NRSG 201 Exam 2 V3 | NRSG 201 Med Surg 1 |
Actual Q&A with Rationale (NRSG201 Exam 2) | Ivy
Tech
1. A nurse is assessing a client who has a suspected fluid volume deficit. Which of the
following findings should the nurse expect?
A. Distended neck veins
B. Blood pressure 150/90 mm Hg
C. Heart rate 110/min
D. Increased skin turgor
Correct Answer: C
Explanation: A heart rate of 110/min is a sign of tachycardia, which is a compensatory
mechanism for fluid volume deficit. Fluid volume deficit typically causes hypotension
rather than hypertension. The nurse would also expect to see flattened neck veins and
decreased skin turgor in a client with dehydration.
2. A client is diagnosed with hypokalemia and is prescribed a potassium supplement. The
nurse should monitor the client for which of the following medication toxicities?
A. Warfarin toxicity
B. Amoxicillin toxicity
C. Lisinopril toxicity
,D. Digoxin toxicity
Correct Answer: D
Explanation: Hypokalemia increases the risk for digoxin toxicity because low potassium
levels enhance the effects of digoxin on the heart. The nurse must monitor for symptoms
such as nausea, vomiting, and visual disturbances like yellow-green halos. Potassium levels
should be maintained within the normal range of 3.5 to 5.0 mEq/L to prevent this
complication.
3. A nurse is reviewing the arterial blood gas (ABG) results of a client with COPD: pH 7.30,
PaCO2 52 mm Hg, HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Partially compensated metabolic acidosis
B. Compensated metabolic alkalosis
C. Uncompensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Correct Answer: D
Explanation: The pH of 7.30 indicates acidosis as it is below the normal range of 7.35. The
PaCO2 of 52 mm Hg is elevated, suggesting a respiratory cause, while the HCO3 is within
the normal range, indicating no compensation has occurred. These findings are common in
clients with COPD who experience hypoventilation and carbon dioxide retention.
, 4. A client is scheduled for an elective surgery. Who is responsible for obtaining the informed
consent?
A. The charge nurse
B. The preoperative nurse
C. The anesthesiologist
D. The surgeon
Correct Answer: D
Explanation: The surgeon is legally responsible for explaining the procedure, risks,
benefits, and alternatives to the client to obtain informed consent. The nurse’s role is to
witness the client’s signature and verify that the client understands the information
provided. If the client has further questions, the nurse must notify the surgeon to return
and provide clarification.
5. During a surgical procedure, the client’s heart rate increases to 120/min and the end-tidal
CO2 rises sharply. The nurse suspects malignant hyperthermia. Which medication should be
prepared?
A. Atropine
B. Epinephrine
C. Dantrolene
D. Lidocaine
Actual Q&A with Rationale (NRSG201 Exam 2) | Ivy
Tech
1. A nurse is assessing a client who has a suspected fluid volume deficit. Which of the
following findings should the nurse expect?
A. Distended neck veins
B. Blood pressure 150/90 mm Hg
C. Heart rate 110/min
D. Increased skin turgor
Correct Answer: C
Explanation: A heart rate of 110/min is a sign of tachycardia, which is a compensatory
mechanism for fluid volume deficit. Fluid volume deficit typically causes hypotension
rather than hypertension. The nurse would also expect to see flattened neck veins and
decreased skin turgor in a client with dehydration.
2. A client is diagnosed with hypokalemia and is prescribed a potassium supplement. The
nurse should monitor the client for which of the following medication toxicities?
A. Warfarin toxicity
B. Amoxicillin toxicity
C. Lisinopril toxicity
,D. Digoxin toxicity
Correct Answer: D
Explanation: Hypokalemia increases the risk for digoxin toxicity because low potassium
levels enhance the effects of digoxin on the heart. The nurse must monitor for symptoms
such as nausea, vomiting, and visual disturbances like yellow-green halos. Potassium levels
should be maintained within the normal range of 3.5 to 5.0 mEq/L to prevent this
complication.
3. A nurse is reviewing the arterial blood gas (ABG) results of a client with COPD: pH 7.30,
PaCO2 52 mm Hg, HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Partially compensated metabolic acidosis
B. Compensated metabolic alkalosis
C. Uncompensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Correct Answer: D
Explanation: The pH of 7.30 indicates acidosis as it is below the normal range of 7.35. The
PaCO2 of 52 mm Hg is elevated, suggesting a respiratory cause, while the HCO3 is within
the normal range, indicating no compensation has occurred. These findings are common in
clients with COPD who experience hypoventilation and carbon dioxide retention.
, 4. A client is scheduled for an elective surgery. Who is responsible for obtaining the informed
consent?
A. The charge nurse
B. The preoperative nurse
C. The anesthesiologist
D. The surgeon
Correct Answer: D
Explanation: The surgeon is legally responsible for explaining the procedure, risks,
benefits, and alternatives to the client to obtain informed consent. The nurse’s role is to
witness the client’s signature and verify that the client understands the information
provided. If the client has further questions, the nurse must notify the surgeon to return
and provide clarification.
5. During a surgical procedure, the client’s heart rate increases to 120/min and the end-tidal
CO2 rises sharply. The nurse suspects malignant hyperthermia. Which medication should be
prepared?
A. Atropine
B. Epinephrine
C. Dantrolene
D. Lidocaine