NU 155 MEDICAL-SURGICAL NURSING
COMPREHENSIVE EXAM PREP
QUESTIONS & ANSWERS 100%
GUARANTEE PASS | GALEN COLLEGE
OF NURSING
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted with an
exacerbation. The arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mmHg, HCO3 28
mEq/L. How should the nurse interpret these results?
A. Partially compensated respiratory acidosis
B. Compensated metabolic acidosis
C. Uncompensated respiratory alkalosis
D. Fully compensated respiratory acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (attempting to compensate), indicating partial compensation as
the pH is not yet within the normal range.
2. A client is experiencing an acute adrenal crisis (Addisonian crisis). Which intravenous fluid
order should the nurse prioritize?
A. 5% Dextrose in 0.9% Sodium Chloride
,B. 0.45% Sodium Chloride
C. Lactated Ringer’s Solution
D. 0.33% Sodium Chloride
Answer: A
Conceptual Explanation: In Addisonian crisis, the patient is severely hyponatremic and
hypoglycemic. D5NS provides both necessary sodium and glucose to stabilize the patient.
3. The nurse is caring for a patient with a traumatic brain injury. Which finding is the most
sensitive indicator of increasing intracranial pressure (ICP)?
A. Widening pulse pressure
B. Change in level of consciousness
C. Dilated and fixed pupils
D. Projectile vomiting
Answer: B
Conceptual Explanation: A change in the level of consciousness (LOC) is the earliest and
most sensitive sign of neurological deterioration and increased ICP.
4. A patient with a history of heart failure is prescribed Digoxin. Which electrolyte imbalance
increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
, C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Hypokalemia sensitizes the myocardium to digoxin, significantly
increasing the risk of toxicity even if digoxin levels are within the therapeutic range.
5. Following a thyroidectomy, a patient complains of numbness and tingling around the
mouth and in the fingertips. Which action should the nurse take first?
A. Check the patient’s temperature
B. Notify the physician of potential nerve damage
C. Assess for Trousseau’s sign
D. Administer a PRN sedative
Answer: C
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, often caused
by accidental damage to the parathyroid glands during thyroid surgery. Assessing for
Trousseau’s or Chvostek’s sign confirms neuromuscular irritability.
6. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes a blood glucose of
600 mg/dL and the start of an insulin drip. What is the primary goal of initial fluid
resuscitation?
A. To lower blood glucose levels rapidly
COMPREHENSIVE EXAM PREP
QUESTIONS & ANSWERS 100%
GUARANTEE PASS | GALEN COLLEGE
OF NURSING
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted with an
exacerbation. The arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mmHg, HCO3 28
mEq/L. How should the nurse interpret these results?
A. Partially compensated respiratory acidosis
B. Compensated metabolic acidosis
C. Uncompensated respiratory alkalosis
D. Fully compensated respiratory acidosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (attempting to compensate), indicating partial compensation as
the pH is not yet within the normal range.
2. A client is experiencing an acute adrenal crisis (Addisonian crisis). Which intravenous fluid
order should the nurse prioritize?
A. 5% Dextrose in 0.9% Sodium Chloride
,B. 0.45% Sodium Chloride
C. Lactated Ringer’s Solution
D. 0.33% Sodium Chloride
Answer: A
Conceptual Explanation: In Addisonian crisis, the patient is severely hyponatremic and
hypoglycemic. D5NS provides both necessary sodium and glucose to stabilize the patient.
3. The nurse is caring for a patient with a traumatic brain injury. Which finding is the most
sensitive indicator of increasing intracranial pressure (ICP)?
A. Widening pulse pressure
B. Change in level of consciousness
C. Dilated and fixed pupils
D. Projectile vomiting
Answer: B
Conceptual Explanation: A change in the level of consciousness (LOC) is the earliest and
most sensitive sign of neurological deterioration and increased ICP.
4. A patient with a history of heart failure is prescribed Digoxin. Which electrolyte imbalance
increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
, C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Hypokalemia sensitizes the myocardium to digoxin, significantly
increasing the risk of toxicity even if digoxin levels are within the therapeutic range.
5. Following a thyroidectomy, a patient complains of numbness and tingling around the
mouth and in the fingertips. Which action should the nurse take first?
A. Check the patient’s temperature
B. Notify the physician of potential nerve damage
C. Assess for Trousseau’s sign
D. Administer a PRN sedative
Answer: C
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, often caused
by accidental damage to the parathyroid glands during thyroid surgery. Assessing for
Trousseau’s or Chvostek’s sign confirms neuromuscular irritability.
6. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes a blood glucose of
600 mg/dL and the start of an insulin drip. What is the primary goal of initial fluid
resuscitation?
A. To lower blood glucose levels rapidly
