NUR 253 EXAM 1 - ADVANCED
MEDICAL-SURGICAL NURSING
CONCEPTS QUESTIONS & ANSWERS
(VERIFIED ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
,2. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which EKG
change should the nurse monitor for most closely?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST-segment depression
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T
waves and eventually widened QRS complexes.
3. Which assessment finding is a classic sign of hypocalcemia?
A. Negative Babinski reflex
B. Bradycardia
C. Positive Chvostek’s sign
D. Hypoactive bowel sounds
Answer: C
Conceptual Explanation: Chvostek’s sign (facial twitching when tapping the facial nerve)
and Trousseau’s sign are hallmarks of hypocalcemia and neuromuscular irritability.
, 4. A patient is scheduled for surgery. Who is legally responsible for obtaining the patient’s
informed consent?
A. The circulating nurse
B. The anesthesiologist
C. The surgeon
D. The charge nurse
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure, risks,
and benefits; the nurse’s role is typically to witness the signature.
5. During the intraoperative period, a patient develops muscle rigidity, tachycardia, and a
rapidly rising temperature. What is the priority nursing action?
A. Administering chilled IV fluids
B. Applying cooling blankets
C. Administering Dantrolene sodium
D. Increasing the oxygen flow rate
Answer: C
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
emergency. Dantrolene is the specific muscle relaxant used to treat it.
MEDICAL-SURGICAL NURSING
CONCEPTS QUESTIONS & ANSWERS
(VERIFIED ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
,2. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which EKG
change should the nurse monitor for most closely?
A. Prominent U waves
B. Tall, peaked T waves
C. Prolonged PR interval
D. ST-segment depression
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T
waves and eventually widened QRS complexes.
3. Which assessment finding is a classic sign of hypocalcemia?
A. Negative Babinski reflex
B. Bradycardia
C. Positive Chvostek’s sign
D. Hypoactive bowel sounds
Answer: C
Conceptual Explanation: Chvostek’s sign (facial twitching when tapping the facial nerve)
and Trousseau’s sign are hallmarks of hypocalcemia and neuromuscular irritability.
, 4. A patient is scheduled for surgery. Who is legally responsible for obtaining the patient’s
informed consent?
A. The circulating nurse
B. The anesthesiologist
C. The surgeon
D. The charge nurse
Answer: C
Conceptual Explanation: The surgeon is responsible for explaining the procedure, risks,
and benefits; the nurse’s role is typically to witness the signature.
5. During the intraoperative period, a patient develops muscle rigidity, tachycardia, and a
rapidly rising temperature. What is the priority nursing action?
A. Administering chilled IV fluids
B. Applying cooling blankets
C. Administering Dantrolene sodium
D. Increasing the oxygen flow rate
Answer: C
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
emergency. Dantrolene is the specific muscle relaxant used to treat it.
