NU 157 Exam 3 V2 | NU 157 Medical-
Surgical Nursing I-A | NCLEX (NGN) Q&A
with Rationale (NU157 Exam 3) | Galen
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse prioritize and report to the
healthcare provider immediately?
A. New onset of shortness of breath and pleuritic chest pain.
B. Report of pain as 7 on a scale of 0 to 10.
C. Urine output of 120 mL over the last 4 hours.
D. Serosanguineous drainage on the surgical dressing.
Correct Answer: A
Explanation: New onset of shortness of breath and pleuritic chest pain are classic signs of
a pulmonary embolism, which is a life-threatening complication after orthopedic surgery.
While pain management and monitoring urine output (which is currently adequate at
30mL/hr) are important, respiratory distress takes priority. Serosanguineous drainage is
an expected finding in the early postoperative period.
2. A nurse is preparing a client for a scheduled cholecystectomy. Which of the following
actions are responsibilities of the nurse regarding informed consent? (Select All That Apply)
A. Explaining the risks and benefits of the surgical procedure.
,B. Witnessing the client’s signature on the consent form.
C. Verifying that the client understands the information provided by the surgeon.
D. Describing alternative treatments to the surgical procedure.
E. Ensuring the client is competent to provide consent.
F. Notifying the surgeon if the client has additional questions.
Correct Answer: B, C, E, F
Explanation: The nurse’s role in informed consent is to witness the signature, ensure the
client is competent, and verify the client’s understanding. It is the surgeon’s responsibility
to explain the risks, benefits, and alternatives of the procedure. If the client has further
questions, the nurse must advocate for the client by notifying the surgeon to return and
provide clarification.
3. A nurse is assessing a client with a potassium level of 2.8 mEq/L. Which of the following
ECG changes should the nurse expect to observe?
A. Tall, peaked T waves
B. Widened QRS complex
C. Prominent U waves
D. Shortened QT interval
Correct Answer: C
, Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an ECG as
prominent U waves, ST-segment depression, and flat or inverted T waves. Tall, peaked T
waves and a widened QRS complex are characteristic of hyperkalemia. These cardiac
changes are critical to monitor because they can lead to lethal arrhythmias.
4. A nurse is assessing a client who is in the early stages of hypovolemic shock. Which of the
following clinical manifestations should the nurse expect?
A. Bradycardia
B. Increased heart rate
C. Hypotension
D. Warm, flushed skin
Correct Answer: B
Explanation: In the initial stage of hypovolemic shock, the body uses compensatory
mechanisms like the sympathetic nervous system to maintain cardiac output, resulting in
tachycardia. Hypotension is often a later sign indicating that compensatory mechanisms
are failing. The skin usually becomes cool and clammy due to peripheral vasoconstriction,
not warm and flushed.
5. A client presents with the following arterial blood gas (ABG) results: pH 7.28, PaCO2 50
mmHg, and HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Respiratory alkalosis
B. Metabolic acidosis
Surgical Nursing I-A | NCLEX (NGN) Q&A
with Rationale (NU157 Exam 3) | Galen
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse prioritize and report to the
healthcare provider immediately?
A. New onset of shortness of breath and pleuritic chest pain.
B. Report of pain as 7 on a scale of 0 to 10.
C. Urine output of 120 mL over the last 4 hours.
D. Serosanguineous drainage on the surgical dressing.
Correct Answer: A
Explanation: New onset of shortness of breath and pleuritic chest pain are classic signs of
a pulmonary embolism, which is a life-threatening complication after orthopedic surgery.
While pain management and monitoring urine output (which is currently adequate at
30mL/hr) are important, respiratory distress takes priority. Serosanguineous drainage is
an expected finding in the early postoperative period.
2. A nurse is preparing a client for a scheduled cholecystectomy. Which of the following
actions are responsibilities of the nurse regarding informed consent? (Select All That Apply)
A. Explaining the risks and benefits of the surgical procedure.
,B. Witnessing the client’s signature on the consent form.
C. Verifying that the client understands the information provided by the surgeon.
D. Describing alternative treatments to the surgical procedure.
E. Ensuring the client is competent to provide consent.
F. Notifying the surgeon if the client has additional questions.
Correct Answer: B, C, E, F
Explanation: The nurse’s role in informed consent is to witness the signature, ensure the
client is competent, and verify the client’s understanding. It is the surgeon’s responsibility
to explain the risks, benefits, and alternatives of the procedure. If the client has further
questions, the nurse must advocate for the client by notifying the surgeon to return and
provide clarification.
3. A nurse is assessing a client with a potassium level of 2.8 mEq/L. Which of the following
ECG changes should the nurse expect to observe?
A. Tall, peaked T waves
B. Widened QRS complex
C. Prominent U waves
D. Shortened QT interval
Correct Answer: C
, Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an ECG as
prominent U waves, ST-segment depression, and flat or inverted T waves. Tall, peaked T
waves and a widened QRS complex are characteristic of hyperkalemia. These cardiac
changes are critical to monitor because they can lead to lethal arrhythmias.
4. A nurse is assessing a client who is in the early stages of hypovolemic shock. Which of the
following clinical manifestations should the nurse expect?
A. Bradycardia
B. Increased heart rate
C. Hypotension
D. Warm, flushed skin
Correct Answer: B
Explanation: In the initial stage of hypovolemic shock, the body uses compensatory
mechanisms like the sympathetic nervous system to maintain cardiac output, resulting in
tachycardia. Hypotension is often a later sign indicating that compensatory mechanisms
are failing. The skin usually becomes cool and clammy due to peripheral vasoconstriction,
not warm and flushed.
5. A client presents with the following arterial blood gas (ABG) results: pH 7.28, PaCO2 50
mmHg, and HCO3 24 mEq/L. How should the nurse interpret these findings?
A. Respiratory alkalosis
B. Metabolic acidosis
