NUR 216 MEDICAL SURGICAL NURSING I
EXAM 2 FINAL BLOCK QUESTIONS WITH
CORRECT VERIFIED ANSWERS AND
HIGHLY DETAILED PATHOPHYSIOLOGY
RATIONALES ACHIEVE GRADE A+
HONORS | INSTANT PDF DOWNLOAD
NUR 216 Medical-Surgical Nursing I (Examination 2)
1. A 58-year-old male patient with a 30 pack-year smoking history is
admitted to the medical unit with an acute exacerbation of chronic
obstructive pulmonary disease (COPD). On assessment, the nurse
notes loud expiratory wheezes, a respiratory rate of 26 breaths per
minute, and an oxygen saturation of 87% on room air. Which
oxygen delivery setup should the nurse implement first to provide
a precise, controlled concentration of oxygen without depressing
his hypoxic drive?
• A simple face mask set at 8 L/min.
• A non-rebreather mask set at 15 L/min.
• A Venturi mask titrated to the ordered fractional
concentration (FiO2).
• A high-flow nasal cannula set at 40 L/min and 100% FiO2.
Correct Answer Description: A Venturi mask is the most accurate
device for delivering a precise oxygen concentration to patients
with COPD. It avoids delivering excessive oxygen, which could
override the low-oxygen baseline that drives their respiratory
centers. [1]
2. A nurse is caring for a patient who returned to the unit 4 hours ago
following a total thyroidectomy for Graves' disease. The patient
complains of a tingling sensation around her mouth and muscle
twitching in her right hand during blood pressure cuff inflation.
The nurse should recognize these findings as indicative of which
postoperative complication?
• Acute laryngeal nerve damage.
,• Accidental parathyroidectomy resulting in severe
hypocalcemia.
• Developing thyrotoxic crisis (thyroid storm).
• Postoperative systemic fluid volume deficit.
Correct Answer Description: Perioral numbness and a positive
Trousseau's sign (carpal spasm during cuff inflation) are classic
signs of neuromuscular irritability caused by hypocalcemia,
which occurs post-thyroidectomy if the parathyroid glands are
injured or removed.
3. A patient is admitted to the hospital with a primary diagnosis of
acute deep vein thrombosis (DVT) in the left lower extremity.
Which of the following nursing orders should the nurse expect to
implement to safely care for this patient and minimize
complications?
• Apply a commercial ice pack to the affected calf muscle for 20
minutes every hour.
• Perform vigorous passive range of motion exercises on the left leg
twice daily.
• Elevate the left leg above heart level and avoid massaging
the area.
• Instruct the patient to keep the leg dependent over the side of the
bed.
Correct Answer Description: Elevating the affected leg promotes
venous return and reduces localized edema. Massaging or
vigorous movement is strictly contraindicated as it can dislodge
the thrombus, turning it into a fatal pulmonary embolism. [1]
4. A nurse is preparing to perform an abdominal assessment on a
client reporting localized right lower quadrant pain. In what
sequential order should the nurse execute the physical assessment
techniques?
• Inspection, Palpation, Percussion, Auscultation
• Inspection, Auscultation, Percussion, Palpation
• Auscultation, Inspection, Palpation, Percussion
• Percussion, Auscultation, Inspection, Palpation
Correct Answer Description: For an abdominal assessment,
, auscultation and percussion must precede palpation to avoid
artificially stimulating peristalsis and altering the frequency of
bowel sounds. [1, 2]
5. A client undergoes a lumbar puncture for cerebrospinal fluid (CSF)
analysis to rule out multiple sclerosis. Following the procedure,
which nursing intervention is a priority to minimize the risk of the
patient developing a severe spinal headache?
• Encourage the patient to walk around the unit for 30 minutes.
• Instruct the patient to remain flat in a supine position for
several hours and increase fluid intake.
• Elevate the head of the bed to a high-Fowler's position
immediately.
• Apply a commercial ice pack directly over the cervical spine area.
Correct Answer Description: Lying flat helps maintain consistent
spinal fluid pressure and prevents CSF leakage from the dural
puncture site, which is the primary cause of a post-puncture
spinal headache. [1]
6. A patient with history of advanced liver cirrhosis presents with
severe abdominal distension due to ascites. The healthcare
provider schedules a therapeutic paracentesis. Which action must
the nurse have the patient perform immediately before the
procedure to ensure safety?
• Consume a large meal to prevent post-procedural hypoglycemia.
• Void completely to empty the bladder and minimize the
risk of accidental puncture.
• Complete an aggressive bowel prep using oral laxatives.
• Lie flat in a prone position on a hard procedural table.
Correct Answer Description: Emptying the bladder moves it
downward out of the pelvic cavity, significantly reducing the risk
of the paracentesis needle accidentally perforating it during fluid
extraction.
7. A nurse is caring for a patient who has a chest tube connected to a
traditional water-seal drainage system. During the shift
assessment, the nurse notes continuous, rapid bubbling in the
, water-seal chamber. How should the nurse interpret this finding?
[1, 2]
• This is a normal, expected finding indicating system patency.
• The chest tube is successfully removing fluid from the pleural
space.
• There is an active air leak present in the drainage system
or chest wall connection.
• The suction control chamber pressure is set too low.
Correct Answer Description: Continuous bubbling in the water-
seal chamber indicates an air leak in the system or a loose
connection. Intermittent bubbling with expiration or coughing is
a normal variant. [1]
8. While reviewing a patient’s morning laboratory results, the nurse
notes a serum potassium level of 2.8 mEq/L. Which cardiac
rhythm manifestation is the patient most at risk for developing as a
consequence of this specific electrolyte imbalance?
• Ventricular dysrhythmias and prominent U waves.
• Tall, peaked T waves and widened QRS complexes.
• Sinus bradycardia with a shortened PR interval.
• First-degree atrioventricular block with flat P waves.
Correct Answer Description: Hypokalemia (potassium < 3.5
mEq/L) alters myocardial repolarization, leading to dangerous
ventricular arrhythmias, ST depression, flat T waves, and
characteristic U waves on an EKG.
9. A client is admitted with a diagnosis of acute pancreatitis. The
patient reports severe, burning epigastric pain that radiates
directly to the back. Which of the following positions should the
nurse suggest to help alleviate the patient's abdominal discomfort?
• Flat supine position with legs fully extended.
• Sitting up, leaning forward, or adopting a fetal side-lying
position.
• Prone position with a pillow under the upper chest.
• Trendelenburg position with the feet elevated above the head.
Correct Answer Description: Epigastric pain from pancreatitis
EXAM 2 FINAL BLOCK QUESTIONS WITH
CORRECT VERIFIED ANSWERS AND
HIGHLY DETAILED PATHOPHYSIOLOGY
RATIONALES ACHIEVE GRADE A+
HONORS | INSTANT PDF DOWNLOAD
NUR 216 Medical-Surgical Nursing I (Examination 2)
1. A 58-year-old male patient with a 30 pack-year smoking history is
admitted to the medical unit with an acute exacerbation of chronic
obstructive pulmonary disease (COPD). On assessment, the nurse
notes loud expiratory wheezes, a respiratory rate of 26 breaths per
minute, and an oxygen saturation of 87% on room air. Which
oxygen delivery setup should the nurse implement first to provide
a precise, controlled concentration of oxygen without depressing
his hypoxic drive?
• A simple face mask set at 8 L/min.
• A non-rebreather mask set at 15 L/min.
• A Venturi mask titrated to the ordered fractional
concentration (FiO2).
• A high-flow nasal cannula set at 40 L/min and 100% FiO2.
Correct Answer Description: A Venturi mask is the most accurate
device for delivering a precise oxygen concentration to patients
with COPD. It avoids delivering excessive oxygen, which could
override the low-oxygen baseline that drives their respiratory
centers. [1]
2. A nurse is caring for a patient who returned to the unit 4 hours ago
following a total thyroidectomy for Graves' disease. The patient
complains of a tingling sensation around her mouth and muscle
twitching in her right hand during blood pressure cuff inflation.
The nurse should recognize these findings as indicative of which
postoperative complication?
• Acute laryngeal nerve damage.
,• Accidental parathyroidectomy resulting in severe
hypocalcemia.
• Developing thyrotoxic crisis (thyroid storm).
• Postoperative systemic fluid volume deficit.
Correct Answer Description: Perioral numbness and a positive
Trousseau's sign (carpal spasm during cuff inflation) are classic
signs of neuromuscular irritability caused by hypocalcemia,
which occurs post-thyroidectomy if the parathyroid glands are
injured or removed.
3. A patient is admitted to the hospital with a primary diagnosis of
acute deep vein thrombosis (DVT) in the left lower extremity.
Which of the following nursing orders should the nurse expect to
implement to safely care for this patient and minimize
complications?
• Apply a commercial ice pack to the affected calf muscle for 20
minutes every hour.
• Perform vigorous passive range of motion exercises on the left leg
twice daily.
• Elevate the left leg above heart level and avoid massaging
the area.
• Instruct the patient to keep the leg dependent over the side of the
bed.
Correct Answer Description: Elevating the affected leg promotes
venous return and reduces localized edema. Massaging or
vigorous movement is strictly contraindicated as it can dislodge
the thrombus, turning it into a fatal pulmonary embolism. [1]
4. A nurse is preparing to perform an abdominal assessment on a
client reporting localized right lower quadrant pain. In what
sequential order should the nurse execute the physical assessment
techniques?
• Inspection, Palpation, Percussion, Auscultation
• Inspection, Auscultation, Percussion, Palpation
• Auscultation, Inspection, Palpation, Percussion
• Percussion, Auscultation, Inspection, Palpation
Correct Answer Description: For an abdominal assessment,
, auscultation and percussion must precede palpation to avoid
artificially stimulating peristalsis and altering the frequency of
bowel sounds. [1, 2]
5. A client undergoes a lumbar puncture for cerebrospinal fluid (CSF)
analysis to rule out multiple sclerosis. Following the procedure,
which nursing intervention is a priority to minimize the risk of the
patient developing a severe spinal headache?
• Encourage the patient to walk around the unit for 30 minutes.
• Instruct the patient to remain flat in a supine position for
several hours and increase fluid intake.
• Elevate the head of the bed to a high-Fowler's position
immediately.
• Apply a commercial ice pack directly over the cervical spine area.
Correct Answer Description: Lying flat helps maintain consistent
spinal fluid pressure and prevents CSF leakage from the dural
puncture site, which is the primary cause of a post-puncture
spinal headache. [1]
6. A patient with history of advanced liver cirrhosis presents with
severe abdominal distension due to ascites. The healthcare
provider schedules a therapeutic paracentesis. Which action must
the nurse have the patient perform immediately before the
procedure to ensure safety?
• Consume a large meal to prevent post-procedural hypoglycemia.
• Void completely to empty the bladder and minimize the
risk of accidental puncture.
• Complete an aggressive bowel prep using oral laxatives.
• Lie flat in a prone position on a hard procedural table.
Correct Answer Description: Emptying the bladder moves it
downward out of the pelvic cavity, significantly reducing the risk
of the paracentesis needle accidentally perforating it during fluid
extraction.
7. A nurse is caring for a patient who has a chest tube connected to a
traditional water-seal drainage system. During the shift
assessment, the nurse notes continuous, rapid bubbling in the
, water-seal chamber. How should the nurse interpret this finding?
[1, 2]
• This is a normal, expected finding indicating system patency.
• The chest tube is successfully removing fluid from the pleural
space.
• There is an active air leak present in the drainage system
or chest wall connection.
• The suction control chamber pressure is set too low.
Correct Answer Description: Continuous bubbling in the water-
seal chamber indicates an air leak in the system or a loose
connection. Intermittent bubbling with expiration or coughing is
a normal variant. [1]
8. While reviewing a patient’s morning laboratory results, the nurse
notes a serum potassium level of 2.8 mEq/L. Which cardiac
rhythm manifestation is the patient most at risk for developing as a
consequence of this specific electrolyte imbalance?
• Ventricular dysrhythmias and prominent U waves.
• Tall, peaked T waves and widened QRS complexes.
• Sinus bradycardia with a shortened PR interval.
• First-degree atrioventricular block with flat P waves.
Correct Answer Description: Hypokalemia (potassium < 3.5
mEq/L) alters myocardial repolarization, leading to dangerous
ventricular arrhythmias, ST depression, flat T waves, and
characteristic U waves on an EKG.
9. A client is admitted with a diagnosis of acute pancreatitis. The
patient reports severe, burning epigastric pain that radiates
directly to the back. Which of the following positions should the
nurse suggest to help alleviate the patient's abdominal discomfort?
• Flat supine position with legs fully extended.
• Sitting up, leaning forward, or adopting a fetal side-lying
position.
• Prone position with a pillow under the upper chest.
• Trendelenburg position with the feet elevated above the head.
Correct Answer Description: Epigastric pain from pancreatitis
