MDC II EXAM 1 NCLEX (RASMUSSEN) NEWEST 2026/
2027 ACTUAL EXAM TEST BANK| MEDICAL SURGICAL
NURSING II EXAM 1 REVIEW WITH COMPLETE 350
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+
(BRAND NEW!!)
1. A patient has a serum sodium level of 118 mEq/L. Which
assessment finding requires immediate intervention?
A) Muscle twitching
B) Altered mental status
C) Dry mucous membranes
D) Thirst
Correct Answer: B
Rationale: Severe hyponatremia (sodium <120 mEq/L) can cause
cerebral edema, seizures, and coma. Altered mental status
1
,indicates significant brain involvement and requires immediate
intervention (hypertonic saline). Muscle twitching (A) is early sign
but less urgent. Dry mucous membranes (C) and thirst (D) are
signs of hypernatremia, not hyponatremia.
2. A patient with heart failure has a serum potassium of 2.8
mEq/L. The nurse administers IV potassium. Which is the most
important safety intervention?
A) Administer via IV push over 5 minutes
B) Use an infusion pump and do not exceed 10 mEq/hour
(peripheral) or 20 mEq/hour (central)
C) Mix potassium in 50 mL of fluid and give rapidly
D) Administer undiluted potassium chloride
Correct Answer: B
Rationale: IV potassium must be diluted and infused via infusion
pump at a rate not exceeding 10 mEq/hour peripherally (20
mEq/hour centrally) to prevent cardiac arrest. IV push (A), rapid
2
,infusion (C), and undiluted administration (D) can cause fatal
hyperkalemia and cardiac arrhythmias.
3. A patient with chronic kidney disease has a serum potassium
of 6.9 mEq/L. The nurse should first:
A) Prepare for hemodialysis
B) Administer IV calcium gluconate (cardioprotection) followed by
insulin + glucose and albuterol
C) Give oral sodium polystyrene sulfonate (Kayexalate)
D) Restrict dietary potassium
Correct Answer: B
Rationale: Severe hyperkalemia (>6.5 mEq/L) is a medical
emergency. IV calcium gluconate stabilizes the cardiac
membrane. Insulin + glucose shifts potassium into cells. Albuterol
also lowers potassium. Dialysis (A) is definitive but not first in an
emergency. Kayexalate (C) works slowly.
3
, 4. A patient has a serum calcium of 12.5 mg/dL (normal 8.5–
10.2). Which symptom is most concerning?
A) Muscle cramps
B) Positive Chvostek’s sign
C) Cardiac arrhythmias (shortened QT interval)
D) Paresthesias
Correct Answer: C
Rationale: Hypercalcemia shortens the QT interval and can lead
to life-threatening arrhythmias. Chvostek’s sign (B) and muscle
cramps (A) are signs of hypocalcemia, not hypercalcemia.
Paresthesias (D) can occur but arrhythmias are most concerning.
5. A patient with acute pancreatitis has a serum calcium of 6.8
mg/dL. The nurse should assess for:
A) Trousseau’s sign (carpopedal spasm with BP cuff inflation)
B) Polyuria
4
2027 ACTUAL EXAM TEST BANK| MEDICAL SURGICAL
NURSING II EXAM 1 REVIEW WITH COMPLETE 350
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+
(BRAND NEW!!)
1. A patient has a serum sodium level of 118 mEq/L. Which
assessment finding requires immediate intervention?
A) Muscle twitching
B) Altered mental status
C) Dry mucous membranes
D) Thirst
Correct Answer: B
Rationale: Severe hyponatremia (sodium <120 mEq/L) can cause
cerebral edema, seizures, and coma. Altered mental status
1
,indicates significant brain involvement and requires immediate
intervention (hypertonic saline). Muscle twitching (A) is early sign
but less urgent. Dry mucous membranes (C) and thirst (D) are
signs of hypernatremia, not hyponatremia.
2. A patient with heart failure has a serum potassium of 2.8
mEq/L. The nurse administers IV potassium. Which is the most
important safety intervention?
A) Administer via IV push over 5 minutes
B) Use an infusion pump and do not exceed 10 mEq/hour
(peripheral) or 20 mEq/hour (central)
C) Mix potassium in 50 mL of fluid and give rapidly
D) Administer undiluted potassium chloride
Correct Answer: B
Rationale: IV potassium must be diluted and infused via infusion
pump at a rate not exceeding 10 mEq/hour peripherally (20
mEq/hour centrally) to prevent cardiac arrest. IV push (A), rapid
2
,infusion (C), and undiluted administration (D) can cause fatal
hyperkalemia and cardiac arrhythmias.
3. A patient with chronic kidney disease has a serum potassium
of 6.9 mEq/L. The nurse should first:
A) Prepare for hemodialysis
B) Administer IV calcium gluconate (cardioprotection) followed by
insulin + glucose and albuterol
C) Give oral sodium polystyrene sulfonate (Kayexalate)
D) Restrict dietary potassium
Correct Answer: B
Rationale: Severe hyperkalemia (>6.5 mEq/L) is a medical
emergency. IV calcium gluconate stabilizes the cardiac
membrane. Insulin + glucose shifts potassium into cells. Albuterol
also lowers potassium. Dialysis (A) is definitive but not first in an
emergency. Kayexalate (C) works slowly.
3
, 4. A patient has a serum calcium of 12.5 mg/dL (normal 8.5–
10.2). Which symptom is most concerning?
A) Muscle cramps
B) Positive Chvostek’s sign
C) Cardiac arrhythmias (shortened QT interval)
D) Paresthesias
Correct Answer: C
Rationale: Hypercalcemia shortens the QT interval and can lead
to life-threatening arrhythmias. Chvostek’s sign (B) and muscle
cramps (A) are signs of hypocalcemia, not hypercalcemia.
Paresthesias (D) can occur but arrhythmias are most concerning.
5. A patient with acute pancreatitis has a serum calcium of 6.8
mg/dL. The nurse should assess for:
A) Trousseau’s sign (carpopedal spasm with BP cuff inflation)
B) Polyuria
4
