NUR 210 ADVANCED MED-SURG AND
FUNDAMENTALS FINAL EXAM
QUESTIONS AND ANSWERS 2026/2027
1. A patient with chronic kidney disease presents with a potassium level of 6.4 mEq/L. Which
EKG finding is the most critical to monitor for?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic EKG changes,
most notably tall, peaked T waves. If untreated, it can progress to QRS widening and
cardiac arrest.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
severe, prolonged vomiting?
A. pH 7.30, PaCO2 52, HCO3 26
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 25, HCO3 22
Answer: B
Conceptual Explanation: Vomiting leads to the loss of gastric acid (HCl), causing
Metabolic Alkalosis (elevated pH and elevated Bicarbonate).
3. A nurse is caring for a patient who is 12 hours post-abdominal surgery. The patient’s
oxygen saturation drops to 89% on room air. What is the priority nursing action?
A. Administer the prescribed PRN pain medication
B. Request a stat chest X-ray
C. Encourage the patient to perform incentive spirometry
D. Assess the surgical site for dehiscence
Answer: C
Conceptual Explanation: Post-operative hypoxemia is frequently caused by atelectasis.
Promoting lung expansion via incentive spirometry or deep breathing is the priority
intervention.
4. During a blood transfusion, the patient reports chills, low back pain, and nausea. What is
the nurse’s first action?
A. Stop the infusion immediately
B. Slow the infusion rate and call the physician
C. Administer diphenhydramine as ordered
, D. Check the patient’s temperature
Answer: A
Conceptual Explanation: Chills and low back pain are hallmark signs of a hemolytic
transfusion reaction. The infusion must be stopped immediately to prevent further harm.
5. Which of the following instructions should a nurse include when teaching a patient about a
newly prescribed loop diuretic?
A. Rise slowly from a sitting or lying position
B. Restrict intake of bananas and orange juice
C. Take the medication at bedtime
D. Avoid using salt substitutes containing potassium
Answer: A
Conceptual Explanation: Loop diuretics can cause orthostatic hypotension. Rising slowly
prevents falls. Unlike potassium-sparing diuretics, loop diuretics cause potassium loss, so
bananas are often encouraged.
6. A nurse is assessing a patient with suspected hypocalcemia. Which finding would confirm
this suspicion?
A. Negative Chvostek’s sign
B. Hyporeflexia and muscle weakness
C. Polyuria and extreme thirst
FUNDAMENTALS FINAL EXAM
QUESTIONS AND ANSWERS 2026/2027
1. A patient with chronic kidney disease presents with a potassium level of 6.4 mEq/L. Which
EKG finding is the most critical to monitor for?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes characteristic EKG changes,
most notably tall, peaked T waves. If untreated, it can progress to QRS widening and
cardiac arrest.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
severe, prolonged vomiting?
A. pH 7.30, PaCO2 52, HCO3 26
B. pH 7.48, PaCO2 40, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 25, HCO3 22
Answer: B
Conceptual Explanation: Vomiting leads to the loss of gastric acid (HCl), causing
Metabolic Alkalosis (elevated pH and elevated Bicarbonate).
3. A nurse is caring for a patient who is 12 hours post-abdominal surgery. The patient’s
oxygen saturation drops to 89% on room air. What is the priority nursing action?
A. Administer the prescribed PRN pain medication
B. Request a stat chest X-ray
C. Encourage the patient to perform incentive spirometry
D. Assess the surgical site for dehiscence
Answer: C
Conceptual Explanation: Post-operative hypoxemia is frequently caused by atelectasis.
Promoting lung expansion via incentive spirometry or deep breathing is the priority
intervention.
4. During a blood transfusion, the patient reports chills, low back pain, and nausea. What is
the nurse’s first action?
A. Stop the infusion immediately
B. Slow the infusion rate and call the physician
C. Administer diphenhydramine as ordered
, D. Check the patient’s temperature
Answer: A
Conceptual Explanation: Chills and low back pain are hallmark signs of a hemolytic
transfusion reaction. The infusion must be stopped immediately to prevent further harm.
5. Which of the following instructions should a nurse include when teaching a patient about a
newly prescribed loop diuretic?
A. Rise slowly from a sitting or lying position
B. Restrict intake of bananas and orange juice
C. Take the medication at bedtime
D. Avoid using salt substitutes containing potassium
Answer: A
Conceptual Explanation: Loop diuretics can cause orthostatic hypotension. Rising slowly
prevents falls. Unlike potassium-sparing diuretics, loop diuretics cause potassium loss, so
bananas are often encouraged.
6. A nurse is assessing a patient with suspected hypocalcemia. Which finding would confirm
this suspicion?
A. Negative Chvostek’s sign
B. Hyporeflexia and muscle weakness
C. Polyuria and extreme thirst
