NUR 242 MED-SURG NURSING EXAM 2
PRACTICE QUESTIONS AND ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which assessment finding is most characteristic of a patient experiencing left-sided heart
failure?
A. Crackles or wheezing in the lungs
B. Peripheral edema in the lower extremities
,C. Jugular venous distension (JVD)
D. Hepatosplenomegaly
Answer: A
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary veins and lungs, leading to pulmonary congestion and crackles. JVD and
peripheral edema are signs of right-sided heart failure.
3. A nurse is preparing to administer Digoxin to a patient with heart failure. Which laboratory
value should be checked first?
A. Serum Sodium
B. Serum Calcium
C. Serum Potassium
D. Serum Glucose
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) increases the risk of Digoxin
toxicity. The nurse must check potassium levels and the apical pulse for a full minute
before administration.
4. A patient is diagnosed with peripheral arterial disease (PAD). Which symptom should the
nurse expect the patient to report?
A. Pain that improves with leg elevation
, B. Heavy, aching pain at the end of the day
C. Intermittent claudication during exercise
D. Brownish discoloration of the lower legs
Answer: C
Conceptual Explanation: Intermittent claudication is the classic symptom of PAD, where
muscle pain occurs during activity due to ischemia and resolves with rest. Aching pain and
discoloration are associated with venous disease.
5. A patient has just returned from a thyroidectomy. Which equipment is most essential for
the nurse to have at the bedside?
A. A bag-valve-mask and incentive spirometer
B. A blood glucose monitor
C. A tracheostomy tray and suction equipment
D. An automated external defibrillator (AED)
Answer: C
Conceptual Explanation: Post-thyroidectomy patients are at risk for airway obstruction
due to edema or laryngeal nerve damage. A tracheostomy tray is vital for emergency
airway management.
PRACTICE QUESTIONS AND ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. Which assessment finding is most characteristic of a patient experiencing left-sided heart
failure?
A. Crackles or wheezing in the lungs
B. Peripheral edema in the lower extremities
,C. Jugular venous distension (JVD)
D. Hepatosplenomegaly
Answer: A
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary veins and lungs, leading to pulmonary congestion and crackles. JVD and
peripheral edema are signs of right-sided heart failure.
3. A nurse is preparing to administer Digoxin to a patient with heart failure. Which laboratory
value should be checked first?
A. Serum Sodium
B. Serum Calcium
C. Serum Potassium
D. Serum Glucose
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) increases the risk of Digoxin
toxicity. The nurse must check potassium levels and the apical pulse for a full minute
before administration.
4. A patient is diagnosed with peripheral arterial disease (PAD). Which symptom should the
nurse expect the patient to report?
A. Pain that improves with leg elevation
, B. Heavy, aching pain at the end of the day
C. Intermittent claudication during exercise
D. Brownish discoloration of the lower legs
Answer: C
Conceptual Explanation: Intermittent claudication is the classic symptom of PAD, where
muscle pain occurs during activity due to ischemia and resolves with rest. Aching pain and
discoloration are associated with venous disease.
5. A patient has just returned from a thyroidectomy. Which equipment is most essential for
the nurse to have at the bedside?
A. A bag-valve-mask and incentive spirometer
B. A blood glucose monitor
C. A tracheostomy tray and suction equipment
D. An automated external defibrillator (AED)
Answer: C
Conceptual Explanation: Post-thyroidectomy patients are at risk for airway obstruction
due to edema or laryngeal nerve damage. A tracheostomy tray is vital for emergency
airway management.
