NUR242 MEDICAL-SURGICAL NURSING
EXAM 1 QUESTIONS AND ANSWERS
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Hyperactive bowel sounds
B. Increased thirst and dry mucous membranes
C. Cardiac dysrhythmias and peaked T waves
D. Muscle twitching and seizures
Answer: D
Conceptual Explanation: Hyponatremia (sodium < 135 mEq/L) primarily affects the
central nervous system due to cellular swelling, leading to confusion, muscle weakness, and
potentially life-threatening seizures.
2. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 50 mmHg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
,C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (>
45 mmHg), which correlates with the acidic pH, while the HCO3 is normal, confirming
respiratory acidosis.
3. Which assessment finding is a hallmark sign of hypocalcemia?
A. Positive Chvostek’s sign
B. Negative Romberg’s sign
C. Presence of U waves on ECG
D. Diminished deep tendon reflexes
Answer: A
Conceptual Explanation: Chvostek’s sign (facial twitching when the facial nerve is tapped)
is a classic indicator of increased neuromuscular excitability associated with hypocalcemia.
4. During the preoperative assessment, a patient reports a family history of severe reactions
to general anesthesia involving high fevers. Which condition should the nurse suspect?
A. Malignant hyperthermia
B. Neuroleptic malignant syndrome
C. Anaphylactic shock
, D. Septicemia
Answer: A
Conceptual Explanation: Malignant hyperthermia is a rare, inherited muscle disorder
triggered by certain anesthetic agents, characterized by rapid rise in temperature and
muscle rigidity.
5. A postoperative patient has developed a wound evisceration. Which action should the
nurse take first?
A. Push the protruding organs back into the abdominal cavity
B. Cover the protruding organs with sterile gauze soaked in normal saline
C. Notify the surgeon immediately and prepare for surgery
D. Place the patient in a high-Fowler’s position
Answer: B
Conceptual Explanation: Evisceration is a surgical emergency. The nurse’s first action is
to protect the exposed organs by covering them with sterile, saline-moistened dressings to
prevent drying and infection.
6. A patient with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which
medication should the nurse anticipate administering to stabilize the cardiac membrane?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
EXAM 1 QUESTIONS AND ANSWERS
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Hyperactive bowel sounds
B. Increased thirst and dry mucous membranes
C. Cardiac dysrhythmias and peaked T waves
D. Muscle twitching and seizures
Answer: D
Conceptual Explanation: Hyponatremia (sodium < 135 mEq/L) primarily affects the
central nervous system due to cellular swelling, leading to confusion, muscle weakness, and
potentially life-threatening seizures.
2. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 50 mmHg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
,C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (>
45 mmHg), which correlates with the acidic pH, while the HCO3 is normal, confirming
respiratory acidosis.
3. Which assessment finding is a hallmark sign of hypocalcemia?
A. Positive Chvostek’s sign
B. Negative Romberg’s sign
C. Presence of U waves on ECG
D. Diminished deep tendon reflexes
Answer: A
Conceptual Explanation: Chvostek’s sign (facial twitching when the facial nerve is tapped)
is a classic indicator of increased neuromuscular excitability associated with hypocalcemia.
4. During the preoperative assessment, a patient reports a family history of severe reactions
to general anesthesia involving high fevers. Which condition should the nurse suspect?
A. Malignant hyperthermia
B. Neuroleptic malignant syndrome
C. Anaphylactic shock
, D. Septicemia
Answer: A
Conceptual Explanation: Malignant hyperthermia is a rare, inherited muscle disorder
triggered by certain anesthetic agents, characterized by rapid rise in temperature and
muscle rigidity.
5. A postoperative patient has developed a wound evisceration. Which action should the
nurse take first?
A. Push the protruding organs back into the abdominal cavity
B. Cover the protruding organs with sterile gauze soaked in normal saline
C. Notify the surgeon immediately and prepare for surgery
D. Place the patient in a high-Fowler’s position
Answer: B
Conceptual Explanation: Evisceration is a surgical emergency. The nurse’s first action is
to protect the exposed organs by covering them with sterile, saline-moistened dressings to
prevent drying and infection.
6. A patient with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which
medication should the nurse anticipate administering to stabilize the cardiac membrane?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
