GALEN NUR 242 MEDICAL-SURGICAL
NURSING EXAM 1 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.25, a PaCO2 of 50 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: The pH is low (acidic), the PaCO2 is high (acidic), and the HCO3
is normal, indicating an uncompensated respiratory acidosis.
2. Which cellular adaptation is characterized by the replacement of one adult cell type with
another adult cell type that is better able to survive stressful conditions?
A. Atrophy
B. Hyperplasia
,C. Dysplasia
D. Metaplasia
Answer: D
Conceptual Explanation: Metaplasia is a reversible change in which one adult cell type is
replaced by another, often as a response to chronic irritation.
3. A patient with a potassium level of 6.2 mEq/L is admitted. Which EKG change should the
nurse monitor for most closely?
A. ST-segment depression
B. Prominent U waves
C. Prolonged PR interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves due to the
rapid repolarization of the ventricles.
4. What is the primary physiological mechanism behind Trousseau’s sign in a patient with
hypocalcemia?
A. Hyperpolarization of nerve membranes
B. Decreased action potential threshold
C. Increased neuromuscular excitability
, D. Peripheral nerve demyelination
Answer: C
Conceptual Explanation: Hypocalcemia decreases the threshold for nerve excitation,
allowing sodium to enter cells more easily, leading to tetany and muscle spasms like
Trousseau’s sign.
5. During the preoperative phase, what is the nurse’s primary responsibility regarding
informed consent?
A. Explaining the risks and benefits of the procedure
B. Determining the patient’s capacity to give consent
C. Selecting the surgical site and marking it
D. Witnessing the patient’s signature and ensuring understanding
Answer: D
Conceptual Explanation: The surgeon is responsible for explaining the procedure; the
nurse witnesses the signature and ensures the patient is competent and informed.
6. A patient has a serum sodium level of 125 mEq/L. Which clinical manifestation is a priority
for the nurse to assess?
A. Dry mucous membranes
B. Confusion and seizures
C. Increased thirst
NURSING EXAM 1 COMPREHENSIVE
QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.25, a PaCO2 of 50 mmHg, and an HCO3 of 24 mEq/L.
Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Conceptual Explanation: The pH is low (acidic), the PaCO2 is high (acidic), and the HCO3
is normal, indicating an uncompensated respiratory acidosis.
2. Which cellular adaptation is characterized by the replacement of one adult cell type with
another adult cell type that is better able to survive stressful conditions?
A. Atrophy
B. Hyperplasia
,C. Dysplasia
D. Metaplasia
Answer: D
Conceptual Explanation: Metaplasia is a reversible change in which one adult cell type is
replaced by another, often as a response to chronic irritation.
3. A patient with a potassium level of 6.2 mEq/L is admitted. Which EKG change should the
nurse monitor for most closely?
A. ST-segment depression
B. Prominent U waves
C. Prolonged PR interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves due to the
rapid repolarization of the ventricles.
4. What is the primary physiological mechanism behind Trousseau’s sign in a patient with
hypocalcemia?
A. Hyperpolarization of nerve membranes
B. Decreased action potential threshold
C. Increased neuromuscular excitability
, D. Peripheral nerve demyelination
Answer: C
Conceptual Explanation: Hypocalcemia decreases the threshold for nerve excitation,
allowing sodium to enter cells more easily, leading to tetany and muscle spasms like
Trousseau’s sign.
5. During the preoperative phase, what is the nurse’s primary responsibility regarding
informed consent?
A. Explaining the risks and benefits of the procedure
B. Determining the patient’s capacity to give consent
C. Selecting the surgical site and marking it
D. Witnessing the patient’s signature and ensuring understanding
Answer: D
Conceptual Explanation: The surgeon is responsible for explaining the procedure; the
nurse witnesses the signature and ensures the patient is competent and informed.
6. A patient has a serum sodium level of 125 mEq/L. Which clinical manifestation is a priority
for the nurse to assess?
A. Dry mucous membranes
B. Confusion and seizures
C. Increased thirst
