NUR 242 EXAM 1 () | MED-
SURG NURSING | GALEN COLLEGE.
QUESTIONS AND ANSWERS
1. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing intervention
is the highest priority for this patient?
A. Encouraging increased oral fluid intake
B. Monitoring daily weights
C. Administering hypotonic IV fluids
D. Implementing seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) places the patient at
high risk for cerebral edema, seizures, and coma. Seizure precautions are a priority for
safety. Increasing fluids or giving hypotonic solutions would worsen the condition.
2. The nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, HCO3 26 mEq/L. Which condition does this reflect?
A. Metabolic Acidosis
,B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45 mmHg), which is the respiratory component, while the HCO3 is normal. This indicates
uncompensated respiratory acidosis.
3. During the preoperative assessment, a patient reports an allergy to avocados and bananas.
Which action should the nurse take next?
A. Document the food allergy and continue the assessment
B. Notify the surgical team of a potential latex allergy
C. Administer an antihistamine as a prophylactic measure
D. Inform the patient that these foods are not served post-operatively
Answer: B
Conceptual Explanation: There is a known cross-sensitivity between certain foods
(avocados, bananas, chestnuts, kiwis) and latex. Patients with these allergies are at higher
risk for a latex reaction in the OR.
, 4. A patient with hyperkalemia is prescribed sodium polystyrene sulfonate. How does this
medication work to lower potassium?
A. It shifts potassium into the cells in exchange for glucose
B. It exchanges sodium ions for potassium ions in the intestine
C. It promotes potassium excretion through the kidneys
D. It blocks the effects of potassium on the cardiac conduction system
Answer: B
Conceptual Explanation: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange
resin that removes potassium by exchanging it for sodium in the large intestine, allowing it
to be excreted in stool.
5. Which clinical manifestation would the nurse expect to find in a patient with
hypocalcemia?
A. Negative Chvostek’s sign
B. Muscle flaccidity and weakness
C. Prolonged ST segment on ECG
D. Shortened QT interval
Answer: C
SURG NURSING | GALEN COLLEGE.
QUESTIONS AND ANSWERS
1. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing intervention
is the highest priority for this patient?
A. Encouraging increased oral fluid intake
B. Monitoring daily weights
C. Administering hypotonic IV fluids
D. Implementing seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) places the patient at
high risk for cerebral edema, seizures, and coma. Seizure precautions are a priority for
safety. Increasing fluids or giving hypotonic solutions would worsen the condition.
2. The nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, HCO3 26 mEq/L. Which condition does this reflect?
A. Metabolic Acidosis
,B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45 mmHg), which is the respiratory component, while the HCO3 is normal. This indicates
uncompensated respiratory acidosis.
3. During the preoperative assessment, a patient reports an allergy to avocados and bananas.
Which action should the nurse take next?
A. Document the food allergy and continue the assessment
B. Notify the surgical team of a potential latex allergy
C. Administer an antihistamine as a prophylactic measure
D. Inform the patient that these foods are not served post-operatively
Answer: B
Conceptual Explanation: There is a known cross-sensitivity between certain foods
(avocados, bananas, chestnuts, kiwis) and latex. Patients with these allergies are at higher
risk for a latex reaction in the OR.
, 4. A patient with hyperkalemia is prescribed sodium polystyrene sulfonate. How does this
medication work to lower potassium?
A. It shifts potassium into the cells in exchange for glucose
B. It exchanges sodium ions for potassium ions in the intestine
C. It promotes potassium excretion through the kidneys
D. It blocks the effects of potassium on the cardiac conduction system
Answer: B
Conceptual Explanation: Sodium polystyrene sulfonate (Kayexalate) is a cation-exchange
resin that removes potassium by exchanging it for sodium in the large intestine, allowing it
to be excreted in stool.
5. Which clinical manifestation would the nurse expect to find in a patient with
hypocalcemia?
A. Negative Chvostek’s sign
B. Muscle flaccidity and weakness
C. Prolonged ST segment on ECG
D. Shortened QT interval
Answer: C
