NURS 120 MEDICAL-SURGICAL
NURSING EXAM 1 STUDY GUIDE (2026
UPDATE) - COMPREHENSIVE REVIEW
1. A patient is admitted with a serum potassium level of 6.2 mEq/L. Which assessment finding
should the nurse prioritize?
A. Muscle weakness and leg cramps
B. Cardiac dysrhythmias and peaked T-waves
C. Hyperactive bowel sounds and diarrhea
D. Increased urinary output and dilute urine
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes significant changes in cardiac
conduction, most notably peaked T-waves and potentially lethal dysrhythmias like V-fib.
2. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.35, PaCO2 40, HCO3 24
B. pH 7.42, PaCO2 48, HCO3 32
C. pH 7.28, PaCO2 55, HCO3 24
,D. pH 7.32, PaCO2 50, HCO3 30
Answer: D
Conceptual Explanation: Partial compensation means the pH is still abnormal (low for
acidosis), the primary cause (CO2) is high, and the buffer (HCO3) is moving in the opposite
direction to compensate.
3. A nurse is caring for a patient who has developed malignant hyperthermia during surgery.
What is the priority medication to administer?
A. Succinylcholine
B. Dantrolene sodium
C. Epinephrine
D. Atropine sulfate
Answer: B
Conceptual Explanation: Dantrolene is the only specific skeletal muscle relaxant used to
treat the metabolic crisis of malignant hyperthermia.
4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
For which specific surgical risk should the nurse screen?
A. Iodine sensitivity
B. Latex allergy
C. Penicillin cross-reactivity
, D. Propofol intolerance
Answer: B
Conceptual Explanation: There is a known cross-reactivity between certain fruits
(bananas, avocados, kiwis) and latex due to similar protein structures.
5. A patient with a serum sodium level of 120 mEq/L is at highest risk for which complication?
A. Seizures and cerebral edema
B. Cardiac arrest
C. Tetany and Chvostek’s sign
D. Profound dehydration and thirst
Answer: A
Conceptual Explanation: Severe hyponatremia causes fluid to shift into cells, leading to
cerebral edema, confusion, and seizures.
6. Which nursing intervention is most appropriate for a patient with a Stage 2 pressure injury
on the coccyx?
A. Massaging the reddened area every 2 hours
B. Applying a dry gauze dressing
C. Performing surgical debridement
D. Applying a hydrocolloid dressing
NURSING EXAM 1 STUDY GUIDE (2026
UPDATE) - COMPREHENSIVE REVIEW
1. A patient is admitted with a serum potassium level of 6.2 mEq/L. Which assessment finding
should the nurse prioritize?
A. Muscle weakness and leg cramps
B. Cardiac dysrhythmias and peaked T-waves
C. Hyperactive bowel sounds and diarrhea
D. Increased urinary output and dilute urine
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes significant changes in cardiac
conduction, most notably peaked T-waves and potentially lethal dysrhythmias like V-fib.
2. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.35, PaCO2 40, HCO3 24
B. pH 7.42, PaCO2 48, HCO3 32
C. pH 7.28, PaCO2 55, HCO3 24
,D. pH 7.32, PaCO2 50, HCO3 30
Answer: D
Conceptual Explanation: Partial compensation means the pH is still abnormal (low for
acidosis), the primary cause (CO2) is high, and the buffer (HCO3) is moving in the opposite
direction to compensate.
3. A nurse is caring for a patient who has developed malignant hyperthermia during surgery.
What is the priority medication to administer?
A. Succinylcholine
B. Dantrolene sodium
C. Epinephrine
D. Atropine sulfate
Answer: B
Conceptual Explanation: Dantrolene is the only specific skeletal muscle relaxant used to
treat the metabolic crisis of malignant hyperthermia.
4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
For which specific surgical risk should the nurse screen?
A. Iodine sensitivity
B. Latex allergy
C. Penicillin cross-reactivity
, D. Propofol intolerance
Answer: B
Conceptual Explanation: There is a known cross-reactivity between certain fruits
(bananas, avocados, kiwis) and latex due to similar protein structures.
5. A patient with a serum sodium level of 120 mEq/L is at highest risk for which complication?
A. Seizures and cerebral edema
B. Cardiac arrest
C. Tetany and Chvostek’s sign
D. Profound dehydration and thirst
Answer: A
Conceptual Explanation: Severe hyponatremia causes fluid to shift into cells, leading to
cerebral edema, confusion, and seizures.
6. Which nursing intervention is most appropriate for a patient with a Stage 2 pressure injury
on the coccyx?
A. Massaging the reddened area every 2 hours
B. Applying a dry gauze dressing
C. Performing surgical debridement
D. Applying a hydrocolloid dressing
