the respiratory therapist immediately
Answer: B
Conceptual Explanation: High-pressure alarms often indicate obstruction (kink,
secretions, biting); the nurse must assess the patient first to determine the cause.
5. Which laboratory finding is most indicative of Acute Pancreatitis?
A. Decreased serum calcium
B. Decreased White Blood Cell count
C. Elevated serum amylase and lipase
D. Elevated serum albumin
Answer: C
Conceptual Explanation: Amylase and lipase are digestive enzymes that leak into the
blood during pancreatic inflammation.
6. A patient is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which IV fluid should
the nurse anticipate first?
A. D5 1/2 Normal Saline
B. 0.9% Normal Saline
C. 0.45% Normal Saline
D. Lactated Ringer’s
II - EXAM 2 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient with chronic heart failure presents with peripheral edema, jugular venous
distention, and abdominal girth increase. Which condition does the nurse suspect?
A. Right-sided heart failure
B. Left-sided heart failure
C. Pulmonary edema
D. Mitral valve stenosis
Answer: A
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
peripheral edema, JVD, and ascites.
2. Which arterial blood gas (ABG) result is most consistent with a patient experiencing a
severe asthma attack and early respiratory distress?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
C. pH 7.35, PaCO2 40 mmHg, HCO3 22 mEq/L
,D. pH 7.25, PaCO2 35 mmHg, HCO3 18 mEq/L
Answer: A
Conceptual Explanation: Early asthma attacks often cause hyperventilation, leading to
respiratory alkalosis (high pH, low PaCO2).
3. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse expect to administer for immediate stabilization of the cardiac
membrane?
A. Calcium gluconate
B. Furosemide
C. Sodium polystyrene sulfonate
D. Regular insulin and D50
Answer: A
Conceptual Explanation: Calcium gluconate is used in hyperkalemia to protect the heart
from arrhythmias by stabilizing the myocardial cell membrane.
4. A patient in the ICU is on a ventilator. The high-pressure alarm sounds. What is the nurse’s
priority action?
A. Check for a disconnected tube
B. Assess the patient’s oxygen saturation and breath sounds
C. Increase the oxygen concentration (FiO2)
, D. Call the respiratory therapist immediately
Answer: B
Conceptual Explanation: High-pressure alarms often indicate obstruction (kink,
secretions, biting); the nurse must assess the patient first to determine the cause.
5. Which laboratory finding is most indicative of Acute Pancreatitis?
A. Decreased serum calcium
B. Decreased White Blood Cell count
C. Elevated serum amylase and lipase
D. Elevated serum albumin
Answer: C
Conceptual Explanation: Amylase and lipase are digestive enzymes that leak into the
blood during pancreatic inflammation.
6. A patient is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which IV fluid should
the nurse anticipate first?
A. D5 1/2 Normal Saline
B. 0.9% Normal Saline
C. 0.45% Normal Saline
D. Lactated Ringer’s
