Galen NUR 170 Concepts of Medical-Surgical Nursing: Midterm
Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Third spacing refers to:
A. Fluid shifting into interstitial spaces where it is not usable
B. Fluid in blood vessels
C. Fluid in cells
D. Urine output
Correct Answer: A. Fluid shifting into interstitial spaces where it is not usable
Rationale: e.g., ascites.
2. Chvostek's sign is elicited by:
A. Inflating a BP cuff on the arm
B. Checking deep tendon reflexes
C. Tapping the facial nerve in front of the ear and observing twitching
D. Pressing on the eyeball
Correct Answer: C. Tapping the facial nerve in front of the ear and observing twitching
Rationale: Facial twitch.
3. Calcium gluconate is given in severe hyperkalemia to:
A. Lower potassium levels directly
B. Increase urine output
C. Raise sodium
D. Stabilize the cardiac membrane
Correct Answer: D. Stabilize the cardiac membrane
Rationale: Protects heart.
4. Trousseau's sign is elicited by:
A. Tapping the cheek
B. Inflating a BP cuff above systolic pressure and observing carpal spasm
C. Flexing the neck
D. Tapping the knee
Correct Answer: B. Inflating a BP cuff above systolic pressure and observing carpal spasm
Rationale: Carpal spasm.
5. Hyponatremia may cause:
A. Peaked T waves
B. Confusion, headache and seizures
C. Kidney stones
D. Tetany only
Correct Answer: B. Confusion, headache and seizures
Rationale: Neurologic effects.
6. Before administering IV potassium, the nurse should verify:
A. The client has eaten
B. The client is ambulatory
C. Adequate urine output (at least 30 mL/hr)
D. The client's weight is stable
Correct Answer: C. Adequate urine output (at least 30 mL/hr)
Rationale: Kidneys excrete K.
,7. A client with hypokalemia is most likely to report:
A. Tingling around the lips only
B. Excess thirst only
C. Bradycardia only
D. Muscle weakness and leg cramps
Correct Answer: D. Muscle weakness and leg cramps
Rationale: Neuromuscular effects.
8. Salt substitutes often contain:
A. Sodium chloride
B. Calcium carbonate
C. Magnesium
D. Potassium chloride
Correct Answer: D. Potassium chloride
Rationale: Avoid in hyperkalemia.
9. The normal serum potassium range is:
A. 135-145 mEq/L
B. 1.5-2.5 mEq/L
C. 8.5-10.5 mEq/L
D. 3.5-5.0 mEq/L
Correct Answer: D. 3.5-5.0 mEq/L
Rationale: Normal potassium.
10. The nurse notes a client's potassium is 6.8 mEq/L. The priority action is to:
A. Give potassium supplements
B. Encourage bananas
C. Place the client on a cardiac monitor and notify the provider
D. Recheck in 24 hours
Correct Answer: C. Place the client on a cardiac monitor and notify the provider
Rationale: Life-threatening.
11. Rapid correction of chronic hyponatremia can cause:
A. Hypokalemia only
B. Hypercalcemia
C. Diabetes insipidus
D. Osmotic demyelination syndrome
Correct Answer: D. Osmotic demyelination syndrome
Rationale: Correct slowly.
12. Older adults are at increased risk for dehydration because of:
A. Increased thirst
B. Decreased thirst sensation and kidney concentrating ability
C. More body water
D. Less medication use
Correct Answer: B. Decreased thirst sensation and kidney concentrating ability
Rationale: Age-related changes.
, 13. A high urine specific gravity (e.g., 1.035) suggests:
A. Dehydration (concentrated urine)
B. Fluid overload
C. Diabetes insipidus
D. Normal hydration always
Correct Answer: A. Dehydration (concentrated urine)
Rationale: Concentrated.
14. Oral potassium supplements should be given:
A. With food or a full glass of water to reduce GI irritation
B. On an empty stomach
C. Crushed in juice without water
D. IV push
Correct Answer: A. With food or a full glass of water to reduce GI irritation
Rationale: GI irritation.
15. The normal total serum calcium range is approximately:
A. 3.5-5.0 mg/dL
B. 9.0-10.5 mg/dL
C. 135-145 mg/dL
D. 1.3-2.1 mg/dL
Correct Answer: B. 9.0-10.5 mg/dL
Rationale: Normal calcium.
16. Oxygen saturation (SpO2) normal range for most adults is:
A. 80-85%
B. 70-75%
C. 95-100%
D. 50-60%
Correct Answer: C. 95-100%
Rationale: Normal.
17. If a TPN bag runs out and a new one is not available, the nurse should hang:
A. Normal saline
B. D5W only always
C. D10W to prevent hypoglycemia
D. Nothing
Correct Answer: C. D10W to prevent hypoglycemia
Rationale: Rebound hypoglycemia.
18. ABG: pH 7.28, PaCO2 40, HCO3 16 indicates:
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Uncompensated metabolic acidosis
Correct Answer: D. Uncompensated metabolic acidosis
Rationale: Low pH, low HCO3.
Exam (Units 1-7) - Questions with Correct Answers
100 questions
1. Third spacing refers to:
A. Fluid shifting into interstitial spaces where it is not usable
B. Fluid in blood vessels
C. Fluid in cells
D. Urine output
Correct Answer: A. Fluid shifting into interstitial spaces where it is not usable
Rationale: e.g., ascites.
2. Chvostek's sign is elicited by:
A. Inflating a BP cuff on the arm
B. Checking deep tendon reflexes
C. Tapping the facial nerve in front of the ear and observing twitching
D. Pressing on the eyeball
Correct Answer: C. Tapping the facial nerve in front of the ear and observing twitching
Rationale: Facial twitch.
3. Calcium gluconate is given in severe hyperkalemia to:
A. Lower potassium levels directly
B. Increase urine output
C. Raise sodium
D. Stabilize the cardiac membrane
Correct Answer: D. Stabilize the cardiac membrane
Rationale: Protects heart.
4. Trousseau's sign is elicited by:
A. Tapping the cheek
B. Inflating a BP cuff above systolic pressure and observing carpal spasm
C. Flexing the neck
D. Tapping the knee
Correct Answer: B. Inflating a BP cuff above systolic pressure and observing carpal spasm
Rationale: Carpal spasm.
5. Hyponatremia may cause:
A. Peaked T waves
B. Confusion, headache and seizures
C. Kidney stones
D. Tetany only
Correct Answer: B. Confusion, headache and seizures
Rationale: Neurologic effects.
6. Before administering IV potassium, the nurse should verify:
A. The client has eaten
B. The client is ambulatory
C. Adequate urine output (at least 30 mL/hr)
D. The client's weight is stable
Correct Answer: C. Adequate urine output (at least 30 mL/hr)
Rationale: Kidneys excrete K.
,7. A client with hypokalemia is most likely to report:
A. Tingling around the lips only
B. Excess thirst only
C. Bradycardia only
D. Muscle weakness and leg cramps
Correct Answer: D. Muscle weakness and leg cramps
Rationale: Neuromuscular effects.
8. Salt substitutes often contain:
A. Sodium chloride
B. Calcium carbonate
C. Magnesium
D. Potassium chloride
Correct Answer: D. Potassium chloride
Rationale: Avoid in hyperkalemia.
9. The normal serum potassium range is:
A. 135-145 mEq/L
B. 1.5-2.5 mEq/L
C. 8.5-10.5 mEq/L
D. 3.5-5.0 mEq/L
Correct Answer: D. 3.5-5.0 mEq/L
Rationale: Normal potassium.
10. The nurse notes a client's potassium is 6.8 mEq/L. The priority action is to:
A. Give potassium supplements
B. Encourage bananas
C. Place the client on a cardiac monitor and notify the provider
D. Recheck in 24 hours
Correct Answer: C. Place the client on a cardiac monitor and notify the provider
Rationale: Life-threatening.
11. Rapid correction of chronic hyponatremia can cause:
A. Hypokalemia only
B. Hypercalcemia
C. Diabetes insipidus
D. Osmotic demyelination syndrome
Correct Answer: D. Osmotic demyelination syndrome
Rationale: Correct slowly.
12. Older adults are at increased risk for dehydration because of:
A. Increased thirst
B. Decreased thirst sensation and kidney concentrating ability
C. More body water
D. Less medication use
Correct Answer: B. Decreased thirst sensation and kidney concentrating ability
Rationale: Age-related changes.
, 13. A high urine specific gravity (e.g., 1.035) suggests:
A. Dehydration (concentrated urine)
B. Fluid overload
C. Diabetes insipidus
D. Normal hydration always
Correct Answer: A. Dehydration (concentrated urine)
Rationale: Concentrated.
14. Oral potassium supplements should be given:
A. With food or a full glass of water to reduce GI irritation
B. On an empty stomach
C. Crushed in juice without water
D. IV push
Correct Answer: A. With food or a full glass of water to reduce GI irritation
Rationale: GI irritation.
15. The normal total serum calcium range is approximately:
A. 3.5-5.0 mg/dL
B. 9.0-10.5 mg/dL
C. 135-145 mg/dL
D. 1.3-2.1 mg/dL
Correct Answer: B. 9.0-10.5 mg/dL
Rationale: Normal calcium.
16. Oxygen saturation (SpO2) normal range for most adults is:
A. 80-85%
B. 70-75%
C. 95-100%
D. 50-60%
Correct Answer: C. 95-100%
Rationale: Normal.
17. If a TPN bag runs out and a new one is not available, the nurse should hang:
A. Normal saline
B. D5W only always
C. D10W to prevent hypoglycemia
D. Nothing
Correct Answer: C. D10W to prevent hypoglycemia
Rationale: Rebound hypoglycemia.
18. ABG: pH 7.28, PaCO2 40, HCO3 16 indicates:
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Uncompensated metabolic acidosis
Correct Answer: D. Uncompensated metabolic acidosis
Rationale: Low pH, low HCO3.
