Medical-Surgical Nursing
II Advanced Clinical Care Assessment
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Medical-Surgical Nursing
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,Medical-Surgical Nursing II: Advanced Clinical Care Assessment 2026/2027 UPDATED – Galen
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 50 mm Hg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause, while the normal HCO3 indicates no compensation has occurred yet.
2. Which clinical manifestation is a hallmark sign of Diabetic Ketoacidosis (DKA) but is
typically absent in Hyperosmolar Hyperglycemic State (HHS)?
A. Severe dehydration
B. Hyperglycemia
C. Altered mental status
D. Kussmaul respirations
Answer: D
, Rationale: Kussmaul respirations (deep, rapid breathing) occur in DKA as a compensatory
mechanism to blow off CO2 due to metabolic acidosis; HHS does not typically involve
significant ketosis or acidosis.
3. A patient with Chronic Kidney Disease (CKD) is prescribed a low-potassium diet. Which
food choice should the nurse advise the patient to avoid?
A. Apples
B. White rice
C. Green beans
D. Spinach
Answer: D
Rationale: Spinach is high in potassium, which can lead to life-threatening arrhythmias in
patients with impaired renal excretion.
4. The nurse is assessing a patient with a head injury and notes the following: eyes open to
pain, incomprehensible sounds, and withdrawal from pain. What is the Glasgow Coma Scale
(GCS) score?
A. 12
B. 10
C. 6
D. 8
II Advanced Clinical Care Assessment
Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Nursing Program
Medical-Surgical Nursing
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,Medical-Surgical Nursing II: Advanced Clinical Care Assessment 2026/2027 UPDATED – Galen
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 50 mm Hg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a
respiratory cause, while the normal HCO3 indicates no compensation has occurred yet.
2. Which clinical manifestation is a hallmark sign of Diabetic Ketoacidosis (DKA) but is
typically absent in Hyperosmolar Hyperglycemic State (HHS)?
A. Severe dehydration
B. Hyperglycemia
C. Altered mental status
D. Kussmaul respirations
Answer: D
, Rationale: Kussmaul respirations (deep, rapid breathing) occur in DKA as a compensatory
mechanism to blow off CO2 due to metabolic acidosis; HHS does not typically involve
significant ketosis or acidosis.
3. A patient with Chronic Kidney Disease (CKD) is prescribed a low-potassium diet. Which
food choice should the nurse advise the patient to avoid?
A. Apples
B. White rice
C. Green beans
D. Spinach
Answer: D
Rationale: Spinach is high in potassium, which can lead to life-threatening arrhythmias in
patients with impaired renal excretion.
4. The nurse is assessing a patient with a head injury and notes the following: eyes open to
pain, incomprehensible sounds, and withdrawal from pain. What is the Glasgow Coma Scale
(GCS) score?
A. 12
B. 10
C. 6
D. 8
