NUR 355 Exam 1: Acute & Chronic Health Disruptions In
Adults I V3 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is caring for a patient who has a potassium level of 2.8 mEq/L. Which of the following findings
should the nurse expect on the electrocardiogram (ECG)?
A. Peaked T waves
B. Widened QRS complex
C. Shortened QT interval
D. Presence of U waves
Ans: D
Explanation: Hypokalemia is characterized by a potassium level below 3.5 mEq/L and often results in
specific cardiac conduction changes. The presence of U waves is a classic sign of low potassium levels
impacting myocardial repolarization. Other findings include ST-segment depression and flattened or
inverted T waves. Peaked T waves and widened QRS complexes are more indicative of hyperkalemia
rather than hypokalemia. The nurse must prioritize cardiac monitoring to detect these changes and
prevent life-threatening arrhythmias.
2. A patient is admitted with severe vomiting and diarrhea for three days. Which clinical manifestation
should the nurse anticipate?
A. Orthostatic hypotension
B. Distended neck veins
C. Bradycardia
D. Peripheral edema
,Ans: A
Explanation: Severe vomiting and diarrhea lead to fluid volume deficit due to the excessive loss of
isotonic fluids. Orthostatic hypotension occurs as a result of decreased circulating blood volume when the
patient changes position. The compensatory mechanism of the body includes tachycardia to maintain
cardiac output, not bradycardia. Distended neck veins and peripheral edema are signs of fluid volume
excess, which is the opposite of this patient’s condition. Nursing care focuses on fluid resuscitation and
monitoring for signs of decreased organ perfusion.
3. Which task is a primary responsibility of the nurse when obtaining informed consent for a surgical
procedure?
A. Explaining the risks and benefits of the surgery
B. Describing alternative treatments to the patient
C. Providing the patient with a surgical diagnosis
D. Witnessing the patient’s signature on the form
Ans: D
Explanation: The nurse’s role in informed consent is primarily to act as a witness to the patient’s
signature. It is the surgeon’s legal responsibility to explain the procedure, risks, benefits, and alternatives
to the patient. The nurse ensures that the patient is competent and signing the document voluntarily
without coercion. If the patient expresses a lack of understanding, the nurse must notify the surgeon to
provide further clarification. Verification of the signature is a critical step in the preoperative checklist
process.
4. A patient undergoes a thyroidectomy and later complains of numbness and tingling around the mouth.
Which assessment should the nurse perform first?
A. Evaluate the patient’s heart rate
, B. Check the patient’s blood pressure
C. Assess for Chvostek’s sign
D. Obtain a bedside blood glucose
Ans: C
Explanation: Hypocalcemia can occur after a thyroidectomy if the parathyroid glands are accidentally
damaged or removed. Numbness and tingling around the mouth, known as circumoral paresthesia, are
early indicators of low serum calcium. Assessing for Chvostek’s sign involves tapping the facial nerve to
look for twitching, which indicates neuromuscular irritability. This assessment helps the nurse identify
the need for calcium replacement therapy to prevent tetany or seizures. Blood glucose and blood
pressure monitoring are important but are not the priority for these specific neurological symptoms.
5. An arterial blood gas (ABG) result shows pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L. How should the
nurse interpret these results?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Ans: B
Explanation: The pH of 7.30 is below the normal range of 7.35 to 7.45, indicating an acidotic state. The
PaCO2 of 52 mmHg is elevated, which signifies that carbon dioxide is being retained by the lungs. Because
the PaCO2 is the component causing the drop in pH, the condition is classified as respiratory. The HCO3 is
within the normal range of 22 to 26 mEq/L, indicating that no compensation has occurred yet. This
pattern is commonly seen in patients with respiratory depression or obstructive lung diseases.
Adults I V3 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A nurse is caring for a patient who has a potassium level of 2.8 mEq/L. Which of the following findings
should the nurse expect on the electrocardiogram (ECG)?
A. Peaked T waves
B. Widened QRS complex
C. Shortened QT interval
D. Presence of U waves
Ans: D
Explanation: Hypokalemia is characterized by a potassium level below 3.5 mEq/L and often results in
specific cardiac conduction changes. The presence of U waves is a classic sign of low potassium levels
impacting myocardial repolarization. Other findings include ST-segment depression and flattened or
inverted T waves. Peaked T waves and widened QRS complexes are more indicative of hyperkalemia
rather than hypokalemia. The nurse must prioritize cardiac monitoring to detect these changes and
prevent life-threatening arrhythmias.
2. A patient is admitted with severe vomiting and diarrhea for three days. Which clinical manifestation
should the nurse anticipate?
A. Orthostatic hypotension
B. Distended neck veins
C. Bradycardia
D. Peripheral edema
,Ans: A
Explanation: Severe vomiting and diarrhea lead to fluid volume deficit due to the excessive loss of
isotonic fluids. Orthostatic hypotension occurs as a result of decreased circulating blood volume when the
patient changes position. The compensatory mechanism of the body includes tachycardia to maintain
cardiac output, not bradycardia. Distended neck veins and peripheral edema are signs of fluid volume
excess, which is the opposite of this patient’s condition. Nursing care focuses on fluid resuscitation and
monitoring for signs of decreased organ perfusion.
3. Which task is a primary responsibility of the nurse when obtaining informed consent for a surgical
procedure?
A. Explaining the risks and benefits of the surgery
B. Describing alternative treatments to the patient
C. Providing the patient with a surgical diagnosis
D. Witnessing the patient’s signature on the form
Ans: D
Explanation: The nurse’s role in informed consent is primarily to act as a witness to the patient’s
signature. It is the surgeon’s legal responsibility to explain the procedure, risks, benefits, and alternatives
to the patient. The nurse ensures that the patient is competent and signing the document voluntarily
without coercion. If the patient expresses a lack of understanding, the nurse must notify the surgeon to
provide further clarification. Verification of the signature is a critical step in the preoperative checklist
process.
4. A patient undergoes a thyroidectomy and later complains of numbness and tingling around the mouth.
Which assessment should the nurse perform first?
A. Evaluate the patient’s heart rate
, B. Check the patient’s blood pressure
C. Assess for Chvostek’s sign
D. Obtain a bedside blood glucose
Ans: C
Explanation: Hypocalcemia can occur after a thyroidectomy if the parathyroid glands are accidentally
damaged or removed. Numbness and tingling around the mouth, known as circumoral paresthesia, are
early indicators of low serum calcium. Assessing for Chvostek’s sign involves tapping the facial nerve to
look for twitching, which indicates neuromuscular irritability. This assessment helps the nurse identify
the need for calcium replacement therapy to prevent tetany or seizures. Blood glucose and blood
pressure monitoring are important but are not the priority for these specific neurological symptoms.
5. An arterial blood gas (ABG) result shows pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L. How should the
nurse interpret these results?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Ans: B
Explanation: The pH of 7.30 is below the normal range of 7.35 to 7.45, indicating an acidotic state. The
PaCO2 of 52 mmHg is elevated, which signifies that carbon dioxide is being retained by the lungs. Because
the PaCO2 is the component causing the drop in pH, the condition is classified as respiratory. The HCO3 is
within the normal range of 22 to 26 mEq/L, indicating that no compensation has occurred yet. This
pattern is commonly seen in patients with respiratory depression or obstructive lung diseases.
