NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 3 QUESTIONS AND ANSWERS
1. A patient presents with a potassium level of 6.2 mEq/L. Which EKG change is the nurse
most likely to observe?
A. Tall, peaked T waves
B. Prominent U waves
C. ST-segment depression
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves,
widened QRS complexes, and prolonged PR intervals. U waves are associated with
hypokalemia.
2. When administering IV potassium chloride, which action by the nurse is a priority for
safety?
A. Administering the medication via rapid IV push
B. Restricting fluid intake during the infusion
C. Ensuring the infusion rate does not exceed 10 mEq/hour in a peripheral line
,D. Checking the patient’s blood pressure every 5 minutes
Answer: C
Conceptual Explanation: Potassium must never be given IV push as it can cause fatal
cardiac arrest. The standard safe rate for peripheral IV potassium is 10 mEq/hr.
3. A patient with a history of chronic alcoholism presents with tremors, hyperactive deep
tendon reflexes, and a positive Chvostek’s sign. Which electrolyte imbalance should the nurse
suspect?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
Answer: C
Conceptual Explanation: Hypomagnesemia often presents similarly to hypocalcemia with
neuromuscular irritability (tetany, tremors, positive Chvostek/Trousseau signs). Chronic
alcoholism is a major risk factor for magnesium deficiency.
4. An arterial blood gas (ABG) shows: pH 7.32, PaCO2 55 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
, C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation has
occurred yet.
5. During the preoperative assessment, a patient states, ‘I am terrified of waking up during
surgery.’ Which response by the nurse is most appropriate?
A. ‘Tell me more about your concerns regarding the anesthesia.’
B. ‘Don’t worry, the anesthesiologist is very experienced.’
C. ‘That rarely happens with modern techniques.’
D. ‘I will make sure the surgeon knows you are nervous.’
Answer: A
Conceptual Explanation: Using open-ended therapeutic communication techniques
allows the patient to express their fears and provides the nurse an opportunity to provide
education and support.
- EXAM 3 QUESTIONS AND ANSWERS
1. A patient presents with a potassium level of 6.2 mEq/L. Which EKG change is the nurse
most likely to observe?
A. Tall, peaked T waves
B. Prominent U waves
C. ST-segment depression
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves,
widened QRS complexes, and prolonged PR intervals. U waves are associated with
hypokalemia.
2. When administering IV potassium chloride, which action by the nurse is a priority for
safety?
A. Administering the medication via rapid IV push
B. Restricting fluid intake during the infusion
C. Ensuring the infusion rate does not exceed 10 mEq/hour in a peripheral line
,D. Checking the patient’s blood pressure every 5 minutes
Answer: C
Conceptual Explanation: Potassium must never be given IV push as it can cause fatal
cardiac arrest. The standard safe rate for peripheral IV potassium is 10 mEq/hr.
3. A patient with a history of chronic alcoholism presents with tremors, hyperactive deep
tendon reflexes, and a positive Chvostek’s sign. Which electrolyte imbalance should the nurse
suspect?
A. Hypermagnesemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
Answer: C
Conceptual Explanation: Hypomagnesemia often presents similarly to hypocalcemia with
neuromuscular irritability (tetany, tremors, positive Chvostek/Trousseau signs). Chronic
alcoholism is a major risk factor for magnesium deficiency.
4. An arterial blood gas (ABG) shows: pH 7.32, PaCO2 55 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
, C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation has
occurred yet.
5. During the preoperative assessment, a patient states, ‘I am terrified of waking up during
surgery.’ Which response by the nurse is most appropriate?
A. ‘Tell me more about your concerns regarding the anesthesia.’
B. ‘Don’t worry, the anesthesiologist is very experienced.’
C. ‘That rarely happens with modern techniques.’
D. ‘I will make sure the surgeon knows you are nervous.’
Answer: A
Conceptual Explanation: Using open-ended therapeutic communication techniques
allows the patient to express their fears and provides the nurse an opportunity to provide
education and support.
