,NURS 201 final exam Medical Surgical Nursing Questions And
Answers 2026/2027 West Coast University
Q1. A patient's ABG results are pH 7.30, PaCO₂ 55 mm Hg, and HCO₃⁻ 24
mEq/L. Which acid-base imbalance is present?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: C
Rationale: The pH is low, indicating acidosis, while the PaCO₂ is elevated,
identifying the respiratory system as the primary cause. The bicarbonate is
within the expected range.
Q2. A patient's ABG results are pH 7.50, PaCO₂ 30 mm Hg, and HCO₃⁻ 24
mEq/L. Which imbalance is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: The elevated pH indicates alkalosis and the low PaCO₂ identifies
excessive carbon-dioxide elimination as the primary cause.
Q3. A patient has pH 7.31, PaCO₂ 38 mm Hg, and HCO₃⁻ 18 mEq/L. Which
condition is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: The pH is low and the bicarbonate is decreased, identifying
metabolic acidosis as the primary problem.
Q4. Which finding is most concerning in a patient with hyperkalemia?
A. Constipation
B. Peaked T waves on the ECG
, C. Increased appetite
D. Warm skin
Correct Answer: B
Rationale: Hyperkalemia alters cardiac conduction and can produce peaked
T waves and other potentially life-threatening dysrhythmias.
Q5. A patient has a potassium level of 6.7 mEq/L and new ECG changes.
What should the nurse do first?
A. Encourage a potassium-rich snack
B. Obtain and monitor the ECG and initiate urgent treatment measures
C. Administer a potassium supplement
D. Restrict all sodium
Correct Answer: B
Rationale: Severe hyperkalemia with ECG changes can rapidly cause fatal
dysrhythmias and requires immediate cardiac assessment and treatment.
Q6. Which finding is commonly associated with hypokalemia?
A. Muscle weakness and dysrhythmias
B. Peaked T waves
C. Severe flushing
D. Hyperactive reflexes as the defining sign
Correct Answer: A
Rationale: Potassium deficiency can impair skeletal and cardiac muscle
function, causing weakness, cramps, and dysrhythmias.
Q7. A patient with severe diarrhea develops metabolic acidosis. Which
mechanism best explains the imbalance?
A. Excess bicarbonate retention
B. Loss of bicarbonate through the gastrointestinal tract
C. Excess carbon dioxide retention
D. Increased hydrochloric acid secretion
Correct Answer: B
Rationale: Significant diarrhea can cause substantial bicarbonate loss from
the gastrointestinal tract, contributing to metabolic acidosis.
Q8. Which patient has the greatest risk for dehydration?
Answers 2026/2027 West Coast University
Q1. A patient's ABG results are pH 7.30, PaCO₂ 55 mm Hg, and HCO₃⁻ 24
mEq/L. Which acid-base imbalance is present?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: C
Rationale: The pH is low, indicating acidosis, while the PaCO₂ is elevated,
identifying the respiratory system as the primary cause. The bicarbonate is
within the expected range.
Q2. A patient's ABG results are pH 7.50, PaCO₂ 30 mm Hg, and HCO₃⁻ 24
mEq/L. Which imbalance is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Rationale: The elevated pH indicates alkalosis and the low PaCO₂ identifies
excessive carbon-dioxide elimination as the primary cause.
Q3. A patient has pH 7.31, PaCO₂ 38 mm Hg, and HCO₃⁻ 18 mEq/L. Which
condition is present?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: The pH is low and the bicarbonate is decreased, identifying
metabolic acidosis as the primary problem.
Q4. Which finding is most concerning in a patient with hyperkalemia?
A. Constipation
B. Peaked T waves on the ECG
, C. Increased appetite
D. Warm skin
Correct Answer: B
Rationale: Hyperkalemia alters cardiac conduction and can produce peaked
T waves and other potentially life-threatening dysrhythmias.
Q5. A patient has a potassium level of 6.7 mEq/L and new ECG changes.
What should the nurse do first?
A. Encourage a potassium-rich snack
B. Obtain and monitor the ECG and initiate urgent treatment measures
C. Administer a potassium supplement
D. Restrict all sodium
Correct Answer: B
Rationale: Severe hyperkalemia with ECG changes can rapidly cause fatal
dysrhythmias and requires immediate cardiac assessment and treatment.
Q6. Which finding is commonly associated with hypokalemia?
A. Muscle weakness and dysrhythmias
B. Peaked T waves
C. Severe flushing
D. Hyperactive reflexes as the defining sign
Correct Answer: A
Rationale: Potassium deficiency can impair skeletal and cardiac muscle
function, causing weakness, cramps, and dysrhythmias.
Q7. A patient with severe diarrhea develops metabolic acidosis. Which
mechanism best explains the imbalance?
A. Excess bicarbonate retention
B. Loss of bicarbonate through the gastrointestinal tract
C. Excess carbon dioxide retention
D. Increased hydrochloric acid secretion
Correct Answer: B
Rationale: Significant diarrhea can cause substantial bicarbonate loss from
the gastrointestinal tract, contributing to metabolic acidosis.
Q8. Which patient has the greatest risk for dehydration?
