NSG320 EXAM 2 NURSING CONCEPTS
QUESTIONS AND ANSWERS
1. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with an
arterial blood gas (ABG) showing pH 7.31, PaCO2 55 mmHg, and HCO3 28 mEq/L. Which acid-
base imbalance is occurring?
A. Partially Compensated Respiratory Acidosis
B. Compensated Respiratory Alkalosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is below 7.35 (acidosis), the PaCO2 is high (respiratory
cause), and the HCO3 is elevated, indicating the kidneys are attempting to compensate but
haven’t normalized the pH yet.
2. Which clinical manifestation should a nurse expect to find in a patient experiencing
hypocalcemia?
A. Trousseau’s sign
,B. Negative Chvostek’s sign
C. Shortened QT interval on ECG
D. Hyporeflexia
Answer: A
Conceptual Explanation: Hypocalcemia increases neuromuscular excitability, leading to
Trousseau’s sign (carpal spasm with BP cuff inflation) and Chvostek’s sign.
3. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing intervention
is the highest priority?
A. Encouraging oral fluid intake
B. Administering 0.45% Sodium Chloride intravenously
C. Checking orthostatic blood pressure
D. Implementing seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) puts the patient at
high risk for cerebral edema and seizures.
4. A nurse is caring for a patient with heart failure. Which assessment finding is most
indicative of right-sided heart failure?
A. Pulmonary crackles
B. Jugular venous distention
, C. Dyspnea on exertion
D. Frothy pink sputum
Answer: B
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly.
5. A patient’s EKG shows peaked T-waves and a widened QRS complex. Which electrolyte
imbalance should the nurse suspect?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Conceptual Explanation: Hyperkalemia causes peaked T-waves and eventually QRS
widening, which can lead to cardiac arrest.
6. When administering intravenous potassium chloride, which action by the nurse is
essential?
A. Administering via IV push for rapid effect
B. Avoiding the use of an infusion pump
C. Restricting fluid intake during administration
QUESTIONS AND ANSWERS
1. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with an
arterial blood gas (ABG) showing pH 7.31, PaCO2 55 mmHg, and HCO3 28 mEq/L. Which acid-
base imbalance is occurring?
A. Partially Compensated Respiratory Acidosis
B. Compensated Respiratory Alkalosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is below 7.35 (acidosis), the PaCO2 is high (respiratory
cause), and the HCO3 is elevated, indicating the kidneys are attempting to compensate but
haven’t normalized the pH yet.
2. Which clinical manifestation should a nurse expect to find in a patient experiencing
hypocalcemia?
A. Trousseau’s sign
,B. Negative Chvostek’s sign
C. Shortened QT interval on ECG
D. Hyporeflexia
Answer: A
Conceptual Explanation: Hypocalcemia increases neuromuscular excitability, leading to
Trousseau’s sign (carpal spasm with BP cuff inflation) and Chvostek’s sign.
3. A patient is admitted with a serum sodium level of 118 mEq/L. Which nursing intervention
is the highest priority?
A. Encouraging oral fluid intake
B. Administering 0.45% Sodium Chloride intravenously
C. Checking orthostatic blood pressure
D. Implementing seizure precautions
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) puts the patient at
high risk for cerebral edema and seizures.
4. A nurse is caring for a patient with heart failure. Which assessment finding is most
indicative of right-sided heart failure?
A. Pulmonary crackles
B. Jugular venous distention
, C. Dyspnea on exertion
D. Frothy pink sputum
Answer: B
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly.
5. A patient’s EKG shows peaked T-waves and a widened QRS complex. Which electrolyte
imbalance should the nurse suspect?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Conceptual Explanation: Hyperkalemia causes peaked T-waves and eventually QRS
widening, which can lead to cardiac arrest.
6. When administering intravenous potassium chloride, which action by the nurse is
essential?
A. Administering via IV push for rapid effect
B. Avoiding the use of an infusion pump
C. Restricting fluid intake during administration
