NRSG 201 Exam 2 V2 | NRSG 201 Med Surg 1 |
Actual Q&A with Rationale (NRSG201 Exam 2) | Ivy
Tech
1. A client presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) change is the nurse most likely to observe?
A. Prominent U waves
B. ST-segment depression
C. Prolonged QT interval
D. Tall, peaked T waves
Correct Answer: D
Explanation: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
cardiac conduction and repolarization. Tall, peaked T waves are one of the earliest ECG
changes seen as potassium levels rise. The nurse must monitor for further progression into
widened QRS complexes or ventricular fibrillation.
2. A nurse is caring for a client with metabolic alkalosis. Which arterial blood gas (ABG) result
is consistent with this condition?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.28, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 25, HCO3 22
Correct Answer: A
Explanation: Metabolic alkalosis is characterized by a high pH (above 7.45) and an
elevated bicarbonate level (above 26 mEq/L). In this scenario, the pH of 7.48 indicates
alkalosis and the HCO3 of 30 confirms the metabolic origin. The PaCO2 remains within the
normal range, indicating no respiratory compensation is yet evident.
3. Which nursing intervention is most appropriate for a client diagnosed with viral
pneumonia?
A. Encouraging increased fluid intake to 2 to 3 liters per day
B. Administering broad-spectrum antibiotics
C. Placing the client on strict contact precautions
D. Restricting physical activity to absolute bed rest
Correct Answer: A
Explanation: Viral pneumonia does not respond to antibiotics, so supportive care is the
primary focus of treatment. Increasing fluid intake helps to liquefy secretions, making them
easier for the client to expectorate. Maintaining hydration also supports the immune
response and prevents dehydration during febrile episodes.
4. The nurse is preparing a client for surgery. Who is legally responsible for obtaining the
informed consent?
A. The surgeon performing the procedure
, B. The anesthesia provider
C. The perioperative nurse
D. The hospital administrator
Correct Answer: A
Explanation: The surgeon is legally responsible for explaining the procedure, risks,
benefits, and alternatives to the client. While the nurse often witnesses the client’s
signature, they do not provide the primary education for consent. If the client does not
understand the surgery, the nurse must notify the surgeon to return and provide further
clarification.
5. A client has a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse anticipate?
A. Extreme thirst
B. Dry mucous membranes
C. Confusion and lethargy
D. Flushed skin
Correct Answer: C
Explanation: Hyponatremia causes a shift of water into the cells, leading to cellular
swelling, which is particularly dangerous in the brain. Neurological symptoms such as
Actual Q&A with Rationale (NRSG201 Exam 2) | Ivy
Tech
1. A client presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) change is the nurse most likely to observe?
A. Prominent U waves
B. ST-segment depression
C. Prolonged QT interval
D. Tall, peaked T waves
Correct Answer: D
Explanation: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
cardiac conduction and repolarization. Tall, peaked T waves are one of the earliest ECG
changes seen as potassium levels rise. The nurse must monitor for further progression into
widened QRS complexes or ventricular fibrillation.
2. A nurse is caring for a client with metabolic alkalosis. Which arterial blood gas (ABG) result
is consistent with this condition?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.28, PaCO2 35, HCO3 18
,D. pH 7.50, PaCO2 25, HCO3 22
Correct Answer: A
Explanation: Metabolic alkalosis is characterized by a high pH (above 7.45) and an
elevated bicarbonate level (above 26 mEq/L). In this scenario, the pH of 7.48 indicates
alkalosis and the HCO3 of 30 confirms the metabolic origin. The PaCO2 remains within the
normal range, indicating no respiratory compensation is yet evident.
3. Which nursing intervention is most appropriate for a client diagnosed with viral
pneumonia?
A. Encouraging increased fluid intake to 2 to 3 liters per day
B. Administering broad-spectrum antibiotics
C. Placing the client on strict contact precautions
D. Restricting physical activity to absolute bed rest
Correct Answer: A
Explanation: Viral pneumonia does not respond to antibiotics, so supportive care is the
primary focus of treatment. Increasing fluid intake helps to liquefy secretions, making them
easier for the client to expectorate. Maintaining hydration also supports the immune
response and prevents dehydration during febrile episodes.
4. The nurse is preparing a client for surgery. Who is legally responsible for obtaining the
informed consent?
A. The surgeon performing the procedure
, B. The anesthesia provider
C. The perioperative nurse
D. The hospital administrator
Correct Answer: A
Explanation: The surgeon is legally responsible for explaining the procedure, risks,
benefits, and alternatives to the client. While the nurse often witnesses the client’s
signature, they do not provide the primary education for consent. If the client does not
understand the surgery, the nurse must notify the surgeon to return and provide further
clarification.
5. A client has a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse anticipate?
A. Extreme thirst
B. Dry mucous membranes
C. Confusion and lethargy
D. Flushed skin
Correct Answer: C
Explanation: Hyponatremia causes a shift of water into the cells, leading to cellular
swelling, which is particularly dangerous in the brain. Neurological symptoms such as
