NRSG 201 Exam 1 V1 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A nurse is assessing a patient with fluid volume excess. Which clinical manifestation should
the nurse prioritize for immediate reporting?
A. 1+ pitting edema in the lower extremities
B. New onset of bilateral crackles in the lung bases
C. Weight gain of 1 lb since yesterday
D. Distended neck veins when lying flat
Correct Answer: B
The presence of new crackles indicates that fluid is moving into the pulmonary
interstitium and alveoli, which can lead to life-threatening pulmonary edema. While
peripheral edema and neck vein distension are signs of fluid excess, respiratory
compromise is the highest priority based on the ABC (Airway, Breathing, Circulation)
framework. The nurse must act quickly to prevent worsening gas exchange and potential
respiratory failure.
2. Which intervention is the priority for a patient diagnosed with severe hyponatremia
(Sodium 118 mEq/L)?
A. Encouraging increased oral fluid intake
,B. Administering hypotonic IV fluids
C. Restricting dietary salt intake
D. Implementing seizure precautions and frequent neurologic checks
Correct Answer: D
Severe hyponatremia causes water to shift into brain cells, leading to cerebral edema and
a high risk for seizures or coma. Seizure precautions are essential for maintaining patient
safety during the correction phase of this electrolyte imbalance. Neurological assessments
are necessary to monitor for signs of worsening intracranial pressure or central pontine
myelinolysis during treatment.
3. A patient is scheduled for elective surgery. Who is legally responsible for obtaining
informed consent?
A. The preoperative nurse
B. The nurse manager
C. The surgeon performing the procedure
D. The anesthesia provider
Correct Answer: C
The surgeon is legally mandated to explain the risks, benefits, and alternatives of the
procedure to the patient to ensure informed consent is obtained. The nurse’s role is
typically limited to witnessing the patient’s signature and ensuring the signed form is in the
, chart. If the patient expresses confusion or has further questions, the nurse must contact
the surgeon to return and provide clarification before the procedure begins.
4. During the intraoperative phase, a patient develops muscle rigidity, tachycardia, and a
rapidly rising body temperature. Which medication should the nurse prepare to administer?
A. Atropine
B. Epinephrine
C. Naloxone
D. Dantrolene sodium
Correct Answer: D
These symptoms are classic indicators of malignant hyperthermia, a rare but life-
threatening reaction to volatile anesthetic gases or succinylcholine. Dantrolene sodium is
the specific skeletal muscle relaxant used to treat this condition by inhibiting calcium
release from the sarcoplasmic reticulum. Immediate intervention is required to stop the
hypermetabolic state and prevent organ failure or death.
5. A patient’s ABG results are: pH 7.30, PaCO2 55, HCO3 24. How should the nurse interpret
these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A nurse is assessing a patient with fluid volume excess. Which clinical manifestation should
the nurse prioritize for immediate reporting?
A. 1+ pitting edema in the lower extremities
B. New onset of bilateral crackles in the lung bases
C. Weight gain of 1 lb since yesterday
D. Distended neck veins when lying flat
Correct Answer: B
The presence of new crackles indicates that fluid is moving into the pulmonary
interstitium and alveoli, which can lead to life-threatening pulmonary edema. While
peripheral edema and neck vein distension are signs of fluid excess, respiratory
compromise is the highest priority based on the ABC (Airway, Breathing, Circulation)
framework. The nurse must act quickly to prevent worsening gas exchange and potential
respiratory failure.
2. Which intervention is the priority for a patient diagnosed with severe hyponatremia
(Sodium 118 mEq/L)?
A. Encouraging increased oral fluid intake
,B. Administering hypotonic IV fluids
C. Restricting dietary salt intake
D. Implementing seizure precautions and frequent neurologic checks
Correct Answer: D
Severe hyponatremia causes water to shift into brain cells, leading to cerebral edema and
a high risk for seizures or coma. Seizure precautions are essential for maintaining patient
safety during the correction phase of this electrolyte imbalance. Neurological assessments
are necessary to monitor for signs of worsening intracranial pressure or central pontine
myelinolysis during treatment.
3. A patient is scheduled for elective surgery. Who is legally responsible for obtaining
informed consent?
A. The preoperative nurse
B. The nurse manager
C. The surgeon performing the procedure
D. The anesthesia provider
Correct Answer: C
The surgeon is legally mandated to explain the risks, benefits, and alternatives of the
procedure to the patient to ensure informed consent is obtained. The nurse’s role is
typically limited to witnessing the patient’s signature and ensuring the signed form is in the
, chart. If the patient expresses confusion or has further questions, the nurse must contact
the surgeon to return and provide clarification before the procedure begins.
4. During the intraoperative phase, a patient develops muscle rigidity, tachycardia, and a
rapidly rising body temperature. Which medication should the nurse prepare to administer?
A. Atropine
B. Epinephrine
C. Naloxone
D. Dantrolene sodium
Correct Answer: D
These symptoms are classic indicators of malignant hyperthermia, a rare but life-
threatening reaction to volatile anesthetic gases or succinylcholine. Dantrolene sodium is
the specific skeletal muscle relaxant used to treat this condition by inhibiting calcium
release from the sarcoplasmic reticulum. Immediate intervention is required to stop the
hypermetabolic state and prevent organ failure or death.
5. A patient’s ABG results are: pH 7.30, PaCO2 55, HCO3 24. How should the nurse interpret
these findings?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
