Galen NUR 242 Exam 1 Med-Surg Study Guide 2026 – Galen College
1. A patient’s ABG results are pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is low (acidosis), and the PaCO2 is high (respiratory), while the HCO3 is
normal, indicating an uncompensated respiratory acidosis.
2. Which electrolyte imbalance is most associated with a positive Chvostek’s
sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Chvostek’s (facial twitching) and Trousseau’s sign.
,3. A patient presents with tall, peaked T waves on an EKG. Which electrolyte
abnormality should the nurse suspect?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: C
Rationale: Tall, peaked T waves are a classic early EKG sign of hyperkalemia, which can
progress to heart block or cardiac arrest.
4. The nurse is caring for a patient with a sodium level of 120 mEq/L. Which
priority intervention should be implemented?
A. Encourage increased water intake
B. Administer a dose of Furosemide
C. Place the patient on seizure precautions
D. Increase the IV rate of D5W
Answer: C
Rationale: Severe hyponatremia (below 125 mEq/L) puts the patient at high risk for
cerebral edema and seizures.
5. What is the primary goal of the ‘Time-Out’ procedure in the operating room?
A. To verify the patient’s insurance coverage
B. To prevent wrong-site, wrong-procedure, and wrong-person surgery
C. To ensure the surgeon has arrived on time
D. To allow the anesthesiologist to administer sedatives
Answer: B
Rationale: The Time-Out is a safety protocol where the entire surgical team stops to verify
the patient, site, and procedure.
, 6. A patient is 12 hours post-op and has not voided. What should the nurse’s
first action be?
A. Perform a bladder scan
B. Insert a Foley catheter immediately
C. Encourage the patient to drink 1000mL of water
D. Notify the surgeon immediately
Answer: A
Rationale: A bladder scan is a non-invasive first step to assess for urinary retention before
escalating to invasive procedures.
7. Which medication is the antidote for Malignant Hyperthermia?
A. Naloxone
B. Dantrolene
C. Atropine
D. Flumazenil
Answer: B
Rationale: Dantrolene is a skeletal muscle relaxant that specifically treats the
hypermetabolic crisis of malignant hyperthermia.
8. Using the Rule of Nines, what percentage of total body surface area (TBSA) is
burned if a patient has burns on the entire front of the torso and the entire right
arm?
A. 18%
B. 36%
C. 27%
D. 45%
Answer: C
Rationale: The anterior torso is 18% and the entire right arm is 9%. 18 + 9 = 27%.
1. A patient’s ABG results are pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is low (acidosis), and the PaCO2 is high (respiratory), while the HCO3 is
normal, indicating an uncompensated respiratory acidosis.
2. Which electrolyte imbalance is most associated with a positive Chvostek’s
sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to signs like
Chvostek’s (facial twitching) and Trousseau’s sign.
,3. A patient presents with tall, peaked T waves on an EKG. Which electrolyte
abnormality should the nurse suspect?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: C
Rationale: Tall, peaked T waves are a classic early EKG sign of hyperkalemia, which can
progress to heart block or cardiac arrest.
4. The nurse is caring for a patient with a sodium level of 120 mEq/L. Which
priority intervention should be implemented?
A. Encourage increased water intake
B. Administer a dose of Furosemide
C. Place the patient on seizure precautions
D. Increase the IV rate of D5W
Answer: C
Rationale: Severe hyponatremia (below 125 mEq/L) puts the patient at high risk for
cerebral edema and seizures.
5. What is the primary goal of the ‘Time-Out’ procedure in the operating room?
A. To verify the patient’s insurance coverage
B. To prevent wrong-site, wrong-procedure, and wrong-person surgery
C. To ensure the surgeon has arrived on time
D. To allow the anesthesiologist to administer sedatives
Answer: B
Rationale: The Time-Out is a safety protocol where the entire surgical team stops to verify
the patient, site, and procedure.
, 6. A patient is 12 hours post-op and has not voided. What should the nurse’s
first action be?
A. Perform a bladder scan
B. Insert a Foley catheter immediately
C. Encourage the patient to drink 1000mL of water
D. Notify the surgeon immediately
Answer: A
Rationale: A bladder scan is a non-invasive first step to assess for urinary retention before
escalating to invasive procedures.
7. Which medication is the antidote for Malignant Hyperthermia?
A. Naloxone
B. Dantrolene
C. Atropine
D. Flumazenil
Answer: B
Rationale: Dantrolene is a skeletal muscle relaxant that specifically treats the
hypermetabolic crisis of malignant hyperthermia.
8. Using the Rule of Nines, what percentage of total body surface area (TBSA) is
burned if a patient has burns on the entire front of the torso and the entire right
arm?
A. 18%
B. 36%
C. 27%
D. 45%
Answer: C
Rationale: The anterior torso is 18% and the entire right arm is 9%. 18 + 9 = 27%.
