NUR 170 Exam 7 - Concepts of Medical-Surgical Nursing 2026 |Galen
College
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which clinical
manifestation should the nurse prioritize for assessment?
A. Increased bowel sounds
B. Cardiac dysrhythmias
C. Hyperactive deep tendon reflexes
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) significantly affects cardiac electrical
conduction, potentially leading to life-threatening dysrhythmias.
2. When obtaining informed consent for a surgical procedure, what is the
primary responsibility of the nurse?
A. Explaining the risks and benefits of the surgery
B. Witnessing the patient’s signature on the consent form
C. Describing alternative treatments to the patient
D. Performing the preoperative physical assessment
Answer: B
Rationale: The surgeon is responsible for explaining the procedure, risks, and benefits.
The nurse’s role is to witness the signature and ensure the patient is competent to sign.
,3. A patient has an arterial blood gas (ABG) result of pH 7.30, PaCO2 52 mmHg,
and HCO3 24 mEq/L. How should the nurse interpret this result?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 (>45) indicates a
respiratory cause, and a normal HCO3 suggests no compensation yet.
4. Which intervention is most effective in preventing postoperative pulmonary
atelectasis?
A. Administering prophylactic antibiotics
B. Limiting fluid intake to prevent pulmonary edema
C. Maintaining the patient in a supine position
D. Encouraging the use of an incentive spirometer every hour while awake
Answer: D
Rationale: Incentive spirometry promotes deep breathing and lung expansion, which helps
open collapsed alveoli (atelectasis) post-surgery.
5. A patient undergoing chemotherapy is diagnosed with neutropenia. Which
representative action should the nurse include in the care plan?
A. Encourage a diet high in fresh fruits and salads
B. Place fresh flowers in the patient’s room to boost morale
C. Administer aspirin for any signs of fever
D. Perform frequent hand hygiene and limit visitors with infections
Answer: D
Rationale: Neutropenic patients are at high risk for infection. Strict hand hygiene and
avoiding exposure to pathogens (including fresh produce or flowers) are essential.
, 6. What is the hallmark sign of a ‘Trousseau’s sign’ during an assessment for
hypocalcemia?
A. Twitching of the facial muscles when the facial nerve is tapped
B. Numbness and tingling in the extremities
C. Carpal spasm induced by inflating a blood pressure cuff
D. Severe muscle cramps in the calves
Answer: C
Rationale: Trousseau’s sign is a carpal spasm caused by inflating a BP cuff above systolic
pressure for a few minutes, indicating neuromuscular irritability from low calcium.
7. Which electrolyte imbalance is a patient at risk for if they are taking a loop
diuretic like Furosemide?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Rationale: Loop diuretics cause the kidneys to excrete water, sodium, and potassium,
frequently leading to hypokalemia.
8. During the inflammatory process, which vascular change occurs immediately
after injury?
A. Permanent narrowing of blood vessels
B. Vasoconstriction followed by vasodilation
C. Decreased capillary permeability
D. Decreased blood flow to the site
Answer: B
Rationale: The initial response to injury is brief vasoconstriction to control bleeding,
followed immediately by vasodilation to bring white blood cells to the area.
College
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which clinical
manifestation should the nurse prioritize for assessment?
A. Increased bowel sounds
B. Cardiac dysrhythmias
C. Hyperactive deep tendon reflexes
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) significantly affects cardiac electrical
conduction, potentially leading to life-threatening dysrhythmias.
2. When obtaining informed consent for a surgical procedure, what is the
primary responsibility of the nurse?
A. Explaining the risks and benefits of the surgery
B. Witnessing the patient’s signature on the consent form
C. Describing alternative treatments to the patient
D. Performing the preoperative physical assessment
Answer: B
Rationale: The surgeon is responsible for explaining the procedure, risks, and benefits.
The nurse’s role is to witness the signature and ensure the patient is competent to sign.
,3. A patient has an arterial blood gas (ABG) result of pH 7.30, PaCO2 52 mmHg,
and HCO3 24 mEq/L. How should the nurse interpret this result?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 (>45) indicates a
respiratory cause, and a normal HCO3 suggests no compensation yet.
4. Which intervention is most effective in preventing postoperative pulmonary
atelectasis?
A. Administering prophylactic antibiotics
B. Limiting fluid intake to prevent pulmonary edema
C. Maintaining the patient in a supine position
D. Encouraging the use of an incentive spirometer every hour while awake
Answer: D
Rationale: Incentive spirometry promotes deep breathing and lung expansion, which helps
open collapsed alveoli (atelectasis) post-surgery.
5. A patient undergoing chemotherapy is diagnosed with neutropenia. Which
representative action should the nurse include in the care plan?
A. Encourage a diet high in fresh fruits and salads
B. Place fresh flowers in the patient’s room to boost morale
C. Administer aspirin for any signs of fever
D. Perform frequent hand hygiene and limit visitors with infections
Answer: D
Rationale: Neutropenic patients are at high risk for infection. Strict hand hygiene and
avoiding exposure to pathogens (including fresh produce or flowers) are essential.
, 6. What is the hallmark sign of a ‘Trousseau’s sign’ during an assessment for
hypocalcemia?
A. Twitching of the facial muscles when the facial nerve is tapped
B. Numbness and tingling in the extremities
C. Carpal spasm induced by inflating a blood pressure cuff
D. Severe muscle cramps in the calves
Answer: C
Rationale: Trousseau’s sign is a carpal spasm caused by inflating a BP cuff above systolic
pressure for a few minutes, indicating neuromuscular irritability from low calcium.
7. Which electrolyte imbalance is a patient at risk for if they are taking a loop
diuretic like Furosemide?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Rationale: Loop diuretics cause the kidneys to excrete water, sodium, and potassium,
frequently leading to hypokalemia.
8. During the inflammatory process, which vascular change occurs immediately
after injury?
A. Permanent narrowing of blood vessels
B. Vasoconstriction followed by vasodilation
C. Decreased capillary permeability
D. Decreased blood flow to the site
Answer: B
Rationale: The initial response to injury is brief vasoconstriction to control bleeding,
followed immediately by vasodilation to bring white blood cells to the area.
