NRSG 201 Final Exam V1 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Final Exam) | Ivy Tech
1. A nurse is reviewing the laboratory results for a patient with a potassium level of 3.2
mEq/L. Which assessment finding is most consistent with this result?
A. Presence of prominent U waves on the EKG
B. Hyperactive bowel sounds
C. Peaked T waves
D. Hyperreflexia
Correct Answer: A
Hypokalemia, defined as a potassium level below 3.5 mEq/L, affects cardiac conduction
and can lead to the presence of U waves. Low potassium levels cause muscle weakness and
decreased GI motility, rather than hyperactivity. Monitoring the EKG is a priority to detect
life-threatening dysrhythmias associated with this electrolyte imbalance.
2. A patient is admitted with a serum sodium level of 124 mEq/L. What is the priority nursing
intervention?
A. Implement seizure precautions
B. Administer a hypotonic IV solution
C. Encourage increased oral fluid intake
,D. Increase dietary salt intake only
Correct Answer: A
Severe hyponatremia, where sodium levels fall below 125 mEq/L, puts the patient at high
risk for cerebral edema and seizures. The nurse must prioritize safety by implementing
seizure precautions and frequently monitoring neurological status. Restricting fluids rather
than encouraging them is often the treatment of choice to prevent further dilution of serum
sodium.
3. Which arterial blood gas (ABG) result should the nurse recognize as compensated
respiratory acidosis?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 55, HCO3 30
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.35, PaCO2 35, HCO3 24
Correct Answer: B
In compensated respiratory acidosis, the pH returns to the normal range but remains on
the acidic side (7.35-7.39). The PaCO2 is elevated, indicating the respiratory cause, while
the HCO3 is elevated as the kidneys retain bicarbonate to compensate. This specific result
shows a normal pH with both CO2 and Bicarb levels elevated, signifying full compensation.
, 4. A patient is scheduled for surgery tomorrow. The nurse notes the patient is currently
taking aspirin 81 mg daily. Which action by the nurse is most appropriate?
A. Administer the aspirin as scheduled in the morning
B. Document the medication and take no further action
C. Notify the surgeon as aspirin increases the risk of bleeding
D. Tell the patient to switch to ibuprofen for the day
Correct Answer: C
Aspirin is an antiplatelet agent that significantly increases the risk of intraoperative and
postoperative bleeding. Most surgeons require patients to discontinue aspirin at least 7 to
10 days before an elective procedure. The nurse must notify the surgical team to determine
if the surgery should proceed or be rescheduled.
5. During the intraoperative phase, the patient develops a heart rate of 140, a rigid jaw, and a
rapidly rising body temperature. Which medication should the nurse prepare?
A. Dantrolene sodium
B. Epinephrine
C. Furosemide
D. Atropine sulfate
Correct Answer: A
Surg 1 | Actual Q&A with Rationale
(NRSG201 Final Exam) | Ivy Tech
1. A nurse is reviewing the laboratory results for a patient with a potassium level of 3.2
mEq/L. Which assessment finding is most consistent with this result?
A. Presence of prominent U waves on the EKG
B. Hyperactive bowel sounds
C. Peaked T waves
D. Hyperreflexia
Correct Answer: A
Hypokalemia, defined as a potassium level below 3.5 mEq/L, affects cardiac conduction
and can lead to the presence of U waves. Low potassium levels cause muscle weakness and
decreased GI motility, rather than hyperactivity. Monitoring the EKG is a priority to detect
life-threatening dysrhythmias associated with this electrolyte imbalance.
2. A patient is admitted with a serum sodium level of 124 mEq/L. What is the priority nursing
intervention?
A. Implement seizure precautions
B. Administer a hypotonic IV solution
C. Encourage increased oral fluid intake
,D. Increase dietary salt intake only
Correct Answer: A
Severe hyponatremia, where sodium levels fall below 125 mEq/L, puts the patient at high
risk for cerebral edema and seizures. The nurse must prioritize safety by implementing
seizure precautions and frequently monitoring neurological status. Restricting fluids rather
than encouraging them is often the treatment of choice to prevent further dilution of serum
sodium.
3. Which arterial blood gas (ABG) result should the nurse recognize as compensated
respiratory acidosis?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 55, HCO3 30
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.35, PaCO2 35, HCO3 24
Correct Answer: B
In compensated respiratory acidosis, the pH returns to the normal range but remains on
the acidic side (7.35-7.39). The PaCO2 is elevated, indicating the respiratory cause, while
the HCO3 is elevated as the kidneys retain bicarbonate to compensate. This specific result
shows a normal pH with both CO2 and Bicarb levels elevated, signifying full compensation.
, 4. A patient is scheduled for surgery tomorrow. The nurse notes the patient is currently
taking aspirin 81 mg daily. Which action by the nurse is most appropriate?
A. Administer the aspirin as scheduled in the morning
B. Document the medication and take no further action
C. Notify the surgeon as aspirin increases the risk of bleeding
D. Tell the patient to switch to ibuprofen for the day
Correct Answer: C
Aspirin is an antiplatelet agent that significantly increases the risk of intraoperative and
postoperative bleeding. Most surgeons require patients to discontinue aspirin at least 7 to
10 days before an elective procedure. The nurse must notify the surgical team to determine
if the surgery should proceed or be rescheduled.
5. During the intraoperative phase, the patient develops a heart rate of 140, a rigid jaw, and a
rapidly rising body temperature. Which medication should the nurse prepare?
A. Dantrolene sodium
B. Epinephrine
C. Furosemide
D. Atropine sulfate
Correct Answer: A
