HERZING UNIVERSITY NSG 223 MED SURG II FINAL EXAM (2026/2027) – MEDICAL-SURGICAL NURSING II
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed furosemide and digoxin. Which of the following electrolyte imbalances
would place this patient at the highest risk for digoxin toxicity?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
🟢 Correct Answer: B. Hypokalemia
🔴 RATIONALE: Hypokalemia increases the risk of digoxin toxicity by enhancing the binding of digoxin to
cardiac sodium-potassium ATPase pumps. Furosemide is a loop diuretic that promotes potassium loss, making
patients particularly vulnerable. While other electrolyte imbalances can affect digoxin, hypokalemia is the most
clinically significant risk factor.
Question 2
,A patient is 24 hours post-hemicolectomy. The nurse notes the patient has a temperature of 101.2°F,
tachycardia, and a rigid, board-like abdomen with absent bowel sounds. Which of the following is the priority
nursing action?
A. Administer prescribed antipyretics
B. Increase the rate of IV fluids
C. Notify the healthcare provider immediately
D. Apply a heating pad to the patient's abdomen
🟢 Correct Answer: C. Notify the healthcare provider immediately
🔴 RATIONALE: Postoperative fever, tachycardia, and a rigid, board-like abdomen with absent bowel sounds are
classic signs of an anastomotic leak or peritonitis, which is a life-threatening surgical emergency requiring
immediate notification of the healthcare provider. Antipyretics and IV fluids may be indicated, but they do not
address the underlying surgical complication.
Question 3
A patient with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG) result showing pH
7.32, PaCO2 58 mmHg, HCO3- 28 mEq/L, and PaO2 60 mmHg. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Metabolic alkalosis
,C. Respiratory acidosis with partial compensation
D. Respiratory alkalosis
🟢 Correct Answer: C. Respiratory acidosis with partial compensation
🔴 RATIONALE: The ABG shows a low pH (acidemia), elevated PaCO2 (respiratory acidosis), and elevated HCO3-
(partial metabolic compensation). The pH is not yet normalized, indicating partial compensation. The elevated
PaCO2 is consistent with COPD-related chronic hypercapnia.
Question 4
A patient with a new ileostomy is concerned about the high volume of liquid stool output. Which of the
following dietary instructions should the nurse provide?
A. Increase intake of fresh fruits and vegetables to thicken the stool
B. Avoid foods high in soluble fiber such as oats and bananas
C. Eat foods that contain pectin and soluble fiber to help thicken the stool
D. Increase fluid intake to replace losses from the stoma
🟢 Correct Answer: C. Eat foods that contain pectin and soluble fiber to help thicken the stool
🔴 RATIONALE: Soluble fiber (found in applesauce, bananas, oats, and pectin) helps absorb water and thicken
the stool in a patient with an ileostomy. Fresh fruits and vegetables with skins can cause obstruction. While
increasing fluid is important, it does not help thicken the stool.
, Question 5
A patient is scheduled for a cardiac catheterization. Which of the following allergies is most important for the
nurse to assess prior to the procedure?
A. Allergy to penicillin
B. Allergy to latex
C. Allergy to shellfish
D. Allergy to contrast dye
🟢 Correct Answer: D. Allergy to contrast dye
🔴 RATIONALE: Contrast dye, which may be iodine-based, is used during cardiac catheterization. A known
allergy to contrast dye or shellfish (which may cross-react) is a significant risk factor for anaphylaxis and must be
assessed. Premedication with antihistamines and corticosteroids may be ordered. Penicillin and latex allergies
are also important but not as directly related to the dye itself.
Question 6
A patient with cirrhosis is exhibiting confusion, asterixis, and a flapping tremor. Which of the following
interventions is a priority for this patient?
A. Administer a benzodiazepine for agitation
B. Restrict dietary protein intake
QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed furosemide and digoxin. Which of the following electrolyte imbalances
would place this patient at the highest risk for digoxin toxicity?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
🟢 Correct Answer: B. Hypokalemia
🔴 RATIONALE: Hypokalemia increases the risk of digoxin toxicity by enhancing the binding of digoxin to
cardiac sodium-potassium ATPase pumps. Furosemide is a loop diuretic that promotes potassium loss, making
patients particularly vulnerable. While other electrolyte imbalances can affect digoxin, hypokalemia is the most
clinically significant risk factor.
Question 2
,A patient is 24 hours post-hemicolectomy. The nurse notes the patient has a temperature of 101.2°F,
tachycardia, and a rigid, board-like abdomen with absent bowel sounds. Which of the following is the priority
nursing action?
A. Administer prescribed antipyretics
B. Increase the rate of IV fluids
C. Notify the healthcare provider immediately
D. Apply a heating pad to the patient's abdomen
🟢 Correct Answer: C. Notify the healthcare provider immediately
🔴 RATIONALE: Postoperative fever, tachycardia, and a rigid, board-like abdomen with absent bowel sounds are
classic signs of an anastomotic leak or peritonitis, which is a life-threatening surgical emergency requiring
immediate notification of the healthcare provider. Antipyretics and IV fluids may be indicated, but they do not
address the underlying surgical complication.
Question 3
A patient with chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG) result showing pH
7.32, PaCO2 58 mmHg, HCO3- 28 mEq/L, and PaO2 60 mmHg. Which acid-base imbalance is the patient
experiencing?
A. Metabolic acidosis
B. Metabolic alkalosis
,C. Respiratory acidosis with partial compensation
D. Respiratory alkalosis
🟢 Correct Answer: C. Respiratory acidosis with partial compensation
🔴 RATIONALE: The ABG shows a low pH (acidemia), elevated PaCO2 (respiratory acidosis), and elevated HCO3-
(partial metabolic compensation). The pH is not yet normalized, indicating partial compensation. The elevated
PaCO2 is consistent with COPD-related chronic hypercapnia.
Question 4
A patient with a new ileostomy is concerned about the high volume of liquid stool output. Which of the
following dietary instructions should the nurse provide?
A. Increase intake of fresh fruits and vegetables to thicken the stool
B. Avoid foods high in soluble fiber such as oats and bananas
C. Eat foods that contain pectin and soluble fiber to help thicken the stool
D. Increase fluid intake to replace losses from the stoma
🟢 Correct Answer: C. Eat foods that contain pectin and soluble fiber to help thicken the stool
🔴 RATIONALE: Soluble fiber (found in applesauce, bananas, oats, and pectin) helps absorb water and thicken
the stool in a patient with an ileostomy. Fresh fruits and vegetables with skins can cause obstruction. While
increasing fluid is important, it does not help thicken the stool.
, Question 5
A patient is scheduled for a cardiac catheterization. Which of the following allergies is most important for the
nurse to assess prior to the procedure?
A. Allergy to penicillin
B. Allergy to latex
C. Allergy to shellfish
D. Allergy to contrast dye
🟢 Correct Answer: D. Allergy to contrast dye
🔴 RATIONALE: Contrast dye, which may be iodine-based, is used during cardiac catheterization. A known
allergy to contrast dye or shellfish (which may cross-react) is a significant risk factor for anaphylaxis and must be
assessed. Premedication with antihistamines and corticosteroids may be ordered. Penicillin and latex allergies
are also important but not as directly related to the dye itself.
Question 6
A patient with cirrhosis is exhibiting confusion, asterixis, and a flapping tremor. Which of the following
interventions is a priority for this patient?
A. Administer a benzodiazepine for agitation
B. Restrict dietary protein intake
