NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 2 COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient has a serum potassium level of 6.2 mEq/L. Which of the following is the priority
nursing intervention?
A. Monitor the patient’s intake and output.
B. Encourage the intake of bananas and orange juice.
C. Administer a potassium-sparing diuretic.
D. Place the patient on a cardiac monitor.
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening
cardiac dysrhythmias. Cardiac monitoring is the priority to detect changes like peaked T
waves or widened QRS complexes.
2. During the intraoperative phase, which member of the surgical team is responsible for
maintaining the sterile field and passing instruments?
A. The circulating nurse
,B. The anesthesiologist
C. The scrub nurse
D. The surgeon’s assistant
Answer: C
Conceptual Explanation: The scrub nurse (or scrub tech) works within the sterile field,
handles sterile equipment, and assists the surgeon. The circulating nurse works outside the
sterile field.
3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, so it is uncompensated
respiratory acidosis.
4. Which assessment finding is an early sign of malignant hyperthermia during surgery?
A. Hyperthermia (105°F)
, B. Muscle rigidity
C. Hypotension
D. Tachycardia
Answer: D
Conceptual Explanation: Tachycardia is often the earliest sign of malignant hyperthermia.
High fever is a late sign of this life-threatening metabolic emergency.
5. The nurse is caring for a patient who is 2 days post-abdominal surgery. The patient reports
a ‘popping’ sensation and the nurse notes loops of bowel protruding from the wound. What
is the immediate action?
A. Apply a sterile, saline-soaked dressing over the organs.
B. Push the organs back into the abdominal cavity.
C. Call the surgeon immediately and wait for orders.
D. Instruct the patient to cough to clear the airway.
Answer: A
Conceptual Explanation: This is evisceration. The priority is to cover the exposed organs
with sterile dressings moistened with sterile normal saline to prevent drying and infection,
then notify the surgeon.
- EXAM 2 COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient has a serum potassium level of 6.2 mEq/L. Which of the following is the priority
nursing intervention?
A. Monitor the patient’s intake and output.
B. Encourage the intake of bananas and orange juice.
C. Administer a potassium-sparing diuretic.
D. Place the patient on a cardiac monitor.
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening
cardiac dysrhythmias. Cardiac monitoring is the priority to detect changes like peaked T
waves or widened QRS complexes.
2. During the intraoperative phase, which member of the surgical team is responsible for
maintaining the sterile field and passing instruments?
A. The circulating nurse
,B. The anesthesiologist
C. The scrub nurse
D. The surgeon’s assistant
Answer: C
Conceptual Explanation: The scrub nurse (or scrub tech) works within the sterile field,
handles sterile equipment, and assists the surgeon. The circulating nurse works outside the
sterile field.
3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 52 mmHg, HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, so it is uncompensated
respiratory acidosis.
4. Which assessment finding is an early sign of malignant hyperthermia during surgery?
A. Hyperthermia (105°F)
, B. Muscle rigidity
C. Hypotension
D. Tachycardia
Answer: D
Conceptual Explanation: Tachycardia is often the earliest sign of malignant hyperthermia.
High fever is a late sign of this life-threatening metabolic emergency.
5. The nurse is caring for a patient who is 2 days post-abdominal surgery. The patient reports
a ‘popping’ sensation and the nurse notes loops of bowel protruding from the wound. What
is the immediate action?
A. Apply a sterile, saline-soaked dressing over the organs.
B. Push the organs back into the abdominal cavity.
C. Call the surgeon immediately and wait for orders.
D. Instruct the patient to cough to clear the airway.
Answer: A
Conceptual Explanation: This is evisceration. The priority is to cover the exposed organs
with sterile dressings moistened with sterile normal saline to prevent drying and infection,
then notify the surgeon.
