NUR242 MEDICAL-SURGICAL NURSING
EXAM 2 QUESTIONS AND ANSWERS
1. A nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). Which of
the following laboratory findings should the nurse expect?
A. Hypokalemia and hypernatremia
B. Hypophosphatemia and hypocalcemia
C. Hyperkalemia and metabolic acidosis
D. Decreased blood urea nitrogen (BUN) and creatinine
Answer: C
Conceptual Explanation: During the oliguric phase of AKI, the kidneys cannot excrete
potassium or acid waste products, leading to hyperkalemia and metabolic acidosis. BUN
and creatinine typically increase.
2. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L and
tall, peaked T-waves on the EKG. Which medication should the nurse expect to administer
first to protect the myocardium?
A. Sodium polystyrene sulfonate (Kayexalate)
,B. Furosemide (Lasix)
C. Calcium gluconate
D. Insulin with Dextrose 50%
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but is administered
first in severe hyperkalemia to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
3. The nurse is assessing a patient with Graves’ disease. Which clinical manifestation is most
characteristic of this condition?
A. Bradycardia and weight gain
B. Cold intolerance and lethargy
C. Hypotension and dry skin
D. Exophthalmos and heat intolerance
Answer: D
Conceptual Explanation: Graves’ disease is a form of hyperthyroidism characterized by a
hypermetabolic state, including exophthalmos (bulging eyes), heat intolerance,
tachycardia, and weight loss.
, 4. A patient who underwent a thyroidectomy 12 hours ago reports numbness and tingling in
their fingertips. What action should the nurse take first?
A. Administer a PRN dose of levothyroxine
B. Assess for Chvostek’s sign
C. Encourage the patient to ambulate
D. Check the surgical dressing for bleeding
Answer: B
Conceptual Explanation: Paresthesia after a thyroidectomy suggests hypocalcemia due to
accidental parathyroid damage. Chvostek’s sign is a clinical indicator of hypocalcemia.
5. Which arterial blood gas (ABG) result would the nurse expect in a patient experiencing an
acute exacerbation of COPD?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 58, HCO3 26
D. pH 7.28, PaCO2 38, HCO3 18
Answer: C
Conceptual Explanation: COPD exacerbations lead to CO2 retention (hypercapnia),
resulting in respiratory acidosis, characterized by a low pH and an elevated PaCO2.
EXAM 2 QUESTIONS AND ANSWERS
1. A nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). Which of
the following laboratory findings should the nurse expect?
A. Hypokalemia and hypernatremia
B. Hypophosphatemia and hypocalcemia
C. Hyperkalemia and metabolic acidosis
D. Decreased blood urea nitrogen (BUN) and creatinine
Answer: C
Conceptual Explanation: During the oliguric phase of AKI, the kidneys cannot excrete
potassium or acid waste products, leading to hyperkalemia and metabolic acidosis. BUN
and creatinine typically increase.
2. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L and
tall, peaked T-waves on the EKG. Which medication should the nurse expect to administer
first to protect the myocardium?
A. Sodium polystyrene sulfonate (Kayexalate)
,B. Furosemide (Lasix)
C. Calcium gluconate
D. Insulin with Dextrose 50%
Answer: C
Conceptual Explanation: Calcium gluconate does not lower potassium but is administered
first in severe hyperkalemia to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
3. The nurse is assessing a patient with Graves’ disease. Which clinical manifestation is most
characteristic of this condition?
A. Bradycardia and weight gain
B. Cold intolerance and lethargy
C. Hypotension and dry skin
D. Exophthalmos and heat intolerance
Answer: D
Conceptual Explanation: Graves’ disease is a form of hyperthyroidism characterized by a
hypermetabolic state, including exophthalmos (bulging eyes), heat intolerance,
tachycardia, and weight loss.
, 4. A patient who underwent a thyroidectomy 12 hours ago reports numbness and tingling in
their fingertips. What action should the nurse take first?
A. Administer a PRN dose of levothyroxine
B. Assess for Chvostek’s sign
C. Encourage the patient to ambulate
D. Check the surgical dressing for bleeding
Answer: B
Conceptual Explanation: Paresthesia after a thyroidectomy suggests hypocalcemia due to
accidental parathyroid damage. Chvostek’s sign is a clinical indicator of hypocalcemia.
5. Which arterial blood gas (ABG) result would the nurse expect in a patient experiencing an
acute exacerbation of COPD?
A. pH 7.50, PaCO2 30, HCO3 24
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 58, HCO3 26
D. pH 7.28, PaCO2 38, HCO3 18
Answer: C
Conceptual Explanation: COPD exacerbations lead to CO2 retention (hypercapnia),
resulting in respiratory acidosis, characterized by a low pH and an elevated PaCO2.
