MSN 377 EXAM 4 QUESTIONS
WITH COMPLETE SOLUTIONS
Course
MSN 377 - Med/Surg 2
Question 1
A nurse is assessing a patient admitted with acute heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral ankle edema
B. Crackles throughout both lung fields
C. Blood pressure of 146/84 mmHg
D. Heart rate of 92 beats/min
Correct Answer: B. Crackles throughout both lung fields
Solution:
Diffuse crackles indicate pulmonary edema caused by fluid accumulation in the alveoli. This
impairs gas exchange and can rapidly progress to respiratory failure. Immediate interventions
include oxygen therapy, positioning the patient upright, and notifying the healthcare provider.
Question 2
Which laboratory finding is most concerning in a patient receiving furosemide?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.4 mg/dL
D. Glucose 102 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Solution:
Loop diuretics increase potassium excretion. Severe hypokalemia increases the risk of
dysrhythmias, muscle weakness, and digitalis toxicity.
Question 3
A patient with type 2 diabetes has an HbA1c of 9.4%. What does this result indicate?
A. Excellent glycemic control
B. Normal blood glucose
,C. Poor long-term glucose control
D. Acute hypoglycemia
Correct Answer: C. Poor long-term glucose control
Solution:
Hemoglobin A1c reflects average blood glucose over the previous 2–3 months. Values above 7%
generally indicate suboptimal glycemic control for many adults.
Question 4
Which electrolyte imbalance is commonly associated with chronic kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia only
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Solution:
Impaired renal potassium excretion frequently results in hyperkalemia, which can cause life-
threatening cardiac arrhythmias.
Question 5
Which assessment finding is characteristic of left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary congestion
D. Jugular venous distention
Correct Answer: C. Pulmonary congestion
Solution:
Left ventricular failure causes blood to back up into the pulmonary circulation, producing
dyspnea, orthopnea, and crackles.
Question 6
Which patient is at greatest risk for developing deep vein thrombosis (DVT)?
,A. A healthy young adult who exercises daily
B. A postoperative patient on prolonged bed rest
C. A patient with seasonal allergies
D. A patient with controlled hypertension
Correct Answer: B. A postoperative patient on prolonged bed rest
Solution:
Venous stasis, endothelial injury, and hypercoagulability (Virchow's triad) significantly increase
the risk of DVT.
Question 7
Which medication is considered the first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Hydrocortisone
D. Albuterol
Correct Answer: B. Epinephrine
Solution:
Intramuscular epinephrine rapidly reverses airway edema, bronchospasm, and hypotension.
Question 8
Which finding suggests hypoglycemia?
A. Warm, dry skin
B. Tremors and diaphoresis
C. Polyuria
D. Fruity breath odor
Correct Answer: B. Tremors and diaphoresis
Solution:
Hypoglycemia stimulates the sympathetic nervous system, causing sweating, tremors,
palpitations, and anxiety.
Question 9
Which nursing intervention has the highest priority for a patient with suspected sepsis?
, A. Encourage oral fluids
B. Obtain cultures and begin prescribed antibiotics promptly
C. Restrict activity
D. Delay treatment until culture results return
Correct Answer: B. Obtain cultures and begin prescribed antibiotics promptly
Solution:
Early cultures followed by timely administration of broad-spectrum antibiotics are critical to
improving survival in sepsis.
Question 10
Which ABG value indicates respiratory acidosis?
A. pH 7.52, PaCO₂ 28 mmHg
B. pH 7.28, PaCO₂ 55 mmHg
C. pH 7.36, PaCO₂ 38 mmHg
D. pH 7.48, PaCO₂ 30 mmHg
Correct Answer: B.
Solution:
Respiratory acidosis is characterized by a low pH with elevated carbon dioxide due to
hypoventilation.
Question 11
Which patient should be assessed first?
A. Stable patient awaiting discharge
B. Patient with chest pain and diaphoresis
C. Patient requesting pain medication
D. Patient scheduled for physical therapy
Correct Answer: B.
Solution:
Chest pain accompanied by diaphoresis may indicate an acute myocardial infarction requiring
immediate evaluation.
Question 12
WITH COMPLETE SOLUTIONS
Course
MSN 377 - Med/Surg 2
Question 1
A nurse is assessing a patient admitted with acute heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral ankle edema
B. Crackles throughout both lung fields
C. Blood pressure of 146/84 mmHg
D. Heart rate of 92 beats/min
Correct Answer: B. Crackles throughout both lung fields
Solution:
Diffuse crackles indicate pulmonary edema caused by fluid accumulation in the alveoli. This
impairs gas exchange and can rapidly progress to respiratory failure. Immediate interventions
include oxygen therapy, positioning the patient upright, and notifying the healthcare provider.
Question 2
Which laboratory finding is most concerning in a patient receiving furosemide?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.4 mg/dL
D. Glucose 102 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Solution:
Loop diuretics increase potassium excretion. Severe hypokalemia increases the risk of
dysrhythmias, muscle weakness, and digitalis toxicity.
Question 3
A patient with type 2 diabetes has an HbA1c of 9.4%. What does this result indicate?
A. Excellent glycemic control
B. Normal blood glucose
,C. Poor long-term glucose control
D. Acute hypoglycemia
Correct Answer: C. Poor long-term glucose control
Solution:
Hemoglobin A1c reflects average blood glucose over the previous 2–3 months. Values above 7%
generally indicate suboptimal glycemic control for many adults.
Question 4
Which electrolyte imbalance is commonly associated with chronic kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia only
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Solution:
Impaired renal potassium excretion frequently results in hyperkalemia, which can cause life-
threatening cardiac arrhythmias.
Question 5
Which assessment finding is characteristic of left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary congestion
D. Jugular venous distention
Correct Answer: C. Pulmonary congestion
Solution:
Left ventricular failure causes blood to back up into the pulmonary circulation, producing
dyspnea, orthopnea, and crackles.
Question 6
Which patient is at greatest risk for developing deep vein thrombosis (DVT)?
,A. A healthy young adult who exercises daily
B. A postoperative patient on prolonged bed rest
C. A patient with seasonal allergies
D. A patient with controlled hypertension
Correct Answer: B. A postoperative patient on prolonged bed rest
Solution:
Venous stasis, endothelial injury, and hypercoagulability (Virchow's triad) significantly increase
the risk of DVT.
Question 7
Which medication is considered the first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Hydrocortisone
D. Albuterol
Correct Answer: B. Epinephrine
Solution:
Intramuscular epinephrine rapidly reverses airway edema, bronchospasm, and hypotension.
Question 8
Which finding suggests hypoglycemia?
A. Warm, dry skin
B. Tremors and diaphoresis
C. Polyuria
D. Fruity breath odor
Correct Answer: B. Tremors and diaphoresis
Solution:
Hypoglycemia stimulates the sympathetic nervous system, causing sweating, tremors,
palpitations, and anxiety.
Question 9
Which nursing intervention has the highest priority for a patient with suspected sepsis?
, A. Encourage oral fluids
B. Obtain cultures and begin prescribed antibiotics promptly
C. Restrict activity
D. Delay treatment until culture results return
Correct Answer: B. Obtain cultures and begin prescribed antibiotics promptly
Solution:
Early cultures followed by timely administration of broad-spectrum antibiotics are critical to
improving survival in sepsis.
Question 10
Which ABG value indicates respiratory acidosis?
A. pH 7.52, PaCO₂ 28 mmHg
B. pH 7.28, PaCO₂ 55 mmHg
C. pH 7.36, PaCO₂ 38 mmHg
D. pH 7.48, PaCO₂ 30 mmHg
Correct Answer: B.
Solution:
Respiratory acidosis is characterized by a low pH with elevated carbon dioxide due to
hypoventilation.
Question 11
Which patient should be assessed first?
A. Stable patient awaiting discharge
B. Patient with chest pain and diaphoresis
C. Patient requesting pain medication
D. Patient scheduled for physical therapy
Correct Answer: B.
Solution:
Chest pain accompanied by diaphoresis may indicate an acute myocardial infarction requiring
immediate evaluation.
Question 12
