COMPREHENSIVE MEDICAL-
SURGICAL NURSING EXAM
QUESTIONS AND ANSWERS
1. A patient presents with arterial blood gas results showing pH 7.30, PaCO2 50 mmHg, and
HCO3 24 mEq/L. Which condition is the patient most likely experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above
45 mmHg, while the HCO3 is within the normal range, indicating an uncompensated
respiratory cause.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a nasal
cannula at 2 L/min. Which finding requires immediate intervention?
A. Respiratory rate of 8 breaths/min
B. Barrel-shaped chest
,C. SpO2 of 90%
D. Clubbing of the fingers
Answer: A
Conceptual Explanation: Patients with COPD may rely on a hypoxic drive to breathe.
Excess oxygen can suppress this drive, leading to significant bradypnea or respiratory
arrest.
3. A patient with left-sided heart failure is most likely to exhibit which clinical manifestation?
A. Peripheral edema
B. Crackles in the lung bases
C. Jugular venous distension
D. Hepatomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood forward effectively, causing fluid back-up into the
lungs.
4. When caring for a patient post-thyroidectomy, the nurse notes the patient has developed
laryngeal stridor and tingling in the fingertips. What is the priority action?
A. Administer a sedative
B. Prepare for calcium gluconate administration
, C. Check the patient’s potassium level
D. Apply a warm compress to the neck
Answer: B
Conceptual Explanation: These signs indicate hypocalcemia, likely due to accidental
damage or removal of the parathyroid glands during surgery. Calcium gluconate is the
emergency treatment for tetany.
5. A client is diagnosed with Cushing’s Syndrome. Which laboratory finding should the nurse
expect?
A. Hyponatremia
B. Hyperglycemia
C. Hyperkalemia
D. Hypoglycemia
Answer: B
Conceptual Explanation: Cushing’s Syndrome involves excess cortisol, which leads to
increased glucose production and insulin resistance, resulting in elevated blood sugar
levels.
6. A nurse is assessing a patient with a suspected diagnosis of Addison’s Disease. Which
assessment finding is characteristic of this condition?
A. Moon face
SURGICAL NURSING EXAM
QUESTIONS AND ANSWERS
1. A patient presents with arterial blood gas results showing pH 7.30, PaCO2 50 mmHg, and
HCO3 24 mEq/L. Which condition is the patient most likely experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above
45 mmHg, while the HCO3 is within the normal range, indicating an uncompensated
respiratory cause.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a nasal
cannula at 2 L/min. Which finding requires immediate intervention?
A. Respiratory rate of 8 breaths/min
B. Barrel-shaped chest
,C. SpO2 of 90%
D. Clubbing of the fingers
Answer: A
Conceptual Explanation: Patients with COPD may rely on a hypoxic drive to breathe.
Excess oxygen can suppress this drive, leading to significant bradypnea or respiratory
arrest.
3. A patient with left-sided heart failure is most likely to exhibit which clinical manifestation?
A. Peripheral edema
B. Crackles in the lung bases
C. Jugular venous distension
D. Hepatomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood forward effectively, causing fluid back-up into the
lungs.
4. When caring for a patient post-thyroidectomy, the nurse notes the patient has developed
laryngeal stridor and tingling in the fingertips. What is the priority action?
A. Administer a sedative
B. Prepare for calcium gluconate administration
, C. Check the patient’s potassium level
D. Apply a warm compress to the neck
Answer: B
Conceptual Explanation: These signs indicate hypocalcemia, likely due to accidental
damage or removal of the parathyroid glands during surgery. Calcium gluconate is the
emergency treatment for tetany.
5. A client is diagnosed with Cushing’s Syndrome. Which laboratory finding should the nurse
expect?
A. Hyponatremia
B. Hyperglycemia
C. Hyperkalemia
D. Hypoglycemia
Answer: B
Conceptual Explanation: Cushing’s Syndrome involves excess cortisol, which leads to
increased glucose production and insulin resistance, resulting in elevated blood sugar
levels.
6. A nurse is assessing a patient with a suspected diagnosis of Addison’s Disease. Which
assessment finding is characteristic of this condition?
A. Moon face
