NUR 242 MED-SURG NURSING EXAM 1
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A patient presents with a serum sodium level of 122 mEq/L. Which nursing intervention is
the highest priority?
A. Encouraging increased oral fluid intake
B. Administering hypotonic intravenous fluids
C. Implementing seizure precautions and monitoring neurological status
D. Restricting dietary sodium intake
Answer: C
Conceptual Explanation: A sodium level of 122 mEq/L indicates severe hyponatremia,
which places the patient at high risk for cerebral edema and seizures. Safety through
seizure precautions is the priority.
2. Which clinical manifestation should the nurse expect to find in a patient with a serum
potassium level of 6.2 mEq/L?
A. Hyporeflexia and muscle weakness
,B. Tall, peaked T waves on the ECG
C. Prominent U waves on the ECG
D. Increased bowel sounds and diarrhea
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) typically causes cardiac
conduction changes, most notably tall, peaked T waves. U waves are associated with
hypokalemia.
3. The nurse is caring for a patient with a pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. How should the nurse interpret these ABG results?
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) and the HCO3 is normal, indicating the respiratory system is the cause of the
imbalance.
, 4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
Which action is most important for the nurse to take?
A. Document the allergy and proceed as normal
B. Ask the patient if they are also allergic to shellfish
C. Notify the kitchen to ensure these fruits are not on the tray
D. Alert the surgical team of a potential latex allergy
Answer: D
Conceptual Explanation: There is a known cross-reactivity between certain foods
(bananas, avocados, kiwi, chestnuts) and latex. This information is critical for preventing
intraoperative anaphylaxis.
5. A patient is 12 hours postoperative following abdominal surgery and has not voided. What
is the nurse’s first action?
A. Perform a bladder scan
B. Insert a straight catheter immediately
C. Increase the IV fluid rate
D. Administer a diuretic as ordered
Answer: A
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A patient presents with a serum sodium level of 122 mEq/L. Which nursing intervention is
the highest priority?
A. Encouraging increased oral fluid intake
B. Administering hypotonic intravenous fluids
C. Implementing seizure precautions and monitoring neurological status
D. Restricting dietary sodium intake
Answer: C
Conceptual Explanation: A sodium level of 122 mEq/L indicates severe hyponatremia,
which places the patient at high risk for cerebral edema and seizures. Safety through
seizure precautions is the priority.
2. Which clinical manifestation should the nurse expect to find in a patient with a serum
potassium level of 6.2 mEq/L?
A. Hyporeflexia and muscle weakness
,B. Tall, peaked T waves on the ECG
C. Prominent U waves on the ECG
D. Increased bowel sounds and diarrhea
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) typically causes cardiac
conduction changes, most notably tall, peaked T waves. U waves are associated with
hypokalemia.
3. The nurse is caring for a patient with a pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. How should the nurse interpret these ABG results?
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) and the HCO3 is normal, indicating the respiratory system is the cause of the
imbalance.
, 4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
Which action is most important for the nurse to take?
A. Document the allergy and proceed as normal
B. Ask the patient if they are also allergic to shellfish
C. Notify the kitchen to ensure these fruits are not on the tray
D. Alert the surgical team of a potential latex allergy
Answer: D
Conceptual Explanation: There is a known cross-reactivity between certain foods
(bananas, avocados, kiwi, chestnuts) and latex. This information is critical for preventing
intraoperative anaphylaxis.
5. A patient is 12 hours postoperative following abdominal surgery and has not voided. What
is the nurse’s first action?
A. Perform a bladder scan
B. Insert a straight catheter immediately
C. Increase the IV fluid rate
D. Administer a diuretic as ordered
Answer: A
