NU 155 Medical-Surgical Nursing I - Exam 3 Prep 2026 Galen College
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which
assessment finding should the nurse prioritize?
A. Irregular heart rhythm
B. Hyperactive bowel sounds
C. Increased muscle strength
D. Elevated blood pressure
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias and EKG changes like flat T waves.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.50, HCO3 30 mEq/L
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.32, HCO3 18 mEq/L
D. pH 7.30, PaCO2 50 mmHg
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated
PaCO2 (>45 mmHg).
,3. The nurse is caring for a patient with fluid volume excess. Which clinical
manifestation is expected?
A. Threaded pulse
B. Flat neck veins
C. Decreased central venous pressure
D. Crackles in the lungs
Answer: D
Rationale: Fluid volume excess often leads to pulmonary congestion, manifesting as
crackles on auscultation, jugular vein distention, and edema.
4. A patient has a positive Chvostek’s sign. Which electrolyte imbalance does
the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia.
5. What is the primary goal of the ‘Time Out’ procedure in the operating room?
A. To ensure the correct patient, site, and procedure
B. To confirm the patient’s insurance coverage
C. To allow the surgeon to rest before starting
D. To count the sponges after the surgery is over
Answer: A
Rationale: The ‘Time Out’ is a safety protocol to prevent wrong-site, wrong-procedure, and
wrong-person surgery.
, 6. A patient is scheduled for surgery and has been NPO since midnight. What is
the main reason for this requirement?
A. To prevent post-operative diarrhea
B. To make the patient lose weight before surgery
C. To reduce the risk of aspiration during anesthesia
D. To prevent the need for a urinary catheter
Answer: C
Rationale: Being NPO (nothing by mouth) reduces gastric contents, minimizing the risk of
vomiting and aspiration during induction of anesthesia.
7. The nurse notes a patient’s serum sodium level is 152 mEq/L. Which
intervention should the nurse anticipate?
A. Administration of 3% Normal Saline
B. Encouraging salt tablets
C. Restricting plain water intake
D. Administration of hypotonic IV fluids
Answer: D
Rationale: Hypernatremia (>145 mEq/L) requires dilution of the serum, typically achieved
with hypotonic fluids (e.g., 0.45% NS) or D5W.
8. Which patient is at the highest risk for developing metabolic alkalosis?
A. A patient with chronic obstructive pulmonary disease (COPD)
B. A patient with prolonged nasogastric suctioning
C. A patient with poorly controlled Type 1 Diabetes
D. A patient with severe diarrhea
Answer: B
Rationale: Gastric secretions are acidic; removing them via suctioning or vomiting leads to
a loss of acid and an increase in bicarbonate levels, causing metabolic alkalosis.
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which
assessment finding should the nurse prioritize?
A. Irregular heart rhythm
B. Hyperactive bowel sounds
C. Increased muscle strength
D. Elevated blood pressure
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias and EKG changes like flat T waves.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.50, HCO3 30 mEq/L
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.32, HCO3 18 mEq/L
D. pH 7.30, PaCO2 50 mmHg
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated
PaCO2 (>45 mmHg).
,3. The nurse is caring for a patient with fluid volume excess. Which clinical
manifestation is expected?
A. Threaded pulse
B. Flat neck veins
C. Decreased central venous pressure
D. Crackles in the lungs
Answer: D
Rationale: Fluid volume excess often leads to pulmonary congestion, manifesting as
crackles on auscultation, jugular vein distention, and edema.
4. A patient has a positive Chvostek’s sign. Which electrolyte imbalance does
the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia.
5. What is the primary goal of the ‘Time Out’ procedure in the operating room?
A. To ensure the correct patient, site, and procedure
B. To confirm the patient’s insurance coverage
C. To allow the surgeon to rest before starting
D. To count the sponges after the surgery is over
Answer: A
Rationale: The ‘Time Out’ is a safety protocol to prevent wrong-site, wrong-procedure, and
wrong-person surgery.
, 6. A patient is scheduled for surgery and has been NPO since midnight. What is
the main reason for this requirement?
A. To prevent post-operative diarrhea
B. To make the patient lose weight before surgery
C. To reduce the risk of aspiration during anesthesia
D. To prevent the need for a urinary catheter
Answer: C
Rationale: Being NPO (nothing by mouth) reduces gastric contents, minimizing the risk of
vomiting and aspiration during induction of anesthesia.
7. The nurse notes a patient’s serum sodium level is 152 mEq/L. Which
intervention should the nurse anticipate?
A. Administration of 3% Normal Saline
B. Encouraging salt tablets
C. Restricting plain water intake
D. Administration of hypotonic IV fluids
Answer: D
Rationale: Hypernatremia (>145 mEq/L) requires dilution of the serum, typically achieved
with hypotonic fluids (e.g., 0.45% NS) or D5W.
8. Which patient is at the highest risk for developing metabolic alkalosis?
A. A patient with chronic obstructive pulmonary disease (COPD)
B. A patient with prolonged nasogastric suctioning
C. A patient with poorly controlled Type 1 Diabetes
D. A patient with severe diarrhea
Answer: B
Rationale: Gastric secretions are acidic; removing them via suctioning or vomiting leads to
a loss of acid and an increase in bicarbonate levels, causing metabolic alkalosis.
