MEDICAL-SURGICAL NURSING EXAM 3
COMPREHENSIVE STUDY GUIDE
1. A patient presents with a potassium level of 6.8 mEq/L and tall, peaked T waves on the
EKG. Which medication should the nurse expect to administer first to stabilize the cardiac
membrane?
A. Sodium Polystyrene Sulfonate
B. Insulin with Dextrose
C. Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: Calcium gluconate is administered in severe hyperkalemia to
stabilize the myocardial cell membrane and prevent life-threatening arrhythmias, though it
does not lower the actual potassium level.
2. Which assessment finding is a hallmark sign of a patient experiencing Cardiac Tamponade?
A. Bounding peripheral pulses
B. Hypotension with bradycardia
,C. Flattened neck veins
D. Narrowed pulse pressure and muffled heart sounds
Answer: D
Conceptual Explanation: Beck’s triad for cardiac tamponade includes hypotension,
muffled heart sounds, and jugular venous distention (JVD), often accompanied by a
narrowed pulse pressure.
3. A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL, Kussmaul
respirations, and a pH of 7.25. What is the priority nursing intervention?
A. Administering subcutaneous Glargine insulin
B. Giving oral glucose tablets
C. Initiating IV fluid resuscitation with Normal Saline
D. Administering IV Bicarbonate
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the immediate priority is fluid
resuscitation to restore circulatory volume and perfusion before or concurrent with insulin
therapy.
, 4. A patient is 12 hours post-thyroidectomy. The nurse notes the patient is experiencing
muscle twitching and a positive Chvostek’s sign. Which electrolyte imbalance does this
indicate?
A. Hyperkalemia
B. Hypomagnesemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Conceptual Explanation: Hypocalcemia is a potential complication of thyroidectomy if the
parathyroid glands are accidentally damaged or removed, leading to neuromuscular
irritability like Chvostek’s sign.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Which oxygen flow rate is typically recommended to avoid suppressing the hypoxic
drive?
A. 10-12 Liters/min
B. 6-8 Liters/min
C. 1-2 Liters/min
D. Non-rebreather mask at 15 Liters/min
Answer: C
COMPREHENSIVE STUDY GUIDE
1. A patient presents with a potassium level of 6.8 mEq/L and tall, peaked T waves on the
EKG. Which medication should the nurse expect to administer first to stabilize the cardiac
membrane?
A. Sodium Polystyrene Sulfonate
B. Insulin with Dextrose
C. Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: Calcium gluconate is administered in severe hyperkalemia to
stabilize the myocardial cell membrane and prevent life-threatening arrhythmias, though it
does not lower the actual potassium level.
2. Which assessment finding is a hallmark sign of a patient experiencing Cardiac Tamponade?
A. Bounding peripheral pulses
B. Hypotension with bradycardia
,C. Flattened neck veins
D. Narrowed pulse pressure and muffled heart sounds
Answer: D
Conceptual Explanation: Beck’s triad for cardiac tamponade includes hypotension,
muffled heart sounds, and jugular venous distention (JVD), often accompanied by a
narrowed pulse pressure.
3. A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL, Kussmaul
respirations, and a pH of 7.25. What is the priority nursing intervention?
A. Administering subcutaneous Glargine insulin
B. Giving oral glucose tablets
C. Initiating IV fluid resuscitation with Normal Saline
D. Administering IV Bicarbonate
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the immediate priority is fluid
resuscitation to restore circulatory volume and perfusion before or concurrent with insulin
therapy.
, 4. A patient is 12 hours post-thyroidectomy. The nurse notes the patient is experiencing
muscle twitching and a positive Chvostek’s sign. Which electrolyte imbalance does this
indicate?
A. Hyperkalemia
B. Hypomagnesemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Conceptual Explanation: Hypocalcemia is a potential complication of thyroidectomy if the
parathyroid glands are accidentally damaged or removed, leading to neuromuscular
irritability like Chvostek’s sign.
5. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Which oxygen flow rate is typically recommended to avoid suppressing the hypoxic
drive?
A. 10-12 Liters/min
B. 6-8 Liters/min
C. 1-2 Liters/min
D. Non-rebreather mask at 15 Liters/min
Answer: C
