NUR 242 EXAM 2 () | MED-
SURG NURSING QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which provider order should the nurse prioritize to prevent life-threatening cardiac
dysrhythmias?
A. Administer IV calcium gluconate
B. Administer sodium polystyrene sulfonate orally
C. Administer IV regular insulin with 50% dextrose
D. Initiate urgent hemodialysis
Answer: A
Conceptual Explanation: IV calcium gluconate is administered to stabilize the myocardial
cell membrane and prevent arrhythmias in the presence of severe hyperkalemia. While the
other options help lower potassium, they do not provide immediate cardiac protection.
2. The nurse is caring for a patient admitted with an exacerbation of Left-sided Heart Failure.
Which clinical manifestation should the nurse expect to assess?
A. Jugular venous distension (JVD)
,B. Peripheral dependent edema
C. Hepatosplenomegaly
D. Crackles in the lung bases
Answer: D
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood into the systemic circulation effectively, causing fluid
to back up into the lungs. JVD, edema, and hepatosplenomegaly are signs of right-sided
heart failure.
3. A patient is diagnosed with Pheochromocytoma. The nurse should monitor for which
classic triad of symptoms?
A. Diarrhea, flushing, and wheezing
B. Hypotension, bradycardia, and cold skin
C. Hyperglycemia, polyuria, and weight loss
D. Hypertension, headache, and diaphoresis
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The excessive release of epinephrine and norepinephrine causes severe
hypertension, pounding headaches, and profuse sweating.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 580
mg/dL, Kussmaul respirations, and a fruity breath odor. Which Acid-Base imbalance is this
patient likely experiencing?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: These are classic signs of Diabetic Ketoacidosis (DKA). The
accumulation of ketones (acids) leads to metabolic acidosis. Kussmaul respirations are the
body’s attempt to blow off CO2 to compensate for the acidity.
5. A patient with a history of COPD is receiving oxygen via nasal cannula at 2L/min. The
patient’s SpO2 is 90%. Which action is most appropriate for the nurse?
A. Increase the oxygen flow to 6L/min to reach 98% SpO2
B. Position the patient flat to improve chest expansion
C. Switch to a non-rebreather mask immediately
D. Maintain the current flow rate and continue to monitor
Answer: D
SURG NURSING QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which provider order should the nurse prioritize to prevent life-threatening cardiac
dysrhythmias?
A. Administer IV calcium gluconate
B. Administer sodium polystyrene sulfonate orally
C. Administer IV regular insulin with 50% dextrose
D. Initiate urgent hemodialysis
Answer: A
Conceptual Explanation: IV calcium gluconate is administered to stabilize the myocardial
cell membrane and prevent arrhythmias in the presence of severe hyperkalemia. While the
other options help lower potassium, they do not provide immediate cardiac protection.
2. The nurse is caring for a patient admitted with an exacerbation of Left-sided Heart Failure.
Which clinical manifestation should the nurse expect to assess?
A. Jugular venous distension (JVD)
,B. Peripheral dependent edema
C. Hepatosplenomegaly
D. Crackles in the lung bases
Answer: D
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood into the systemic circulation effectively, causing fluid
to back up into the lungs. JVD, edema, and hepatosplenomegaly are signs of right-sided
heart failure.
3. A patient is diagnosed with Pheochromocytoma. The nurse should monitor for which
classic triad of symptoms?
A. Diarrhea, flushing, and wheezing
B. Hypotension, bradycardia, and cold skin
C. Hyperglycemia, polyuria, and weight loss
D. Hypertension, headache, and diaphoresis
Answer: D
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla. The excessive release of epinephrine and norepinephrine causes severe
hypertension, pounding headaches, and profuse sweating.
, 4. A patient with Type 1 Diabetes Mellitus presents to the ED with a blood glucose of 580
mg/dL, Kussmaul respirations, and a fruity breath odor. Which Acid-Base imbalance is this
patient likely experiencing?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: These are classic signs of Diabetic Ketoacidosis (DKA). The
accumulation of ketones (acids) leads to metabolic acidosis. Kussmaul respirations are the
body’s attempt to blow off CO2 to compensate for the acidity.
5. A patient with a history of COPD is receiving oxygen via nasal cannula at 2L/min. The
patient’s SpO2 is 90%. Which action is most appropriate for the nurse?
A. Increase the oxygen flow to 6L/min to reach 98% SpO2
B. Position the patient flat to improve chest expansion
C. Switch to a non-rebreather mask immediately
D. Maintain the current flow rate and continue to monitor
Answer: D
