MED-SURG FINAL EXAM
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L. How
should the nurse interpret these arterial blood gas (ABG) results?
A. Respiratory Acidosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Acidosis, Partially Compensated
D. Respiratory Acidosis, Fully Compensated
Answer: B
Conceptual Explanation: The pH is low (acidosis). The PaCO2 is high (respiratory cause).
The HCO3 is elevated (compensatory mechanism), but because the pH is not yet within
normal range, it is partially compensated.
2. Which clinical manifestation is a hallmark sign of Autonomic Dysreflexia in a patient with a
spinal cord injury above T6?
A. Tachycardia and hypotension
B. Extreme shivering and pale skin below the level of injury
,C. Flaccid paralysis and loss of reflex activity
D. Severe pounding headache and profuse sweating above the level of injury
Answer: D
Conceptual Explanation: Autonomic Dysreflexia is characterized by a massive
sympathetic response resulting in severe hypertension, a pounding headache, and
flushing/sweating above the level of the spinal cord injury.
3. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Regular insulin and dextrose
Answer: B
Conceptual Explanation: While insulin and Kayexalate lower potassium, Calcium
Gluconate is the priority to stabilize the myocardial cell membrane and prevent life-
threatening dysrhythmias in severe hyperkalemia.
, 4. A nurse is caring for a patient in the ICU who has developed Acute Respiratory Distress
Syndrome (ARDS). Which positioning strategy is most effective for improving oxygenation?
A. High-Fowler position
B. Prone positioning
C. Trendelenburg position
D. Supine positioning with legs elevated
Answer: B
Conceptual Explanation: Prone positioning is used in ARDS to improve oxygenation by
recruiting collapsed alveoli in the posterior lung fields and improving ventilation-perfusion
matching.
5. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention
B. Crackles or wheezing in the lungs
C. Peripheral edema in the lower extremities
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. The other options
are signs of right-sided heart failure.
COMPREHENSIVE STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L. How
should the nurse interpret these arterial blood gas (ABG) results?
A. Respiratory Acidosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Acidosis, Partially Compensated
D. Respiratory Acidosis, Fully Compensated
Answer: B
Conceptual Explanation: The pH is low (acidosis). The PaCO2 is high (respiratory cause).
The HCO3 is elevated (compensatory mechanism), but because the pH is not yet within
normal range, it is partially compensated.
2. Which clinical manifestation is a hallmark sign of Autonomic Dysreflexia in a patient with a
spinal cord injury above T6?
A. Tachycardia and hypotension
B. Extreme shivering and pale skin below the level of injury
,C. Flaccid paralysis and loss of reflex activity
D. Severe pounding headache and profuse sweating above the level of injury
Answer: D
Conceptual Explanation: Autonomic Dysreflexia is characterized by a massive
sympathetic response resulting in severe hypertension, a pounding headache, and
flushing/sweating above the level of the spinal cord injury.
3. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Regular insulin and dextrose
Answer: B
Conceptual Explanation: While insulin and Kayexalate lower potassium, Calcium
Gluconate is the priority to stabilize the myocardial cell membrane and prevent life-
threatening dysrhythmias in severe hyperkalemia.
, 4. A nurse is caring for a patient in the ICU who has developed Acute Respiratory Distress
Syndrome (ARDS). Which positioning strategy is most effective for improving oxygenation?
A. High-Fowler position
B. Prone positioning
C. Trendelenburg position
D. Supine positioning with legs elevated
Answer: B
Conceptual Explanation: Prone positioning is used in ARDS to improve oxygenation by
recruiting collapsed alveoli in the posterior lung fields and improving ventilation-perfusion
matching.
5. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention
B. Crackles or wheezing in the lungs
C. Peripheral edema in the lower extremities
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. The other options
are signs of right-sided heart failure.
