NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 1 QUESTIONS AND ANSWERS
1. A patient who underwent a major abdominal surgery 12 hours ago has a urine output of 20
mL/hour for the past 2 hours. Which action should the nurse take first?
A. Document the finding as a normal post-operative response.
B. Increase the intravenous fluid rate immediately.
C. Assess the patency of the urinary catheter and check for kinks.
D. Administer a prescribed diuretic to stimulate kidney function.
Answer: C
Conceptual Explanation: Low urine output (less than 30 mL/hr) post-operatively may
indicate dehydration or renal issues, but the first nursing action should be to check for
mechanical obstructions like catheter kinks before escalating.
2. Which clinical manifestation is a hallmark sign of malignant hyperthermia during general
anesthesia?
A. Hypothermia and bradycardia
B. Hyperglycemia and pinpoint pupils
C. Hypertension and increased bowel sounds
,D. Muscle rigidity and unexplained tachypnea
Answer: D
Conceptual Explanation: Malignant hyperthermia is a life-threatening complication of
general anesthesia characterized by muscle rigidity, tachycardia, and a rapid rise in body
temperature.
3. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, HCO3 26 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: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
with a normal HCO3 indicates that the cause is respiratory.
4. A patient is diagnosed with hypokalemia. Which ECG change is most characteristic of this
electrolyte imbalance?
A. Tall, peaked T waves
B. Shortened QT interval
C. Widened QRS complex
, D. Presence of U waves
Answer: D
Conceptual Explanation: Hypokalemia typically presents with ST segment depression,
flattened T waves, and the appearance of U waves on an ECG.
5. When obtaining informed consent for a surgical procedure, what is the primary
responsibility of the nurse?
A. Ensuring the patient is fully informed and witnessing the signature.
B. Explaining the risks and benefits of the surgery to the patient.
C. Choosing the best surgical approach for the patient.
D. Obtaining the signature even if the patient is confused.
Answer: A
Conceptual Explanation: The surgeon is responsible for explaining the procedure and
risks; the nurse’s role is to witness the patient’s signature and verify that the patient
understands the information provided.
6. A patient presents with a serum sodium level of 155 mEq/L. Which intervention is a
priority?
A. Restrict fluid intake to 1000 mL per day.
B. Administer 3% Sodium Chloride IV.
C. Encourage increased oral water intake.
- EXAM 1 QUESTIONS AND ANSWERS
1. A patient who underwent a major abdominal surgery 12 hours ago has a urine output of 20
mL/hour for the past 2 hours. Which action should the nurse take first?
A. Document the finding as a normal post-operative response.
B. Increase the intravenous fluid rate immediately.
C. Assess the patency of the urinary catheter and check for kinks.
D. Administer a prescribed diuretic to stimulate kidney function.
Answer: C
Conceptual Explanation: Low urine output (less than 30 mL/hr) post-operatively may
indicate dehydration or renal issues, but the first nursing action should be to check for
mechanical obstructions like catheter kinks before escalating.
2. Which clinical manifestation is a hallmark sign of malignant hyperthermia during general
anesthesia?
A. Hypothermia and bradycardia
B. Hyperglycemia and pinpoint pupils
C. Hypertension and increased bowel sounds
,D. Muscle rigidity and unexplained tachypnea
Answer: D
Conceptual Explanation: Malignant hyperthermia is a life-threatening complication of
general anesthesia characterized by muscle rigidity, tachycardia, and a rapid rise in body
temperature.
3. A nurse is reviewing the arterial blood gas (ABG) results for a patient: pH 7.30, PaCO2 52
mmHg, HCO3 26 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: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
with a normal HCO3 indicates that the cause is respiratory.
4. A patient is diagnosed with hypokalemia. Which ECG change is most characteristic of this
electrolyte imbalance?
A. Tall, peaked T waves
B. Shortened QT interval
C. Widened QRS complex
, D. Presence of U waves
Answer: D
Conceptual Explanation: Hypokalemia typically presents with ST segment depression,
flattened T waves, and the appearance of U waves on an ECG.
5. When obtaining informed consent for a surgical procedure, what is the primary
responsibility of the nurse?
A. Ensuring the patient is fully informed and witnessing the signature.
B. Explaining the risks and benefits of the surgery to the patient.
C. Choosing the best surgical approach for the patient.
D. Obtaining the signature even if the patient is confused.
Answer: A
Conceptual Explanation: The surgeon is responsible for explaining the procedure and
risks; the nurse’s role is to witness the patient’s signature and verify that the patient
understands the information provided.
6. A patient presents with a serum sodium level of 155 mEq/L. Which intervention is a
priority?
A. Restrict fluid intake to 1000 mL per day.
B. Administer 3% Sodium Chloride IV.
C. Encourage increased oral water intake.
