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,7NUR 201/NUR201 EXAM 2 MEDICAL-SURGICAL NU
1. A patient with chronic kidney disease has a serum potassium level of 6.1 mEq/L.
Which finding requires the nurse's greatest attention?
A) Peaked T waves on the ECG
B) Dry oral mucosa
C) Constipation
D) Increased thirst
Correct Answer: Peaked T waves on the ECG
Rationale: Hyperkalemia can alter cardiac conduction and cause potentially fatal
dysrhythmias. Peaked T waves are a classic early ECG manifestation. As potassium rises
further, PR prolongation, QRS widening, ventricular dysrhythmias, and cardiac arrest
may occur. Dry mucosa and thirst are more closely associated with dehydration or
hypernatremia, while constipation is not the immediate life-threatening concern.
2. A patient taking furosemide reports weakness and muscle cramps. Which
electrolyte disturbance should the nurse suspect?
A) Hypercalcemia
B) Hypernatremia
C) Hypokalemia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics such as furosemide increase renal potassium excretion.
Hypokalemia commonly causes muscle weakness, cramps, fatigue, constipation, and
cardiac dysrhythmias. Severe potassium depletion may produce flattened T waves, ST
depression, prominent U waves, and potentially dangerous ventricular rhythms.
3. Which food should the nurse recommend as a relatively rich dietary source of
potassium?
A) Banana
B) White bread
C) Hard candy
D) Gelatin
Correct Answer: Banana
Rationale: Bananas are a familiar potassium-rich food. Other significant sources include
potatoes, oranges, tomatoes, avocados, beans, and many leafy vegetables. Dietary
recommendations must be individualized because patients with impaired renal potassium
excretion may require potassium restriction rather than supplementation.
, 4. A patient with prolonged vomiting is at greatest risk for which acid-base
disturbance?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Respiratory acidosis
D) Metabolic alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Gastric secretions contain hydrochloric acid. Prolonged vomiting removes
hydrogen and chloride ions, which increases serum bicarbonate relative to hydrogen
concentration and produces metabolic alkalosis. Significant vomiting may also cause
hypokalemia and volume depletion.
5. Which finding is most consistent with hypocalcemia?
A) Positive Trousseau sign
B) Decreased neuromuscular excitability
C) Constipation
D) Kidney stones
Correct Answer: Positive Trousseau sign
Rationale: Hypocalcemia increases neuromuscular excitability and may produce
paresthesias, muscle cramps, tetany, hyperreflexia, seizures, and positive Chvostek or
Trousseau signs. Constipation and kidney stones are more commonly associated with
hypercalcemia.
6. Which assessment finding should the nurse expect in a patient with hypercalcemia?
A) Tetany
B) Hyperreflexia
C) Constipation
D) Laryngospasm
Correct Answer: Constipation
Rationale: Excess calcium decreases neuromuscular and gastrointestinal smooth-muscle
activity. Patients may develop weakness, lethargy, diminished reflexes, constipation,
nausea, confusion, dysrhythmias, and renal calculi. Tetany and laryngospasm are
manifestations of hypocalcemia.
7. A patient's serum sodium level is 118 mEq/L. Which assessment is the priority?
A) Neurologic status
B) Nail condition
C) Hair texture
D) Bowel pattern
,7NUR 201/NUR201 EXAM 2 MEDICAL-SURGICAL NU
1. A patient with chronic kidney disease has a serum potassium level of 6.1 mEq/L.
Which finding requires the nurse's greatest attention?
A) Peaked T waves on the ECG
B) Dry oral mucosa
C) Constipation
D) Increased thirst
Correct Answer: Peaked T waves on the ECG
Rationale: Hyperkalemia can alter cardiac conduction and cause potentially fatal
dysrhythmias. Peaked T waves are a classic early ECG manifestation. As potassium rises
further, PR prolongation, QRS widening, ventricular dysrhythmias, and cardiac arrest
may occur. Dry mucosa and thirst are more closely associated with dehydration or
hypernatremia, while constipation is not the immediate life-threatening concern.
2. A patient taking furosemide reports weakness and muscle cramps. Which
electrolyte disturbance should the nurse suspect?
A) Hypercalcemia
B) Hypernatremia
C) Hypokalemia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics such as furosemide increase renal potassium excretion.
Hypokalemia commonly causes muscle weakness, cramps, fatigue, constipation, and
cardiac dysrhythmias. Severe potassium depletion may produce flattened T waves, ST
depression, prominent U waves, and potentially dangerous ventricular rhythms.
3. Which food should the nurse recommend as a relatively rich dietary source of
potassium?
A) Banana
B) White bread
C) Hard candy
D) Gelatin
Correct Answer: Banana
Rationale: Bananas are a familiar potassium-rich food. Other significant sources include
potatoes, oranges, tomatoes, avocados, beans, and many leafy vegetables. Dietary
recommendations must be individualized because patients with impaired renal potassium
excretion may require potassium restriction rather than supplementation.
, 4. A patient with prolonged vomiting is at greatest risk for which acid-base
disturbance?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Respiratory acidosis
D) Metabolic alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Gastric secretions contain hydrochloric acid. Prolonged vomiting removes
hydrogen and chloride ions, which increases serum bicarbonate relative to hydrogen
concentration and produces metabolic alkalosis. Significant vomiting may also cause
hypokalemia and volume depletion.
5. Which finding is most consistent with hypocalcemia?
A) Positive Trousseau sign
B) Decreased neuromuscular excitability
C) Constipation
D) Kidney stones
Correct Answer: Positive Trousseau sign
Rationale: Hypocalcemia increases neuromuscular excitability and may produce
paresthesias, muscle cramps, tetany, hyperreflexia, seizures, and positive Chvostek or
Trousseau signs. Constipation and kidney stones are more commonly associated with
hypercalcemia.
6. Which assessment finding should the nurse expect in a patient with hypercalcemia?
A) Tetany
B) Hyperreflexia
C) Constipation
D) Laryngospasm
Correct Answer: Constipation
Rationale: Excess calcium decreases neuromuscular and gastrointestinal smooth-muscle
activity. Patients may develop weakness, lethargy, diminished reflexes, constipation,
nausea, confusion, dysrhythmias, and renal calculi. Tetany and laryngospasm are
manifestations of hypocalcemia.
7. A patient's serum sodium level is 118 mEq/L. Which assessment is the priority?
A) Neurologic status
B) Nail condition
C) Hair texture
D) Bowel pattern
