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NUR 170 MED SURG EXAM 1 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
A client has a serum sodium of 150 mEq/L. Which assessment
finding is most likely?
A. Edema
B. Thirst and dry mucous membranes
C. Muscle weakness
D. Bradycardia
Answer: B
Rationale: Hypernatremia (normal 135–145 mEq/L) causes
cellular dehydration, leading to thirst and dry mucous
membranes.
Question 2
Which of the following is the normal serum potassium range?
A. 2.5–4.0 mEq/L
B. 3.5–5.0 mEq/L
C. 5.5–7.0 mEq/L
D. 1.0–3.0 mEq/L
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Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L.
Question 3
A client has a potassium level of 6.5 mEq/L. Which ECG change
is most concerning?
A. U waves
B. Peaked T waves and widened QRS
C. Prolonged PR interval only
D. ST depression only
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS,
and can lead to ventricular fibrillation/cardiac arrest.
Question 4
Which acid-base imbalance is caused by prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting causes loss of hydrochloric acid, leading to
metabolic alkalosis.
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Question 5
Which of the following is a sign of hypocalcemia?
A. Positive Chvostek's and Trousseau's signs
B. Decreased deep tendon reflexes
C. Bradycardia
D. Constipation
Answer: A
Rationale: Hypocalcemia causes neuromuscular irritability,
positive Chvostek's (facial twitch) and Trousseau's (carpal
spasm).
Question 6
A client with respiratory acidosis has which ABG finding?
A. pH 7.30, PaCO₂ 50, HCO₃ 24
B. pH 7.48, PaCO₂ 35, HCO₃ 28
C. pH 7.35, PaCO₂ 40, HCO₃ 24
D. pH 7.45, PaCO₂ 30, HCO₃ 22
Answer: A
Rationale: Respiratory acidosis is low pH with elevated PaCO₂;
HCO₃ may be normal or elevated if compensated.
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Question 7
Which of the following is the priority nursing action for a client
with hypovolemic shock?
A. Administer vasopressors first
B. Administer isotonic crystalloids and identify the source of
blood/fluid loss
C. Place in Trendelenburg
D. Give oral fluids
Answer: B
Rationale: Fluid resuscitation with isotonic crystalloids and
controlling the source of loss are priorities in hypovolemic
shock.
Question 8
A client is scheduled for surgery. Who is responsible for
obtaining informed consent?
A. The nurse
B. The surgeon/proceduralist
C. The nursing assistant
D. The pharmacist
Answer: B
Rationale: The provider performing the procedure is
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NUR 170 MED SURG EXAM 1 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
A client has a serum sodium of 150 mEq/L. Which assessment
finding is most likely?
A. Edema
B. Thirst and dry mucous membranes
C. Muscle weakness
D. Bradycardia
Answer: B
Rationale: Hypernatremia (normal 135–145 mEq/L) causes
cellular dehydration, leading to thirst and dry mucous
membranes.
Question 2
Which of the following is the normal serum potassium range?
A. 2.5–4.0 mEq/L
B. 3.5–5.0 mEq/L
C. 5.5–7.0 mEq/L
D. 1.0–3.0 mEq/L
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Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L.
Question 3
A client has a potassium level of 6.5 mEq/L. Which ECG change
is most concerning?
A. U waves
B. Peaked T waves and widened QRS
C. Prolonged PR interval only
D. ST depression only
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS,
and can lead to ventricular fibrillation/cardiac arrest.
Question 4
Which acid-base imbalance is caused by prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting causes loss of hydrochloric acid, leading to
metabolic alkalosis.
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Question 5
Which of the following is a sign of hypocalcemia?
A. Positive Chvostek's and Trousseau's signs
B. Decreased deep tendon reflexes
C. Bradycardia
D. Constipation
Answer: A
Rationale: Hypocalcemia causes neuromuscular irritability,
positive Chvostek's (facial twitch) and Trousseau's (carpal
spasm).
Question 6
A client with respiratory acidosis has which ABG finding?
A. pH 7.30, PaCO₂ 50, HCO₃ 24
B. pH 7.48, PaCO₂ 35, HCO₃ 28
C. pH 7.35, PaCO₂ 40, HCO₃ 24
D. pH 7.45, PaCO₂ 30, HCO₃ 22
Answer: A
Rationale: Respiratory acidosis is low pH with elevated PaCO₂;
HCO₃ may be normal or elevated if compensated.
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Question 7
Which of the following is the priority nursing action for a client
with hypovolemic shock?
A. Administer vasopressors first
B. Administer isotonic crystalloids and identify the source of
blood/fluid loss
C. Place in Trendelenburg
D. Give oral fluids
Answer: B
Rationale: Fluid resuscitation with isotonic crystalloids and
controlling the source of loss are priorities in hypovolemic
shock.
Question 8
A client is scheduled for surgery. Who is responsible for
obtaining informed consent?
A. The nurse
B. The surgeon/proceduralist
C. The nursing assistant
D. The pharmacist
Answer: B
Rationale: The provider performing the procedure is
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