NUR242 MEDICAL-SURGICAL NURSING
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient with Type 1 Diabetes presents with deep, rapid respirations and a fruity breath
odor. Which arterial blood gas (ABG) result is most consistent with this condition?
A. pH 7.30, PaCO2 48, HCO3 24
B. pH 7.45, PaCO2 40, HCO3 28
C. pH 7.50, PaCO2 32, HCO3 22
D. pH 7.25, PaCO2 30, HCO3 15
Answer: D
Conceptual Explanation: The symptoms describe Diabetic Ketoacidosis (DKA), which
manifests as metabolic acidosis. Kussmaul respirations (rapid/deep) are a compensatory
mechanism to blow off CO2, resulting in low pH, low HCO3, and low PaCO2.
2. Following a fracture of the femur, a patient develops sudden chest pain, tachypnea, and
petechiae on the upper chest. What is the priority nursing action?
A. Apply 100 percent oxygen via non-rebreather mask
,B. Administer a bolus of IV fluids
C. Perform a neurovascular check on the affected limb
D. Start a heparin infusion immediately
Answer: A
Conceptual Explanation: Petechiae on the chest following a long-bone fracture are
pathognomonic for Fat Embolism Syndrome. Maintaining oxygenation is the immediate
priority to prevent hypoxia.
3. Which laboratory value is most indicative of the effectiveness of Lactulose therapy in a
patient with hepatic encephalopathy?
A. Decreasing serum bilirubin levels
B. Increasing serum albumin levels
C. Decreasing serum ammonia levels
D. Normalizing Prothrombin Time (PT)
Answer: C
Conceptual Explanation: Lactulose is an osmotic laxative that reduces serum ammonia
levels by trapping it in the gut and facilitating its excretion via stool.
4. A patient in an Addisonian crisis is admitted. Which electrolyte abnormality should the
nurse expect to find?
A. Hypokalemia and Hypernatremia
, B. Hypercalcemia and Hypoglycemia
C. Hypomagnesemia and Hyperchloremia
D. Hyperkalemia and Hyponatremia
Answer: D
Conceptual Explanation: Adrenal insufficiency (Addison’s) leads to a lack of aldosterone,
causing the kidneys to lose sodium and retain potassium, resulting in hyponatremia and
hyperkalemia.
5. A nurse is caring for a patient who just underwent a thyroidectomy. The patient reports
tingling in the fingers and around the mouth. Which medication should the nurse have
available?
A. Potassium Chloride
B. Calcium Gluconate
C. Magnesium Sulfate
D. Sodium Bicarbonate
Answer: B
Conceptual Explanation: Tingling around the mouth and fingers (paresthesia) indicates
hypocalcemia, often caused by accidental damage to the parathyroid glands during thyroid
surgery.
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient with Type 1 Diabetes presents with deep, rapid respirations and a fruity breath
odor. Which arterial blood gas (ABG) result is most consistent with this condition?
A. pH 7.30, PaCO2 48, HCO3 24
B. pH 7.45, PaCO2 40, HCO3 28
C. pH 7.50, PaCO2 32, HCO3 22
D. pH 7.25, PaCO2 30, HCO3 15
Answer: D
Conceptual Explanation: The symptoms describe Diabetic Ketoacidosis (DKA), which
manifests as metabolic acidosis. Kussmaul respirations (rapid/deep) are a compensatory
mechanism to blow off CO2, resulting in low pH, low HCO3, and low PaCO2.
2. Following a fracture of the femur, a patient develops sudden chest pain, tachypnea, and
petechiae on the upper chest. What is the priority nursing action?
A. Apply 100 percent oxygen via non-rebreather mask
,B. Administer a bolus of IV fluids
C. Perform a neurovascular check on the affected limb
D. Start a heparin infusion immediately
Answer: A
Conceptual Explanation: Petechiae on the chest following a long-bone fracture are
pathognomonic for Fat Embolism Syndrome. Maintaining oxygenation is the immediate
priority to prevent hypoxia.
3. Which laboratory value is most indicative of the effectiveness of Lactulose therapy in a
patient with hepatic encephalopathy?
A. Decreasing serum bilirubin levels
B. Increasing serum albumin levels
C. Decreasing serum ammonia levels
D. Normalizing Prothrombin Time (PT)
Answer: C
Conceptual Explanation: Lactulose is an osmotic laxative that reduces serum ammonia
levels by trapping it in the gut and facilitating its excretion via stool.
4. A patient in an Addisonian crisis is admitted. Which electrolyte abnormality should the
nurse expect to find?
A. Hypokalemia and Hypernatremia
, B. Hypercalcemia and Hypoglycemia
C. Hypomagnesemia and Hyperchloremia
D. Hyperkalemia and Hyponatremia
Answer: D
Conceptual Explanation: Adrenal insufficiency (Addison’s) leads to a lack of aldosterone,
causing the kidneys to lose sodium and retain potassium, resulting in hyponatremia and
hyperkalemia.
5. A nurse is caring for a patient who just underwent a thyroidectomy. The patient reports
tingling in the fingers and around the mouth. Which medication should the nurse have
available?
A. Potassium Chloride
B. Calcium Gluconate
C. Magnesium Sulfate
D. Sodium Bicarbonate
Answer: B
Conceptual Explanation: Tingling around the mouth and fingers (paresthesia) indicates
hypocalcemia, often caused by accidental damage to the parathyroid glands during thyroid
surgery.
