NUR 170 Exam 3: Med Surg - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which physical finding
should the nurse expect to observe?
A. Presence of pink, frothy sputum
B. Respiratory rate of 12 breaths per minute at rest
C. Increased pH on arterial blood gas analysis
D. Anteroposterior chest diameter equal to the lateral diameter
Correct Answer: D
Rationale: A barrel chest is a characteristic sign of COPD resulting from chronic air trapping. This
anatomical change occurs when the lungs become chronically hyperinflated due to lost elasticity. The
nurse should document this finding as an indicator of disease progression. It is caused by the structural
remodeling of the thoracic cage over time. Assessment of respiratory effort is also critical for these
patients.
2. A client is admitted with heart failure and is prescribed furosemide. Which electrolyte imbalance is the
priority for the nurse to monitor?
A. Hypercalcemia
B. Hypomagnesemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
,Rationale: Furosemide is a loop diuretic that causes the excretion of potassium in the urine. Low
potassium levels can lead to life-threatening cardiac dysrhythmias and muscle weakness. The nurse must
monitor serum potassium levels frequently during therapy. Educating the client on potassium-rich foods
is a vital nursing intervention. If levels drop below the normal range, a potassium supplement may be
necessary.
3. Which arterial blood gas (ABG) result is most consistent with a client experiencing an exacerbation of
COPD?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.30, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Correct Answer: B
Rationale: Clients with COPD often retain carbon dioxide, leading to respiratory acidosis. A pH below
7.35 and a PaCO2 above 45 mmHg confirm this condition. The kidneys may partially compensate by
retaining bicarbonate, resulting in an elevated HCO3 level. This specific ABG profile indicates the client is
struggling with gas exchange. Monitoring for signs of CO2 narcosis is essential for safety.
4. A nurse is caring for a client with suspected pulmonary tuberculosis (TB). What is the priority nursing
action?
A. Obtain a sputum culture for acid-fast bacilli.
B. Administer the prescribed antitubercular medications.
C. Place the client in a negative-pressure airflow room.
D. Perform a tuberculin skin test.
, Correct Answer: C
Rationale: The priority action for a suspected TB patient is to prevent the spread of airborne pathogens.
Placing the client in a negative-pressure room is a critical component of airborne precautions. Healthcare
workers must also wear an N95 respirator when entering the room. This intervention protects other
patients and staff from inhaling infectious droplets. Once isolation is established, further diagnostic tests
can be safely performed.
5. A client presents to the emergency department with sudden onset of shortness of breath and chest pain
that worsens with deep breathing. Which condition should the nurse suspect?
A. Myocardial infarction
B. Pneumonia
C. Pulmonary embolism
D. Congestive heart failure
Correct Answer: C
Rationale: Sudden dyspnea and pleuritic chest pain are classic hallmarks of a pulmonary embolism. This
condition occurs when a blood clot lodges in the pulmonary vasculature, obstructing flow. The nurse
should immediately assess oxygen saturation and apply supplemental oxygen. Prompt notification of the
healthcare provider is necessary for diagnostic imaging like a CT angiogram. Stabilizing the client’s
hemodynamics is the primary goal of care.
6. Which assessment finding should a nurse expect in a client diagnosed with right-sided heart failure?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
C. Frothy blood-tinged sputum
Updated and Latest Questions and Correct Answers with
Rationale
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which physical finding
should the nurse expect to observe?
A. Presence of pink, frothy sputum
B. Respiratory rate of 12 breaths per minute at rest
C. Increased pH on arterial blood gas analysis
D. Anteroposterior chest diameter equal to the lateral diameter
Correct Answer: D
Rationale: A barrel chest is a characteristic sign of COPD resulting from chronic air trapping. This
anatomical change occurs when the lungs become chronically hyperinflated due to lost elasticity. The
nurse should document this finding as an indicator of disease progression. It is caused by the structural
remodeling of the thoracic cage over time. Assessment of respiratory effort is also critical for these
patients.
2. A client is admitted with heart failure and is prescribed furosemide. Which electrolyte imbalance is the
priority for the nurse to monitor?
A. Hypercalcemia
B. Hypomagnesemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
,Rationale: Furosemide is a loop diuretic that causes the excretion of potassium in the urine. Low
potassium levels can lead to life-threatening cardiac dysrhythmias and muscle weakness. The nurse must
monitor serum potassium levels frequently during therapy. Educating the client on potassium-rich foods
is a vital nursing intervention. If levels drop below the normal range, a potassium supplement may be
necessary.
3. Which arterial blood gas (ABG) result is most consistent with a client experiencing an exacerbation of
COPD?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L
C. pH 7.30, PaCO2 35 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Correct Answer: B
Rationale: Clients with COPD often retain carbon dioxide, leading to respiratory acidosis. A pH below
7.35 and a PaCO2 above 45 mmHg confirm this condition. The kidneys may partially compensate by
retaining bicarbonate, resulting in an elevated HCO3 level. This specific ABG profile indicates the client is
struggling with gas exchange. Monitoring for signs of CO2 narcosis is essential for safety.
4. A nurse is caring for a client with suspected pulmonary tuberculosis (TB). What is the priority nursing
action?
A. Obtain a sputum culture for acid-fast bacilli.
B. Administer the prescribed antitubercular medications.
C. Place the client in a negative-pressure airflow room.
D. Perform a tuberculin skin test.
, Correct Answer: C
Rationale: The priority action for a suspected TB patient is to prevent the spread of airborne pathogens.
Placing the client in a negative-pressure room is a critical component of airborne precautions. Healthcare
workers must also wear an N95 respirator when entering the room. This intervention protects other
patients and staff from inhaling infectious droplets. Once isolation is established, further diagnostic tests
can be safely performed.
5. A client presents to the emergency department with sudden onset of shortness of breath and chest pain
that worsens with deep breathing. Which condition should the nurse suspect?
A. Myocardial infarction
B. Pneumonia
C. Pulmonary embolism
D. Congestive heart failure
Correct Answer: C
Rationale: Sudden dyspnea and pleuritic chest pain are classic hallmarks of a pulmonary embolism. This
condition occurs when a blood clot lodges in the pulmonary vasculature, obstructing flow. The nurse
should immediately assess oxygen saturation and apply supplemental oxygen. Prompt notification of the
healthcare provider is necessary for diagnostic imaging like a CT angiogram. Stabilizing the client’s
hemodynamics is the primary goal of care.
6. Which assessment finding should a nurse expect in a client diagnosed with right-sided heart failure?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
C. Frothy blood-tinged sputum
