NUR 210 & NUR 242 Nursing Fundamentals & Med-Surg Foundations -
Exam 4 Review 2026 |Galen College
1. A patient presents with a serum potassium level of 3.1 mEq/L. Which clinical
manifestation should the nurse monitor for most closely?
A. Peaked T-waves on EKG
B. Hyperactive bowel sounds
C. Positive Chvostek’s sign
D. Muscle weakness and cardiac arrhythmias
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) often causes muscle weakness, fatigue,
and cardiac dysrhythmias. Peaked T-waves are associated with hyperkalemia.
2. When assessing a pressure injury, the nurse notes partial-thickness loss of
dermis presenting as a shallow open ulcer with a red-pink wound bed, without
slough. How should this be staged?
A. Stage 2
B. Stage 1
C. Stage 3
D. Stage 4
Answer: A
Rationale: Stage 2 involves partial-thickness skin loss with exposed dermis. Stage 1 is non-
blanchable erythema; Stage 3 involves full-thickness skin loss with adipose tissue visible.
,3. Which task is the nurse’s primary responsibility regarding informed consent
for a surgical procedure?
A. Explaining the risks and benefits of the surgery
B. Describing alternative treatments available
C. Determining the patient’s surgical candidacy
D. Obtaining the signature and witnessing the patient’s understanding
Answer: D
Rationale: The surgeon is responsible for explaining the procedure, risks, and benefits.
The nurse’s role is to witness the signature and ensure the patient is competent and giving
consent voluntarily.
4. A patient is suspected of having active pulmonary tuberculosis. Which type of
transmission-based precautions must the nurse implement?
A. Droplet Precautions
B. Contact Precautions
C. Protective Environment
D. Airborne Precautions
Answer: D
Rationale: Tuberculosis requires Airborne Precautions, including a private negative-
pressure room and the use of an N95 respirator.
5. An elderly patient reports feeling lightheaded when standing up from a lying
position. The nurse suspects orthostatic hypotension. What is the defining
criteria for this condition?
A. A drop in diastolic BP of 5 mmHg
B. An increase in heart rate of 5 beats per minute
C. A drop in systolic BP of at least 20 mmHg within 3 minutes of standing
D. A systolic BP reading below 100 mmHg regardless of position
Answer: C
, Rationale: Orthostatic hypotension is defined as a decrease in systolic BP of 20 mmHg or
more, or a decrease in diastolic BP of 10 mmHg or more within 3 minutes of standing.
6. Which arterial blood gas (ABG) result is consistent with a patient experiencing
metabolic acidosis?
A. pH 7.30, HCO3 18 mEq/L
B. pH 7.50, HCO3 30 mEq/L
C. pH 7.32, PaCO2 50 mmHg
D. pH 7.48, PaCO2 30 mmHg
Answer: A
Rationale: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate
level (<22 mEq/L).
7. When performing a subcutaneous injection for an average-sized adult using a
25-gauge, 5/8-inch needle, what is the appropriate angle of insertion?
A. 45 to 90 degrees
B. 15 degrees
C. 90 degrees only
D. 10 degrees
Answer: A
Rationale: Subcutaneous injections are typically administered at a 45-degree angle if you
can grasp 1 inch of tissue, or a 90-degree angle if you can grasp 2 inches of tissue.
8. A patient is diagnosed with fluid volume excess. Which clinical finding should
the nurse expect to observe?
A. Crackles upon lung auscultation
B. Weak, thready pulse
C. Flattened neck veins
D. Poor skin turgor
Answer: A
Exam 4 Review 2026 |Galen College
1. A patient presents with a serum potassium level of 3.1 mEq/L. Which clinical
manifestation should the nurse monitor for most closely?
A. Peaked T-waves on EKG
B. Hyperactive bowel sounds
C. Positive Chvostek’s sign
D. Muscle weakness and cardiac arrhythmias
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) often causes muscle weakness, fatigue,
and cardiac dysrhythmias. Peaked T-waves are associated with hyperkalemia.
2. When assessing a pressure injury, the nurse notes partial-thickness loss of
dermis presenting as a shallow open ulcer with a red-pink wound bed, without
slough. How should this be staged?
A. Stage 2
B. Stage 1
C. Stage 3
D. Stage 4
Answer: A
Rationale: Stage 2 involves partial-thickness skin loss with exposed dermis. Stage 1 is non-
blanchable erythema; Stage 3 involves full-thickness skin loss with adipose tissue visible.
,3. Which task is the nurse’s primary responsibility regarding informed consent
for a surgical procedure?
A. Explaining the risks and benefits of the surgery
B. Describing alternative treatments available
C. Determining the patient’s surgical candidacy
D. Obtaining the signature and witnessing the patient’s understanding
Answer: D
Rationale: The surgeon is responsible for explaining the procedure, risks, and benefits.
The nurse’s role is to witness the signature and ensure the patient is competent and giving
consent voluntarily.
4. A patient is suspected of having active pulmonary tuberculosis. Which type of
transmission-based precautions must the nurse implement?
A. Droplet Precautions
B. Contact Precautions
C. Protective Environment
D. Airborne Precautions
Answer: D
Rationale: Tuberculosis requires Airborne Precautions, including a private negative-
pressure room and the use of an N95 respirator.
5. An elderly patient reports feeling lightheaded when standing up from a lying
position. The nurse suspects orthostatic hypotension. What is the defining
criteria for this condition?
A. A drop in diastolic BP of 5 mmHg
B. An increase in heart rate of 5 beats per minute
C. A drop in systolic BP of at least 20 mmHg within 3 minutes of standing
D. A systolic BP reading below 100 mmHg regardless of position
Answer: C
, Rationale: Orthostatic hypotension is defined as a decrease in systolic BP of 20 mmHg or
more, or a decrease in diastolic BP of 10 mmHg or more within 3 minutes of standing.
6. Which arterial blood gas (ABG) result is consistent with a patient experiencing
metabolic acidosis?
A. pH 7.30, HCO3 18 mEq/L
B. pH 7.50, HCO3 30 mEq/L
C. pH 7.32, PaCO2 50 mmHg
D. pH 7.48, PaCO2 30 mmHg
Answer: A
Rationale: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate
level (<22 mEq/L).
7. When performing a subcutaneous injection for an average-sized adult using a
25-gauge, 5/8-inch needle, what is the appropriate angle of insertion?
A. 45 to 90 degrees
B. 15 degrees
C. 90 degrees only
D. 10 degrees
Answer: A
Rationale: Subcutaneous injections are typically administered at a 45-degree angle if you
can grasp 1 inch of tissue, or a 90-degree angle if you can grasp 2 inches of tissue.
8. A patient is diagnosed with fluid volume excess. Which clinical finding should
the nurse expect to observe?
A. Crackles upon lung auscultation
B. Weak, thready pulse
C. Flattened neck veins
D. Poor skin turgor
Answer: A
