PNR 201/PNR201 Exam 3 V2 | Medical-Surgical
Nursing Q&A with Rationale | Fortis College
1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing respiratory
acidosis. Which arterial blood gas (ABG) result should the nurse expect?
A. pH 7.32, PaCO2 52 mmHg
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.31, HCO3 18 mEq/L
D. pH 7.50, HCO3 30 mEq/L
Correct Answer: A
Explanation: Respiratory acidosis is characterized by a low pH and an elevated PaCO2
level. In patients with COPD, air trapping leads to CO2 retention which causes the pH to
drop below the normal range of 7.35 to 7.45. This specific result reflects the inability of the
lungs to effectively exhale carbon dioxide.
2. Which electrolyte imbalance is most likely to occur in a patient with excessive nasogastric
(NG) tube suctioning?
A. Hypercalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
,Correct Answer: B
Explanation: Nasogastric suctioning removes gastric secretions which are rich in
potassium and hydrochloric acid. The loss of these fluids frequently leads to hypokalemia
as well as metabolic alkalosis. Nurses must monitor potassium levels closely to prevent
cardiac dysrhythmias in these patients.
3. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte abnormality is the
nurse testing for?
A. Hypermagnesemia
B. Hyponatremia
C. Hypocalcemia
D. Hypokalemia
Correct Answer: C
Explanation: Trousseau’s sign is an indicator of latent tetany caused by hypocalcemia. It is
elicited by inflating a blood pressure cuff on the upper arm to a level above the systolic
pressure for 2 to 3 minutes. A positive result is indicated by carpal spasms of the hand and
fingers.
4. A patient presents with a potassium level of 6.2 mEq/L. Which medication should the nurse
anticipate administering to lower the potassium level quickly?
A. Spironolactone
B. Intravenous Insulin and Dextrose
, C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Potassium Chloride IV
Correct Answer: B
Explanation: Intravenous insulin helps shift potassium from the extracellular fluid into the
intracellular space, thereby lowering serum levels. Dextrose is administered
simultaneously to prevent the patient from becoming hypoglycemic. This is a standard
emergency treatment for severe hyperkalemia while waiting for slower methods to work.
5. What is the primary characteristic of a malignant tumor that distinguishes it from a benign
tumor?
A. Ability to metastasize
B. Encapsulated growth
C. Slow rate of growth
D. Cells that resemble parent tissue
Correct Answer: A
Explanation: Malignant tumors have the ability to invade surrounding tissues and spread
to distant sites through the blood or lymph systems. Benign tumors are typically
encapsulated and do not spread beyond their original location. This ability to metastasize
makes malignant tumors much more dangerous and difficult to treat.
Nursing Q&A with Rationale | Fortis College
1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing respiratory
acidosis. Which arterial blood gas (ABG) result should the nurse expect?
A. pH 7.32, PaCO2 52 mmHg
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.31, HCO3 18 mEq/L
D. pH 7.50, HCO3 30 mEq/L
Correct Answer: A
Explanation: Respiratory acidosis is characterized by a low pH and an elevated PaCO2
level. In patients with COPD, air trapping leads to CO2 retention which causes the pH to
drop below the normal range of 7.35 to 7.45. This specific result reflects the inability of the
lungs to effectively exhale carbon dioxide.
2. Which electrolyte imbalance is most likely to occur in a patient with excessive nasogastric
(NG) tube suctioning?
A. Hypercalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
,Correct Answer: B
Explanation: Nasogastric suctioning removes gastric secretions which are rich in
potassium and hydrochloric acid. The loss of these fluids frequently leads to hypokalemia
as well as metabolic alkalosis. Nurses must monitor potassium levels closely to prevent
cardiac dysrhythmias in these patients.
3. A nurse is assessing a patient for Trousseau’s sign. Which electrolyte abnormality is the
nurse testing for?
A. Hypermagnesemia
B. Hyponatremia
C. Hypocalcemia
D. Hypokalemia
Correct Answer: C
Explanation: Trousseau’s sign is an indicator of latent tetany caused by hypocalcemia. It is
elicited by inflating a blood pressure cuff on the upper arm to a level above the systolic
pressure for 2 to 3 minutes. A positive result is indicated by carpal spasms of the hand and
fingers.
4. A patient presents with a potassium level of 6.2 mEq/L. Which medication should the nurse
anticipate administering to lower the potassium level quickly?
A. Spironolactone
B. Intravenous Insulin and Dextrose
, C. Sodium Polystyrene Sulfonate (Kayexalate)
D. Potassium Chloride IV
Correct Answer: B
Explanation: Intravenous insulin helps shift potassium from the extracellular fluid into the
intracellular space, thereby lowering serum levels. Dextrose is administered
simultaneously to prevent the patient from becoming hypoglycemic. This is a standard
emergency treatment for severe hyperkalemia while waiting for slower methods to work.
5. What is the primary characteristic of a malignant tumor that distinguishes it from a benign
tumor?
A. Ability to metastasize
B. Encapsulated growth
C. Slow rate of growth
D. Cells that resemble parent tissue
Correct Answer: A
Explanation: Malignant tumors have the ability to invade surrounding tissues and spread
to distant sites through the blood or lymph systems. Benign tumors are typically
encapsulated and do not spread beyond their original location. This ability to metastasize
makes malignant tumors much more dangerous and difficult to treat.