NRSG 201 Exam 1 V2 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A patient is prescribed digoxin and a loop diuretic for heart failure. Which electrolyte
imbalance should the nurse prioritize monitoring to prevent drug toxicity?
A. Potassium
B. Calcium
C. Sodium
D. Magnesium
Correct Answer: A
Potassium competes with digoxin for binding sites on the sodium-potassium ATPase
pump. Low serum potassium levels (hypokalemia) increase the risk of digoxin toxicity
because more digoxin can bind to the pump sites. The nurse must monitor for clinical signs
of toxicity such as bradycardia, nausea, and visual disturbances like yellow halos.
2. The nurse is preparing a patient for an elective surgical procedure. What is the nurse’s
primary responsibility regarding the informed consent process?
A. Explaining the risks and benefits
B. Witnessing the patient signature
C. Describing alternative treatments
,D. Obtaining the surgical signature
Correct Answer: B
The nurse’s role in the consent process is limited to witnessing the patient’s signature and
ensuring the patient is competent. The surgeon is legally responsible for explaining the
procedure, its risks, and any alternatives. If the nurse identifies that the patient does not
understand the procedure, the surgeon must be contacted to clarify.
3. A patient presents with a pH of 7.25, PaCO2 of 55, and HCO3 of 24. Which acid-base
imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Correct Answer: A
A pH of 7.25 indicates acidosis, and a PaCO2 of 55 mmHg is higher than the normal range
of 35 to 45 mmHg. Because the PaCO2 is elevated and the HCO3 is within the normal range,
the imbalance is respiratory in nature. This condition often occurs in patients with
hypoventilation or obstructive lung diseases like COPD.
4. During surgery, a patient develops tachycardia, muscle rigidity, and a rapidly rising body
temperature. Which medication should the nurse expect the surgical team to administer?
A. Atropine
, B. Naloxone
C. Epinephrine
D. Dantrolene
Correct Answer: D
Malignant hyperthermia is a life-threatening, inherited reaction to certain anesthetic
agents characterized by muscle rigidity and hypermetabolism. Dantrolene is the specific
skeletal muscle relaxant used to treat this metabolic crisis by slowing metabolism.
Immediate intervention includes stopping the triggering agents and cooling the patient.
5. Which assessment finding should the nurse associate with a positive Chvostek’s sign?
A. Facial twitching when the cheek is tapped
B. Carpal spasm when a BP cuff is inflated
C. Muscle weakness in the lower extremities
D. Numbness and tingling in the fingers
Correct Answer: A
A positive Chvostek’s sign is a clinical indicator of hypocalcemia or hypomagnesemia. It is
elicited by tapping the facial nerve in front of the ear, which results in twitching of the facial
muscles. This hypersensitivity of the nerves occurs due to the electrolyte imbalance
affecting nerve transmission.
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 1) | Ivy Tech
1. A patient is prescribed digoxin and a loop diuretic for heart failure. Which electrolyte
imbalance should the nurse prioritize monitoring to prevent drug toxicity?
A. Potassium
B. Calcium
C. Sodium
D. Magnesium
Correct Answer: A
Potassium competes with digoxin for binding sites on the sodium-potassium ATPase
pump. Low serum potassium levels (hypokalemia) increase the risk of digoxin toxicity
because more digoxin can bind to the pump sites. The nurse must monitor for clinical signs
of toxicity such as bradycardia, nausea, and visual disturbances like yellow halos.
2. The nurse is preparing a patient for an elective surgical procedure. What is the nurse’s
primary responsibility regarding the informed consent process?
A. Explaining the risks and benefits
B. Witnessing the patient signature
C. Describing alternative treatments
,D. Obtaining the surgical signature
Correct Answer: B
The nurse’s role in the consent process is limited to witnessing the patient’s signature and
ensuring the patient is competent. The surgeon is legally responsible for explaining the
procedure, its risks, and any alternatives. If the nurse identifies that the patient does not
understand the procedure, the surgeon must be contacted to clarify.
3. A patient presents with a pH of 7.25, PaCO2 of 55, and HCO3 of 24. Which acid-base
imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Correct Answer: A
A pH of 7.25 indicates acidosis, and a PaCO2 of 55 mmHg is higher than the normal range
of 35 to 45 mmHg. Because the PaCO2 is elevated and the HCO3 is within the normal range,
the imbalance is respiratory in nature. This condition often occurs in patients with
hypoventilation or obstructive lung diseases like COPD.
4. During surgery, a patient develops tachycardia, muscle rigidity, and a rapidly rising body
temperature. Which medication should the nurse expect the surgical team to administer?
A. Atropine
, B. Naloxone
C. Epinephrine
D. Dantrolene
Correct Answer: D
Malignant hyperthermia is a life-threatening, inherited reaction to certain anesthetic
agents characterized by muscle rigidity and hypermetabolism. Dantrolene is the specific
skeletal muscle relaxant used to treat this metabolic crisis by slowing metabolism.
Immediate intervention includes stopping the triggering agents and cooling the patient.
5. Which assessment finding should the nurse associate with a positive Chvostek’s sign?
A. Facial twitching when the cheek is tapped
B. Carpal spasm when a BP cuff is inflated
C. Muscle weakness in the lower extremities
D. Numbness and tingling in the fingers
Correct Answer: A
A positive Chvostek’s sign is a clinical indicator of hypocalcemia or hypomagnesemia. It is
elicited by tapping the facial nerve in front of the ear, which results in twitching of the facial
muscles. This hypersensitivity of the nerves occurs due to the electrolyte imbalance
affecting nerve transmission.
