NURS 201 Quiz 1 V1 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 1) | West Coast
University
1. A nurse is assessing a client who has a serum potassium level of 6.5 mEq/L. Which of the
following findings should the nurse prioritize?
A. Abdominal cramping and hyperactive bowel sounds
B. Muscle weakness in the lower extremities
C. Tall, peaked T waves on the ECG
D. Paresthesia of the hands and feet
Answer: C
Rationale: Hyperkalemia is a medical emergency that can lead to life-threatening cardiac
dysrhythmias. Peaked T waves are an early sign of potassium toxicity and indicate a risk for
cardiac arrest. The nurse must prioritize cardiac monitoring to ensure the safety of the
client.
2. A client is scheduled for an elective surgery. Who is legally responsible for obtaining
informed consent?
A. The circulating nurse
B. The nurse manager
,C. The anesthesiologist
D. The surgeon performing the procedure
Answer: D
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits,
and alternatives to the client. The nurse’s role is to witness the client’s signature and
ensure the client is competent to sign. If the client has questions about the surgery itself,
the nurse must notify the surgeon to return and provide further clarification.
3. A nurse is caring for a client with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L.
The nurse should interpret these results as which of the following?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH of 7.25 indicates acidosis since it is below the normal range of 7.35 to
7.45. The PaCO2 of 50 mmHg is elevated, which is the primary cause of the acidosis in
respiratory conditions. Because the bicarbonate level is within the normal range, the
condition is currently uncompensated.
, 4. During the preoperative assessment, a client reports an allergy to bananas and avocados.
For which of the following complications should the nurse be particularly alert?
A. Latex allergy
B. Anaphylaxis to anesthetic agents
C. Sensitivity to iodine-based cleansers
D. Malignant hyperthermia
Answer: A
Rationale: Clients with allergies to certain fruits, such as bananas, avocados, and kiwi, have
a higher risk of having a cross-reactive latex allergy. The nurse must document this finding
and ensure a latex-free environment is maintained during the perioperative period. Failure
to recognize this can lead to severe intraoperative anaphylactic reactions.
5. Which of the following is a classic clinical manifestation of hypocalcemia?
A. Constipation and abdominal pain
B. Depressed deep tendon reflexes
C. Polyuria and polydipsia
D. Positive Trousseau’s sign
Answer: D
Rationale: Trousseau’s sign involves a carpal spasm induced by inflating a blood pressure
cuff above the systolic pressure, indicating neuromuscular irritability. This occurs because
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 1) | West Coast
University
1. A nurse is assessing a client who has a serum potassium level of 6.5 mEq/L. Which of the
following findings should the nurse prioritize?
A. Abdominal cramping and hyperactive bowel sounds
B. Muscle weakness in the lower extremities
C. Tall, peaked T waves on the ECG
D. Paresthesia of the hands and feet
Answer: C
Rationale: Hyperkalemia is a medical emergency that can lead to life-threatening cardiac
dysrhythmias. Peaked T waves are an early sign of potassium toxicity and indicate a risk for
cardiac arrest. The nurse must prioritize cardiac monitoring to ensure the safety of the
client.
2. A client is scheduled for an elective surgery. Who is legally responsible for obtaining
informed consent?
A. The circulating nurse
B. The nurse manager
,C. The anesthesiologist
D. The surgeon performing the procedure
Answer: D
Rationale: The surgeon is legally responsible for explaining the procedure, risks, benefits,
and alternatives to the client. The nurse’s role is to witness the client’s signature and
ensure the client is competent to sign. If the client has questions about the surgery itself,
the nurse must notify the surgeon to return and provide further clarification.
3. A nurse is caring for a client with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L.
The nurse should interpret these results as which of the following?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH of 7.25 indicates acidosis since it is below the normal range of 7.35 to
7.45. The PaCO2 of 50 mmHg is elevated, which is the primary cause of the acidosis in
respiratory conditions. Because the bicarbonate level is within the normal range, the
condition is currently uncompensated.
, 4. During the preoperative assessment, a client reports an allergy to bananas and avocados.
For which of the following complications should the nurse be particularly alert?
A. Latex allergy
B. Anaphylaxis to anesthetic agents
C. Sensitivity to iodine-based cleansers
D. Malignant hyperthermia
Answer: A
Rationale: Clients with allergies to certain fruits, such as bananas, avocados, and kiwi, have
a higher risk of having a cross-reactive latex allergy. The nurse must document this finding
and ensure a latex-free environment is maintained during the perioperative period. Failure
to recognize this can lead to severe intraoperative anaphylactic reactions.
5. Which of the following is a classic clinical manifestation of hypocalcemia?
A. Constipation and abdominal pain
B. Depressed deep tendon reflexes
C. Polyuria and polydipsia
D. Positive Trousseau’s sign
Answer: D
Rationale: Trousseau’s sign involves a carpal spasm induced by inflating a blood pressure
cuff above the systolic pressure, indicating neuromuscular irritability. This occurs because
