NUR 170 Medical-Surgical Nursing Exam 4 Study Guide 2026 Galen
College
1. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which
finding should the nurse report to the provider immediately?
A. Oxygen saturation of 91%
B. Productive cough with clear sputum
C. New onset of confusion and lethargy
D. Respiratory rate of 22 breaths per minute
Answer: C
Rationale: Confusion and lethargy in a COPD patient receiving oxygen can indicate CO2
narcosis, a condition where high CO2 levels lead to mental status changes.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.30, PaCO2 55, HCO3 26
B. pH 7.48, PaCO2 32, HCO3 24
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated
PaCO2 (>45 mmHg).
,3. A patient is scheduled for a bronchoscopy. Which nursing action is a priority
post-procedure?
A. Administering oral fluids immediately
B. Monitoring the gag reflex before allowing oral intake
C. Encouraging the patient to walk in the hallway
D. Applying a heating pad to the neck
Answer: B
Rationale: The gag reflex is suppressed during a bronchoscopy due to local anesthesia.
Assessing for its return is critical to prevent aspiration before the patient eats or drinks.
4. A nurse is caring for a patient with a potassium level of 2.8 mEq/L. Which EKG
change should the nurse expect?
A. Prominent U waves
B. Widened QRS complex
C. Tall, peaked T waves
D. Shortened QT interval
Answer: A
Rationale: Hypokalemia typically presents with ST-segment depression, flat or inverted T
waves, and prominent U waves on an EKG.
5. What is the primary goal of using an incentive spirometer after surgery?
A. To increase heart rate
B. To prevent atelectasis
C. To reduce surgical site pain
D. To decrease oxygen demand
Answer: B
Rationale: Incentive spirometry encourages deep breathing, which helps expand the
alveoli and prevents atelectasis (collapsed lung tissue) in postoperative patients.
, 6. A nurse is assessing a patient for Chvostek’s sign. Which electrolyte imbalance
is the nurse testing for?
A. Hypomagnesemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) and
Trousseau’s sign (carpal spasm with BP cuff inflation) are classic signs of hypocalcemia.
7. A patient with heart failure has gained 4 lbs (1.8 kg) in 24 hours. What is the
nurse’s priority action?
A. Assess lung sounds for crackles
B. Document the weight and continue to monitor
C. Encourage the patient to increase fluid intake
D. Notify the dietitian to adjust the meal plan
Answer: A
Rationale: Rapid weight gain in heart failure indicates fluid volume excess. The nurse
should prioritize assessing the patient’s respiratory status for signs of pulmonary edema.
8. Which medication is considered a ‘rescue’ inhaler for acute asthma
symptoms?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Montelukast
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used for the rapid relief of
bronchospasm. The others are long-term maintenance or anti-inflammatory drugs.
College
1. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which
finding should the nurse report to the provider immediately?
A. Oxygen saturation of 91%
B. Productive cough with clear sputum
C. New onset of confusion and lethargy
D. Respiratory rate of 22 breaths per minute
Answer: C
Rationale: Confusion and lethargy in a COPD patient receiving oxygen can indicate CO2
narcosis, a condition where high CO2 levels lead to mental status changes.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.30, PaCO2 55, HCO3 26
B. pH 7.48, PaCO2 32, HCO3 24
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated
PaCO2 (>45 mmHg).
,3. A patient is scheduled for a bronchoscopy. Which nursing action is a priority
post-procedure?
A. Administering oral fluids immediately
B. Monitoring the gag reflex before allowing oral intake
C. Encouraging the patient to walk in the hallway
D. Applying a heating pad to the neck
Answer: B
Rationale: The gag reflex is suppressed during a bronchoscopy due to local anesthesia.
Assessing for its return is critical to prevent aspiration before the patient eats or drinks.
4. A nurse is caring for a patient with a potassium level of 2.8 mEq/L. Which EKG
change should the nurse expect?
A. Prominent U waves
B. Widened QRS complex
C. Tall, peaked T waves
D. Shortened QT interval
Answer: A
Rationale: Hypokalemia typically presents with ST-segment depression, flat or inverted T
waves, and prominent U waves on an EKG.
5. What is the primary goal of using an incentive spirometer after surgery?
A. To increase heart rate
B. To prevent atelectasis
C. To reduce surgical site pain
D. To decrease oxygen demand
Answer: B
Rationale: Incentive spirometry encourages deep breathing, which helps expand the
alveoli and prevents atelectasis (collapsed lung tissue) in postoperative patients.
, 6. A nurse is assessing a patient for Chvostek’s sign. Which electrolyte imbalance
is the nurse testing for?
A. Hypomagnesemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) and
Trousseau’s sign (carpal spasm with BP cuff inflation) are classic signs of hypocalcemia.
7. A patient with heart failure has gained 4 lbs (1.8 kg) in 24 hours. What is the
nurse’s priority action?
A. Assess lung sounds for crackles
B. Document the weight and continue to monitor
C. Encourage the patient to increase fluid intake
D. Notify the dietitian to adjust the meal plan
Answer: A
Rationale: Rapid weight gain in heart failure indicates fluid volume excess. The nurse
should prioritize assessing the patient’s respiratory status for signs of pulmonary edema.
8. Which medication is considered a ‘rescue’ inhaler for acute asthma
symptoms?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Montelukast
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used for the rapid relief of
bronchospasm. The others are long-term maintenance or anti-inflammatory drugs.
