NU 155 MEDICAL-SURGICAL NURSING
EXAM 3 - ADVANCED PRACTICE
QUESTIONS & ANSWERS 100%
GUARANTEE PASS | GALEN COLLEGE
OF NURSING
1. A patient is undergoing emergency surgery for a bowel obstruction. Which clinical
manifestation would most likely suggest the onset of Malignant Hyperthermia?
A. Sudden drop in body temperature to 35°C (95°F)
B. Bradypnea and respiratory alkalosis
C. Generalized muscle rigidity and unexplained tachycardia
D. Hypotension and decreased end-tidal carbon dioxide
Answer: C
Conceptual Explanation: Malignant hyperthermia is a life-threatening complication of
general anesthesia. The earliest signs are muscle rigidity and tachycardia, followed by a
rise in end-tidal CO2 levels and eventually a severe rise in temperature.
,2. A nurse is caring for a patient who is 12 hours post-thoracotomy. The chest tube drainage
system shows continuous bubbling in the water seal chamber. What is the priority nursing
action?
A. Document the finding as a normal expected occurrence
B. Increase the suction level on the drainage unit
C. Clamp the chest tube immediately
D. Check for a leak in the system or at the insertion site
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system or at the patient’s insertion site. Intermittent bubbling is normal with
expiration or coughing, but continuous bubbling is not.
3. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. Which arterial blood gas (ABG) result would indicate the patient is
experiencing oxygen-induced hypoventilation?
A. pH 7.32, PaCO2 50 mmHg, HCO3 30 mEq/L
B. pH 7.48, PaCO2 30 mmHg, PaO2 95 mmHg
C. pH 7.35, PaCO2 45 mmHg, PaO2 80 mmHg
D. pH 7.30, PaCO2 65 mmHg, PaO2 55 mmHg
Answer: D
, Conceptual Explanation: Oxygen-induced hypoventilation in COPD occurs when the
hypoxic drive is suppressed, leading to severe CO2 retention (hypercapnia) and respiratory
acidosis. Option A shows low pH and significantly high PaCO2.
4. A patient is admitted with a serum potassium level of 6.5 mEq/L. Which EKG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves, widened
QRS complexes, and potentially cardiac arrest. U waves are characteristic of hypokalemia.
5. Following a thyroidectomy, a patient reports numbness and tingling around the mouth.
What is the nurse’s priority assessment?
A. Check the surgical dressing for bleeding
B. Assess for Chvostek’s sign
C. Evaluate the patient’s voice for hoarseness
D. Measure the patient’s blood pressure in both arms
Answer: B
EXAM 3 - ADVANCED PRACTICE
QUESTIONS & ANSWERS 100%
GUARANTEE PASS | GALEN COLLEGE
OF NURSING
1. A patient is undergoing emergency surgery for a bowel obstruction. Which clinical
manifestation would most likely suggest the onset of Malignant Hyperthermia?
A. Sudden drop in body temperature to 35°C (95°F)
B. Bradypnea and respiratory alkalosis
C. Generalized muscle rigidity and unexplained tachycardia
D. Hypotension and decreased end-tidal carbon dioxide
Answer: C
Conceptual Explanation: Malignant hyperthermia is a life-threatening complication of
general anesthesia. The earliest signs are muscle rigidity and tachycardia, followed by a
rise in end-tidal CO2 levels and eventually a severe rise in temperature.
,2. A nurse is caring for a patient who is 12 hours post-thoracotomy. The chest tube drainage
system shows continuous bubbling in the water seal chamber. What is the priority nursing
action?
A. Document the finding as a normal expected occurrence
B. Increase the suction level on the drainage unit
C. Clamp the chest tube immediately
D. Check for a leak in the system or at the insertion site
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system or at the patient’s insertion site. Intermittent bubbling is normal with
expiration or coughing, but continuous bubbling is not.
3. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. Which arterial blood gas (ABG) result would indicate the patient is
experiencing oxygen-induced hypoventilation?
A. pH 7.32, PaCO2 50 mmHg, HCO3 30 mEq/L
B. pH 7.48, PaCO2 30 mmHg, PaO2 95 mmHg
C. pH 7.35, PaCO2 45 mmHg, PaO2 80 mmHg
D. pH 7.30, PaCO2 65 mmHg, PaO2 55 mmHg
Answer: D
, Conceptual Explanation: Oxygen-induced hypoventilation in COPD occurs when the
hypoxic drive is suppressed, leading to severe CO2 retention (hypercapnia) and respiratory
acidosis. Option A shows low pH and significantly high PaCO2.
4. A patient is admitted with a serum potassium level of 6.5 mEq/L. Which EKG change should
the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves, widened
QRS complexes, and potentially cardiac arrest. U waves are characteristic of hypokalemia.
5. Following a thyroidectomy, a patient reports numbness and tingling around the mouth.
What is the nurse’s priority assessment?
A. Check the surgical dressing for bleeding
B. Assess for Chvostek’s sign
C. Evaluate the patient’s voice for hoarseness
D. Measure the patient’s blood pressure in both arms
Answer: B
