NUR 155 COMPREHENSIVE EXAM
PREP: EXAMS 2, 3, AND 4 QUESTIONS
AND ANSWERS
1. A patient with a serum potassium level of 6.2 mEq/L is admitted to the medical-surgical
unit. Which assessment finding should the nurse prioritize?
A. Hyperactive bowel sounds and abdominal cramping
B. Tall, peaked T-waves on the electrocardiogram (ECG)
C. Increased muscle strength in lower extremities
D. Hyperreflexia in the patellar tendons
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can cause life-
threatening cardiac dysrhythmias; tall, peaked T-waves are a classic early sign of
potassium toxicity affecting cardiac conduction.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
The nurse interprets these results as:
A. Metabolic Acidosis
B. Respiratory Alkalosis
,C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the bicarbonate (HCO3) is within the normal range (22-
26), it is uncompensated respiratory acidosis.
3. Which assessment finding is most indicative of fluid volume deficit (hypovolemia) in an
elderly patient?
A. Crackles heard upon auscultation of the lungs
B. Distended neck veins while sitting upright
C. Pitting edema in the sacral region
D. Orthostatic hypotension and increased heart rate
Answer: D
Conceptual Explanation: Fluid volume deficit leads to decreased circulating volume,
resulting in a drop in blood pressure when changing positions (orthostatic hypotension)
and a compensatory increase in heart rate.
4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s serum potassium level
, B. Assess for a positive Babinski sign
C. Administer a prescribed bronchodilator
D. Assess for Trousseau’s or Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) and in the
extremities are signs of hypocalcemia, a potential complication of thyroid surgery if the
parathyroid glands are damaged.
5. While assessing a peripheral IV site, the nurse notes coolness, pallor, and swelling around
the insertion site. The patient reports pain. How should the nurse document this?
A. Phlebitis
B. Thrombosis
C. Extravasation
D. Infiltration
Answer: D
Conceptual Explanation: Infiltration is characterized by the leakage of non-vesicant IV
fluid into the tissue, causing coolness, pallor, and edema. Phlebitis would involve warmth
and redness.
PREP: EXAMS 2, 3, AND 4 QUESTIONS
AND ANSWERS
1. A patient with a serum potassium level of 6.2 mEq/L is admitted to the medical-surgical
unit. Which assessment finding should the nurse prioritize?
A. Hyperactive bowel sounds and abdominal cramping
B. Tall, peaked T-waves on the electrocardiogram (ECG)
C. Increased muscle strength in lower extremities
D. Hyperreflexia in the patellar tendons
Answer: B
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can cause life-
threatening cardiac dysrhythmias; tall, peaked T-waves are a classic early sign of
potassium toxicity affecting cardiac conduction.
2. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
The nurse interprets these results as:
A. Metabolic Acidosis
B. Respiratory Alkalosis
,C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the bicarbonate (HCO3) is within the normal range (22-
26), it is uncompensated respiratory acidosis.
3. Which assessment finding is most indicative of fluid volume deficit (hypovolemia) in an
elderly patient?
A. Crackles heard upon auscultation of the lungs
B. Distended neck veins while sitting upright
C. Pitting edema in the sacral region
D. Orthostatic hypotension and increased heart rate
Answer: D
Conceptual Explanation: Fluid volume deficit leads to decreased circulating volume,
resulting in a drop in blood pressure when changing positions (orthostatic hypotension)
and a compensatory increase in heart rate.
4. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s serum potassium level
, B. Assess for a positive Babinski sign
C. Administer a prescribed bronchodilator
D. Assess for Trousseau’s or Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) and in the
extremities are signs of hypocalcemia, a potential complication of thyroid surgery if the
parathyroid glands are damaged.
5. While assessing a peripheral IV site, the nurse notes coolness, pallor, and swelling around
the insertion site. The patient reports pain. How should the nurse document this?
A. Phlebitis
B. Thrombosis
C. Extravasation
D. Infiltration
Answer: D
Conceptual Explanation: Infiltration is characterized by the leakage of non-vesicant IV
fluid into the tissue, causing coolness, pallor, and edema. Phlebitis would involve warmth
and redness.
