NRSG 201 Final Exam V2 | NRSG 201 Med Surg 1 |
Actual Q&A with Rationale (NRSG201 Final Exam) |
Ivy Tech
1. A patient with chronic kidney disease presents with a pH of 7.28, HCO3 of 16 mEq/L, and
PaCO2 of 36 mmHg. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: The pH level of 7.28 is below the normal range of 7.35-7.45, indicating
acidosis. A bicarbonate (HCO3) level of 16 is low, which signifies a metabolic cause for the
acidosis. Since the PaCO2 is within normal range, the imbalance is not respiratory in origin.
2. A nurse is caring for a patient who is 4 hours postoperative following abdominal surgery.
The patient reports a ‘popping’ sensation and the nurse observes a loop of bowel protruding
through the incision. What is the priority nursing action?
A. Push the bowel back into the abdominal cavity gently
B. Cover the protruding organ with sterile towels moistened with sterile normal saline
C. Apply a dry sterile dressing over the wound
,D. Place the patient in a high-Fowler’s position
Correct Answer: B
Explanation: Evisceration is a medical emergency that requires immediate intervention to
keep the bowel moist. The nurse should use sterile saline-soaked dressings to prevent
tissue necrosis and drying. The healthcare provider must be notified immediately while the
patient is kept in a low-Fowler’s position with knees flexed to reduce abdominal pressure.
3. Which electrolyte imbalance should a nurse monitor for in a patient receiving high-dose
furosemide (Lasix) for heart failure?
A. Hyperkalemia
B. Hypermagnesemia
C. Hypercalcemia
D. Hypokalemia
Correct Answer: D
Explanation: Furosemide is a loop diuretic that causes the excretion of sodium, water, and
potassium. Patients on this medication are at high risk for hypokalemia, which can lead to
life-threatening cardiac dysrhythmias. Monitoring serum potassium levels and encouraging
potassium-rich foods or supplements is a vital nursing responsibility.
4. A nurse is teaching a patient with Type 1 Diabetes Mellitus about the ‘Dawn Phenomenon’.
Which statement by the patient indicates an understanding of the teaching?
A. I should reduce my insulin dose before bed
, B. My blood sugar is high in the morning because of growth hormone release during sleep
C. My blood sugar drops too low in the middle of the night
D. I need to eat a large snack before bedtime to prevent this
Correct Answer: B
Explanation: The Dawn Phenomenon is characterized by hyperglycemia upon awakening
due to the release of counter-regulatory hormones like growth hormone or cortisol. This is
different from the Somogyi effect, which involves rebound hyperglycemia following
nighttime hypoglycemia. Management usually involves increasing the evening dose of
intermediate-acting insulin.
5. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary edema
B. Peripheral edema and jugular venous distention
C. Orthopnea
D. Crackles in the lungs
Correct Answer: B
Explanation: Right-sided heart failure results in the inability of the right ventricle to pump
blood into the lungs, causing backflow into the systemic circulation. This leads to systemic
symptoms such as peripheral edema, hepatomegaly, and jugular venous distention (JVD).
Actual Q&A with Rationale (NRSG201 Final Exam) |
Ivy Tech
1. A patient with chronic kidney disease presents with a pH of 7.28, HCO3 of 16 mEq/L, and
PaCO2 of 36 mmHg. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: The pH level of 7.28 is below the normal range of 7.35-7.45, indicating
acidosis. A bicarbonate (HCO3) level of 16 is low, which signifies a metabolic cause for the
acidosis. Since the PaCO2 is within normal range, the imbalance is not respiratory in origin.
2. A nurse is caring for a patient who is 4 hours postoperative following abdominal surgery.
The patient reports a ‘popping’ sensation and the nurse observes a loop of bowel protruding
through the incision. What is the priority nursing action?
A. Push the bowel back into the abdominal cavity gently
B. Cover the protruding organ with sterile towels moistened with sterile normal saline
C. Apply a dry sterile dressing over the wound
,D. Place the patient in a high-Fowler’s position
Correct Answer: B
Explanation: Evisceration is a medical emergency that requires immediate intervention to
keep the bowel moist. The nurse should use sterile saline-soaked dressings to prevent
tissue necrosis and drying. The healthcare provider must be notified immediately while the
patient is kept in a low-Fowler’s position with knees flexed to reduce abdominal pressure.
3. Which electrolyte imbalance should a nurse monitor for in a patient receiving high-dose
furosemide (Lasix) for heart failure?
A. Hyperkalemia
B. Hypermagnesemia
C. Hypercalcemia
D. Hypokalemia
Correct Answer: D
Explanation: Furosemide is a loop diuretic that causes the excretion of sodium, water, and
potassium. Patients on this medication are at high risk for hypokalemia, which can lead to
life-threatening cardiac dysrhythmias. Monitoring serum potassium levels and encouraging
potassium-rich foods or supplements is a vital nursing responsibility.
4. A nurse is teaching a patient with Type 1 Diabetes Mellitus about the ‘Dawn Phenomenon’.
Which statement by the patient indicates an understanding of the teaching?
A. I should reduce my insulin dose before bed
, B. My blood sugar is high in the morning because of growth hormone release during sleep
C. My blood sugar drops too low in the middle of the night
D. I need to eat a large snack before bedtime to prevent this
Correct Answer: B
Explanation: The Dawn Phenomenon is characterized by hyperglycemia upon awakening
due to the release of counter-regulatory hormones like growth hormone or cortisol. This is
different from the Somogyi effect, which involves rebound hyperglycemia following
nighttime hypoglycemia. Management usually involves increasing the evening dose of
intermediate-acting insulin.
5. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary edema
B. Peripheral edema and jugular venous distention
C. Orthopnea
D. Crackles in the lungs
Correct Answer: B
Explanation: Right-sided heart failure results in the inability of the right ventricle to pump
blood into the lungs, causing backflow into the systemic circulation. This leads to systemic
symptoms such as peripheral edema, hepatomegaly, and jugular venous distention (JVD).
