GALEN NUR 242 MEDICAL SURGICAL
NURSING EXAM 1 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse prioritize first?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Administer 10 units of regular insulin with 50% Dextrose IV
C. Initiate a 2-gram sodium restricted diet
D. Administer Calcium Gluconate IV
Answer: D
Conceptual Explanation: Calcium Gluconate is the priority in severe hyperkalemia
because it stabilizes the cardiac cell membrane to prevent lethal arrhythmias, although it
does not lower the potassium level itself.
2. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.35, PaCO2 48, HCO3 28
,C. pH 7.28, PaCO2 40, HCO3 18
D. pH 7.32, PaCO2 50, HCO3 29
Answer: D
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (below 7.35), the PaCO2 is high (causing the acidosis), and the HCO3 is elevated
(indicating the kidneys are attempting to compensate).
3. A nurse is caring for a patient who is 12 hours post-operative. The patient is lethargic, has a
respiratory rate of 8 breaths per minute, and a pulse oximetry of 88%. Which action should
the nurse take first?
A. Apply oxygen via nasal cannula at 2L/min
B. Administer the ordered PRN Naloxone
C. Attempt to arouse the patient and encourage deep breathing
D. Call a Rapid Response Team
Answer: C
Conceptual Explanation: The first step is to attempt to stimulate the patient. If the patient
does not respond or the status does not improve, Naloxone and Rapid Response may be
indicated, but arousal is the immediate first nursing action.
, 4. A patient with a serum sodium level of 118 mEq/L is at greatest risk for which
complication?
A. Cardiac dysrhythmias
B. Hyperactive deep tendon reflexes
C. Tetany and muscle spasms
D. Seizures and cerebral edema
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) leads to a fluid shift
into brain cells, causing cerebral edema and significant risk for seizures and coma.
5. During the preoperative assessment, a patient reports an allergy to avocados and bananas.
Which precaution is most important for the surgical team?
A. Use latex-free equipment and supplies during the procedure
B. Ensure the patient receives a prophylactic antihistamine
C. Document the allergy and proceed as normal
D. Ask the patient if they are also allergic to iodine
Answer: A
Conceptual Explanation: Cross-reactivity exists between certain foods (avocado, banana,
kiwi, chestnuts) and latex; therefore, the patient should be treated as having a potential
latex allergy.
NURSING EXAM 1 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse prioritize first?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Administer 10 units of regular insulin with 50% Dextrose IV
C. Initiate a 2-gram sodium restricted diet
D. Administer Calcium Gluconate IV
Answer: D
Conceptual Explanation: Calcium Gluconate is the priority in severe hyperkalemia
because it stabilizes the cardiac cell membrane to prevent lethal arrhythmias, although it
does not lower the potassium level itself.
2. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.35, PaCO2 48, HCO3 28
,C. pH 7.28, PaCO2 40, HCO3 18
D. pH 7.32, PaCO2 50, HCO3 29
Answer: D
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (below 7.35), the PaCO2 is high (causing the acidosis), and the HCO3 is elevated
(indicating the kidneys are attempting to compensate).
3. A nurse is caring for a patient who is 12 hours post-operative. The patient is lethargic, has a
respiratory rate of 8 breaths per minute, and a pulse oximetry of 88%. Which action should
the nurse take first?
A. Apply oxygen via nasal cannula at 2L/min
B. Administer the ordered PRN Naloxone
C. Attempt to arouse the patient and encourage deep breathing
D. Call a Rapid Response Team
Answer: C
Conceptual Explanation: The first step is to attempt to stimulate the patient. If the patient
does not respond or the status does not improve, Naloxone and Rapid Response may be
indicated, but arousal is the immediate first nursing action.
, 4. A patient with a serum sodium level of 118 mEq/L is at greatest risk for which
complication?
A. Cardiac dysrhythmias
B. Hyperactive deep tendon reflexes
C. Tetany and muscle spasms
D. Seizures and cerebral edema
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) leads to a fluid shift
into brain cells, causing cerebral edema and significant risk for seizures and coma.
5. During the preoperative assessment, a patient reports an allergy to avocados and bananas.
Which precaution is most important for the surgical team?
A. Use latex-free equipment and supplies during the procedure
B. Ensure the patient receives a prophylactic antihistamine
C. Document the allergy and proceed as normal
D. Ask the patient if they are also allergic to iodine
Answer: A
Conceptual Explanation: Cross-reactivity exists between certain foods (avocado, banana,
kiwi, chestnuts) and latex; therefore, the patient should be treated as having a potential
latex allergy.
