MED-SURG NURSING CLINICAL JUDGMENT
& COLLABORATIVE CARE MCQ PREP KIT –
HIGH-YIELD RATIONALES
This comprehensive medical-surgical test bank
features verified multiple-choice questions
complete with italicised answers and bolded clinical
judgment rationales. It perfectly aligns with
advanced concepts of collaborative care and
nursing prioritization to help you master complex
pathophysiology and pharmacology. Ideal for
nursing students aiming for top tier grades, this
resource provides the ultimate preparation for
course exams and the NCLEX-RN.
1. A nurse reviews the arterial blood gas (ABG)
results of a patient with severe COPD: pH 7.31,
PaCO2 55 mm Hg, HCO3 28 mEq/L, PaO2 72 mm
Hg. Which interpretation is correct?
A) Uncompensated metabolic acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated respiratory alkalosis
D) Uncompensated respiratory acidosis
Answer: B) Partially compensated respiratory
acidosis
, Rationale: The pH is below normal (7.35–7.45),
indicating acidosis. The PaCO2 is elevated
(normal 35–45), showing a respiratory cause.
The HCO3 is elevated (normal 22–26), indicating
the kidneys are retaining bicarbonate to
compensate, but the pH is not yet normal.
2. An older adult patient is admitted with
dehydration. Which assessment finding requires
immediate intervention by the nurse?
A) Skin tenting on the forearm
B) Urine output of 20 mL/hr for 2 consecutive
hours
C) Concentrated, dark amber urine
D) Dried, cracked mucous membranes
Answer: B) Urine output of 20 mL/hr for 2
consecutive hours
Rationale: A urine output below 30 mL/hr
indicates inadequate renal perfusion and
potential acute kidney injury, demanding
immediate fluid resuscitation. The other options
are expected signs of dehydration.
3. A patient is 4 hours postoperative following a
total thyroidectomy. The nurse notes muscle
twitching and a positive Chvostek's sign. Which
, medication should the nurse prepare to
administer?
A) Potassium chloride
B) Calcium gluconate
C) Magnesium sulfate
D) Sodium bicarbonate
Answer: B) Calcium gluconate
Rationale: A positive Chvostek's sign and
muscle twitching indicate hypocalcemia, a
common complication of thyroidectomy if the
parathyroid glands are accidentally damaged or
removed.
4. The nurse cares for a patient with a serum
potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change is most critical
for the nurse to monitor?
A) Prolonged QT interval
B) ST-segment depression
C) Tall, peaked T waves
D) Prominent U waves
Answer: C) Tall, peaked T waves
Rationale: Hyperkalemia causes tall, peaked T
waves, widening QRS complexes, and can
progress to ventricular fibrillation or cardiac
arrest if left untreated.
, 5. A patient with chronic kidney disease misses
three consecutive hemodialysis sessions. Which
acid-base imbalance is this patient at highest
risk for developing?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Answer: C) Metabolic acidosis
Rationale: The kidneys are responsible for
excreting hydrogen ions and regenerating
bicarbonate. In kidney failure, hydrogen ions
accumulate and bicarbonate is depleted, leading
to metabolic acidosis.
6. A nurse prepares to administer an IV infusion of
3% sodium chloride to a patient with severe
hyponatremia. Which nursing action is a priority
safety measure?
A) Infuse the solution rapidly over 1 hour.
B) Monitor neurological status every 1 to 2
hours.
C) Assess for signs of fluid volume deficit.
D) Teach the patient to increase dietary fluid
intake.
Answer: B) Monitor neurological status every 1
& COLLABORATIVE CARE MCQ PREP KIT –
HIGH-YIELD RATIONALES
This comprehensive medical-surgical test bank
features verified multiple-choice questions
complete with italicised answers and bolded clinical
judgment rationales. It perfectly aligns with
advanced concepts of collaborative care and
nursing prioritization to help you master complex
pathophysiology and pharmacology. Ideal for
nursing students aiming for top tier grades, this
resource provides the ultimate preparation for
course exams and the NCLEX-RN.
1. A nurse reviews the arterial blood gas (ABG)
results of a patient with severe COPD: pH 7.31,
PaCO2 55 mm Hg, HCO3 28 mEq/L, PaO2 72 mm
Hg. Which interpretation is correct?
A) Uncompensated metabolic acidosis
B) Partially compensated respiratory acidosis
C) Fully compensated respiratory alkalosis
D) Uncompensated respiratory acidosis
Answer: B) Partially compensated respiratory
acidosis
, Rationale: The pH is below normal (7.35–7.45),
indicating acidosis. The PaCO2 is elevated
(normal 35–45), showing a respiratory cause.
The HCO3 is elevated (normal 22–26), indicating
the kidneys are retaining bicarbonate to
compensate, but the pH is not yet normal.
2. An older adult patient is admitted with
dehydration. Which assessment finding requires
immediate intervention by the nurse?
A) Skin tenting on the forearm
B) Urine output of 20 mL/hr for 2 consecutive
hours
C) Concentrated, dark amber urine
D) Dried, cracked mucous membranes
Answer: B) Urine output of 20 mL/hr for 2
consecutive hours
Rationale: A urine output below 30 mL/hr
indicates inadequate renal perfusion and
potential acute kidney injury, demanding
immediate fluid resuscitation. The other options
are expected signs of dehydration.
3. A patient is 4 hours postoperative following a
total thyroidectomy. The nurse notes muscle
twitching and a positive Chvostek's sign. Which
, medication should the nurse prepare to
administer?
A) Potassium chloride
B) Calcium gluconate
C) Magnesium sulfate
D) Sodium bicarbonate
Answer: B) Calcium gluconate
Rationale: A positive Chvostek's sign and
muscle twitching indicate hypocalcemia, a
common complication of thyroidectomy if the
parathyroid glands are accidentally damaged or
removed.
4. The nurse cares for a patient with a serum
potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change is most critical
for the nurse to monitor?
A) Prolonged QT interval
B) ST-segment depression
C) Tall, peaked T waves
D) Prominent U waves
Answer: C) Tall, peaked T waves
Rationale: Hyperkalemia causes tall, peaked T
waves, widening QRS complexes, and can
progress to ventricular fibrillation or cardiac
arrest if left untreated.
, 5. A patient with chronic kidney disease misses
three consecutive hemodialysis sessions. Which
acid-base imbalance is this patient at highest
risk for developing?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Answer: C) Metabolic acidosis
Rationale: The kidneys are responsible for
excreting hydrogen ions and regenerating
bicarbonate. In kidney failure, hydrogen ions
accumulate and bicarbonate is depleted, leading
to metabolic acidosis.
6. A nurse prepares to administer an IV infusion of
3% sodium chloride to a patient with severe
hyponatremia. Which nursing action is a priority
safety measure?
A) Infuse the solution rapidly over 1 hour.
B) Monitor neurological status every 1 to 2
hours.
C) Assess for signs of fluid volume deficit.
D) Teach the patient to increase dietary fluid
intake.
Answer: B) Monitor neurological status every 1
