NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 2 COMPREHENSIVE PREP
1. A patient is admitted with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L. Which
condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. The elevated PaCO2 (>45)
indicates a respiratory cause, while the normal HCO3 indicates no compensation has
occurred yet.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with a
potassium level of 6.2 mEq/L?
A. Hyperactive bowel sounds
B. Tall, peaked T-waves on ECG
C. Increased muscle strength
,D. Tachycardia
Answer: B
Conceptual Explanation: Hyperkalemia (K > 5.0) can cause life-threatening cardiac
dysrhythmias. Tall, peaked T-waves are a classic early sign of high potassium levels.
3. A patient with a history of chronic alcoholism is at highest risk for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypernatremia
C. Hypomagnesemia
D. Hypokalemia
Answer: C
Conceptual Explanation: Chronic alcohol use often leads to malnutrition and increased
renal excretion of magnesium, resulting in hypomagnesemia.
4. The nurse is caring for a patient scheduled for surgery. The patient states, ‘I’m not sure
what the surgeon is going to do.’ What is the nurse’s priority action?
A. Explain the surgical procedure to the patient.
B. Notify the surgeon that the patient needs further clarification.
C. Proceed with the preoperative checklist.
D. Ask the patient to sign the consent form anyway.
, Answer: B
Conceptual Explanation: It is the surgeon’s responsibility to explain the procedure and
obtain informed consent. The nurse’s role is to witness the signature and ensure the
patient understands; if they do not, the surgeon must be called back.
5. During the intraoperative phase, a patient develops a heart rate of 120 bpm, muscle
rigidity, and a rapidly rising temperature. Which medication should the nurse prepare?
A. Atropine
B. Epinephrine
C. Dantrolene Sodium
D. Naloxone
Answer: C
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
anesthesia complication. Dantrolene is the specific skeletal muscle relaxant used to treat it.
6. A postoperative patient reports sudden chest pain and shortness of breath. The nurse
notes a respiratory rate of 28 and oxygen saturation of 88%. What is the priority
intervention?
A. Obtain an ECG
B. Administer pain medication
C. Encourage the patient to use the incentive spirometer
- EXAM 2 COMPREHENSIVE PREP
1. A patient is admitted with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L. Which
condition does the nurse suspect?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. The elevated PaCO2 (>45)
indicates a respiratory cause, while the normal HCO3 indicates no compensation has
occurred yet.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with a
potassium level of 6.2 mEq/L?
A. Hyperactive bowel sounds
B. Tall, peaked T-waves on ECG
C. Increased muscle strength
,D. Tachycardia
Answer: B
Conceptual Explanation: Hyperkalemia (K > 5.0) can cause life-threatening cardiac
dysrhythmias. Tall, peaked T-waves are a classic early sign of high potassium levels.
3. A patient with a history of chronic alcoholism is at highest risk for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypernatremia
C. Hypomagnesemia
D. Hypokalemia
Answer: C
Conceptual Explanation: Chronic alcohol use often leads to malnutrition and increased
renal excretion of magnesium, resulting in hypomagnesemia.
4. The nurse is caring for a patient scheduled for surgery. The patient states, ‘I’m not sure
what the surgeon is going to do.’ What is the nurse’s priority action?
A. Explain the surgical procedure to the patient.
B. Notify the surgeon that the patient needs further clarification.
C. Proceed with the preoperative checklist.
D. Ask the patient to sign the consent form anyway.
, Answer: B
Conceptual Explanation: It is the surgeon’s responsibility to explain the procedure and
obtain informed consent. The nurse’s role is to witness the signature and ensure the
patient understands; if they do not, the surgeon must be called back.
5. During the intraoperative phase, a patient develops a heart rate of 120 bpm, muscle
rigidity, and a rapidly rising temperature. Which medication should the nurse prepare?
A. Atropine
B. Epinephrine
C. Dantrolene Sodium
D. Naloxone
Answer: C
Conceptual Explanation: These are signs of Malignant Hyperthermia, a life-threatening
anesthesia complication. Dantrolene is the specific skeletal muscle relaxant used to treat it.
6. A postoperative patient reports sudden chest pain and shortness of breath. The nurse
notes a respiratory rate of 28 and oxygen saturation of 88%. What is the priority
intervention?
A. Obtain an ECG
B. Administer pain medication
C. Encourage the patient to use the incentive spirometer
