NUR 170
Medical Surg Exam 2 Study Guide (2026)
Exam 2 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical Surg | Exam 2 Study Guide (2026) UPDATED – Galen
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Increased thirst and dry mucous membranes
B. Altered mental status and seizures
C. Hyperreflexia and muscle twitching
D. Cardiac dysrhythmias and peaked T waves
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema, which manifests as confusion, headache, and potentially
seizures or coma.
2. Which electrolyte imbalance is a patient at risk for when receiving massive blood
transfusions stored with citrate?
A. Hyperkalemia
B. Hypercalcemia
C. Hypocalcemia
D. Hyponatremia
, Answer: C
Rationale: Citrate used as an anticoagulant in stored blood binds to ionized calcium,
potentially leading to hypocalcemia in patients receiving large volumes of blood.
3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which medication order
should the nurse clarify first?
A. Sodium polystyrene sulfonate (Kayexalate) PO
B. Regular insulin and 50% Dextrose IV
C. Spironolactone (Aldactone) 25mg PO
D. Calcium gluconate IV
Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic that would further increase the
potassium level in a patient already experiencing hyperkalemia (K+ > 5.0).
4. The nurse notes a positive Chvostek’s sign in a patient post-thyroidectomy. Which action is
most appropriate?
A. Administer potassium chloride via IV pump
B. Document the finding as a normal post-op response
C. Place the patient in Trendelenburg position
D. Prepare to administer IV calcium gluconate
Answer: D
Medical Surg Exam 2 Study Guide (2026)
Exam 2 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical Surg | Exam 2 Study Guide (2026) UPDATED – Galen
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical manifestation
should the nurse prioritize for assessment?
A. Increased thirst and dry mucous membranes
B. Altered mental status and seizures
C. Hyperreflexia and muscle twitching
D. Cardiac dysrhythmias and peaked T waves
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema, which manifests as confusion, headache, and potentially
seizures or coma.
2. Which electrolyte imbalance is a patient at risk for when receiving massive blood
transfusions stored with citrate?
A. Hyperkalemia
B. Hypercalcemia
C. Hypocalcemia
D. Hyponatremia
, Answer: C
Rationale: Citrate used as an anticoagulant in stored blood binds to ionized calcium,
potentially leading to hypocalcemia in patients receiving large volumes of blood.
3. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which medication order
should the nurse clarify first?
A. Sodium polystyrene sulfonate (Kayexalate) PO
B. Regular insulin and 50% Dextrose IV
C. Spironolactone (Aldactone) 25mg PO
D. Calcium gluconate IV
Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic that would further increase the
potassium level in a patient already experiencing hyperkalemia (K+ > 5.0).
4. The nurse notes a positive Chvostek’s sign in a patient post-thyroidectomy. Which action is
most appropriate?
A. Administer potassium chloride via IV pump
B. Document the finding as a normal post-op response
C. Place the patient in Trendelenburg position
D. Prepare to administer IV calcium gluconate
Answer: D
