NSG 1400 Medical-Surgical Nursing I
VERIFIED EXAM PREP & SUCCESS GUIDE (2026/2027) - GALEN COLLEGE
(1) A patient with persistent vomiting is at risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
CORRECT ANSWER: B
Med-Surg Rationale: Vomiting results in the loss of gastric hydrochloric acid, leading to
an excess of bicarbonate in the blood (Metabolic Alkalosis).
(2) Which clinical manifestation should the nurse expect in a patient with a serum
potassium level of 2.8 mEq/L?
A. Peaked T-waves
B. Muscle weakness and leg cramps
C. Hyperactive bowel sounds
D. Chvostek's sign
CORRECT ANSWER: B
Med-Surg Rationale: Hypokalemia (low potassium) commonly causes neuromuscular
excitability decrease, leading to muscle weakness, cramps, and cardiac arrhythmias (U-
waves, flat T-waves).
,(3) A nurse is preparing a patient for surgery. What is the priority nursing action to
ensure patient safety?
A. Administering the pre-operative sedative.
B. Verifying the patient has signed the informed consent form.
C. Teaching the patient how to use the incentive spirometer.
D. Removing the patient's jewelry and dentures.
CORRECT ANSWER: B
Med-Surg Rationale: While all are important, ensuring informed consent is signed and on
the chart is a critical legal and safety requirement before any invasive procedure begins.
(4) To prevent post-operative deep vein thrombosis (DVT), which intervention is most
effective?
A. Administering prophylactic Vitamin K.
B. Encouraging early ambulation and leg exercises.
C. Placing a pillow under the patient's knees.
D. Massaging the patient's calves hourly.
CORRECT ANSWER: B
Med-Surg Rationale: Early ambulation and active leg exercises promote venous return
and prevent stasis, the primary cause of DVT. Massaging calves is contraindicated as it may
dislodge an existing clot.
,(5) Which 'Warning Sign' of cancer is represented by the 'T' in the CAUTION acronym?
A. Tenderness in the joints
B. Thickening or a lump in the breast or elsewhere
C. Temporary loss of vision
D. Tiredness and fatigue
CORRECT ANSWER: B
Med-Surg Rationale: CAUTION: Change in bowel/bladder, A sore that won't heal, Unusual
bleeding, Thickening/lump, Indigestion, Obvious change in wart/mole, Nagging cough.
(6) A patient receiving chemotherapy has a platelet count of 40,000/mm3. Which
nursing intervention is most important?
A. Implement neutropenic precautions.
B. Monitor for signs of bleeding and use a soft toothbrush.
C. Increase intake of dark leafy greens.
D. Administer erythropoietin as ordered.
CORRECT ANSWER: B
Med-Surg Rationale: Thrombocytopenia (low platelets) increases the risk of bleeding.
Precautions include avoiding IM injections and using soft tools for hygiene.
, (7) A patient is using a Patient-Controlled Analgesia (PCA) pump. The nurse finds the
patient's respiratory rate is 8 breaths per minute. What is the priority action?
A. Check the pump settings for a malfunction.
B. Document the findings and continue to monitor.
C. Administer Naloxone (Narcan) per protocol.
D. Stimulate the patient and encourage deep breathing.
CORRECT ANSWER: C
Med-Surg Rationale: Opioid-induced respiratory depression (RR < 10) is a medical
emergency requiring the reversal agent Naloxone.
(8) An elderly patient with a history of heart failure is receiving an IV infusion. The
nurse notes new crackles in the lung bases and jugular venous distention. The nurse
suspects:
A. Allergic reaction
B. Fluid volume deficit
C. Fluid volume overload
D. Septic shock
CORRECT ANSWER: C
Med-Surg Rationale: Crackles and JVD are classic signs of hypervolemia (fluid overload),
especially in patients with compromised cardiac function.
VERIFIED EXAM PREP & SUCCESS GUIDE (2026/2027) - GALEN COLLEGE
(1) A patient with persistent vomiting is at risk for which acid-base imbalance?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
CORRECT ANSWER: B
Med-Surg Rationale: Vomiting results in the loss of gastric hydrochloric acid, leading to
an excess of bicarbonate in the blood (Metabolic Alkalosis).
(2) Which clinical manifestation should the nurse expect in a patient with a serum
potassium level of 2.8 mEq/L?
A. Peaked T-waves
B. Muscle weakness and leg cramps
C. Hyperactive bowel sounds
D. Chvostek's sign
CORRECT ANSWER: B
Med-Surg Rationale: Hypokalemia (low potassium) commonly causes neuromuscular
excitability decrease, leading to muscle weakness, cramps, and cardiac arrhythmias (U-
waves, flat T-waves).
,(3) A nurse is preparing a patient for surgery. What is the priority nursing action to
ensure patient safety?
A. Administering the pre-operative sedative.
B. Verifying the patient has signed the informed consent form.
C. Teaching the patient how to use the incentive spirometer.
D. Removing the patient's jewelry and dentures.
CORRECT ANSWER: B
Med-Surg Rationale: While all are important, ensuring informed consent is signed and on
the chart is a critical legal and safety requirement before any invasive procedure begins.
(4) To prevent post-operative deep vein thrombosis (DVT), which intervention is most
effective?
A. Administering prophylactic Vitamin K.
B. Encouraging early ambulation and leg exercises.
C. Placing a pillow under the patient's knees.
D. Massaging the patient's calves hourly.
CORRECT ANSWER: B
Med-Surg Rationale: Early ambulation and active leg exercises promote venous return
and prevent stasis, the primary cause of DVT. Massaging calves is contraindicated as it may
dislodge an existing clot.
,(5) Which 'Warning Sign' of cancer is represented by the 'T' in the CAUTION acronym?
A. Tenderness in the joints
B. Thickening or a lump in the breast or elsewhere
C. Temporary loss of vision
D. Tiredness and fatigue
CORRECT ANSWER: B
Med-Surg Rationale: CAUTION: Change in bowel/bladder, A sore that won't heal, Unusual
bleeding, Thickening/lump, Indigestion, Obvious change in wart/mole, Nagging cough.
(6) A patient receiving chemotherapy has a platelet count of 40,000/mm3. Which
nursing intervention is most important?
A. Implement neutropenic precautions.
B. Monitor for signs of bleeding and use a soft toothbrush.
C. Increase intake of dark leafy greens.
D. Administer erythropoietin as ordered.
CORRECT ANSWER: B
Med-Surg Rationale: Thrombocytopenia (low platelets) increases the risk of bleeding.
Precautions include avoiding IM injections and using soft tools for hygiene.
, (7) A patient is using a Patient-Controlled Analgesia (PCA) pump. The nurse finds the
patient's respiratory rate is 8 breaths per minute. What is the priority action?
A. Check the pump settings for a malfunction.
B. Document the findings and continue to monitor.
C. Administer Naloxone (Narcan) per protocol.
D. Stimulate the patient and encourage deep breathing.
CORRECT ANSWER: C
Med-Surg Rationale: Opioid-induced respiratory depression (RR < 10) is a medical
emergency requiring the reversal agent Naloxone.
(8) An elderly patient with a history of heart failure is receiving an IV infusion. The
nurse notes new crackles in the lung bases and jugular venous distention. The nurse
suspects:
A. Allergic reaction
B. Fluid volume deficit
C. Fluid volume overload
D. Septic shock
CORRECT ANSWER: C
Med-Surg Rationale: Crackles and JVD are classic signs of hypervolemia (fluid overload),
especially in patients with compromised cardiac function.
