NSG 3100 Exam 4 | Practice Questions & Answers + Focused
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Medical-Surgical Foundations and Assessment
Q1: A nurse is reviewing the morning laboratory results for a patient scheduled for an
elective total hip arthroplasty later today. Which of the following values requires immediate
notification of the surgeon and a delay of the procedure?
A. Hemoglobin 11.5 g/dL
B. Serum potassium 6.2 mEq/L [CORRECT]
C. Blood glucose 110 mg/dL
D. White blood cell count 6,500/mm³
Correct Answer: B
Rationale: The best answer is the potassium level of 6.2 mEq/L, as severe hyperkalemia
places the patient at an immediate and critical risk for lethal cardiac dysrhythmias,
especially under the stress of general anesthesia.
Q2: A patient with a history of chronic obstructive pulmonary disease (COPD) is admitted
with an exacerbation. Which assessment finding is most consistent with right-sided heart
failure secondary to their respiratory disease?
A. Bilateral crackles in the lower lung bases
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Jugular venous distention and hepatomegaly [CORRECT]
D. Pink, frothy sputum production
Correct Answer: C
Rationale: This choice is correct because right-sided heart failure (cor pulmonale) causes a
backup of blood into the systemic venous system, leading to classic signs like jugular venous
distention, peripheral edema, and an enlarged liver.
Q3: During a respiratory assessment, the nurse notes that a patient with emphysema has a
barrel-shaped chest and uses accessory muscles to breathe. Which underlying
pathophysiological change explains this physical presentation?
A. Excessive mucus production causing airway obstruction
B. Destruction of alveolar walls leading to air trapping and hyperinflation [CORRECT]
C. Inflammation and thickening of the pleural lining
D. Bronchospasm triggered by environmental allergens
Correct Answer: B
Rationale: This aligns with the principle that emphysema involves the destruction of alveolar
elasticity, which causes air to become trapped in the lungs, leading to chronic hyperinflation
and the characteristic barrel chest.
, Q4: A patient with hypoparathyroidism is being assessed for signs of hypocalcemia. The
nurse taps the patient's facial nerve just anterior to the earlobe, and the patient's lip
twitches. What is this clinical sign called?
A. Trousseau’s sign
B. Chvostek’s sign [CORRECT]
C. Babinski reflex
D. Homans’ sign
Correct Answer: B
Rationale: The best answer is Chvostek’s sign, which is a classic indicator of neuromuscular
irritability caused by low serum calcium levels when the facial nerve is stimulated.
Q5: A nurse is evaluating the arterial blood gas (ABG) results for a patient with severe
diarrhea. The laboratory data snippet is as follows:
| Test | Result | Normal Range |
|---|---|---|
| pH | 7.28 | 7.35 - 7.45 |
| PaCO2 | 28 mmHg | 35 - 45 mmHg |
| HCO3- | 14 mEq/L | 22 - 26 mEq/L |
Based on this data, how should the nurse interpret this acid-base imbalance?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory alkalosis
C. Partially compensated metabolic acidosis [CORRECT]
D. Fully compensated metabolic alkalosis
Correct Answer: C
Rationale: This choice is correct because the low pH and low bicarbonate indicate a primary
metabolic acidosis, while the low PaCO2 shows the respiratory system is actively
compensating by hyperventilating to blow off carbon dioxide.
Q6: When performing a neurological assessment using the Glasgow Coma Scale (GCS),
which three parameters must the nurse evaluate to determine the patient's total score?
A. Pupillary response, motor strength, and verbal orientation
B. Eye-opening, verbal response, and motor response [CORRECT]
C. Cranial nerve function, reflex testing, and gait stability
D. Level of consciousness, speech clarity, and memory recall
Correct Answer: B
Rationale: This matches the principle that the GCS is strictly calculated based on the
patient's best eye-opening, verbal, and motor responses to stimuli, yielding a score between
3 and 15.
Q7: A patient who had a cast applied to their right lower leg four hours ago complains of
severe, burning pain that is not relieved by the prescribed intravenous morphine. What is
the most critical early assessment finding of compartment syndrome?
A. Inability to move the toes
B. Pain out of proportion to the injury, especially with passive stretch [CORRECT]
C. Absent pedal pulses on the affected side
D. Cool, mottled skin on the foot
Review | Galen Actual Exam 2026/2027 | Complete Exam-
Style Questions with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Medical-Surgical Foundations and Assessment
Q1: A nurse is reviewing the morning laboratory results for a patient scheduled for an
elective total hip arthroplasty later today. Which of the following values requires immediate
notification of the surgeon and a delay of the procedure?
A. Hemoglobin 11.5 g/dL
B. Serum potassium 6.2 mEq/L [CORRECT]
C. Blood glucose 110 mg/dL
D. White blood cell count 6,500/mm³
Correct Answer: B
Rationale: The best answer is the potassium level of 6.2 mEq/L, as severe hyperkalemia
places the patient at an immediate and critical risk for lethal cardiac dysrhythmias,
especially under the stress of general anesthesia.
Q2: A patient with a history of chronic obstructive pulmonary disease (COPD) is admitted
with an exacerbation. Which assessment finding is most consistent with right-sided heart
failure secondary to their respiratory disease?
A. Bilateral crackles in the lower lung bases
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Jugular venous distention and hepatomegaly [CORRECT]
D. Pink, frothy sputum production
Correct Answer: C
Rationale: This choice is correct because right-sided heart failure (cor pulmonale) causes a
backup of blood into the systemic venous system, leading to classic signs like jugular venous
distention, peripheral edema, and an enlarged liver.
Q3: During a respiratory assessment, the nurse notes that a patient with emphysema has a
barrel-shaped chest and uses accessory muscles to breathe. Which underlying
pathophysiological change explains this physical presentation?
A. Excessive mucus production causing airway obstruction
B. Destruction of alveolar walls leading to air trapping and hyperinflation [CORRECT]
C. Inflammation and thickening of the pleural lining
D. Bronchospasm triggered by environmental allergens
Correct Answer: B
Rationale: This aligns with the principle that emphysema involves the destruction of alveolar
elasticity, which causes air to become trapped in the lungs, leading to chronic hyperinflation
and the characteristic barrel chest.
, Q4: A patient with hypoparathyroidism is being assessed for signs of hypocalcemia. The
nurse taps the patient's facial nerve just anterior to the earlobe, and the patient's lip
twitches. What is this clinical sign called?
A. Trousseau’s sign
B. Chvostek’s sign [CORRECT]
C. Babinski reflex
D. Homans’ sign
Correct Answer: B
Rationale: The best answer is Chvostek’s sign, which is a classic indicator of neuromuscular
irritability caused by low serum calcium levels when the facial nerve is stimulated.
Q5: A nurse is evaluating the arterial blood gas (ABG) results for a patient with severe
diarrhea. The laboratory data snippet is as follows:
| Test | Result | Normal Range |
|---|---|---|
| pH | 7.28 | 7.35 - 7.45 |
| PaCO2 | 28 mmHg | 35 - 45 mmHg |
| HCO3- | 14 mEq/L | 22 - 26 mEq/L |
Based on this data, how should the nurse interpret this acid-base imbalance?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory alkalosis
C. Partially compensated metabolic acidosis [CORRECT]
D. Fully compensated metabolic alkalosis
Correct Answer: C
Rationale: This choice is correct because the low pH and low bicarbonate indicate a primary
metabolic acidosis, while the low PaCO2 shows the respiratory system is actively
compensating by hyperventilating to blow off carbon dioxide.
Q6: When performing a neurological assessment using the Glasgow Coma Scale (GCS),
which three parameters must the nurse evaluate to determine the patient's total score?
A. Pupillary response, motor strength, and verbal orientation
B. Eye-opening, verbal response, and motor response [CORRECT]
C. Cranial nerve function, reflex testing, and gait stability
D. Level of consciousness, speech clarity, and memory recall
Correct Answer: B
Rationale: This matches the principle that the GCS is strictly calculated based on the
patient's best eye-opening, verbal, and motor responses to stimuli, yielding a score between
3 and 15.
Q7: A patient who had a cast applied to their right lower leg four hours ago complains of
severe, burning pain that is not relieved by the prescribed intravenous morphine. What is
the most critical early assessment finding of compartment syndrome?
A. Inability to move the toes
B. Pain out of proportion to the injury, especially with passive stretch [CORRECT]
C. Absent pedal pulses on the affected side
D. Cool, mottled skin on the foot
