NUR242 MEDICAL-SURGICAL NURSING
ADVANCED STUDY GUIDE QUESTIONS
AND ANSWERS
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which electrocardiogram (ECG)
finding should the nurse prioritize for immediate reporting?
A. Prolonged PR interval
B. Presence of a U wave
C. Shortened QT interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves. This indicates a high risk for cardiac dysrhythmias and
arrest.
2. A nurse reviews the ABG results for a patient with COPD: pH 7.31, PaCO2 58 mmHg, HCO3
28 mEq/L. How should the nurse interpret these findings?
A. Compensated Metabolic Acidosis
,B. Fully Compensated Respiratory Acidosis
C. Uncompensated Respiratory Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (< 7.35), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (compensation attempt). Since the pH is not back in the normal
range, it is partially compensated.
3. A patient with suspected SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is likely
to exhibit which of the following electrolyte imbalances?
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: B
Conceptual Explanation: SIADH causes excessive water retention, which leads to
dilutional hyponatremia.
4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
What is the most critical action by the nurse?
A. Document the food allergy and proceed with standard care.
, B. Cancel the surgery immediately.
C. Ask if the patient is allergic to shellfish.
D. Alert the surgical team of a potential latex allergy.
Answer: D
Conceptual Explanation: There is a high cross-reactivity between certain fruits (bananas,
avocados, kiwis) and latex. A latex-free environment must be ensured for safety.
5. A patient is 24 hours post-abdominal surgery and has not passed flatus. The nurse notes
absent bowel sounds. What is the most likely complication?
A. Paralytic ileus
B. Evisceration
C. Diverticulitis
D. Intestinal perforation
Answer: A
Conceptual Explanation: Paralytic ileus is a common post-operative complication where
intestinal peristalsis stops temporarily, resulting in absent bowel sounds and no flatus.
6. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect?
A. Jugular venous distention (JVD)
B. Crackles in the lungs
ADVANCED STUDY GUIDE QUESTIONS
AND ANSWERS
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which electrocardiogram (ECG)
finding should the nurse prioritize for immediate reporting?
A. Prolonged PR interval
B. Presence of a U wave
C. Shortened QT interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves. This indicates a high risk for cardiac dysrhythmias and
arrest.
2. A nurse reviews the ABG results for a patient with COPD: pH 7.31, PaCO2 58 mmHg, HCO3
28 mEq/L. How should the nurse interpret these findings?
A. Compensated Metabolic Acidosis
,B. Fully Compensated Respiratory Acidosis
C. Uncompensated Respiratory Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (< 7.35), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated (compensation attempt). Since the pH is not back in the normal
range, it is partially compensated.
3. A patient with suspected SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is likely
to exhibit which of the following electrolyte imbalances?
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: B
Conceptual Explanation: SIADH causes excessive water retention, which leads to
dilutional hyponatremia.
4. During the preoperative assessment, a patient reports an allergy to bananas and avocados.
What is the most critical action by the nurse?
A. Document the food allergy and proceed with standard care.
, B. Cancel the surgery immediately.
C. Ask if the patient is allergic to shellfish.
D. Alert the surgical team of a potential latex allergy.
Answer: D
Conceptual Explanation: There is a high cross-reactivity between certain fruits (bananas,
avocados, kiwis) and latex. A latex-free environment must be ensured for safety.
5. A patient is 24 hours post-abdominal surgery and has not passed flatus. The nurse notes
absent bowel sounds. What is the most likely complication?
A. Paralytic ileus
B. Evisceration
C. Diverticulitis
D. Intestinal perforation
Answer: A
Conceptual Explanation: Paralytic ileus is a common post-operative complication where
intestinal peristalsis stops temporarily, resulting in absent bowel sounds and no flatus.
6. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect?
A. Jugular venous distention (JVD)
B. Crackles in the lungs
