NUR 253 FINAL EXAM
COMPREHENSIVE STUDY GUIDE
QUESTIONS & ANSWERS (VERIFIED
ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient presents with a pH of 7.32, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (<7.35) indicating acidosis. The PaCO2 is high
(>45 mmHg), which corresponds with the acidic pH, defining it as respiratory acidosis. The
HCO3 is within normal range, indicating no compensation yet.
,2. Which clinical manifestation is most characteristic of Left-sided heart failure?
A. Jugular Venous Distension (JVD)
B. Peripheral Edema
C. Crackles in the lungs
D. Splenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood efficiently to the body, causing backflow into the
lungs.
3. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 42 mg/dL.
What is the priority nursing action?
A. Administer Glucagon IM or SubQ
B. Administer 15g of oral glucose gel
C. Provide 4 ounces of orange juice
D. Recheck blood glucose in 15 minutes
Answer: A
Conceptual Explanation: If a patient is unconscious or cannot swallow safely due to
hypoglycemia, parenteral glucagon or IV D50 is the priority to raise blood sugar quickly
without aspiration risk.
, 4. During the immediate postoperative period, a patient develops muscle rigidity, a rapid rise
in body temperature, and tachycardia. What complication does the nurse suspect?
A. Hypovolemic Shock
B. Malignant Hyperthermia
C. Pulmonary Embolism
D. Septic Shock
Answer: B
Conceptual Explanation: Malignant Hyperthermia is a life-threatening reaction to certain
anesthetic gases and succinylcholine, characterized by muscle rigidity, hypercapnia, and
extreme hyperthermia.
5. A patient is prescribed Digoxin 0.125 mg daily. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum Sodium
B. Serum Calcium
C. Serum Magnesium
D. Serum Potassium
Answer: D
Conceptual Explanation: Hypokalemia (low potassium) increases the risk of Digoxin
toxicity. It is critical to monitor potassium levels while a patient is on this medication.
COMPREHENSIVE STUDY GUIDE
QUESTIONS & ANSWERS (VERIFIED
ANSWERS) WITH EXPERT
EXPLANATIONS | 2026 – 2027 UPDATE
(PDF) GALEN COLLEGE OF NURSING
1. A patient presents with a pH of 7.32, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (<7.35) indicating acidosis. The PaCO2 is high
(>45 mmHg), which corresponds with the acidic pH, defining it as respiratory acidosis. The
HCO3 is within normal range, indicating no compensation yet.
,2. Which clinical manifestation is most characteristic of Left-sided heart failure?
A. Jugular Venous Distension (JVD)
B. Peripheral Edema
C. Crackles in the lungs
D. Splenomegaly
Answer: C
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood efficiently to the body, causing backflow into the
lungs.
3. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 42 mg/dL.
What is the priority nursing action?
A. Administer Glucagon IM or SubQ
B. Administer 15g of oral glucose gel
C. Provide 4 ounces of orange juice
D. Recheck blood glucose in 15 minutes
Answer: A
Conceptual Explanation: If a patient is unconscious or cannot swallow safely due to
hypoglycemia, parenteral glucagon or IV D50 is the priority to raise blood sugar quickly
without aspiration risk.
, 4. During the immediate postoperative period, a patient develops muscle rigidity, a rapid rise
in body temperature, and tachycardia. What complication does the nurse suspect?
A. Hypovolemic Shock
B. Malignant Hyperthermia
C. Pulmonary Embolism
D. Septic Shock
Answer: B
Conceptual Explanation: Malignant Hyperthermia is a life-threatening reaction to certain
anesthetic gases and succinylcholine, characterized by muscle rigidity, hypercapnia, and
extreme hyperthermia.
5. A patient is prescribed Digoxin 0.125 mg daily. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum Sodium
B. Serum Calcium
C. Serum Magnesium
D. Serum Potassium
Answer: D
Conceptual Explanation: Hypokalemia (low potassium) increases the risk of Digoxin
toxicity. It is critical to monitor potassium levels while a patient is on this medication.
