NUR 3300 Exam 2 V3 | NUR 3300 Nursing
Practice II | Q&A with Rationale (NUR3300
Exam 2) | William Paterson University
1. A patient is receiving Digoxin for heart failure and has a serum potassium level of 3.2
mEq/L. What is the nurse’s priority action?
A. Encourage the patient to eat more bananas but proceed with the medication.
B. Administer the scheduled dose of Digoxin as potassium is unrelated to digoxin levels.
C. Assess the patient for signs of digoxin toxicity and notify the provider.
D. Document the finding as a normal variation in patients on diuretics.
Answer: C
Rationale: Hypokalemia increases the risk of digoxin toxicity because low potassium
allows more digoxin to bind to the ATPase pump. The nurse must monitor for symptoms
such as visual disturbances, nausea, and bradycardia. Notifying the provider is essential to
address the electrolyte imbalance and potentially adjust the medication dose.
2. A patient’s EKG shows tall, peaked T-waves and a widened QRS complex. Which electrolyte
imbalance should the nurse suspect?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
,D. Hypermagnesemia
Answer: B
Rationale: Hyperkalemia is known for causing specific EKG changes, including peaked T-
waves and eventual widening of the QRS complex. These changes reflect the effect of high
potassium on myocardial repolarization and conduction. If left untreated, this condition
can progress to ventricular fibrillation or cardiac arrest.
3. A post-operative patient who received heavy sedation has the following ABG results: pH
7.30, PaCO2 52, HCO3 24. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low, indicating acidosis, and the PaCO2 is high, indicating a
respiratory cause due to hypoventilation from sedation. The bicarbonate level is within the
normal range, suggesting no compensation has occurred yet. Respiratory acidosis is a
common post-operative complication related to decreased respiratory drive.
4. A patient scheduled for surgery expresses confusion about the procedure. Who is primarily
responsible for obtaining the informed consent?
A. The registered nurse
, B. The nursing supervisor
C. The surgeon
D. The anesthesiologist
Answer: C
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits,
and alternatives to the patient. While the nurse may witness the patient’s signature, they
must not provide the initial explanation of the surgery. If the patient is confused, the nurse
must notify the surgeon to return and clarify the information.
5. Which clinical manifestation is considered an early sign of malignant hyperthermia during
surgery?
A. Decreased end-tidal carbon dioxide
B. Hypothermia and bradycardia
C. Hypotension and skin flushing
D. Muscle rigidity and tachycardia
Answer: D
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic
gases, often presenting early with unexplained tachycardia and jaw muscle rigidity.
Elevated body temperature is actually a late sign of this condition. Immediate cessation of
the causative agent and administration of dantrolene are critical interventions.
Practice II | Q&A with Rationale (NUR3300
Exam 2) | William Paterson University
1. A patient is receiving Digoxin for heart failure and has a serum potassium level of 3.2
mEq/L. What is the nurse’s priority action?
A. Encourage the patient to eat more bananas but proceed with the medication.
B. Administer the scheduled dose of Digoxin as potassium is unrelated to digoxin levels.
C. Assess the patient for signs of digoxin toxicity and notify the provider.
D. Document the finding as a normal variation in patients on diuretics.
Answer: C
Rationale: Hypokalemia increases the risk of digoxin toxicity because low potassium
allows more digoxin to bind to the ATPase pump. The nurse must monitor for symptoms
such as visual disturbances, nausea, and bradycardia. Notifying the provider is essential to
address the electrolyte imbalance and potentially adjust the medication dose.
2. A patient’s EKG shows tall, peaked T-waves and a widened QRS complex. Which electrolyte
imbalance should the nurse suspect?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
,D. Hypermagnesemia
Answer: B
Rationale: Hyperkalemia is known for causing specific EKG changes, including peaked T-
waves and eventual widening of the QRS complex. These changes reflect the effect of high
potassium on myocardial repolarization and conduction. If left untreated, this condition
can progress to ventricular fibrillation or cardiac arrest.
3. A post-operative patient who received heavy sedation has the following ABG results: pH
7.30, PaCO2 52, HCO3 24. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The pH is low, indicating acidosis, and the PaCO2 is high, indicating a
respiratory cause due to hypoventilation from sedation. The bicarbonate level is within the
normal range, suggesting no compensation has occurred yet. Respiratory acidosis is a
common post-operative complication related to decreased respiratory drive.
4. A patient scheduled for surgery expresses confusion about the procedure. Who is primarily
responsible for obtaining the informed consent?
A. The registered nurse
, B. The nursing supervisor
C. The surgeon
D. The anesthesiologist
Answer: C
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits,
and alternatives to the patient. While the nurse may witness the patient’s signature, they
must not provide the initial explanation of the surgery. If the patient is confused, the nurse
must notify the surgeon to return and clarify the information.
5. Which clinical manifestation is considered an early sign of malignant hyperthermia during
surgery?
A. Decreased end-tidal carbon dioxide
B. Hypothermia and bradycardia
C. Hypotension and skin flushing
D. Muscle rigidity and tachycardia
Answer: D
Rationale: Malignant hyperthermia is a life-threatening reaction to certain anesthetic
gases, often presenting early with unexplained tachycardia and jaw muscle rigidity.
Elevated body temperature is actually a late sign of this condition. Immediate cessation of
the causative agent and administration of dantrolene are critical interventions.
