GALEN NUR 283 COMP 1 COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A patient is admitted with a pH of 7.30, a PaCO2 of 55 mmHg, and an HCO3 of 29 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Respiratory acidosis, uncompensated
B. Respiratory acidosis, partially compensated
C. Metabolic acidosis, partially compensated
D. Metabolic alkalosis, fully compensated
Answer: B
Conceptual Explanation: The pH is below 7.35 (acidosis). The PaCO2 is elevated
(respiratory cause). The HCO3 is elevated, indicating the kidneys are attempting to
compensate, but since the pH is not yet normal, it is partially compensated.
2. Which of the following EKG changes is most characteristic of a patient with a serum
potassium level of 6.8 mEq/L?
A. Prominent U waves
B. Shortened PR interval
C. ST-segment depression
,D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves, widened QRS complexes, and prolonged PR intervals.
3. A nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory finding should the nurse expect?
A. Urine specific gravity 1.002
B. Serum osmolality 310 mOsm/kg
C. Serum sodium 128 mEq/L
D. Hematocrit 55%
Answer: C
Conceptual Explanation: SIADH causes excessive water retention, leading to dilutional
hyponatremia (low serum sodium) and low serum osmolality.
4. Which clinical manifestation is a hallmark sign of Cardiac Tamponade?
A. Widened pulse pressure
B. Inspiratory wheezing
C. Flattened neck veins
D. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
, Answer: D
Conceptual Explanation: Beck’s Triad includes hypotension, jugular venous distention
(JVD), and muffled heart sounds, caused by fluid accumulation in the pericardial sac.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Why is it critical to avoid high concentrations of oxygen in this patient?
A. High oxygen causes pulmonary edema
B. It may eliminate the hypoxic drive to breathe
C. It increases the risk of metabolic alkalosis
D. High oxygen levels cause immediate respiratory alkalosis
Answer: B
Conceptual Explanation: Patients with chronic hypercapnia rely on low oxygen levels
(hypoxic drive) to stimulate breathing; providing too much oxygen can suppress their
respiratory drive.
6. Which medication is the treatment of choice for a patient experiencing an acute episode of
Torsades de Pointes?
A. Epinephrine
B. Amiodarone
C. Calcium Gluconate
D. Magnesium Sulfate
EXAM QUESTIONS AND ANSWERS
1. A patient is admitted with a pH of 7.30, a PaCO2 of 55 mmHg, and an HCO3 of 29 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Respiratory acidosis, uncompensated
B. Respiratory acidosis, partially compensated
C. Metabolic acidosis, partially compensated
D. Metabolic alkalosis, fully compensated
Answer: B
Conceptual Explanation: The pH is below 7.35 (acidosis). The PaCO2 is elevated
(respiratory cause). The HCO3 is elevated, indicating the kidneys are attempting to
compensate, but since the pH is not yet normal, it is partially compensated.
2. Which of the following EKG changes is most characteristic of a patient with a serum
potassium level of 6.8 mEq/L?
A. Prominent U waves
B. Shortened PR interval
C. ST-segment depression
,D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves, widened QRS complexes, and prolonged PR intervals.
3. A nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory finding should the nurse expect?
A. Urine specific gravity 1.002
B. Serum osmolality 310 mOsm/kg
C. Serum sodium 128 mEq/L
D. Hematocrit 55%
Answer: C
Conceptual Explanation: SIADH causes excessive water retention, leading to dilutional
hyponatremia (low serum sodium) and low serum osmolality.
4. Which clinical manifestation is a hallmark sign of Cardiac Tamponade?
A. Widened pulse pressure
B. Inspiratory wheezing
C. Flattened neck veins
D. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
, Answer: D
Conceptual Explanation: Beck’s Triad includes hypotension, jugular venous distention
(JVD), and muffled heart sounds, caused by fluid accumulation in the pericardial sac.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Why is it critical to avoid high concentrations of oxygen in this patient?
A. High oxygen causes pulmonary edema
B. It may eliminate the hypoxic drive to breathe
C. It increases the risk of metabolic alkalosis
D. High oxygen levels cause immediate respiratory alkalosis
Answer: B
Conceptual Explanation: Patients with chronic hypercapnia rely on low oxygen levels
(hypoxic drive) to stimulate breathing; providing too much oxygen can suppress their
respiratory drive.
6. Which medication is the treatment of choice for a patient experiencing an acute episode of
Torsades de Pointes?
A. Epinephrine
B. Amiodarone
C. Calcium Gluconate
D. Magnesium Sulfate
