NUR 3300 Exam 1 V1 | NUR 3300 Nursing
Practice II | Q&A with Rationale (NUR3300
Exam 1) | William Paterson University
1. A patient is admitted with a serum sodium level of 128 mEq/L. Which assessment finding
should the nurse prioritize as a risk for this patient?
A. Increased thirst and dry mucous membranes
B. Cardiac dysrhythmias and peaked T waves
C. Confusion and generalized seizure activity
D. Orthostatic hypotension and tachycardia
Answer: C
Rationale: Hyponatremia causes water to move into cells, leading to cerebral edema. This
increase in intracranial pressure manifests as confusion, lethargy, and potentially seizures.
The nurse must prioritize neurological assessments to ensure patient safety and early
intervention.
2. A nurse is caring for a patient who has been vomiting for 24 hours. Which arterial blood gas
(ABG) result should the nurse anticipate?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting leads to the loss of gastric hydrochloric acid, resulting in metabolic
alkalosis. An elevated pH (>7.45) combined with an elevated bicarbonate level (>26)
reflects this condition. The nurse should monitor for hypoventilation as a compensatory
mechanism.
3. Which electrolyte imbalance is most closely associated with the presence of Trousseau’s
and Chvostek’s signs?
A. Hyperkalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: Hypocalcemia increases neuromuscular excitability, leading to tetany and
characteristic signs like Chvostek’s (facial twitching) and Trousseau’s (carpal spasm).
While hypomagnesemia can present similarly, these specific tests are classically diagnostic
for low calcium. The nurse should have calcium gluconate available for emergency
treatment.
, 4. A patient has a potassium level of 6.2 mEq/L. Which medication order should the nurse
expect to implement first to stabilize the cardiac cell membrane?
A. Calcium gluconate intravenously
B. Furosemide (Lasix) intravenously
C. Sodium polystyrene sulfonate (Kayexalate) orally
D. Regular insulin and 50% Dextrose
Answer: A
Rationale: Calcium gluconate is the priority intervention for severe hyperkalemia because
it protects the heart by raising the action potential threshold. While insulin and Kayexalate
help lower serum potassium, they do not provide immediate cardiac membrane
stabilization. The nurse must monitor the ECG closely for changes like peaked T waves or
widened QRS complexes.
5. During the preoperative assessment, a patient reports a strong family history of high fevers
during surgery. Which complication should the nurse prepare for?
A. Malignant hyperthermia
B. Anaphylactic shock
C. Hypovolemic shock
D. Postoperative ileus
Answer: A
Practice II | Q&A with Rationale (NUR3300
Exam 1) | William Paterson University
1. A patient is admitted with a serum sodium level of 128 mEq/L. Which assessment finding
should the nurse prioritize as a risk for this patient?
A. Increased thirst and dry mucous membranes
B. Cardiac dysrhythmias and peaked T waves
C. Confusion and generalized seizure activity
D. Orthostatic hypotension and tachycardia
Answer: C
Rationale: Hyponatremia causes water to move into cells, leading to cerebral edema. This
increase in intracranial pressure manifests as confusion, lethargy, and potentially seizures.
The nurse must prioritize neurological assessments to ensure patient safety and early
intervention.
2. A nurse is caring for a patient who has been vomiting for 24 hours. Which arterial blood gas
(ABG) result should the nurse anticipate?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 40, HCO3 30
Answer: D
Rationale: Vomiting leads to the loss of gastric hydrochloric acid, resulting in metabolic
alkalosis. An elevated pH (>7.45) combined with an elevated bicarbonate level (>26)
reflects this condition. The nurse should monitor for hypoventilation as a compensatory
mechanism.
3. Which electrolyte imbalance is most closely associated with the presence of Trousseau’s
and Chvostek’s signs?
A. Hyperkalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: Hypocalcemia increases neuromuscular excitability, leading to tetany and
characteristic signs like Chvostek’s (facial twitching) and Trousseau’s (carpal spasm).
While hypomagnesemia can present similarly, these specific tests are classically diagnostic
for low calcium. The nurse should have calcium gluconate available for emergency
treatment.
, 4. A patient has a potassium level of 6.2 mEq/L. Which medication order should the nurse
expect to implement first to stabilize the cardiac cell membrane?
A. Calcium gluconate intravenously
B. Furosemide (Lasix) intravenously
C. Sodium polystyrene sulfonate (Kayexalate) orally
D. Regular insulin and 50% Dextrose
Answer: A
Rationale: Calcium gluconate is the priority intervention for severe hyperkalemia because
it protects the heart by raising the action potential threshold. While insulin and Kayexalate
help lower serum potassium, they do not provide immediate cardiac membrane
stabilization. The nurse must monitor the ECG closely for changes like peaked T waves or
widened QRS complexes.
5. During the preoperative assessment, a patient reports a strong family history of high fevers
during surgery. Which complication should the nurse prepare for?
A. Malignant hyperthermia
B. Anaphylactic shock
C. Hypovolemic shock
D. Postoperative ileus
Answer: A
