NU 192 Exam 1 V2 | NU 192 Medical-
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 1) | Galen
1. A nurse is assessing a client with end-stage renal disease (ESRD). Which of the following
clinical manifestations should the nurse expect to observe? (Select all that apply).
A. Anemia
B. Pruritus
C. Hypokalemia
D. Oliguria
E. Hypertension
F. Hypophosphatemia
Correct Answer: A, B, D, E
Explanation: Clients with ESRD typically experience anemia due to the decreased
production of erythropoietin by the kidneys. Pruritus occurs as a result of uremic waste
products depositing in the skin, often called uremic frost. Hypertension is caused by
sodium and water retention as the kidneys lose their ability to regulate fluid balance.
,2. A client is admitted with a diagnosis of Acute Kidney Injury (AKI). The client’s laboratory
results indicate a potassium level of 6.5 mEq/L. Which cardiac monitor change is the priority
for the nurse to monitor?
A. Tall, peaked T waves
B. U waves
C. Shortened PR interval
D. Prominent P waves
Correct Answer: A
Explanation: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
cardiac conduction. The hallmark EKG change for hyperkalemia is the presence of tall,
peaked T waves, which can progress to a widened QRS complex and cardiac arrest. The
nurse must prioritize monitoring for these changes to ensure timely intervention with
medications like calcium gluconate or insulin with dextrose.
3. The nurse is reviewing the arterial blood gas (ABG) results of a client with chronic
obstructive pulmonary disease (COPD): pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L. How
should the nurse interpret these findings?
A. Metabolic acidosis, fully compensated
B. Respiratory alkalosis, uncompensated
C. Metabolic alkalosis, partially compensated
D. Respiratory acidosis, partially compensated
,Correct Answer: D
Explanation: The pH of 7.32 indicates acidosis, and the elevated PaCO2 of 55 mmHg
indicates that the cause is respiratory in nature. The HCO3 is elevated to 28 mEq/L,
showing that the kidneys are attempting to compensate for the acidic environment.
Because the pH is still outside the normal range, the condition is considered partially
compensated.
4. A client with atrial fibrillation is prescribed warfarin. Which of the following should the
nurse include in the teaching plan? (Select all that apply).
A. Avoid green leafy vegetables entirely.
B. Use a soft-bristle toothbrush.
C. Notify the provider if black, tarry stools occur.
D. Monthly INR blood tests are required.
E. Use a safety razor for shaving.
Correct Answer: B, C, D
Explanation: Warfarin is an anticoagulant that increases the risk of bleeding, necessitating
the use of a soft-bristle toothbrush and reporting signs of internal bleeding like black, tarry
stools. Clients should maintain a consistent intake of Vitamin K rather than avoiding it
entirely to keep INR levels stable. Regular INR monitoring is essential to ensure the dose
remains within the therapeutic range.
, 5. The nurse is caring for a client post-cardiac catheterization. Which assessment finding
requires immediate intervention?
A. A firm, enlarging mass at the insertion site
B. Small amount of bruising at the insertion site
C. A palpable pulse on the affected extremity
D. Client reports thirst and requests water
Correct Answer: A
Explanation: A firm, enlarging mass at the catheter insertion site is indicative of a
hematoma or active arterial bleeding. This is a medical emergency that requires manual
pressure and notification of the physician to prevent hemorrhage. Other findings like mild
bruising are common, but any sign of hematoma expansion suggests a compromised vessel.
6. A client is experiencing Sinus Bradycardia with a heart rate of 38 bpm and is symptomatic
with dizziness and hypotension. Which medication should the nurse anticipate administering
first?
A. Amiodarone
B. Dopamine
C. Atropine
D. Digoxin
Correct Answer: C
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 1) | Galen
1. A nurse is assessing a client with end-stage renal disease (ESRD). Which of the following
clinical manifestations should the nurse expect to observe? (Select all that apply).
A. Anemia
B. Pruritus
C. Hypokalemia
D. Oliguria
E. Hypertension
F. Hypophosphatemia
Correct Answer: A, B, D, E
Explanation: Clients with ESRD typically experience anemia due to the decreased
production of erythropoietin by the kidneys. Pruritus occurs as a result of uremic waste
products depositing in the skin, often called uremic frost. Hypertension is caused by
sodium and water retention as the kidneys lose their ability to regulate fluid balance.
,2. A client is admitted with a diagnosis of Acute Kidney Injury (AKI). The client’s laboratory
results indicate a potassium level of 6.5 mEq/L. Which cardiac monitor change is the priority
for the nurse to monitor?
A. Tall, peaked T waves
B. U waves
C. Shortened PR interval
D. Prominent P waves
Correct Answer: A
Explanation: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
cardiac conduction. The hallmark EKG change for hyperkalemia is the presence of tall,
peaked T waves, which can progress to a widened QRS complex and cardiac arrest. The
nurse must prioritize monitoring for these changes to ensure timely intervention with
medications like calcium gluconate or insulin with dextrose.
3. The nurse is reviewing the arterial blood gas (ABG) results of a client with chronic
obstructive pulmonary disease (COPD): pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L. How
should the nurse interpret these findings?
A. Metabolic acidosis, fully compensated
B. Respiratory alkalosis, uncompensated
C. Metabolic alkalosis, partially compensated
D. Respiratory acidosis, partially compensated
,Correct Answer: D
Explanation: The pH of 7.32 indicates acidosis, and the elevated PaCO2 of 55 mmHg
indicates that the cause is respiratory in nature. The HCO3 is elevated to 28 mEq/L,
showing that the kidneys are attempting to compensate for the acidic environment.
Because the pH is still outside the normal range, the condition is considered partially
compensated.
4. A client with atrial fibrillation is prescribed warfarin. Which of the following should the
nurse include in the teaching plan? (Select all that apply).
A. Avoid green leafy vegetables entirely.
B. Use a soft-bristle toothbrush.
C. Notify the provider if black, tarry stools occur.
D. Monthly INR blood tests are required.
E. Use a safety razor for shaving.
Correct Answer: B, C, D
Explanation: Warfarin is an anticoagulant that increases the risk of bleeding, necessitating
the use of a soft-bristle toothbrush and reporting signs of internal bleeding like black, tarry
stools. Clients should maintain a consistent intake of Vitamin K rather than avoiding it
entirely to keep INR levels stable. Regular INR monitoring is essential to ensure the dose
remains within the therapeutic range.
, 5. The nurse is caring for a client post-cardiac catheterization. Which assessment finding
requires immediate intervention?
A. A firm, enlarging mass at the insertion site
B. Small amount of bruising at the insertion site
C. A palpable pulse on the affected extremity
D. Client reports thirst and requests water
Correct Answer: A
Explanation: A firm, enlarging mass at the catheter insertion site is indicative of a
hematoma or active arterial bleeding. This is a medical emergency that requires manual
pressure and notification of the physician to prevent hemorrhage. Other findings like mild
bruising are common, but any sign of hematoma expansion suggests a compromised vessel.
6. A client is experiencing Sinus Bradycardia with a heart rate of 38 bpm and is symptomatic
with dizziness and hypotension. Which medication should the nurse anticipate administering
first?
A. Amiodarone
B. Dopamine
C. Atropine
D. Digoxin
Correct Answer: C
