NU 155 EXAM 5 MEDICAL-SURGICAL
NURSING QUESTIONS & ANSWERS
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COLLEGE OF NURSING
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes that the patient’s PaO2 remains low despite an FiO2 of 80% and
the addition of Positive End-Expiratory Pressure (PEEP). What is the primary physiological
rationale for increasing PEEP in this patient?
A. To increase the fraction of inspired oxygen delivered to the alveoli.
B. To prevent barotrauma by reducing the peak inspiratory pressure.
C. To recruit collapsed alveoli and improve functional residual capacity.
D. To decrease the metabolic demand of the respiratory muscles.
Answer: C
Conceptual Explanation: PEEP is used in ARDS to keep alveoli open at the end of
expiration, which increases functional residual capacity and improves oxygenation by
recruiting collapsed units.
,2. A patient with chronic kidney disease (CKD) presents with a serum potassium level of 7.2
mEq/L. The nurse should immediately prepare for which intervention to protect the
myocardium?
A. Intravenous administration of Calcium Gluconate.
B. Administration of Sodium Polystyrene Sulfonate (Kayexalate) orally.
C. Continuous infusion of regular insulin with 50% dextrose.
D. Emergent hemodialysis.
Answer: A
Conceptual Explanation: Calcium gluconate does not lower potassium, but it antagonizes
the effects of hyperkalemia on the heart, stabilizing the cardiac membrane and preventing
lethal arrhythmias.
3. The nurse is caring for a patient who sustained a traumatic brain injury. The nurse notes a
widening pulse pressure, bradycardia, and irregular respirations. Which action is the priority?
A. Notify the provider of Cushing’s Triad, suggesting increased intracranial pressure.
B. Prepare for immediate intubation and hyperventilation.
C. Administer a bolus of isotonic saline to improve perfusion.
D. Place the patient in a Trendelenburg position to improve venous return.
Answer: A
, Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending brain
herniation.
4. A patient is admitted with acute pancreatitis. Which laboratory result should the nurse
prioritize as the most specific indicator of pancreatic damage?
A. Elevated Serum Lipase
B. Elevated Serum Amylase
C. Decreased Serum Calcium
D. Elevated White Blood Cell count
Answer: A
Conceptual Explanation: While amylase rises early, serum lipase is more specific to the
pancreas and stays elevated longer, making it the preferred diagnostic marker.
5. Following a thyroidectomy, a patient develops laryngeal nerve damage. Which assessment
finding is most indicative of this complication?
A. Positive Chvostek’s sign
B. Hoarseness or a weak, breathy voice
C. Hypercalcemia
D. Tachycardia and hypertension
Answer: B
NURSING QUESTIONS & ANSWERS
100% GUARANTEE PASS | GALEN
COLLEGE OF NURSING
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes that the patient’s PaO2 remains low despite an FiO2 of 80% and
the addition of Positive End-Expiratory Pressure (PEEP). What is the primary physiological
rationale for increasing PEEP in this patient?
A. To increase the fraction of inspired oxygen delivered to the alveoli.
B. To prevent barotrauma by reducing the peak inspiratory pressure.
C. To recruit collapsed alveoli and improve functional residual capacity.
D. To decrease the metabolic demand of the respiratory muscles.
Answer: C
Conceptual Explanation: PEEP is used in ARDS to keep alveoli open at the end of
expiration, which increases functional residual capacity and improves oxygenation by
recruiting collapsed units.
,2. A patient with chronic kidney disease (CKD) presents with a serum potassium level of 7.2
mEq/L. The nurse should immediately prepare for which intervention to protect the
myocardium?
A. Intravenous administration of Calcium Gluconate.
B. Administration of Sodium Polystyrene Sulfonate (Kayexalate) orally.
C. Continuous infusion of regular insulin with 50% dextrose.
D. Emergent hemodialysis.
Answer: A
Conceptual Explanation: Calcium gluconate does not lower potassium, but it antagonizes
the effects of hyperkalemia on the heart, stabilizing the cardiac membrane and preventing
lethal arrhythmias.
3. The nurse is caring for a patient who sustained a traumatic brain injury. The nurse notes a
widening pulse pressure, bradycardia, and irregular respirations. Which action is the priority?
A. Notify the provider of Cushing’s Triad, suggesting increased intracranial pressure.
B. Prepare for immediate intubation and hyperventilation.
C. Administer a bolus of isotonic saline to improve perfusion.
D. Place the patient in a Trendelenburg position to improve venous return.
Answer: A
, Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending brain
herniation.
4. A patient is admitted with acute pancreatitis. Which laboratory result should the nurse
prioritize as the most specific indicator of pancreatic damage?
A. Elevated Serum Lipase
B. Elevated Serum Amylase
C. Decreased Serum Calcium
D. Elevated White Blood Cell count
Answer: A
Conceptual Explanation: While amylase rises early, serum lipase is more specific to the
pancreas and stays elevated longer, making it the preferred diagnostic marker.
5. Following a thyroidectomy, a patient develops laryngeal nerve damage. Which assessment
finding is most indicative of this complication?
A. Positive Chvostek’s sign
B. Hoarseness or a weak, breathy voice
C. Hypercalcemia
D. Tachycardia and hypertension
Answer: B
