NUR242 MEDICAL-SURGICAL NURSING
EXAM STUDY QUESTIONS AND
ANSWERS
1. A patient’s arterial blood gas (ABG) results show: pH 7.28, PaCO2 55 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is within the normal range, indicating uncompensated
respiratory acidosis.
2. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change
should the nurse most likely expect to observe?
A. Prominent U waves
,B. ST-segment depression
C. Prolonged PR interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest.
3. Using the Parkland Formula, calculate the total volume of IV fluid (Lactated Ringer’s)
required in the first 24 hours for a 70 kg patient with 40% Total Body Surface Area (TBSA)
burns.
A. 11,200 mL
B. 5,600 mL
C. 8,400 mL
D. 2,800 mL
Answer: A
Conceptual Explanation: The Parkland Formula is 4 mL x kg x %TBSA. So, 4 x 70 x 40 =
11,200 mL.
4. During surgery, a patient develops a heart rate of 120 bpm, muscle rigidity, and a rapidly
rising temperature of 104°F. What medication should the nurse anticipate administering?
A. Atropine sulfate
, B. Naloxone
C. Epinephrine
D. Dantrolene sodium
Answer: D
Conceptual Explanation: The symptoms describe malignant hyperthermia, a life-
threatening anesthesia complication treated with Dantrolene, a skeletal muscle relaxant.
5. In a mass casualty incident, which color tag would be assigned to a victim with a traumatic
leg amputation and bright red spurting blood, who is conscious but tachypneic?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
Conceptual Explanation: Red tags (Immediate) are for life-threatening injuries that are
treatable with rapid intervention, such as active arterial bleeding.
6. A patient is admitted with a suspected Addisonian Crisis. Which of the following laboratory
findings is the nurse most likely to find?
A. Hypoglycemia and Hyponatremia
B. Hyperglycemia and Hypernatremia
EXAM STUDY QUESTIONS AND
ANSWERS
1. A patient’s arterial blood gas (ABG) results show: pH 7.28, PaCO2 55 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is within the normal range, indicating uncompensated
respiratory acidosis.
2. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change
should the nurse most likely expect to observe?
A. Prominent U waves
,B. ST-segment depression
C. Prolonged PR interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest.
3. Using the Parkland Formula, calculate the total volume of IV fluid (Lactated Ringer’s)
required in the first 24 hours for a 70 kg patient with 40% Total Body Surface Area (TBSA)
burns.
A. 11,200 mL
B. 5,600 mL
C. 8,400 mL
D. 2,800 mL
Answer: A
Conceptual Explanation: The Parkland Formula is 4 mL x kg x %TBSA. So, 4 x 70 x 40 =
11,200 mL.
4. During surgery, a patient develops a heart rate of 120 bpm, muscle rigidity, and a rapidly
rising temperature of 104°F. What medication should the nurse anticipate administering?
A. Atropine sulfate
, B. Naloxone
C. Epinephrine
D. Dantrolene sodium
Answer: D
Conceptual Explanation: The symptoms describe malignant hyperthermia, a life-
threatening anesthesia complication treated with Dantrolene, a skeletal muscle relaxant.
5. In a mass casualty incident, which color tag would be assigned to a victim with a traumatic
leg amputation and bright red spurting blood, who is conscious but tachypneic?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
Conceptual Explanation: Red tags (Immediate) are for life-threatening injuries that are
treatable with rapid intervention, such as active arterial bleeding.
6. A patient is admitted with a suspected Addisonian Crisis. Which of the following laboratory
findings is the nurse most likely to find?
A. Hypoglycemia and Hyponatremia
B. Hyperglycemia and Hypernatremia
