NUR 170 Med Surg Exam 3 2026-2027 BANK
QUESTIONS WITH DETAILED VERIFIED ANSWERS
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Question 1
A patient with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a productive cough. Which arterial blood
gas (ABG) finding is most consistent with this patient's chronic
condition?
A) pH 7.38, PaCO2 48 mm Hg, HCO3- 30 mEq/L
B) pH 7.32, PaCO2 55 mm Hg, HCO3- 24 mEq/L
C) pH 7.42, PaCO2 38 mm Hg, HCO3- 22 mEq/L
D) pH 7.28, PaCO2 60 mm Hg, HCO3- 26 mEq/L
Answer: A
Explanation: In chronic COPD, the body compensates for respiratory
acidosis by retaining bicarbonate. Option A shows a slightly low pH with
elevated PaCO2 and elevated HCO3-, indicating compensated
respiratory acidosis. Option B shows an acute respiratory acidosis
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without compensation. Option C is normal. Option D shows an acute
respiratory acidosis with partial compensation.
Question 2
A patient with heart failure is receiving furosemide. Which laboratory
value requires the most immediate intervention?
A) Serum potassium 3.0 mEq/L
B) Serum sodium 135 mEq/L
C) Serum creatinine 1.0 mg/dL
D) Serum calcium 9.5 mg/dL
Answer: A
Explanation: Furosemide is a loop diuretic that can cause significant
potassium loss. A potassium level of 3.0 mEq/L is critically low and
places the patient at risk for cardiac arrhythmias. The other values are
within or near normal limits.
Question 3
A nurse is caring for a patient with acute pancreatitis. Which
assessment finding is most concerning?
A) Abdominal pain radiating to the back
B) Nausea and vomiting
C) Hypotension and tachycardia
D) Elevated serum amylase
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Answer: C
Explanation: Hypotension and tachycardia may indicate hypovolemic
shock due to third-spacing of fluids, a life-threatening complication of
acute pancreatitis. Abdominal pain and elevated amylase are expected
findings.
Question 4
Which electrocardiogram (ECG) change is most characteristic of
hyperkalemia?
A) Peaked T waves
B) U waves
C) Prolonged PR interval
D) ST-segment depression
Answer: A
Explanation: Peaked T waves are an early and classic sign of
hyperkalemia. U waves are seen in hypokalemia. A prolonged PR
interval and ST-segment depression can occur in hyperkalemia but are
less specific.
Question 5
A patient with chronic kidney disease (CKD) is prescribed sevelamer.
The nurse explains that the primary purpose of this medication is to:
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A) Lower serum phosphorus levels
B) Increase serum calcium levels
C) Correct metabolic acidosis
D) Stimulate erythropoiesis
Answer: A
Explanation: Sevelamer is a phosphate binder used to manage
hyperphosphatemia in CKD. It does not directly affect calcium, acidosis,
or erythropoiesis.
Question 6
A patient with cirrhosis develops ascites. Which intervention is a
priority to prevent complications?
A) Daily weights and abdominal girth measurements
B) Restricting dietary sodium to 2 g/day
C) Administering intravenous albumin
D) Preparing for paracentesis
Answer: B
Explanation: Sodium restriction is a foundational intervention for
managing ascites because it reduces fluid retention. Daily weights and
paracentesis are important but secondary. IV albumin is used in specific
situations.