NUR 242 MED-SURG NURSING EXAM 1
COMPREHENSIVE ASSESSMENT
QUESTIONS & VERIFIED ANSWERS |
GALEN COLLEGE (A+ GUARANTEE)
1. A patient is admitted with a serum potassium level of 6.2 mEq/L. Which nursing
intervention is the highest priority?
A. Administering a dose of spironolactone
B. Monitoring the patient’s urine output hourly
C. Encouraging the intake of potassium-rich foods
D. Initiating continuous cardiac monitoring
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can cause lethal cardiac
dysrhythmias. Continuous cardiac monitoring is essential to detect life-threatening changes
like peaked T waves or widened QRS complexes.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
severe, prolonged vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.32, PaCO2 35, HCO3 18
,C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.50, PaCO2 30, HCO3 22
Answer: C
Conceptual Explanation: Vomiting leads to the loss of gastric acid (hydrogen ions),
resulting in metabolic alkalosis. This is characterized by an elevated pH (>7.45) and an
elevated bicarbonate (HCO3) level (>26).
3. During the preoperative assessment, a patient reports a strong family history of Malignant
Hyperthermia. Which medication should the nurse anticipate the surgical team will avoid?
A. Fentanyl
B. Succinylcholine
C. Propofol
D. Midazolam
Answer: B
Conceptual Explanation: Malignant Hyperthermia is a life-threatening pharmacogenetic
disorder triggered by volatile inhalational anesthetic agents and the depolarizing muscle
relaxant succinylcholine.
4. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of 45 mg/dL.
What is the immediate nursing action if IV access is unavailable?
A. Administer 1 mg of Glucagon intramuscularly
, B. Administer 15g of simple carbohydrates orally
C. Inject 50 mL of 50% Dextrose (D50) IV push
D. Apply a cold compress to the patient’s forehead
Answer: A
Conceptual Explanation: If a patient is unconscious due to hypoglycemia and has no IV
access, intramuscular or subcutaneous glucagon is the standard treatment to stimulate
glucose release from the liver.
5. A nurse is caring for a patient who is 12 hours postoperative from an abdominal surgery.
The patient reports sudden chest pain and shortness of breath. Which complication should
the nurse suspect first?
A. Atelectasis
B. Hypovolemic shock
C. Paralytic ileus
D. Pulmonary Embolism
Answer: D
Conceptual Explanation: Sudden onset of chest pain and dyspnea in a postoperative
patient are classic signs of a pulmonary embolism, a major complication of deep vein
thrombosis (DVT).
COMPREHENSIVE ASSESSMENT
QUESTIONS & VERIFIED ANSWERS |
GALEN COLLEGE (A+ GUARANTEE)
1. A patient is admitted with a serum potassium level of 6.2 mEq/L. Which nursing
intervention is the highest priority?
A. Administering a dose of spironolactone
B. Monitoring the patient’s urine output hourly
C. Encouraging the intake of potassium-rich foods
D. Initiating continuous cardiac monitoring
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can cause lethal cardiac
dysrhythmias. Continuous cardiac monitoring is essential to detect life-threatening changes
like peaked T waves or widened QRS complexes.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
severe, prolonged vomiting?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.32, PaCO2 35, HCO3 18
,C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.50, PaCO2 30, HCO3 22
Answer: C
Conceptual Explanation: Vomiting leads to the loss of gastric acid (hydrogen ions),
resulting in metabolic alkalosis. This is characterized by an elevated pH (>7.45) and an
elevated bicarbonate (HCO3) level (>26).
3. During the preoperative assessment, a patient reports a strong family history of Malignant
Hyperthermia. Which medication should the nurse anticipate the surgical team will avoid?
A. Fentanyl
B. Succinylcholine
C. Propofol
D. Midazolam
Answer: B
Conceptual Explanation: Malignant Hyperthermia is a life-threatening pharmacogenetic
disorder triggered by volatile inhalational anesthetic agents and the depolarizing muscle
relaxant succinylcholine.
4. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of 45 mg/dL.
What is the immediate nursing action if IV access is unavailable?
A. Administer 1 mg of Glucagon intramuscularly
, B. Administer 15g of simple carbohydrates orally
C. Inject 50 mL of 50% Dextrose (D50) IV push
D. Apply a cold compress to the patient’s forehead
Answer: A
Conceptual Explanation: If a patient is unconscious due to hypoglycemia and has no IV
access, intramuscular or subcutaneous glucagon is the standard treatment to stimulate
glucose release from the liver.
5. A nurse is caring for a patient who is 12 hours postoperative from an abdominal surgery.
The patient reports sudden chest pain and shortness of breath. Which complication should
the nurse suspect first?
A. Atelectasis
B. Hypovolemic shock
C. Paralytic ileus
D. Pulmonary Embolism
Answer: D
Conceptual Explanation: Sudden onset of chest pain and dyspnea in a postoperative
patient are classic signs of a pulmonary embolism, a major complication of deep vein
thrombosis (DVT).
