NSG 3250 MEDICAL-SURGICAL
NURSING FINAL EXAM PREP |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen at
2L/min via nasal cannula. The nurse notes the patient’s SpO2 is 89% and the patient appears
slightly short of breath but is not in distress. Which action is most appropriate?
A. Increase the oxygen flow rate to 4L/min immediately.
B. Notify the provider to request a high-flow mask.
C. Prepare for endotracheal intubation.
D. Continue to monitor as this is an expected finding for COPD patients.
Answer: D
Conceptual Explanation: Patients with COPD often have a ‘hypoxic drive’ and target SpO2
levels are typically between 88-92%. Increasing oxygen too much can suppress their
respiratory drive.
2. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte imbalance should the nurse prioritize for monitoring?
A. Hyperkalemia
,B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Answer: A
Conceptual Explanation: During the oliguric phase, the kidneys fail to excrete potassium,
leading to life-threatening hyperkalemia which can cause cardiac arrhythmias.
3. Which arterial blood gas (ABG) result is most indicative of a patient in uncompensated
Respiratory Acidosis?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.35, PaCO2 48, HCO3 28
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). Normal HCO3 indicates it is uncompensated.
4. A patient is admitted with a suspected Addisonian Crisis. Which clinical manifestation
should the nurse expect to find?
A. Hypertension and hypernatremia
B. Hypotension and hyperkalemia
, C. Hyperglycemia and moon face
D. Bradycardia and weight gain
Answer: B
Conceptual Explanation: Addisonian crisis involves acute adrenal insufficiency leading to
severe hypotension, hyponatremia, and hyperkalemia due to lack of cortisol and
aldosterone.
5. Which assessment finding in a patient with a chest tube requires immediate intervention
by the nurse?
A. Intermittent bubbling in the water-seal chamber during coughing
B. Continuous bubbling in the water-seal chamber
C. Tidaling in the water-seal chamber with respirations
D. Drainage of 50 mL of serosanguinous fluid in 2 hours
Answer: B
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system, which requires immediate troubleshooting. Intermittent bubbling or
tidaling are normal findings.
6. The nurse is preparing to administer Digoxin to a patient with Heart Failure. Which
laboratory value should the nurse check before administration?
A. Serum Sodium
NURSING FINAL EXAM PREP |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen at
2L/min via nasal cannula. The nurse notes the patient’s SpO2 is 89% and the patient appears
slightly short of breath but is not in distress. Which action is most appropriate?
A. Increase the oxygen flow rate to 4L/min immediately.
B. Notify the provider to request a high-flow mask.
C. Prepare for endotracheal intubation.
D. Continue to monitor as this is an expected finding for COPD patients.
Answer: D
Conceptual Explanation: Patients with COPD often have a ‘hypoxic drive’ and target SpO2
levels are typically between 88-92%. Increasing oxygen too much can suppress their
respiratory drive.
2. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte imbalance should the nurse prioritize for monitoring?
A. Hyperkalemia
,B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Answer: A
Conceptual Explanation: During the oliguric phase, the kidneys fail to excrete potassium,
leading to life-threatening hyperkalemia which can cause cardiac arrhythmias.
3. Which arterial blood gas (ABG) result is most indicative of a patient in uncompensated
Respiratory Acidosis?
A. pH 7.48, PaCO2 30, HCO3 22
B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.35, PaCO2 48, HCO3 28
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). Normal HCO3 indicates it is uncompensated.
4. A patient is admitted with a suspected Addisonian Crisis. Which clinical manifestation
should the nurse expect to find?
A. Hypertension and hypernatremia
B. Hypotension and hyperkalemia
, C. Hyperglycemia and moon face
D. Bradycardia and weight gain
Answer: B
Conceptual Explanation: Addisonian crisis involves acute adrenal insufficiency leading to
severe hypotension, hyponatremia, and hyperkalemia due to lack of cortisol and
aldosterone.
5. Which assessment finding in a patient with a chest tube requires immediate intervention
by the nurse?
A. Intermittent bubbling in the water-seal chamber during coughing
B. Continuous bubbling in the water-seal chamber
C. Tidaling in the water-seal chamber with respirations
D. Drainage of 50 mL of serosanguinous fluid in 2 hours
Answer: B
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system, which requires immediate troubleshooting. Intermittent bubbling or
tidaling are normal findings.
6. The nurse is preparing to administer Digoxin to a patient with Heart Failure. Which
laboratory value should the nurse check before administration?
A. Serum Sodium
