Nursing Concepts / Foundations II - Exam 7 2026 |Galen College
1. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH
7.30, PaCO2 52, HCO3 26. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory cause). Since the
HCO3 is within the normal range, it indicates respiratory acidosis.
2. Which assessment finding is most characteristic of hypocalcemia?
A. Positive Trousseau sign
B. Hypoactive bowel sounds
C. Depressed deep tendon reflexes
D. Constipation
Answer: A
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Trousseau’s sign (carpal spasm) and Chvostek’s sign.
,3. When administering a hypertonic intravenous solution, the nurse should
monitor for which cellular effect?
A. Cellular swelling
B. No change in cell size
C. Bursting of red blood cells
D. Cellular shrinkage
Answer: D
Rationale: Hypertonic solutions have a higher osmolality than intracellular fluid, causing
water to move out of the cells and leading to cellular dehydration/shrinkage.
4. A patient is diagnosed with fluid volume excess. Which of the following is a
priority nursing intervention?
A. Encouraging increased fluid intake
B. Administering 0.45% normal saline IV
C. Assessing for peripheral edema and crackles in the lungs
D. Placing the patient in a Trendelenburg position
Answer: C
Rationale: Fluid volume excess often leads to pulmonary edema (crackles) and peripheral
edema; monitoring these is vital for safety and assessment of severity.
5. Which electrolyte imbalance is a patient at risk for when taking a loop
diuretic such as Furosemide?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypermagnesemia
Answer: A
Rationale: Loop diuretics promote the excretion of water, sodium, and potassium,
frequently leading to hypokalemia (low potassium).
, 6. The nurse identifies which patient as being at the highest risk for developing a
pressure injury?
A. A 40-year-old patient who is ambulatory after surgery
B. An 80-year-old patient with fecal incontinence and limited mobility
C. A 25-year-old patient with a fractured arm
D. A 60-year-old patient with well-controlled diabetes
Answer: B
Rationale: Advanced age, incontinence (moisture), and limited mobility are significant risk
factors for skin breakdown and pressure injuries.
7. A wound that is left open for several days to allow edema or infection to
resolve before being closed is healing by:
A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Quaternary intention
Answer: C
Rationale: Tertiary intention, or delayed primary closure, involves leaving a wound open
until it is clean and then suturing it closed.
8. Which of the following is the primary responsibility of the nurse regarding
informed consent for surgery?
A. Explaining the risks and benefits of the procedure
B. Describing alternative treatments available
C. Obtaining the consent if the surgeon is busy
D. Witnessing the patient’s signature on the consent form
Answer: D
Rationale: The surgeon is responsible for explaining the procedure. The nurse acts as a
witness to the signature and ensures the patient is competent to sign.
1. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH
7.30, PaCO2 52, HCO3 26. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory cause). Since the
HCO3 is within the normal range, it indicates respiratory acidosis.
2. Which assessment finding is most characteristic of hypocalcemia?
A. Positive Trousseau sign
B. Hypoactive bowel sounds
C. Depressed deep tendon reflexes
D. Constipation
Answer: A
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Trousseau’s sign (carpal spasm) and Chvostek’s sign.
,3. When administering a hypertonic intravenous solution, the nurse should
monitor for which cellular effect?
A. Cellular swelling
B. No change in cell size
C. Bursting of red blood cells
D. Cellular shrinkage
Answer: D
Rationale: Hypertonic solutions have a higher osmolality than intracellular fluid, causing
water to move out of the cells and leading to cellular dehydration/shrinkage.
4. A patient is diagnosed with fluid volume excess. Which of the following is a
priority nursing intervention?
A. Encouraging increased fluid intake
B. Administering 0.45% normal saline IV
C. Assessing for peripheral edema and crackles in the lungs
D. Placing the patient in a Trendelenburg position
Answer: C
Rationale: Fluid volume excess often leads to pulmonary edema (crackles) and peripheral
edema; monitoring these is vital for safety and assessment of severity.
5. Which electrolyte imbalance is a patient at risk for when taking a loop
diuretic such as Furosemide?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypermagnesemia
Answer: A
Rationale: Loop diuretics promote the excretion of water, sodium, and potassium,
frequently leading to hypokalemia (low potassium).
, 6. The nurse identifies which patient as being at the highest risk for developing a
pressure injury?
A. A 40-year-old patient who is ambulatory after surgery
B. An 80-year-old patient with fecal incontinence and limited mobility
C. A 25-year-old patient with a fractured arm
D. A 60-year-old patient with well-controlled diabetes
Answer: B
Rationale: Advanced age, incontinence (moisture), and limited mobility are significant risk
factors for skin breakdown and pressure injuries.
7. A wound that is left open for several days to allow edema or infection to
resolve before being closed is healing by:
A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Quaternary intention
Answer: C
Rationale: Tertiary intention, or delayed primary closure, involves leaving a wound open
until it is clean and then suturing it closed.
8. Which of the following is the primary responsibility of the nurse regarding
informed consent for surgery?
A. Explaining the risks and benefits of the procedure
B. Describing alternative treatments available
C. Obtaining the consent if the surgeon is busy
D. Witnessing the patient’s signature on the consent form
Answer: D
Rationale: The surgeon is responsible for explaining the procedure. The nurse acts as a
witness to the signature and ensures the patient is competent to sign.
