,NR 324 Adult Health I Final Exam Prep Med-
Surg chamberlain collage of nursing 150 Q&A +
Clinical Cases + Detailed Rationales 2026/2027
1. A patient is 24 hours postoperative following abdominal surgery. The nurse notes diminished
breath sounds at the bases and a low-grade fever. Which intervention should the nurse
prioritize?
A. Administer prescribed PRN antipyretic medication
B. Encourage frequent use of the incentive spirometer
C. Notify the surgeon regarding potential pneumonia
D. Increase the flow rate of the supplemental oxygen
Correct Answer: B
Rationale: Diminished breath sounds and a low-grade fever in the early postoperative period are
hallmark signs of atelectasis. Using an incentive spirometer encourages deep breathing and
alveolar expansion to reverse this condition.
2. A patient has a serum sodium level of 125 mEq/L. Which assessment finding is most
concerning?
A. Dry mucous membranes
B. Thirst
C. Altered mental status
D. Fever
,Correct Answer: C
Rationale: Severe hyponatremia causes cerebral edema, leading to confusion and seizures.
3. A patient has a serum potassium level of 6.8 mEq/L. Which ECG change would the nurse
expect?
A. Flattened T waves
B. U waves
C. Peaked T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia causes peaked (tented) T waves.
4. A patient with hyperkalemia is prescribed IV calcium gluconate. The nurse understands that
this medication works by:
A. Lowering serum potassium levels
B. Antagonizing cardiac effects of hyperkalemia
C. Promoting renal excretion of potassium
D. Shifting potassium into cells
Correct Answer: B
Rationale: Calcium gluconate stabilizes cardiac membranes and prevents life-threatening
dysrhythmias. It does not lower potassium levels.
, 5. A patient with heart failure is prescribed furosemide. Which laboratory result would require
the nurse to hold the medication and notify the provider?
A. Serum sodium 136 mEq/L
B. Serum creatinine 1.1 mg/dL
C. Serum potassium 2.8 mEq/L
D. Blood urea nitrogen 18 mg/dL
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium level of 2.8
mEq/L is critically low and increases the risk for life-threatening arrhythmias.
6. The nurse reviews the ABG results for a patient with severe diarrhea: pH 7.30, PaCO₂ 35,
HCO₃⁻ 18. Which acid-base imbalance is present?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Correct Answer: D
Rationale: The pH is below 7.35 (acidosis), and the HCO₃⁻ is low (metabolic cause). Severe
diarrhea causes loss of bicarbonate.
7. What age group has the highest percentage of total body water content?
A. Older adults
Surg chamberlain collage of nursing 150 Q&A +
Clinical Cases + Detailed Rationales 2026/2027
1. A patient is 24 hours postoperative following abdominal surgery. The nurse notes diminished
breath sounds at the bases and a low-grade fever. Which intervention should the nurse
prioritize?
A. Administer prescribed PRN antipyretic medication
B. Encourage frequent use of the incentive spirometer
C. Notify the surgeon regarding potential pneumonia
D. Increase the flow rate of the supplemental oxygen
Correct Answer: B
Rationale: Diminished breath sounds and a low-grade fever in the early postoperative period are
hallmark signs of atelectasis. Using an incentive spirometer encourages deep breathing and
alveolar expansion to reverse this condition.
2. A patient has a serum sodium level of 125 mEq/L. Which assessment finding is most
concerning?
A. Dry mucous membranes
B. Thirst
C. Altered mental status
D. Fever
,Correct Answer: C
Rationale: Severe hyponatremia causes cerebral edema, leading to confusion and seizures.
3. A patient has a serum potassium level of 6.8 mEq/L. Which ECG change would the nurse
expect?
A. Flattened T waves
B. U waves
C. Peaked T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia causes peaked (tented) T waves.
4. A patient with hyperkalemia is prescribed IV calcium gluconate. The nurse understands that
this medication works by:
A. Lowering serum potassium levels
B. Antagonizing cardiac effects of hyperkalemia
C. Promoting renal excretion of potassium
D. Shifting potassium into cells
Correct Answer: B
Rationale: Calcium gluconate stabilizes cardiac membranes and prevents life-threatening
dysrhythmias. It does not lower potassium levels.
, 5. A patient with heart failure is prescribed furosemide. Which laboratory result would require
the nurse to hold the medication and notify the provider?
A. Serum sodium 136 mEq/L
B. Serum creatinine 1.1 mg/dL
C. Serum potassium 2.8 mEq/L
D. Blood urea nitrogen 18 mg/dL
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium level of 2.8
mEq/L is critically low and increases the risk for life-threatening arrhythmias.
6. The nurse reviews the ABG results for a patient with severe diarrhea: pH 7.30, PaCO₂ 35,
HCO₃⁻ 18. Which acid-base imbalance is present?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Correct Answer: D
Rationale: The pH is below 7.35 (acidosis), and the HCO₃⁻ is low (metabolic cause). Severe
diarrhea causes loss of bicarbonate.
7. What age group has the highest percentage of total body water content?
A. Older adults
