NRSG 201 Exam 2 V1 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 2) | Ivy Tech
1. A nurse is caring for a client who is 24 hours postoperative following abdominal surgery.
The client reports sudden sharp chest pain and dyspnea. Which of the following is the priority
nursing action?
A. Check the client’s surgical dressing for hemorrhage.
B. Apply supplemental oxygen and notify the provider.
C. Administer the prescribed PRN analgesic.
D. Assist the client to use the incentive spirometer.
Correct Answer: B
Sudden sharp chest pain and dyspnea in a postoperative patient are classic signs of a
pulmonary embolism. The nurse must prioritize oxygenation to maintain tissue perfusion
while notifying the healthcare team. This is a medical emergency that takes precedence
over routine postoperative care like incentive spirometry.
2. A nurse is reviewing the arterial blood gas (ABG) results for a client with persistent
vomiting. Results: pH 7.50, PaCO2 40, HCO3 32. How should the nurse interpret these
findings?
A. Respiratory Alkalosis
,B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Acidosis
Correct Answer: B
A pH greater than 7.45 indicates alkalosis, and an elevated bicarbonate (HCO3) level
suggests a metabolic origin. Vomiting causes a loss of gastric acid, leading to an excess of
base in the body. The normal PaCO2 indicates that the lungs are not currently
compensating for the imbalance.
3. During the intraoperative phase, the circulating nurse notices a break in sterile technique
by the surgical resident. Which action should the nurse take first?
A. Report the incident to the surgeon after the procedure.
B. Wait for the scrub nurse to address the contamination.
C. Point out the break in technique immediately to the resident.
D. Document the break in the surgical log.
Correct Answer: C
Patient safety and the prevention of surgical site infections are primary responsibilities of
the circulating nurse. The nurse must act as a patient advocate by immediately identifying
any contamination to ensure it is corrected. Failure to speak up compromises the sterile
field and increases patient risk.
, 4. A client is prescribed furosemide for the treatment of heart failure. Which laboratory value
should the nurse monitor most closely?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Serum Magnesium
Correct Answer: A
Furosemide is a loop diuretic that causes the excretion of potassium along with water and
sodium. Hypokalemia is a common and dangerous side effect that can lead to cardiac
dysrhythmias. Monitoring potassium levels is essential for patients on this medication to
ensure safety.
5. A nurse is assessing a client with suspected hypocalcemia. Which of the following findings
would confirm this diagnosis?
A. Negative Chvostek’s sign
B. Flaccid paralysis
C. A positive Trousseau’s sign
D. Hyporeflexia
Correct Answer: C
Surg 1 | Actual Q&A with Rationale
(NRSG201 Exam 2) | Ivy Tech
1. A nurse is caring for a client who is 24 hours postoperative following abdominal surgery.
The client reports sudden sharp chest pain and dyspnea. Which of the following is the priority
nursing action?
A. Check the client’s surgical dressing for hemorrhage.
B. Apply supplemental oxygen and notify the provider.
C. Administer the prescribed PRN analgesic.
D. Assist the client to use the incentive spirometer.
Correct Answer: B
Sudden sharp chest pain and dyspnea in a postoperative patient are classic signs of a
pulmonary embolism. The nurse must prioritize oxygenation to maintain tissue perfusion
while notifying the healthcare team. This is a medical emergency that takes precedence
over routine postoperative care like incentive spirometry.
2. A nurse is reviewing the arterial blood gas (ABG) results for a client with persistent
vomiting. Results: pH 7.50, PaCO2 40, HCO3 32. How should the nurse interpret these
findings?
A. Respiratory Alkalosis
,B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Acidosis
Correct Answer: B
A pH greater than 7.45 indicates alkalosis, and an elevated bicarbonate (HCO3) level
suggests a metabolic origin. Vomiting causes a loss of gastric acid, leading to an excess of
base in the body. The normal PaCO2 indicates that the lungs are not currently
compensating for the imbalance.
3. During the intraoperative phase, the circulating nurse notices a break in sterile technique
by the surgical resident. Which action should the nurse take first?
A. Report the incident to the surgeon after the procedure.
B. Wait for the scrub nurse to address the contamination.
C. Point out the break in technique immediately to the resident.
D. Document the break in the surgical log.
Correct Answer: C
Patient safety and the prevention of surgical site infections are primary responsibilities of
the circulating nurse. The nurse must act as a patient advocate by immediately identifying
any contamination to ensure it is corrected. Failure to speak up compromises the sterile
field and increases patient risk.
, 4. A client is prescribed furosemide for the treatment of heart failure. Which laboratory value
should the nurse monitor most closely?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Serum Magnesium
Correct Answer: A
Furosemide is a loop diuretic that causes the excretion of potassium along with water and
sodium. Hypokalemia is a common and dangerous side effect that can lead to cardiac
dysrhythmias. Monitoring potassium levels is essential for patients on this medication to
ensure safety.
5. A nurse is assessing a client with suspected hypocalcemia. Which of the following findings
would confirm this diagnosis?
A. Negative Chvostek’s sign
B. Flaccid paralysis
C. A positive Trousseau’s sign
D. Hyporeflexia
Correct Answer: C
