NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 3 PREP 2026 GALEN COLLEGE
1. A patient’s arterial blood gas (ABG) results are pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory
component), and the HCO3 is within normal limits, indicating uncompensated respiratory
acidosis.
2. During the intraoperative phase, a patient develops muscle rigidity, tachycardia, and a
rapidly rising temperature. What is the priority nursing action?
A. Increase oxygen flow
B. Apply cooling blankets
C. Administer IV Dantrolene
,D. Notify the surgeon immediately
Answer: C
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening complication of general anesthesia. Dantrolene is the specific antidote needed
to stop the calcium release.
3. A patient with a potassium level of 6.2 mEq/L is admitted. Which ECG change is the nurse
most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves. U
waves and ST depression are associated with hypokalemia.
4. Which clinical manifestation is a hallmark sign of hypocalcemia?
A. Muscle weakness
B. Positive Trousseau’s sign
C. Constipation
D. Hyporeflexia
, Answer: B
Conceptual Explanation: Trousseau’s sign (carpal spasm with BP cuff inflation) and
Chvostek’s sign are indicative of neuromuscular excitability caused by low calcium.
5. A nurse is caring for a patient with COPD who is receiving oxygen via nasal cannula. Which
oxygen flow rate is generally appropriate to avoid suppressing the hypoxic drive?
A. 8-10 L/min
B. 5-6 L/min
C. 1-2 L/min
D. 12-15 L/min
Answer: C
Conceptual Explanation: Patients with chronic hypercapnia rely on low oxygen levels to
stimulate breathing. High levels of O2 can suppress this drive.
6. A post-operative patient reports sudden chest pain and dyspnea. The nurse suspects a
pulmonary embolism. What is the immediate priority?
A. Obtain a chest X-ray
B. Apply high-flow oxygen
C. Start an IV infusion of Heparin
D. Prepare for an EKG
Answer: B
- EXAM 3 PREP 2026 GALEN COLLEGE
1. A patient’s arterial blood gas (ABG) results are pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory
component), and the HCO3 is within normal limits, indicating uncompensated respiratory
acidosis.
2. During the intraoperative phase, a patient develops muscle rigidity, tachycardia, and a
rapidly rising temperature. What is the priority nursing action?
A. Increase oxygen flow
B. Apply cooling blankets
C. Administer IV Dantrolene
,D. Notify the surgeon immediately
Answer: C
Conceptual Explanation: These are classic signs of Malignant Hyperthermia, a life-
threatening complication of general anesthesia. Dantrolene is the specific antidote needed
to stop the calcium release.
3. A patient with a potassium level of 6.2 mEq/L is admitted. Which ECG change is the nurse
most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves. U
waves and ST depression are associated with hypokalemia.
4. Which clinical manifestation is a hallmark sign of hypocalcemia?
A. Muscle weakness
B. Positive Trousseau’s sign
C. Constipation
D. Hyporeflexia
, Answer: B
Conceptual Explanation: Trousseau’s sign (carpal spasm with BP cuff inflation) and
Chvostek’s sign are indicative of neuromuscular excitability caused by low calcium.
5. A nurse is caring for a patient with COPD who is receiving oxygen via nasal cannula. Which
oxygen flow rate is generally appropriate to avoid suppressing the hypoxic drive?
A. 8-10 L/min
B. 5-6 L/min
C. 1-2 L/min
D. 12-15 L/min
Answer: C
Conceptual Explanation: Patients with chronic hypercapnia rely on low oxygen levels to
stimulate breathing. High levels of O2 can suppress this drive.
6. A post-operative patient reports sudden chest pain and dyspnea. The nurse suspects a
pulmonary embolism. What is the immediate priority?
A. Obtain a chest X-ray
B. Apply high-flow oxygen
C. Start an IV infusion of Heparin
D. Prepare for an EKG
Answer: B
