MEDICAL-SURGICAL NURSING EXAM 1: STUDY
NOTES AND PRACTICE QUESTIONS (WITH
ANSWERS)
1. Fluid & Electrolyte Balance
Hyponatremia (Na+ <135 mEq/L): Causes: vomiting, diuretics, SIADH. S/S: confusion, seizures, nausea.
Tx: sodium replacement, fluid restriction.
Hyperkalemia (K+ >5.0 mEq/L): Causes: renal failure, potassium-sparing diuretics. S/S: muscle
weakness, peaked T waves, arrhythmias. Tx: calcium gluconate, insulin + glucose, dialysis.
2. Acid-Base Balance
Respiratory Acidosis: Hypoventilation, ↑CO₂, causes: COPD, drug overdose. Tx: improve ventilation.
Metabolic Alkalosis: Causes: vomiting, NG suction, diuretics. Tx: replace K⁺/Cl⁻, treat cause.
3. Pre-Op & Post-Op Care
Pre-op nursing role: Verify consent, maintain NPO, check labs/vitals, prep skin.
Post-op priorities (PACU): Airway, breathing, circulation (ABC), pain management, monitor for
complications (bleeding, infection).
Exam Practice Questions
Q1. A patient with COPD presents with confusion and drowsiness. ABGs: pH 7.28, PaCO₂ 55, HCO₃ 24.
Diagnosis: Respiratory Acidosis
Q2. Which nursing action has the highest priority in the immediate post-op period? Ans B
A. Monitor urinary output
B. Maintain airway patency
C. Record intake/output
D. Provide emotional support
Q3. A client with hyperkalemia is at highest risk for which complication?
Answer: Cardiac arrhythmias ✅
NOTES AND PRACTICE QUESTIONS (WITH
ANSWERS)
1. Fluid & Electrolyte Balance
Hyponatremia (Na+ <135 mEq/L): Causes: vomiting, diuretics, SIADH. S/S: confusion, seizures, nausea.
Tx: sodium replacement, fluid restriction.
Hyperkalemia (K+ >5.0 mEq/L): Causes: renal failure, potassium-sparing diuretics. S/S: muscle
weakness, peaked T waves, arrhythmias. Tx: calcium gluconate, insulin + glucose, dialysis.
2. Acid-Base Balance
Respiratory Acidosis: Hypoventilation, ↑CO₂, causes: COPD, drug overdose. Tx: improve ventilation.
Metabolic Alkalosis: Causes: vomiting, NG suction, diuretics. Tx: replace K⁺/Cl⁻, treat cause.
3. Pre-Op & Post-Op Care
Pre-op nursing role: Verify consent, maintain NPO, check labs/vitals, prep skin.
Post-op priorities (PACU): Airway, breathing, circulation (ABC), pain management, monitor for
complications (bleeding, infection).
Exam Practice Questions
Q1. A patient with COPD presents with confusion and drowsiness. ABGs: pH 7.28, PaCO₂ 55, HCO₃ 24.
Diagnosis: Respiratory Acidosis
Q2. Which nursing action has the highest priority in the immediate post-op period? Ans B
A. Monitor urinary output
B. Maintain airway patency
C. Record intake/output
D. Provide emotional support
Q3. A client with hyperkalemia is at highest risk for which complication?
Answer: Cardiac arrhythmias ✅
