NURS 201 Quiz 8 V3 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 8) | West Coast
University
1. A nurse is evaluating the arterial blood gas (ABG) results for a patient with severe chronic
obstructive pulmonary disease (COPD). The results are: pH 7.32, PaCO2 55 mm Hg, and HCO3
28 mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The low pH indicates acidosis, and the elevated PaCO2 level suggests that the
lungs are retaining carbon dioxide. Chronic obstructive pulmonary disease is a classic
cause of hypoventilation leading to respiratory acidosis. The elevated bicarbonate suggests
that the kidneys are partially compensating for the respiratory imbalance.
2. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to find?
A. Hypovolemia
,B. Urine output of 2 liters per day
C. Hypokalemia
D. BUN and Creatinine levels increase
Answer: D
Rationale: The oliguric phase of AKI is characterized by a significant decrease in urine
output, typically less than 400 mL per day. During this phase, waste products such as blood
urea nitrogen (BUN) and creatinine accumulate in the bloodstream. The nurse must also
monitor for hyperkalemia and fluid volume excess during this critical stage.
3. A nurse is caring for a patient scheduled for a cholecystectomy. Which assessment finding
is most characteristic of acute cholecystitis?
A. Pain in the left lower quadrant
B. Pain that decreases after eating a high-fat meal
C. Right upper quadrant pain radiating to the right shoulder
D. Steady, burning pain in the epigastric region
Answer: C
Rationale: Acute cholecystitis typically presents as sharp pain in the right upper quadrant
that often radiates to the right scapula or shoulder. This pain frequently occurs or worsens
after the ingestion of fatty foods due to gallbladder contraction. The nurse should also
, assess for Murphy’s sign, which is inspiratory arrest during deep palpation of the
gallbladder area.
4. A patient with cirrhosis of the liver has developed hepatic encephalopathy. Which
medication should the nurse anticipate administering to reduce the serum ammonia level?
A. Spironolactone
B. Lactulose
C. Propranolol
D. Vitamin K
Answer: B
Rationale: Lactulose is an osmotic laxative that helps trap ammonia in the gut and
facilitates its excretion through the stool. Reducing ammonia levels is essential for
improving the neurological status of patients with hepatic encephalopathy. The nurse
should monitor for the desired effect of two to three soft stools per day.
5. The nurse is providing discharge instructions to a patient with Chronic Kidney Disease
(CKD). Which dietary modification should be emphasized?
A. High protein and high potassium intake
B. Restriction of protein, sodium, and potassium
C. Increased intake of phosphorus-rich foods
D. Unlimited fluid intake to flush the kidneys
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 8) | West Coast
University
1. A nurse is evaluating the arterial blood gas (ABG) results for a patient with severe chronic
obstructive pulmonary disease (COPD). The results are: pH 7.32, PaCO2 55 mm Hg, and HCO3
28 mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: The low pH indicates acidosis, and the elevated PaCO2 level suggests that the
lungs are retaining carbon dioxide. Chronic obstructive pulmonary disease is a classic
cause of hypoventilation leading to respiratory acidosis. The elevated bicarbonate suggests
that the kidneys are partially compensating for the respiratory imbalance.
2. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to find?
A. Hypovolemia
,B. Urine output of 2 liters per day
C. Hypokalemia
D. BUN and Creatinine levels increase
Answer: D
Rationale: The oliguric phase of AKI is characterized by a significant decrease in urine
output, typically less than 400 mL per day. During this phase, waste products such as blood
urea nitrogen (BUN) and creatinine accumulate in the bloodstream. The nurse must also
monitor for hyperkalemia and fluid volume excess during this critical stage.
3. A nurse is caring for a patient scheduled for a cholecystectomy. Which assessment finding
is most characteristic of acute cholecystitis?
A. Pain in the left lower quadrant
B. Pain that decreases after eating a high-fat meal
C. Right upper quadrant pain radiating to the right shoulder
D. Steady, burning pain in the epigastric region
Answer: C
Rationale: Acute cholecystitis typically presents as sharp pain in the right upper quadrant
that often radiates to the right scapula or shoulder. This pain frequently occurs or worsens
after the ingestion of fatty foods due to gallbladder contraction. The nurse should also
, assess for Murphy’s sign, which is inspiratory arrest during deep palpation of the
gallbladder area.
4. A patient with cirrhosis of the liver has developed hepatic encephalopathy. Which
medication should the nurse anticipate administering to reduce the serum ammonia level?
A. Spironolactone
B. Lactulose
C. Propranolol
D. Vitamin K
Answer: B
Rationale: Lactulose is an osmotic laxative that helps trap ammonia in the gut and
facilitates its excretion through the stool. Reducing ammonia levels is essential for
improving the neurological status of patients with hepatic encephalopathy. The nurse
should monitor for the desired effect of two to three soft stools per day.
5. The nurse is providing discharge instructions to a patient with Chronic Kidney Disease
(CKD). Which dietary modification should be emphasized?
A. High protein and high potassium intake
B. Restriction of protein, sodium, and potassium
C. Increased intake of phosphorus-rich foods
D. Unlimited fluid intake to flush the kidneys
