NUR242 MEDICAL-SURGICAL NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse prioritize?
A. Administer oral sodium polystyrene sulfonate
B. Initiate continuous cardiac monitoring
C. Prepare the patient for hemodialysis
D. Administer intravenous regular insulin and 50% dextrose
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) poses an immediate risk of life-
threatening cardiac dysrhythmias. Monitoring the heart rhythm is the highest priority
before or during interventions.
2. A patient who has undergone a total thyroidectomy 6 hours ago reports numbness and
tingling in their fingertips. What is the nurse’s priority assessment?
A. Check the patient’s blood glucose level
,B. Evaluate the surgical dressing for hemorrhage
C. Assess for a positive Chvostek’s sign
D. Assess the patient’s ability to speak clearly
Answer: C
Conceptual Explanation: Tingling/numbness post-thyroidectomy suggests hypocalcemia
due to accidental parathyroid damage. Chvostek’s sign (facial twitching) confirms
neuromuscular irritability related to low calcium.
3. In the emergent phase of burn care, which physiological change is primarily responsible for
the development of burn shock?
A. Decreased metabolic rate
B. Peripheral vasoconstriction
C. Reduced oncotic pressure in the interstitial space
D. Increased capillary permeability
Answer: D
Conceptual Explanation: Massive fluid shifts occur when increased capillary permeability
allows water, sodium, and plasma proteins to move into the interstitial space, leading to
hypovolemia.
, 4. A patient presents with arterial blood gas results: pH 7.28, PaCO2 50, and HCO3 24. Which
condition does this reflect?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation is yet
occurring.
5. The nurse is evaluating the effectiveness of desmopressin (DDAVP) for a patient with
Diabetes Insipidus. Which finding indicates the medication is effective?
A. Decreased urine output and increased specific gravity
B. Serum sodium of 152 mEq/L
C. Urine specific gravity of 1.002
D. Increased thirst and oral intake
Answer: A
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse prioritize?
A. Administer oral sodium polystyrene sulfonate
B. Initiate continuous cardiac monitoring
C. Prepare the patient for hemodialysis
D. Administer intravenous regular insulin and 50% dextrose
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) poses an immediate risk of life-
threatening cardiac dysrhythmias. Monitoring the heart rhythm is the highest priority
before or during interventions.
2. A patient who has undergone a total thyroidectomy 6 hours ago reports numbness and
tingling in their fingertips. What is the nurse’s priority assessment?
A. Check the patient’s blood glucose level
,B. Evaluate the surgical dressing for hemorrhage
C. Assess for a positive Chvostek’s sign
D. Assess the patient’s ability to speak clearly
Answer: C
Conceptual Explanation: Tingling/numbness post-thyroidectomy suggests hypocalcemia
due to accidental parathyroid damage. Chvostek’s sign (facial twitching) confirms
neuromuscular irritability related to low calcium.
3. In the emergent phase of burn care, which physiological change is primarily responsible for
the development of burn shock?
A. Decreased metabolic rate
B. Peripheral vasoconstriction
C. Reduced oncotic pressure in the interstitial space
D. Increased capillary permeability
Answer: D
Conceptual Explanation: Massive fluid shifts occur when increased capillary permeability
allows water, sodium, and plasma proteins to move into the interstitial space, leading to
hypovolemia.
, 4. A patient presents with arterial blood gas results: pH 7.28, PaCO2 50, and HCO3 24. Which
condition does this reflect?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation is yet
occurring.
5. The nurse is evaluating the effectiveness of desmopressin (DDAVP) for a patient with
Diabetes Insipidus. Which finding indicates the medication is effective?
A. Decreased urine output and increased specific gravity
B. Serum sodium of 152 mEq/L
C. Urine specific gravity of 1.002
D. Increased thirst and oral intake
Answer: A
