NUR 242 MEDICAL-SURGICAL NURSING
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause, and since the bicarbonate is within the normal range, it is
respiratory acidosis.
2. Which clinical manifestation is most characteristic of a patient experiencing digoxin
toxicity?
A. Significant hypertension and tachycardia
,B. Visual disturbances, such as yellow or green halos
C. Profuse diaphoresis and shivering
D. Increased urinary output and thirst
Answer: B
Conceptual Explanation: Signs of digoxin toxicity include visual changes (yellow/green
halos), bradycardia, nausea, and vomiting.
3. A patient with a suspected head injury exhibits Cushing’s Triad. Which set of vital signs
does the nurse expect to find?
A. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and Kussmaul respirations
Answer: A
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
characterized by bradycardia, hypertension (widening pulse pressure), and irregular
respirations.
4. Which assessment finding is considered the earliest sign of compartment syndrome in a
patient with a lower leg fracture?
A. Absence of a pedal pulse
, B. Paralysis of the toes
C. Coolness of the extremity
D. Paresthesia or intense pain unrelieved by medication
Answer: D
Conceptual Explanation: The 6 P’s of compartment syndrome include pain, pressure,
paralysis, pallor, pulselessness, and paresthesia. Pain unrelieved by meds and paresthesia
are often the earliest signs.
5. A patient suddenly develops pleuritic chest pain, dyspnea, and a cough with hemoptysis.
Which condition should the nurse suspect first?
A. Myocardial Infarction
B. Pneumothorax
C. Pulmonary Embolism
D. Acute Bronchitis
Answer: C
Conceptual Explanation: Sudden onset of dyspnea, pleuritic chest pain, and hemoptysis
are classic signs of a pulmonary embolism (PE).
6. In a patient diagnosed with Diabetic Ketoacidosis (DKA), which respiratory pattern is the
body’s attempt to compensate for metabolic acidosis?
A. Hypoventilation
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a pH of 7.30, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause, and since the bicarbonate is within the normal range, it is
respiratory acidosis.
2. Which clinical manifestation is most characteristic of a patient experiencing digoxin
toxicity?
A. Significant hypertension and tachycardia
,B. Visual disturbances, such as yellow or green halos
C. Profuse diaphoresis and shivering
D. Increased urinary output and thirst
Answer: B
Conceptual Explanation: Signs of digoxin toxicity include visual changes (yellow/green
halos), bradycardia, nausea, and vomiting.
3. A patient with a suspected head injury exhibits Cushing’s Triad. Which set of vital signs
does the nurse expect to find?
A. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and Kussmaul respirations
Answer: A
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
characterized by bradycardia, hypertension (widening pulse pressure), and irregular
respirations.
4. Which assessment finding is considered the earliest sign of compartment syndrome in a
patient with a lower leg fracture?
A. Absence of a pedal pulse
, B. Paralysis of the toes
C. Coolness of the extremity
D. Paresthesia or intense pain unrelieved by medication
Answer: D
Conceptual Explanation: The 6 P’s of compartment syndrome include pain, pressure,
paralysis, pallor, pulselessness, and paresthesia. Pain unrelieved by meds and paresthesia
are often the earliest signs.
5. A patient suddenly develops pleuritic chest pain, dyspnea, and a cough with hemoptysis.
Which condition should the nurse suspect first?
A. Myocardial Infarction
B. Pneumothorax
C. Pulmonary Embolism
D. Acute Bronchitis
Answer: C
Conceptual Explanation: Sudden onset of dyspnea, pleuritic chest pain, and hemoptysis
are classic signs of a pulmonary embolism (PE).
6. In a patient diagnosed with Diabetic Ketoacidosis (DKA), which respiratory pattern is the
body’s attempt to compensate for metabolic acidosis?
A. Hypoventilation
