NUR 253 MEDICAL-SURGICAL NURSING
I MIDTERM EXAM QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF) GALEN COLLEGE OF
NURSING
1. A patient’s arterial blood gas (ABG) results show a pH of 7.30, PaCO2 of 52 mm Hg, and
HCO3 of 24 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg
suggests the respiratory system is the cause, confirming respiratory acidosis.
,2. Which electrolyte imbalance is most commonly associated with a positive Chvostek’s sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Conceptual Explanation: Chvostek’s sign (facial twitching when tapping the facial nerve)
is a classic sign of hypocalcemia due to increased neuromuscular excitability.
3. A patient is scheduled for surgery and states, ‘I am not really sure why I need this
operation.’ What is the nurse’s priority action?
A. Call the surgeon to explain the procedure and obtain clarified consent
B. Explain the procedure to the patient in detail
C. Proceed with the preoperative checklist
D. Inform the patient that they can ask the anesthesiologist questions
Answer: A
Conceptual Explanation: The nurse’s role is to witness the signature. If the patient does
not understand the procedure, the nurse must notify the surgeon to provide further
explanation.
, 4. When assessing a postoperative patient, which finding would indicate the most immediate
risk for complications?
A. Stridor or crowing sounds upon inspiration
B. A pain score of 6/10
C. Urine output of 45 mL/hr
D. Serosanguineous drainage on the dressing
Answer: A
Conceptual Explanation: Stridor indicates an upper airway obstruction or laryngospasm,
which is a life-threatening respiratory emergency requiring immediate intervention.
5. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change
should the nurse monitor for?
A. Tall, peaked T waves
B. Presence of U waves
C. Shortened PR interval
D. ST segment depression
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic ECG changes
including tall peaked T waves, prolonged PR intervals, and wide QRS complexes.
I MIDTERM EXAM QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF) GALEN COLLEGE OF
NURSING
1. A patient’s arterial blood gas (ABG) results show a pH of 7.30, PaCO2 of 52 mm Hg, and
HCO3 of 24 mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg
suggests the respiratory system is the cause, confirming respiratory acidosis.
,2. Which electrolyte imbalance is most commonly associated with a positive Chvostek’s sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Conceptual Explanation: Chvostek’s sign (facial twitching when tapping the facial nerve)
is a classic sign of hypocalcemia due to increased neuromuscular excitability.
3. A patient is scheduled for surgery and states, ‘I am not really sure why I need this
operation.’ What is the nurse’s priority action?
A. Call the surgeon to explain the procedure and obtain clarified consent
B. Explain the procedure to the patient in detail
C. Proceed with the preoperative checklist
D. Inform the patient that they can ask the anesthesiologist questions
Answer: A
Conceptual Explanation: The nurse’s role is to witness the signature. If the patient does
not understand the procedure, the nurse must notify the surgeon to provide further
explanation.
, 4. When assessing a postoperative patient, which finding would indicate the most immediate
risk for complications?
A. Stridor or crowing sounds upon inspiration
B. A pain score of 6/10
C. Urine output of 45 mL/hr
D. Serosanguineous drainage on the dressing
Answer: A
Conceptual Explanation: Stridor indicates an upper airway obstruction or laryngospasm,
which is a life-threatening respiratory emergency requiring immediate intervention.
5. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change
should the nurse monitor for?
A. Tall, peaked T waves
B. Presence of U waves
C. Shortened PR interval
D. ST segment depression
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic ECG changes
including tall peaked T waves, prolonged PR intervals, and wide QRS complexes.
