Galen NUR 170 Concepts of Medical-Surgical Nursing: Exam 2
- Questions with Correct Answers
100 questions
1. A hypertonic IV solution such as 3% NaCl is used for:
A. Dehydration with hypernatremia
B. Routine maintenance
C. Severe symptomatic hyponatremia
D. Burns only
Correct Answer: C. Severe symptomatic hyponatremia
Rationale: Pulls water from cells.
2. Clients taking digoxin are at greater risk for toxicity if they have:
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia only
Correct Answer: C. Hypokalemia
Rationale: Low K increases toxicity.
3. Normal adult urine output is at least:
A. 5 mL/hr
B. 30 mL/hr (about 0.5 mL/kg/hr)
C. 100 mL/day
D. 500 mL/hr
Correct Answer: B. 30 mL/hr (about 0.5 mL/kg/hr)
Rationale: Minimum.
4. Hypercalcemia may cause:
A. Tetany
B. Positive Chvostek's sign
C. Muscle weakness, constipation and kidney stones
D. Laryngospasm
Correct Answer: C. Muscle weakness, constipation and kidney stones
Rationale: Bones, stones, groans.
5. Hypermagnesemia may cause:
A. Tetany
B. Hyperreflexia
C. Seizures
D. Hypotension, decreased reflexes and respiratory depression
Correct Answer: D. Hypotension, decreased reflexes and respiratory depression
Rationale: CNS depression.
6. A client with hyperkalemia may be treated with:
A. Potassium chloride
B. Insulin with dextrose, calcium gluconate, and potassium-binding agents
C. Spironolactone
D. Salt substitutes
Correct Answer: B. Insulin with dextrose, calcium gluconate, and potassium-binding agents
Rationale: Shift and remove K.
,7. The normal serum sodium range is:
A. 135-145 mEq/L
B. 3.5-5.0 mEq/L
C. 95-105 mEq/L
D. 150-160 mEq/L
Correct Answer: A. 135-145 mEq/L
Rationale: Normal sodium.
8. The most accurate indicator of fluid balance is:
A. Skin turgor
B. Thirst
C. Daily weight
D. Mucous membranes
Correct Answer: C. Daily weight
Rationale: 1 kg = 1 L.
9. Circulatory overload from IV fluids may cause:
A. Hypotension and dry mouth
B. Dyspnea, crackles, distended neck veins and hypertension
C. Bradycardia only
D. Low urine specific gravity only
Correct Answer: B. Dyspnea, crackles, distended neck veins and hypertension
Rationale: Fluid overload.
10. ABG: pH 7.30, PaCO2 52, HCO3 24 indicates:
A. Metabolic acidosis
B. Respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Uncompensated respiratory acidosis
Rationale: Low pH, high CO2, normal HCO3.
11. Infuse 500 mL over 4 hours with a drop factor of 15 gtt/mL. The drip rate is about:
A. 31 gtt/min
B. 125 gtt/min
C. 21 gtt/min
D. 50 gtt/min
Correct Answer: A. 31 gtt/min
Rationale: 500x15/240 = 31.25.
12. A heparin infusion of 25,000 units in 250 mL runs at 10 mL/hr. The client receives:
A. 100 units/hr
B. 2,500 units/hr
C. 1,000 units/hr
D. 10,000 units/hr
Correct Answer: C. 1,000 units/hr
Rationale: 100 units/mL x 10.
, 13. The ROME mnemonic for ABGs means:
A. Respiratory Equal, Metabolic Opposite
B. Rapid Oxygen Means Error
C. Renal Output Measures Electrolytes
D. Respiratory Opposite, Metabolic Equal
Correct Answer: D. Respiratory Opposite, Metabolic Equal
Rationale: Direction of pH vs values.
14. When an IV pump alarms for occlusion, the nurse should first:
A. Check the tubing and site for kinks or clamps
B. Increase pressure
C. Remove the IV
D. Silence and ignore
Correct Answer: A. Check the tubing and site for kinks or clamps
Rationale: Troubleshoot.
15. When changing central line tubing, the client may be asked to:
A. Breathe rapidly
B. Perform the Valsalva maneuver to prevent air embolism
C. Cough repeatedly
D. Sit upright and inhale deeply
Correct Answer: B. Perform the Valsalva maneuver to prevent air embolism
Rationale: Increase intrathoracic pressure.
16. If infiltration occurs, the nurse should first:
A. Stop the infusion and remove the catheter
B. Increase the rate
C. Apply pressure and continue
D. Flush forcefully
Correct Answer: A. Stop the infusion and remove the catheter
Rationale: Stop.
17. Common postoperative complications in the first 24-48 hours include:
A. Wound dehiscence at day 1 always
B. Atelectasis and hemorrhage
C. Pressure injuries only
D. Kidney stones
Correct Answer: B. Atelectasis and hemorrhage
Rationale: Early complications.
18. Herbal supplements such as ginkgo, garlic and ginseng before surgery may increase:
A. Wound healing
B. Blood glucose only
C. Appetite
D. Bleeding risk
Correct Answer: D. Bleeding risk
Rationale: Antiplatelet effects.
- Questions with Correct Answers
100 questions
1. A hypertonic IV solution such as 3% NaCl is used for:
A. Dehydration with hypernatremia
B. Routine maintenance
C. Severe symptomatic hyponatremia
D. Burns only
Correct Answer: C. Severe symptomatic hyponatremia
Rationale: Pulls water from cells.
2. Clients taking digoxin are at greater risk for toxicity if they have:
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia only
Correct Answer: C. Hypokalemia
Rationale: Low K increases toxicity.
3. Normal adult urine output is at least:
A. 5 mL/hr
B. 30 mL/hr (about 0.5 mL/kg/hr)
C. 100 mL/day
D. 500 mL/hr
Correct Answer: B. 30 mL/hr (about 0.5 mL/kg/hr)
Rationale: Minimum.
4. Hypercalcemia may cause:
A. Tetany
B. Positive Chvostek's sign
C. Muscle weakness, constipation and kidney stones
D. Laryngospasm
Correct Answer: C. Muscle weakness, constipation and kidney stones
Rationale: Bones, stones, groans.
5. Hypermagnesemia may cause:
A. Tetany
B. Hyperreflexia
C. Seizures
D. Hypotension, decreased reflexes and respiratory depression
Correct Answer: D. Hypotension, decreased reflexes and respiratory depression
Rationale: CNS depression.
6. A client with hyperkalemia may be treated with:
A. Potassium chloride
B. Insulin with dextrose, calcium gluconate, and potassium-binding agents
C. Spironolactone
D. Salt substitutes
Correct Answer: B. Insulin with dextrose, calcium gluconate, and potassium-binding agents
Rationale: Shift and remove K.
,7. The normal serum sodium range is:
A. 135-145 mEq/L
B. 3.5-5.0 mEq/L
C. 95-105 mEq/L
D. 150-160 mEq/L
Correct Answer: A. 135-145 mEq/L
Rationale: Normal sodium.
8. The most accurate indicator of fluid balance is:
A. Skin turgor
B. Thirst
C. Daily weight
D. Mucous membranes
Correct Answer: C. Daily weight
Rationale: 1 kg = 1 L.
9. Circulatory overload from IV fluids may cause:
A. Hypotension and dry mouth
B. Dyspnea, crackles, distended neck veins and hypertension
C. Bradycardia only
D. Low urine specific gravity only
Correct Answer: B. Dyspnea, crackles, distended neck veins and hypertension
Rationale: Fluid overload.
10. ABG: pH 7.30, PaCO2 52, HCO3 24 indicates:
A. Metabolic acidosis
B. Respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C. Uncompensated respiratory acidosis
Rationale: Low pH, high CO2, normal HCO3.
11. Infuse 500 mL over 4 hours with a drop factor of 15 gtt/mL. The drip rate is about:
A. 31 gtt/min
B. 125 gtt/min
C. 21 gtt/min
D. 50 gtt/min
Correct Answer: A. 31 gtt/min
Rationale: 500x15/240 = 31.25.
12. A heparin infusion of 25,000 units in 250 mL runs at 10 mL/hr. The client receives:
A. 100 units/hr
B. 2,500 units/hr
C. 1,000 units/hr
D. 10,000 units/hr
Correct Answer: C. 1,000 units/hr
Rationale: 100 units/mL x 10.
, 13. The ROME mnemonic for ABGs means:
A. Respiratory Equal, Metabolic Opposite
B. Rapid Oxygen Means Error
C. Renal Output Measures Electrolytes
D. Respiratory Opposite, Metabolic Equal
Correct Answer: D. Respiratory Opposite, Metabolic Equal
Rationale: Direction of pH vs values.
14. When an IV pump alarms for occlusion, the nurse should first:
A. Check the tubing and site for kinks or clamps
B. Increase pressure
C. Remove the IV
D. Silence and ignore
Correct Answer: A. Check the tubing and site for kinks or clamps
Rationale: Troubleshoot.
15. When changing central line tubing, the client may be asked to:
A. Breathe rapidly
B. Perform the Valsalva maneuver to prevent air embolism
C. Cough repeatedly
D. Sit upright and inhale deeply
Correct Answer: B. Perform the Valsalva maneuver to prevent air embolism
Rationale: Increase intrathoracic pressure.
16. If infiltration occurs, the nurse should first:
A. Stop the infusion and remove the catheter
B. Increase the rate
C. Apply pressure and continue
D. Flush forcefully
Correct Answer: A. Stop the infusion and remove the catheter
Rationale: Stop.
17. Common postoperative complications in the first 24-48 hours include:
A. Wound dehiscence at day 1 always
B. Atelectasis and hemorrhage
C. Pressure injuries only
D. Kidney stones
Correct Answer: B. Atelectasis and hemorrhage
Rationale: Early complications.
18. Herbal supplements such as ginkgo, garlic and ginseng before surgery may increase:
A. Wound healing
B. Blood glucose only
C. Appetite
D. Bleeding risk
Correct Answer: D. Bleeding risk
Rationale: Antiplatelet effects.
