NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 3 PREP 2026
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Compensated Metabolic Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (22-26 mEq/L), indicating the body has not yet
started to compensate.
2. A nurse is caring for a patient with left-sided heart failure. Which assessment finding
should the nurse prioritize?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Bilateral crackles in the lungs
,D. Abdominal distention and ascites
Answer: C
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion;
therefore, crackles (rales) are a hallmark sign of fluid backing up into the lungs.
3. Which medication should the nurse anticipate administering to a patient with a potassium
level of 6.2 mEq/L?
A. Sodium polystyrene sulfonate
B. Spironolactone
C. Intravenous Potassium Chloride
D. Lisinopril
Answer: A
Conceptual Explanation: Sodium polystyrene sulfonate (Kayexalate) is used to treat
hyperkalemia by exchanging sodium ions for potassium ions in the intestine.
4. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. The nurse notes the SpO2 is 89%. What is the most appropriate nursing
action?
A. Increase the oxygen flow to 6L/min immediately
B. Document the finding as expected for a COPD patient
C. Switch the patient to a non-rebreather mask
, D. Prepare for immediate endotracheal intubation
Answer: B
Conceptual Explanation: For patients with COPD, an SpO2 between 88% and 92% is often
targeted to prevent the suppression of their hypoxic drive to breathe.
5. When assessing a patient for Deep Vein Thrombosis (DVT), which clinical manifestation is
most characteristic?
A. Bilateral cool and pale extremities
B. Diminished pedal pulses in both feet
C. Unilateral leg swelling and warmth
D. Muscle atrophy in the affected calf
Answer: C
Conceptual Explanation: DVT typically presents unilaterally with edema, warmth,
redness, and tenderness in the affected limb.
6. A nurse is monitoring a patient receiving a heparin infusion for a pulmonary embolism.
Which laboratory value should the nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
- EXAM 3 PREP 2026
1. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Compensated Metabolic Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (22-26 mEq/L), indicating the body has not yet
started to compensate.
2. A nurse is caring for a patient with left-sided heart failure. Which assessment finding
should the nurse prioritize?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Bilateral crackles in the lungs
,D. Abdominal distention and ascites
Answer: C
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion;
therefore, crackles (rales) are a hallmark sign of fluid backing up into the lungs.
3. Which medication should the nurse anticipate administering to a patient with a potassium
level of 6.2 mEq/L?
A. Sodium polystyrene sulfonate
B. Spironolactone
C. Intravenous Potassium Chloride
D. Lisinopril
Answer: A
Conceptual Explanation: Sodium polystyrene sulfonate (Kayexalate) is used to treat
hyperkalemia by exchanging sodium ions for potassium ions in the intestine.
4. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. The nurse notes the SpO2 is 89%. What is the most appropriate nursing
action?
A. Increase the oxygen flow to 6L/min immediately
B. Document the finding as expected for a COPD patient
C. Switch the patient to a non-rebreather mask
, D. Prepare for immediate endotracheal intubation
Answer: B
Conceptual Explanation: For patients with COPD, an SpO2 between 88% and 92% is often
targeted to prevent the suppression of their hypoxic drive to breathe.
5. When assessing a patient for Deep Vein Thrombosis (DVT), which clinical manifestation is
most characteristic?
A. Bilateral cool and pale extremities
B. Diminished pedal pulses in both feet
C. Unilateral leg swelling and warmth
D. Muscle atrophy in the affected calf
Answer: C
Conceptual Explanation: DVT typically presents unilaterally with edema, warmth,
redness, and tenderness in the affected limb.
6. A nurse is monitoring a patient receiving a heparin infusion for a pulmonary embolism.
Which laboratory value should the nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
