NURS 120 MEDICAL-SURGICAL
NURSING EXAM 2 STUDY GUIDE
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is above 45
mmHg (respiratory origin) while the HCO3 is normal, indicating respiratory acidosis.
2. Which clinical manifestation should the nurse expect to find in a patient with a potassium
level of 6.2 mEq/L?
A. Hyperactive bowel sounds
B. Hyporeflexia
C. Prominent U waves on EKG
,D. Tall, peaked T waves on EKG
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0) causes cardiac conduction
disturbances, most notably tall, peaked T waves. U waves are associated with hypokalemia.
3. The nurse is caring for a patient who underwent a thyroidectomy. The patient reports
tingling in the fingers and around the mouth. What is the priority nursing action?
A. Administer potassium chloride
B. Assess for Chvostek’s sign
C. Check the patient’s blood glucose
D. Encourage the patient to cough and deep breathe
Answer: B
Conceptual Explanation: Tingling around the mouth and fingers are signs of
hypocalcemia, a common complication of thyroid surgery due to parathyroid damage.
Chvostek’s sign assesses for neuromuscular excitability related to low calcium.
4. A patient is admitted with a sodium level of 118 mEq/L. Which intervention is the highest
priority?
A. Encourage increased oral fluid intake
B. Provide a high-sodium diet
C. Administer hypotonic saline IV
, D. Initiate seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (<120 mEq/L) places the patient at high
risk for cerebral edema and seizures. Safety is the priority.
5. During the intraoperative phase, the nurse notes the patient has developed muscle rigidity,
tachycardia, and a rapidly rising temperature. Which medication should be prepared
immediately?
A. Atropine sulfate
B. Dantrolene sodium
C. Naloxone
D. Epinephrine
Answer: B
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
reaction to anesthesia. Dantrolene is the specific antidote for this condition.
6. A postoperative patient is coughing and states, ‘Something just popped.’ The nurse notes
the wound has opened and a loop of bowel is visible. What is the nurse’s first action?
A. Push the bowel back into the abdomen
B. Cover the area with sterile dressings soaked in normal saline
C. Apply a tight abdominal binder
NURSING EXAM 2 STUDY GUIDE
QUESTIONS AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is above 45
mmHg (respiratory origin) while the HCO3 is normal, indicating respiratory acidosis.
2. Which clinical manifestation should the nurse expect to find in a patient with a potassium
level of 6.2 mEq/L?
A. Hyperactive bowel sounds
B. Hyporeflexia
C. Prominent U waves on EKG
,D. Tall, peaked T waves on EKG
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0) causes cardiac conduction
disturbances, most notably tall, peaked T waves. U waves are associated with hypokalemia.
3. The nurse is caring for a patient who underwent a thyroidectomy. The patient reports
tingling in the fingers and around the mouth. What is the priority nursing action?
A. Administer potassium chloride
B. Assess for Chvostek’s sign
C. Check the patient’s blood glucose
D. Encourage the patient to cough and deep breathe
Answer: B
Conceptual Explanation: Tingling around the mouth and fingers are signs of
hypocalcemia, a common complication of thyroid surgery due to parathyroid damage.
Chvostek’s sign assesses for neuromuscular excitability related to low calcium.
4. A patient is admitted with a sodium level of 118 mEq/L. Which intervention is the highest
priority?
A. Encourage increased oral fluid intake
B. Provide a high-sodium diet
C. Administer hypotonic saline IV
, D. Initiate seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (<120 mEq/L) places the patient at high
risk for cerebral edema and seizures. Safety is the priority.
5. During the intraoperative phase, the nurse notes the patient has developed muscle rigidity,
tachycardia, and a rapidly rising temperature. Which medication should be prepared
immediately?
A. Atropine sulfate
B. Dantrolene sodium
C. Naloxone
D. Epinephrine
Answer: B
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
reaction to anesthesia. Dantrolene is the specific antidote for this condition.
6. A postoperative patient is coughing and states, ‘Something just popped.’ The nurse notes
the wound has opened and a loop of bowel is visible. What is the nurse’s first action?
A. Push the bowel back into the abdomen
B. Cover the area with sterile dressings soaked in normal saline
C. Apply a tight abdominal binder
