NRSG 201 Final Exam V2 | NRSG 201 Med
Surg 1 | Actual Q&A with Rationale
(NRSG201 Final Exam) | Ivy Tech
1. A nurse is caring for a patient who is 24 hours postoperative following an abdominal
surgery. The patient reports sudden chest pain and dyspnea. Which action should the nurse
take first?
A. Apply oxygen via nasal cannula
B. Check the patient’s surgical incision site
C. Administer the prescribed PRN analgesic
D. Perform an incentive spirometry check
Correct Answer: A
Sudden onset of chest pain and dyspnea in a postoperative patient are classic signs of a
pulmonary embolism. Applying oxygen is the priority to improve oxygenation and prevent
further respiratory distress. The nurse must then notify the healthcare provider and
prepare for further diagnostic testing.
2. A client is admitted with a serum potassium level of 6.2 mEq/L. Which of the following
cardiac changes should the nurse expect to see on the ECG monitor?
A. Prominent U waves
B. Tall, peaked T waves
,C. Prolonged PR interval
D. ST-segment depression
Correct Answer: B
Hyperkalemia, defined as a potassium level above 5.0 mEq/L, significantly affects cardiac
conduction. Tall, peaked T waves are one of the earliest signs of hyperkalemia on an EKG. If
left untreated, this can progress to a widened QRS complex and cardiac arrest.
3. Which clinical manifestation should a nurse expect to find in a patient experiencing fluid
volume deficit?
A. Distended neck veins
B. Orthostatic hypotension
C. Peripheral edema
D. Bounding peripheral pulses
Correct Answer: B
Fluid volume deficit results in a decrease in circulating blood volume, which leads to a
drop in blood pressure when changing positions. Patients will also typically display
tachycardia as the heart attempts to compensate for the low volume. Other signs include
poor skin turgor and dry mucous membranes.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 550
mg/dL and positive ketones in the urine. Which condition is the patient likely experiencing?
A. Hypoglycemia
B. Hyperosmolar Hyperglycemic State (HHS)
C. Diabetic Ketoacidosis (DKA)
D. Metabolic Alkalosis
Correct Answer: C
DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis, most commonly
occurring in Type 1 diabetics. The presence of ketones in the urine is a hallmark sign that
differentiates DKA from HHS. Immediate treatment involves fluid resuscitation and
intravenous insulin.
5. A nurse is providing discharge teaching to a patient with a new diagnosis of
Gastroesophageal Reflux Disease (GERD). Which instruction should the nurse include?
A. Wear tight-fitting clothing to support the abdomen
B. Drink orange juice daily for Vitamin C
C. Lie flat for 30 minutes after meals
D. Avoid eating within 3 hours of bedtime
Correct Answer: D
Surg 1 | Actual Q&A with Rationale
(NRSG201 Final Exam) | Ivy Tech
1. A nurse is caring for a patient who is 24 hours postoperative following an abdominal
surgery. The patient reports sudden chest pain and dyspnea. Which action should the nurse
take first?
A. Apply oxygen via nasal cannula
B. Check the patient’s surgical incision site
C. Administer the prescribed PRN analgesic
D. Perform an incentive spirometry check
Correct Answer: A
Sudden onset of chest pain and dyspnea in a postoperative patient are classic signs of a
pulmonary embolism. Applying oxygen is the priority to improve oxygenation and prevent
further respiratory distress. The nurse must then notify the healthcare provider and
prepare for further diagnostic testing.
2. A client is admitted with a serum potassium level of 6.2 mEq/L. Which of the following
cardiac changes should the nurse expect to see on the ECG monitor?
A. Prominent U waves
B. Tall, peaked T waves
,C. Prolonged PR interval
D. ST-segment depression
Correct Answer: B
Hyperkalemia, defined as a potassium level above 5.0 mEq/L, significantly affects cardiac
conduction. Tall, peaked T waves are one of the earliest signs of hyperkalemia on an EKG. If
left untreated, this can progress to a widened QRS complex and cardiac arrest.
3. Which clinical manifestation should a nurse expect to find in a patient experiencing fluid
volume deficit?
A. Distended neck veins
B. Orthostatic hypotension
C. Peripheral edema
D. Bounding peripheral pulses
Correct Answer: B
Fluid volume deficit results in a decrease in circulating blood volume, which leads to a
drop in blood pressure when changing positions. Patients will also typically display
tachycardia as the heart attempts to compensate for the low volume. Other signs include
poor skin turgor and dry mucous membranes.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 550
mg/dL and positive ketones in the urine. Which condition is the patient likely experiencing?
A. Hypoglycemia
B. Hyperosmolar Hyperglycemic State (HHS)
C. Diabetic Ketoacidosis (DKA)
D. Metabolic Alkalosis
Correct Answer: C
DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis, most commonly
occurring in Type 1 diabetics. The presence of ketones in the urine is a hallmark sign that
differentiates DKA from HHS. Immediate treatment involves fluid resuscitation and
intravenous insulin.
5. A nurse is providing discharge teaching to a patient with a new diagnosis of
Gastroesophageal Reflux Disease (GERD). Which instruction should the nurse include?
A. Wear tight-fitting clothing to support the abdomen
B. Drink orange juice daily for Vitamin C
C. Lie flat for 30 minutes after meals
D. Avoid eating within 3 hours of bedtime
Correct Answer: D
