NUR242 MEDICAL-SURGICAL NURSING
EXAM 3 QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.30, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis), and the PaCO2 is above 45
mmHg (respiratory origin). The HCO3 is normal, indicating an uncompensated respiratory
acidosis.
2. A patient with chronic kidney disease (CKD) has a potassium level of 6.4 mEq/L. Which EKG
change should the nurse monitor for?
A. Tall, peaked T waves
B. U waves
,C. ST-segment depression
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves, widened QRS complexes, and prolonged PR intervals.
3. A nurse is caring for a patient with a serum sodium level of 120 mEq/L. Which clinical
manifestation is the priority concern?
A. Dry mucous membranes
B. Hypotension
C. Seizures
D. Increased thirst
Answer: C
Conceptual Explanation: Severe hyponatremia (< 125 mEq/L) can lead to cerebral
edema, increasing the risk for seizures, coma, and death; safety and neurological
monitoring are priorities.
4. A patient exhibits Trousseau’s sign and Chvostek’s sign. Which electrolyte imbalance
should the nurse anticipate?
A. Hypermagnesemia
B. Hyperkalemia
, C. Hyponatremia
D. Hypocalcemia
Answer: D
Conceptual Explanation: Trousseau’s and Chvostek’s signs are classic indicators of
neuromuscular irritability caused by hypocalcemia.
5. A patient is hyperventilating due to acute anxiety. Which ABG result would the nurse
expect to see?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.32, PaCO2 48, HCO3 22
C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.25, PaCO2 35, HCO3 18
Answer: A
Conceptual Explanation: Hyperventilation causes the excessive blowing off of CO2,
leading to respiratory alkalosis (high pH, low PaCO2).
6. A patient with CKD is receiving Epoetin alfa. Which laboratory result indicates the
medication is effective?
A. Increased Hemoglobin and Hematocrit
B. Decreased serum creatinine
C. Decreased Potassium
EXAM 3 QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.30, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis), and the PaCO2 is above 45
mmHg (respiratory origin). The HCO3 is normal, indicating an uncompensated respiratory
acidosis.
2. A patient with chronic kidney disease (CKD) has a potassium level of 6.4 mEq/L. Which EKG
change should the nurse monitor for?
A. Tall, peaked T waves
B. U waves
,C. ST-segment depression
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an EKG as tall, peaked T waves, widened QRS complexes, and prolonged PR intervals.
3. A nurse is caring for a patient with a serum sodium level of 120 mEq/L. Which clinical
manifestation is the priority concern?
A. Dry mucous membranes
B. Hypotension
C. Seizures
D. Increased thirst
Answer: C
Conceptual Explanation: Severe hyponatremia (< 125 mEq/L) can lead to cerebral
edema, increasing the risk for seizures, coma, and death; safety and neurological
monitoring are priorities.
4. A patient exhibits Trousseau’s sign and Chvostek’s sign. Which electrolyte imbalance
should the nurse anticipate?
A. Hypermagnesemia
B. Hyperkalemia
, C. Hyponatremia
D. Hypocalcemia
Answer: D
Conceptual Explanation: Trousseau’s and Chvostek’s signs are classic indicators of
neuromuscular irritability caused by hypocalcemia.
5. A patient is hyperventilating due to acute anxiety. Which ABG result would the nurse
expect to see?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.32, PaCO2 48, HCO3 22
C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.25, PaCO2 35, HCO3 18
Answer: A
Conceptual Explanation: Hyperventilation causes the excessive blowing off of CO2,
leading to respiratory alkalosis (high pH, low PaCO2).
6. A patient with CKD is receiving Epoetin alfa. Which laboratory result indicates the
medication is effective?
A. Increased Hemoglobin and Hematocrit
B. Decreased serum creatinine
C. Decreased Potassium
