NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 1 COMPREHENSIVE PREP
1. A nurse is assessing a patient with a potassium level of 2.8 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Increased deep tendon reflexes
D. Muscle weakness and cardiac dysrhythmias
Answer: D
Conceptual Explanation: Hypokalemia (K+ < 3.5) causes muscle weakness and life-
threatening dysrhythmias. Peaked T waves are associated with hyperkalemia, not
hypokalemia.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.50, PaCO2 40, HCO3 32
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
,Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45). Option A shows a low pH and high CO2.
3. During the preoperative phase, a patient expresses fear about the surgery. What is the
nurse’s most appropriate initial action?
A. Assure the patient that the surgeon is highly skilled
B. Ask the patient to explain specifically what they are afraid of
C. Administer the prescribed PRN sedative
D. Explain the technical details of the surgical procedure
Answer: B
Conceptual Explanation: The first step in therapeutic communication is to assess the
patient’s concerns. This allows the nurse to provide targeted education and support.
4. A patient who is 1 day postoperative reports sudden chest pain and shortness of breath.
Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Hypovolemic shock
Answer: B
, Conceptual Explanation: Sudden onset of dyspnea and chest pain in a post-op patient is a
classic sign of pulmonary embolism, a medical emergency.
5. Which electrolyte imbalance is characterized by a positive Chvostek’s sign and Trousseau’s
sign?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypernatremia
D. Hypophosphatemia
Answer: B
Conceptual Explanation: Hypocalcemia causes increased neuromuscular excitability,
manifesting as facial twitching (Chvostek) and carpal spasms (Trousseau).
6. A nurse is caring for a patient with a sodium level of 150 mEq/L. Which IV fluid would the
nurse expect the provider to order?
A. 3% Normal Saline
B. 0.9% Normal Saline
C. Lactated Ringer’s
D. 0.45% Normal Saline
Answer: D
- EXAM 1 COMPREHENSIVE PREP
1. A nurse is assessing a patient with a potassium level of 2.8 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Increased deep tendon reflexes
D. Muscle weakness and cardiac dysrhythmias
Answer: D
Conceptual Explanation: Hypokalemia (K+ < 3.5) causes muscle weakness and life-
threatening dysrhythmias. Peaked T waves are associated with hyperkalemia, not
hypokalemia.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.50, PaCO2 40, HCO3 32
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
,Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45). Option A shows a low pH and high CO2.
3. During the preoperative phase, a patient expresses fear about the surgery. What is the
nurse’s most appropriate initial action?
A. Assure the patient that the surgeon is highly skilled
B. Ask the patient to explain specifically what they are afraid of
C. Administer the prescribed PRN sedative
D. Explain the technical details of the surgical procedure
Answer: B
Conceptual Explanation: The first step in therapeutic communication is to assess the
patient’s concerns. This allows the nurse to provide targeted education and support.
4. A patient who is 1 day postoperative reports sudden chest pain and shortness of breath.
Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Myocardial infarction
D. Hypovolemic shock
Answer: B
, Conceptual Explanation: Sudden onset of dyspnea and chest pain in a post-op patient is a
classic sign of pulmonary embolism, a medical emergency.
5. Which electrolyte imbalance is characterized by a positive Chvostek’s sign and Trousseau’s
sign?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypernatremia
D. Hypophosphatemia
Answer: B
Conceptual Explanation: Hypocalcemia causes increased neuromuscular excitability,
manifesting as facial twitching (Chvostek) and carpal spasms (Trousseau).
6. A nurse is caring for a patient with a sodium level of 150 mEq/L. Which IV fluid would the
nurse expect the provider to order?
A. 3% Normal Saline
B. 0.9% Normal Saline
C. Lactated Ringer’s
D. 0.45% Normal Saline
Answer: D
