NUR 209 MEDICAL SURGICAL NURSING
II EXAM 2 QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is being assessed. Which clinical finding should the
nurse expect to observe?
A. Peripheral edema and jugular venous distention
B. Splenomegaly and anorexia
C. Hepatomegaly and abdominal girth increase
D. Dyspnea and crackles upon auscultation
Answer: D
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in respiratory symptoms like dyspnea and crackles. The other options are signs of right-
sided heart failure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.30, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 30 mEq/L
,Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45 mmHg).
3. A patient is receiving hemodialysis for the first time. The nurse monitors for
‘Disequilibrium Syndrome.’ Which symptom is a primary indicator of this condition?
A. Headache and restlessness
B. Severe hypotension
C. Tachycardia and palpitations
D. Hypoglycemia
Answer: A
Conceptual Explanation: Disequilibrium syndrome occurs due to rapid changes in
extracellular fluid composition, leading to cerebral edema. Early signs include headache,
nausea, and restlessness.
4. A patient is admitted with Diabetic Ketoacidosis (DKA). Which acid-base imbalance does
the nurse anticipate?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Metabolic Acidosis
, Answer: D
Conceptual Explanation: DKA involves the breakdown of fats into ketones, which are
acidic, leading to metabolic acidosis.
5. A client taking Digoxin reports seeing yellow halos around lights. What is the nurse’s
priority action?
A. Document the finding and continue monitoring
B. Assess the apical pulse and notify the provider
C. Administer the next scheduled dose
D. Increase oral fluid intake
Answer: B
Conceptual Explanation: Visual disturbances such as yellow halos are classic signs of
Digoxin toxicity. The nurse must hold the drug, check the pulse, and notify the physician.
6. A patient with an acute MI shows ST-segment elevation on the ECG. This finding typically
represents which of the following?
A. Myocardial Ischemia
B. Myocardial Infarction (Necrosis)
C. Myocardial Injury
D. Atrial Depolarization
Answer: C
II EXAM 2 QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is being assessed. Which clinical finding should the
nurse expect to observe?
A. Peripheral edema and jugular venous distention
B. Splenomegaly and anorexia
C. Hepatomegaly and abdominal girth increase
D. Dyspnea and crackles upon auscultation
Answer: D
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, resulting
in respiratory symptoms like dyspnea and crackles. The other options are signs of right-
sided heart failure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in respiratory acidosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.30, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 30 mEq/L
,Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45 mmHg).
3. A patient is receiving hemodialysis for the first time. The nurse monitors for
‘Disequilibrium Syndrome.’ Which symptom is a primary indicator of this condition?
A. Headache and restlessness
B. Severe hypotension
C. Tachycardia and palpitations
D. Hypoglycemia
Answer: A
Conceptual Explanation: Disequilibrium syndrome occurs due to rapid changes in
extracellular fluid composition, leading to cerebral edema. Early signs include headache,
nausea, and restlessness.
4. A patient is admitted with Diabetic Ketoacidosis (DKA). Which acid-base imbalance does
the nurse anticipate?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Metabolic Acidosis
, Answer: D
Conceptual Explanation: DKA involves the breakdown of fats into ketones, which are
acidic, leading to metabolic acidosis.
5. A client taking Digoxin reports seeing yellow halos around lights. What is the nurse’s
priority action?
A. Document the finding and continue monitoring
B. Assess the apical pulse and notify the provider
C. Administer the next scheduled dose
D. Increase oral fluid intake
Answer: B
Conceptual Explanation: Visual disturbances such as yellow halos are classic signs of
Digoxin toxicity. The nurse must hold the drug, check the pulse, and notify the physician.
6. A patient with an acute MI shows ST-segment elevation on the ECG. This finding typically
represents which of the following?
A. Myocardial Ischemia
B. Myocardial Infarction (Necrosis)
C. Myocardial Injury
D. Atrial Depolarization
Answer: C
