NURS 120 MEDICAL-SURGICAL
NURSING EXAM 2 STUDY GUIDE (2026
UPDATE)
1. A patient is scheduled for elective surgery. During the preoperative assessment, the
patient mentions taking Ginkgo biloba daily. What is the nurse’s priority action?
A. Inform the patient that Ginkgo biloba improves memory and is safe.
B. Ask the patient to double the dose to prevent postoperative cognitive decline.
C. Notify the surgeon because it increases the risk of bleeding.
D. Document the finding and proceed without further action.
Answer: C
Conceptual Explanation: Ginkgo biloba has anticoagulant properties and can significantly
increase the risk of intraoperative and postoperative bleeding. It should typically be
stopped 2-3 weeks before surgery.
2. A nurse is caring for a postoperative patient who exhibits muscle rigidity, tachycardia, and
a rapidly rising body temperature of 104°F (40°C). Which medication should the nurse
anticipate administering?
A. Dantrolene sodium
,B. Naloxone
C. Furosemide
D. Acetaminophen
Answer: A
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening reaction to certain anesthetic agents. Dantrolene is the specific skeletal muscle
relaxant used to treat it.
3. Which arterial blood gas (ABG) result is consistent with a patient experiencing a severe
asthma attack and early respiratory failure?
A. pH 7.30, PaCO2 52, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.50, PaCO2 40, HCO3 32
Answer: A
Conceptual Explanation: Respiratory acidosis (low pH and high PaCO2) occurs when a
patient cannot adequately ventilate, leading to CO2 retention, common in severe
obstructive conditions like asthma.
, 4. A patient with a serum potassium level of 6.2 mEq/L is admitted. Which ECG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes tall, peaked T
waves. Prolonged PR intervals and widened QRS complexes can also occur as levels rise.
5. A nurse is teaching a patient about incentive spirometry. What instruction is most accurate
for maximizing lung expansion?
A. Exhale forcefully into the device as hard as possible.
B. Use the device only if you feel short of breath.
C. Inhale slowly and deeply to raise the indicator.
D. Perform 20 breaths rapidly every hour.
Answer: C
Conceptual Explanation: Incentive spirometry requires slow, deep inhalations to expand
the alveoli and prevent atelectasis. Forceful exhalation is used for peak flow meters, not
incentive spirometers.
NURSING EXAM 2 STUDY GUIDE (2026
UPDATE)
1. A patient is scheduled for elective surgery. During the preoperative assessment, the
patient mentions taking Ginkgo biloba daily. What is the nurse’s priority action?
A. Inform the patient that Ginkgo biloba improves memory and is safe.
B. Ask the patient to double the dose to prevent postoperative cognitive decline.
C. Notify the surgeon because it increases the risk of bleeding.
D. Document the finding and proceed without further action.
Answer: C
Conceptual Explanation: Ginkgo biloba has anticoagulant properties and can significantly
increase the risk of intraoperative and postoperative bleeding. It should typically be
stopped 2-3 weeks before surgery.
2. A nurse is caring for a postoperative patient who exhibits muscle rigidity, tachycardia, and
a rapidly rising body temperature of 104°F (40°C). Which medication should the nurse
anticipate administering?
A. Dantrolene sodium
,B. Naloxone
C. Furosemide
D. Acetaminophen
Answer: A
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening reaction to certain anesthetic agents. Dantrolene is the specific skeletal muscle
relaxant used to treat it.
3. Which arterial blood gas (ABG) result is consistent with a patient experiencing a severe
asthma attack and early respiratory failure?
A. pH 7.30, PaCO2 52, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.50, PaCO2 40, HCO3 32
Answer: A
Conceptual Explanation: Respiratory acidosis (low pH and high PaCO2) occurs when a
patient cannot adequately ventilate, leading to CO2 retention, common in severe
obstructive conditions like asthma.
, 4. A patient with a serum potassium level of 6.2 mEq/L is admitted. Which ECG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) causes tall, peaked T
waves. Prolonged PR intervals and widened QRS complexes can also occur as levels rise.
5. A nurse is teaching a patient about incentive spirometry. What instruction is most accurate
for maximizing lung expansion?
A. Exhale forcefully into the device as hard as possible.
B. Use the device only if you feel short of breath.
C. Inhale slowly and deeply to raise the indicator.
D. Perform 20 breaths rapidly every hour.
Answer: C
Conceptual Explanation: Incentive spirometry requires slow, deep inhalations to expand
the alveoli and prevent atelectasis. Forceful exhalation is used for peak flow meters, not
incentive spirometers.
