GALEN NUR 242 MEDICAL-SURGICAL
NURSING EXAM 1 COMPREHENSIVE
STUDY GUIDE
1. A patient’s arterial blood gas (ABG) results show: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, indicating no compensation yet.
2. Which clinical manifestation should the nurse expect to find in a patient with a serum
potassium level of 2.8 mEq/L?
A. Muscle weakness and leg cramps
B. Tall, peaked T waves on ECG
,C. Hyperactive bowel sounds
D. Positive Trousseau’s sign
Answer: A
Conceptual Explanation: Hypokalemia (K+ <3.5) affects muscle contraction, leading to
weakness, cramps, and diminished deep tendon reflexes. Peaked T waves are seen in
hyperkalemia.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte abnormality is the priority for the nurse to monitor?
A. Hyponatremia
B. Hypocalcemia
C. Hypernatremia
D. Hyperkalemia
Answer: A
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
serum sodium level, leading to dilutional hyponatremia.
4. When assessing a patient with hypocalcemia, the nurse briskly taps the patient’s facial
nerve in front of the ear and observes a twitch. What is this sign called?
A. Chvostek’s sign
B. Trousseau’s sign
, C. Babinski’s sign
D. Homans’ sign
Answer: A
Conceptual Explanation: Chvostek’s sign is a spasm of the facial muscles elicited by
tapping the facial nerve, indicating neuromuscular excitability due to hypocalcemia.
5. A patient with chronic kidney disease has a potassium level of 6.4 mEq/L. Which
medication should the nurse be prepared to administer to provide the fastest protection for
the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium Gluconate
D. Spironolactone
Answer: C
Conceptual Explanation: While Kayexalate removes potassium, Calcium Gluconate is
administered first in severe hyperkalemia to stabilize the myocardial cell membrane and
prevent arrhythmias.
NURSING EXAM 1 COMPREHENSIVE
STUDY GUIDE
1. A patient’s arterial blood gas (ABG) results show: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, indicating no compensation yet.
2. Which clinical manifestation should the nurse expect to find in a patient with a serum
potassium level of 2.8 mEq/L?
A. Muscle weakness and leg cramps
B. Tall, peaked T waves on ECG
,C. Hyperactive bowel sounds
D. Positive Trousseau’s sign
Answer: A
Conceptual Explanation: Hypokalemia (K+ <3.5) affects muscle contraction, leading to
weakness, cramps, and diminished deep tendon reflexes. Peaked T waves are seen in
hyperkalemia.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte abnormality is the priority for the nurse to monitor?
A. Hyponatremia
B. Hypocalcemia
C. Hypernatremia
D. Hyperkalemia
Answer: A
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
serum sodium level, leading to dilutional hyponatremia.
4. When assessing a patient with hypocalcemia, the nurse briskly taps the patient’s facial
nerve in front of the ear and observes a twitch. What is this sign called?
A. Chvostek’s sign
B. Trousseau’s sign
, C. Babinski’s sign
D. Homans’ sign
Answer: A
Conceptual Explanation: Chvostek’s sign is a spasm of the facial muscles elicited by
tapping the facial nerve, indicating neuromuscular excitability due to hypocalcemia.
5. A patient with chronic kidney disease has a potassium level of 6.4 mEq/L. Which
medication should the nurse be prepared to administer to provide the fastest protection for
the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Calcium Gluconate
D. Spironolactone
Answer: C
Conceptual Explanation: While Kayexalate removes potassium, Calcium Gluconate is
administered first in severe hyperkalemia to stabilize the myocardial cell membrane and
prevent arrhythmias.
