NUR 170 - NUR 171 MEDICAL-SURGICAL
NURSING EXAM 3 COMPREHENSIVE
QUESTIONS AND CORRECT ANSWERS
2026/2027
1. A patient with heart failure is receiving Furosemide. Which laboratory value should the
nurse monitor most closely to prevent life-threatening complications?
A. Serum Potassium 3.1 mEq/L
B. Serum Sodium 138 mEq/L
C. Serum Glucose 110 mg/dL
D. Serum Calcium 9.2 mg/dL
Answer: A
Conceptual Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. A level of 3.1 mEq/L indicates hypokalemia, which increases the risk of cardiac
arrhythmias.
2. A nurse is caring for a patient who just underwent a subtotal thyroidectomy. The nurse
notes the patient is experiencing muscle spasms and a positive Chvostek sign. Which
medication should the nurse anticipate administering?
A. Potassium Chloride
,B. Levothyroxine
C. Calcium Gluconate
D. Propylthiouracil
Answer: C
Conceptual Explanation: Muscle spasms and a positive Chvostek sign indicate
hypocalcemia, often due to accidental removal or damage to the parathyroid glands during
thyroid surgery.
3. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. The nurse notes the
SpO2 is 89% and the patient is slightly dyspneic. What is the most appropriate nursing action?
A. Increase oxygen to 6L/min immediately
B. Switch to a non-rebreather mask at 15L/min
C. Maintain the current flow and encourage pursed-lip breathing
D. Prepare for immediate intubation
Answer: C
Conceptual Explanation: In COPD patients, the drive to breathe is often triggered by low
oxygen levels rather than high CO2. Maintaining an SpO2 between 88-92% is typical;
pursed-lip breathing helps maintain airway pressure.
, 4. Which arterial blood gas (ABG) result is most indicative of a patient in Respiratory
Acidosis?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). Option A shows a pH of 7.30 and a PaCO2 of 52.
5. A nurse is preparing to administer Digoxin to a patient with Atrial Fibrillation. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure 140/90 mmHg
B. Temperature 99.1 F
C. Respiratory rate 20 breaths per minute
D. Heart rate 52 beats per minute
Answer: D
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate. It is
standard practice to hold the dose if the apical pulse is less than 60 bpm to prevent
bradycardia.
NURSING EXAM 3 COMPREHENSIVE
QUESTIONS AND CORRECT ANSWERS
2026/2027
1. A patient with heart failure is receiving Furosemide. Which laboratory value should the
nurse monitor most closely to prevent life-threatening complications?
A. Serum Potassium 3.1 mEq/L
B. Serum Sodium 138 mEq/L
C. Serum Glucose 110 mg/dL
D. Serum Calcium 9.2 mg/dL
Answer: A
Conceptual Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. A level of 3.1 mEq/L indicates hypokalemia, which increases the risk of cardiac
arrhythmias.
2. A nurse is caring for a patient who just underwent a subtotal thyroidectomy. The nurse
notes the patient is experiencing muscle spasms and a positive Chvostek sign. Which
medication should the nurse anticipate administering?
A. Potassium Chloride
,B. Levothyroxine
C. Calcium Gluconate
D. Propylthiouracil
Answer: C
Conceptual Explanation: Muscle spasms and a positive Chvostek sign indicate
hypocalcemia, often due to accidental removal or damage to the parathyroid glands during
thyroid surgery.
3. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. The nurse notes the
SpO2 is 89% and the patient is slightly dyspneic. What is the most appropriate nursing action?
A. Increase oxygen to 6L/min immediately
B. Switch to a non-rebreather mask at 15L/min
C. Maintain the current flow and encourage pursed-lip breathing
D. Prepare for immediate intubation
Answer: C
Conceptual Explanation: In COPD patients, the drive to breathe is often triggered by low
oxygen levels rather than high CO2. Maintaining an SpO2 between 88-92% is typical;
pursed-lip breathing helps maintain airway pressure.
, 4. Which arterial blood gas (ABG) result is most indicative of a patient in Respiratory
Acidosis?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). Option A shows a pH of 7.30 and a PaCO2 of 52.
5. A nurse is preparing to administer Digoxin to a patient with Atrial Fibrillation. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure 140/90 mmHg
B. Temperature 99.1 F
C. Respiratory rate 20 breaths per minute
D. Heart rate 52 beats per minute
Answer: D
Conceptual Explanation: Digoxin is a cardiac glycoside that slows the heart rate. It is
standard practice to hold the dose if the apical pulse is less than 60 bpm to prevent
bradycardia.
