Page 1 of 182
Galen NUR 242 Exam 1 Med-Surg (Latest
) Questions And Answers,
Verified Answers ||Complete A+ Guide
1. A nurse is assessing a patient with hyponatremia (Na+
128 mEq/L). Which clinical manifestation is most
concerning?
A. Muscle cramps
B. Nausea and vomiting
C. Altered mental status
D. Dry mucous membranes
Answer: C – Altered mental status
Rationale: Severe hyponatremia causes cerebral edema,
leading to confusion, seizures, or coma. This is a medical
,Page 2 of 182
emergency. Muscle cramps and nausea are early signs; dry
mucous membranes suggest dehydration, not hyponatremia.
2. A patient with heart failure has a potassium level of 2.9
mEq/L. Which ECG change does the nurse expect?
A. Peaked T waves
B. Prominent U wave
C. Wide QRS complex
D. Tall, narrow P wave
Answer: B – Prominent U wave
Rationale: Hypokalemia (K+ <3.5) causes U waves, flat T
waves, and ST depression. Peaked T waves occur in
hyperkalemia.
3. A patient is receiving IV furosemide. Which electrolyte
imbalance is the priority to monitor?
A. Hypernatremia
B. Hyperkalemia
,Page 3 of 182
C. Hypokalemia
D. Hypercalcemia
Answer: C – Hypokalemia
Rationale: Loop diuretics (furosemide) increase potassium
excretion in the distal tubule, causing hypokalemia.
4. (SATA) A patient with hyperkalemia (K+ 6.8 mEq/L) is
admitted. Which interventions should the nurse anticipate?
(Select all that apply)
A. IV calcium gluconate
B. IV insulin and dextrose
C. Oral sodium polystyrene sulfonate (Kayexalate)
D. Low-potassium diet
E. IV potassium chloride
Answer: A, B, C, D
Rationale: Calcium gluconate stabilizes the cardiac membrane.
Insulin + dextrose shifts K+ into cells. Kayexalate removes K+
, Page 4 of 182
via GI tract. Low-potassium diet prevents further increase. IV
p. p. p. p. p. p. p. p.
p. potassium chloride would worsen hyperkalemia.
p. p. p. p.
5. A post-op patient has a serum sodium of 155 mEq/L. The
p. p. p. p. p. p. p. p. p. p.
p. nurse identifies this as:
p. p. p.
A. Hyponatremia – fluid overload p. p. p.
B. Hypernatremia – water deficit p. p. p.
C. Hyperkalemia – cardiac risk p. p. p.
D. Hypocalcemia – tetany risk p. p. p.
Answer: B – Hypernatremia – water deficit
p. p. p. p. p. p.
Rationale: Na+ >145 indicates hypernatremia, usually from
p. p. p. p. p. p.
p. free water loss (e.g., NPO status, insensible losses).
p. p. p. p. p. p. p.
6. Scenario: A 72-year-old patient is confused, has poor skin p. p. p. p. p. p. p. p.
p. turgor, and urine output of 20 mL/hr over 2 hours. Lab: Na+
p. p. p. p. p. p. p. p. p. p. p.
150, BUN 48, creatinine 1.9. What is the priorityaction?
p. p. p. p. p. p. p. p. p. p.
A. Administer hypotonic IV fluids p . p . p .
B. Restrict oral fluids p. p.
Galen NUR 242 Exam 1 Med-Surg (Latest
) Questions And Answers,
Verified Answers ||Complete A+ Guide
1. A nurse is assessing a patient with hyponatremia (Na+
128 mEq/L). Which clinical manifestation is most
concerning?
A. Muscle cramps
B. Nausea and vomiting
C. Altered mental status
D. Dry mucous membranes
Answer: C – Altered mental status
Rationale: Severe hyponatremia causes cerebral edema,
leading to confusion, seizures, or coma. This is a medical
,Page 2 of 182
emergency. Muscle cramps and nausea are early signs; dry
mucous membranes suggest dehydration, not hyponatremia.
2. A patient with heart failure has a potassium level of 2.9
mEq/L. Which ECG change does the nurse expect?
A. Peaked T waves
B. Prominent U wave
C. Wide QRS complex
D. Tall, narrow P wave
Answer: B – Prominent U wave
Rationale: Hypokalemia (K+ <3.5) causes U waves, flat T
waves, and ST depression. Peaked T waves occur in
hyperkalemia.
3. A patient is receiving IV furosemide. Which electrolyte
imbalance is the priority to monitor?
A. Hypernatremia
B. Hyperkalemia
,Page 3 of 182
C. Hypokalemia
D. Hypercalcemia
Answer: C – Hypokalemia
Rationale: Loop diuretics (furosemide) increase potassium
excretion in the distal tubule, causing hypokalemia.
4. (SATA) A patient with hyperkalemia (K+ 6.8 mEq/L) is
admitted. Which interventions should the nurse anticipate?
(Select all that apply)
A. IV calcium gluconate
B. IV insulin and dextrose
C. Oral sodium polystyrene sulfonate (Kayexalate)
D. Low-potassium diet
E. IV potassium chloride
Answer: A, B, C, D
Rationale: Calcium gluconate stabilizes the cardiac membrane.
Insulin + dextrose shifts K+ into cells. Kayexalate removes K+
, Page 4 of 182
via GI tract. Low-potassium diet prevents further increase. IV
p. p. p. p. p. p. p. p.
p. potassium chloride would worsen hyperkalemia.
p. p. p. p.
5. A post-op patient has a serum sodium of 155 mEq/L. The
p. p. p. p. p. p. p. p. p. p.
p. nurse identifies this as:
p. p. p.
A. Hyponatremia – fluid overload p. p. p.
B. Hypernatremia – water deficit p. p. p.
C. Hyperkalemia – cardiac risk p. p. p.
D. Hypocalcemia – tetany risk p. p. p.
Answer: B – Hypernatremia – water deficit
p. p. p. p. p. p.
Rationale: Na+ >145 indicates hypernatremia, usually from
p. p. p. p. p. p.
p. free water loss (e.g., NPO status, insensible losses).
p. p. p. p. p. p. p.
6. Scenario: A 72-year-old patient is confused, has poor skin p. p. p. p. p. p. p. p.
p. turgor, and urine output of 20 mL/hr over 2 hours. Lab: Na+
p. p. p. p. p. p. p. p. p. p. p.
150, BUN 48, creatinine 1.9. What is the priorityaction?
p. p. p. p. p. p. p. p. p. p.
A. Administer hypotonic IV fluids p . p . p .
B. Restrict oral fluids p. p.
