NRSG 201 Exam 3 V3 | NRSG 201 Med Surg 1 |
Actual Q&A with Rationale (NRSG201 Exam 3) | Ivy
Tech
1. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 50 mm Hg, and HCO3 24
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: The pH level of 7.31 is below the normal range of 7.35 to 7.45, indicating
acidosis. The PaCO2 level of 50 mm Hg is above the normal range of 35 to 45 mm Hg, which
correlates with the acidic pH. Since the bicarbonate level is normal, this represents an
uncompensated respiratory acidosis often caused by hypoventilation.
2. Which electrolyte imbalance should the nurse monitor for in a patient receiving multiple
units of banked blood?
A. Hypernatremia
B. Hypocalcemia
C. Hypokalemia
,D. Hypermagnesemia
Correct Answer: B
Explanation: Citrate is used as a preservative in banked blood to prevent clotting by
binding with calcium. When large volumes of citrated blood are infused rapidly, the citrate
can bind with the patient’s ionized calcium, leading to hypocalcemia. The nurse must
monitor for symptoms such as tetany, muscle twitching, or a positive Chvostek’s sign.
3. A patient presents with a serum potassium level of 6.2 mEq/L. Which nursing intervention
is the highest priority?
A. Place the patient on a cardiac monitor
B. Administer a potassium-sparing diuretic
C. Encourage intake of orange juice
D. Check the patient’s blood pressure
Correct Answer: A
Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which significantly
increases the risk for lethal cardiac arrhythmias. Placing the patient on a cardiac monitor
allows for immediate detection of EKG changes such as peaked T waves or widened QRS
complexes. This assessment takes priority over other interventions to ensure patient safety
during the management of high potassium.
, 4. During the preoperative period, which member of the surgical team is responsible for
obtaining informed consent?
A. The Surgeon
B. The Preoperative Nurse
C. The Anesthesiologist
D. The Charge Nurse
Correct Answer: A
Explanation: It is the legal and ethical responsibility of the surgeon to explain the
procedure, risks, benefits, and alternatives to the patient. The nurse’s role is to witness the
patient’s signature and clarify that the patient understands the information provided. If the
patient has further questions about the procedure itself, the nurse must notify the surgeon
to return and explain.
5. A patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse
understands that higher concentrations may be dangerous because:
A. High oxygen levels cause metabolic alkalosis
B. High oxygen levels can suppress the hypoxic drive to breathe
C. Oxygen is a flammable gas and poses a fire risk
D. The patient may become addicted to the oxygen therapy
Correct Answer: B
Actual Q&A with Rationale (NRSG201 Exam 3) | Ivy
Tech
1. A patient’s arterial blood gas (ABG) results are pH 7.31, PaCO2 50 mm Hg, and HCO3 24
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: The pH level of 7.31 is below the normal range of 7.35 to 7.45, indicating
acidosis. The PaCO2 level of 50 mm Hg is above the normal range of 35 to 45 mm Hg, which
correlates with the acidic pH. Since the bicarbonate level is normal, this represents an
uncompensated respiratory acidosis often caused by hypoventilation.
2. Which electrolyte imbalance should the nurse monitor for in a patient receiving multiple
units of banked blood?
A. Hypernatremia
B. Hypocalcemia
C. Hypokalemia
,D. Hypermagnesemia
Correct Answer: B
Explanation: Citrate is used as a preservative in banked blood to prevent clotting by
binding with calcium. When large volumes of citrated blood are infused rapidly, the citrate
can bind with the patient’s ionized calcium, leading to hypocalcemia. The nurse must
monitor for symptoms such as tetany, muscle twitching, or a positive Chvostek’s sign.
3. A patient presents with a serum potassium level of 6.2 mEq/L. Which nursing intervention
is the highest priority?
A. Place the patient on a cardiac monitor
B. Administer a potassium-sparing diuretic
C. Encourage intake of orange juice
D. Check the patient’s blood pressure
Correct Answer: A
Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which significantly
increases the risk for lethal cardiac arrhythmias. Placing the patient on a cardiac monitor
allows for immediate detection of EKG changes such as peaked T waves or widened QRS
complexes. This assessment takes priority over other interventions to ensure patient safety
during the management of high potassium.
, 4. During the preoperative period, which member of the surgical team is responsible for
obtaining informed consent?
A. The Surgeon
B. The Preoperative Nurse
C. The Anesthesiologist
D. The Charge Nurse
Correct Answer: A
Explanation: It is the legal and ethical responsibility of the surgeon to explain the
procedure, risks, benefits, and alternatives to the patient. The nurse’s role is to witness the
patient’s signature and clarify that the patient understands the information provided. If the
patient has further questions about the procedure itself, the nurse must notify the surgeon
to return and explain.
5. A patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse
understands that higher concentrations may be dangerous because:
A. High oxygen levels cause metabolic alkalosis
B. High oxygen levels can suppress the hypoxic drive to breathe
C. Oxygen is a flammable gas and poses a fire risk
D. The patient may become addicted to the oxygen therapy
Correct Answer: B
