NUR 242 MEDICAL-SURGICAL NURSING
EXAM 2 PRACTICE TEST QUESTIONS
AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 51 mm Hg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg
indicates a respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory
acidosis.
2. Which cardiac dysrhythmia is characterized by a lack of P waves and an irregularly irregular
ventricular rate?
A. Atrial Flutter
,B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree AV Block
Answer: B
Conceptual Explanation: Atrial fibrillation is defined by the absence of P waves (replaced
by fibrillatory waves) and an irregular R-R interval.
3. A patient with heart failure is prescribed Furosemide. Which electrolyte imbalance should
the nurse monitor for most closely?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C
Conceptual Explanation: Furosemide is a loop diuretic that causes the excretion of
potassium, potentially leading to hypokalemia.
4. Which of the following is a classic sign of Left-Sided Heart Failure?
A. Jugular Venous Distension (JVD)
B. Peripheral Edema
, C. Crackles in the lungs
D. Splenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles.
5. A patient presents with a ‘TEACH’ mnemonic for Tuberculosis. Which finding is most
consistent with active pulmonary TB?
A. Weight gain and bradycardia
B. Inspiratory wheezing
C. Night sweats and hemoptysis
D. Sudden onset of sharp chest pain
Answer: C
Conceptual Explanation: Classic signs of active TB include low-grade fever, night sweats,
fatigue, weight loss, and a productive cough with hemoptysis.
6. The nurse is caring for a patient with a chest tube. What should the nurse do if the chest
tube becomes accidentally disconnected from the drainage system?
A. Clamp the tube immediately near the insertion site
B. Instruct the patient to cough forcefully
C. Cover the site with an occlusive dressing
EXAM 2 PRACTICE TEST QUESTIONS
AND ANSWERS
1. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 51 mm Hg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg
indicates a respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory
acidosis.
2. Which cardiac dysrhythmia is characterized by a lack of P waves and an irregularly irregular
ventricular rate?
A. Atrial Flutter
,B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree AV Block
Answer: B
Conceptual Explanation: Atrial fibrillation is defined by the absence of P waves (replaced
by fibrillatory waves) and an irregular R-R interval.
3. A patient with heart failure is prescribed Furosemide. Which electrolyte imbalance should
the nurse monitor for most closely?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C
Conceptual Explanation: Furosemide is a loop diuretic that causes the excretion of
potassium, potentially leading to hypokalemia.
4. Which of the following is a classic sign of Left-Sided Heart Failure?
A. Jugular Venous Distension (JVD)
B. Peripheral Edema
, C. Crackles in the lungs
D. Splenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles.
5. A patient presents with a ‘TEACH’ mnemonic for Tuberculosis. Which finding is most
consistent with active pulmonary TB?
A. Weight gain and bradycardia
B. Inspiratory wheezing
C. Night sweats and hemoptysis
D. Sudden onset of sharp chest pain
Answer: C
Conceptual Explanation: Classic signs of active TB include low-grade fever, night sweats,
fatigue, weight loss, and a productive cough with hemoptysis.
6. The nurse is caring for a patient with a chest tube. What should the nurse do if the chest
tube becomes accidentally disconnected from the drainage system?
A. Clamp the tube immediately near the insertion site
B. Instruct the patient to cough forcefully
C. Cover the site with an occlusive dressing
