NUR 242 MEDICAL-SURGICAL NURSING
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3- of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), and the PaCO2 is high (respiratory
cause), while the HCO3- is within the normal range, indicating an uncompensated
respiratory acidosis.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary edema
,B. Crackles in the lung bases
C. Dyspnea on exertion
D. Peripheral edema and jugular venous distention
Answer: D
Conceptual Explanation: Right-sided heart failure results in systemic congestion, leading
to peripheral edema, hepatomegaly, and jugular venous distention (JVD).
3. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 40 mg/dL.
What is the priority intervention for the nurse?
A. Administer 15g of oral glucose gel
B. Provide 4 oz of orange juice
C. Wait 15 minutes and recheck the blood glucose
D. Administer Glucagon IM or D50 IV
Answer: D
Conceptual Explanation: Because the patient is unconscious and cannot safely swallow,
parenteral administration of Glucagon or Dextrose 50% is required for emergency
hypoglycemia management.
4. Which assessment finding is most indicative of a tension pneumothorax?
A. Resonance on percussion
B. Bilateral breath sounds
, C. Tracheal deviation to the unaffected side
D. Productive cough with rust-colored sputum
Answer: C
Conceptual Explanation: Tension pneumothorax causes air to build up in the pleural
space, shifting mediastinal structures and causing the trachea to deviate away from the
affected side.
5. A patient is post-operative day 1 following a thyroidectomy. The nurse notes the patient
has positive Chvostek and Trousseau signs. Which electrolyte imbalance is likely?
A. Hypocalcemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: A
Conceptual Explanation: Damage to the parathyroid glands during thyroidectomy can
cause hypocalcemia, characterized by neuromuscular irritability (Chvostek’s and
Trousseau’s signs).
6. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD). Which
oxygen delivery goal is most appropriate for this patient?
A. Maintain SpO2 between 88% and 92%
COMPREHENSIVE FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3- of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), and the PaCO2 is high (respiratory
cause), while the HCO3- is within the normal range, indicating an uncompensated
respiratory acidosis.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary edema
,B. Crackles in the lung bases
C. Dyspnea on exertion
D. Peripheral edema and jugular venous distention
Answer: D
Conceptual Explanation: Right-sided heart failure results in systemic congestion, leading
to peripheral edema, hepatomegaly, and jugular venous distention (JVD).
3. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 40 mg/dL.
What is the priority intervention for the nurse?
A. Administer 15g of oral glucose gel
B. Provide 4 oz of orange juice
C. Wait 15 minutes and recheck the blood glucose
D. Administer Glucagon IM or D50 IV
Answer: D
Conceptual Explanation: Because the patient is unconscious and cannot safely swallow,
parenteral administration of Glucagon or Dextrose 50% is required for emergency
hypoglycemia management.
4. Which assessment finding is most indicative of a tension pneumothorax?
A. Resonance on percussion
B. Bilateral breath sounds
, C. Tracheal deviation to the unaffected side
D. Productive cough with rust-colored sputum
Answer: C
Conceptual Explanation: Tension pneumothorax causes air to build up in the pleural
space, shifting mediastinal structures and causing the trachea to deviate away from the
affected side.
5. A patient is post-operative day 1 following a thyroidectomy. The nurse notes the patient
has positive Chvostek and Trousseau signs. Which electrolyte imbalance is likely?
A. Hypocalcemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: A
Conceptual Explanation: Damage to the parathyroid glands during thyroidectomy can
cause hypocalcemia, characterized by neuromuscular irritability (Chvostek’s and
Trousseau’s signs).
6. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD). Which
oxygen delivery goal is most appropriate for this patient?
A. Maintain SpO2 between 88% and 92%
