NU158 | NU 158 Medical-Surgical Nursing I Exam 2
v2 | Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is caring for a patient who is scheduled for an elective surgery. Which of the
following is the nurse’s primary responsibility regarding informed consent?
A. Ensuring the patient understands the surgical technique.
B. Explaining the risks and benefits of the procedure.
C. Describing the alternative treatments available.
D. Obtaining the patient’s signature on the consent form.
Correct Answer: D
Expert Explanation: The nurse’s role is to witness the signature of the patient and
ensure that the signature is authentic. It is the surgeon’s responsibility to explain
the risks, benefits, and alternatives of the procedure. If the patient does not
understand the surgery, the nurse must notify the surgeon before the patient signs
the form.
2. A patient is diagnosed with hypokalemia. Which of the following assessment
findings should the nurse prioritize?
A. Inverted T-waves on an EKG
B. Hyperactive bowel sounds
,C. Increased deep tendon reflexes
D. Weight gain of 2 lbs in 24 hours
Correct Answer: A
Expert Explanation: Hypokalemia affects cardiac conduction and can lead to life-
threatening arrhythmias. Common EKG changes include inverted T-waves, ST-
segment depression, and the presence of U-waves. Monitoring cardiac status is the
highest priority for a patient with low potassium levels.
3. Which intervention is most effective for preventing atelectasis in a postoperative
patient?
A. Administering prophylactic antibiotics
B. Maintaining a strict bed rest protocol
C. Limiting fluid intake to reduce secretions
D. Frequent use of an incentive spirometer
Correct Answer: D
Expert Explanation: Incentive spirometry encourages deep breathing and helps
expand collapsed alveoli after surgery. This practice is essential for improving gas
exchange and preventing postoperative pneumonia. The nurse should instruct the
patient to perform this 10 times every hour while awake.
,4. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 52, HCO3 25. Which
acid-base imbalance is present?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Correct Answer: C
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. The bicarbonate level is within the normal
range, indicating no compensation has occurred yet. This pattern is commonly seen
in patients with hypoventilation or COPD.
5. What is the priority nursing action for a patient experiencing a suspected
pulmonary embolism?
A. Start a new peripheral IV line.
B. Prepare the patient for a chest X-ray.
C. Administer oxygen via nasal cannula.
D. Obtain a sputum culture specimen.
Correct Answer: C
, Expert Explanation: Immediate administration of oxygen is critical to address
hypoxemia caused by a pulmonary embolism. The nurse should also elevate the
head of the bed to assist with respiratory effort. Following oxygenation, the nurse
should notify the rapid response team or the physician.
6. A patient is receiving 3% sodium chloride IV for severe hyponatremia. The nurse
should monitor for which complication?
A. Hypotension
B. Fluid volume deficit
C. Fluid volume overload
D. Cerebral edema
Correct Answer: C
Expert Explanation: Hypertonic solutions like 3% NaCl pull fluid from the cells into
the vascular space, increasing the risk of fluid overload. The nurse must monitor for
signs such as crackles in the lungs, shortness of breath, and neck vein distension.
These solutions must be administered slowly and monitored closely in an intensive
care setting.
7. Which sign is indicative of hypocalcemia?
A. Negative Trousseau’s sign
B. Positive Chvostek’s sign
v2 | Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is caring for a patient who is scheduled for an elective surgery. Which of the
following is the nurse’s primary responsibility regarding informed consent?
A. Ensuring the patient understands the surgical technique.
B. Explaining the risks and benefits of the procedure.
C. Describing the alternative treatments available.
D. Obtaining the patient’s signature on the consent form.
Correct Answer: D
Expert Explanation: The nurse’s role is to witness the signature of the patient and
ensure that the signature is authentic. It is the surgeon’s responsibility to explain
the risks, benefits, and alternatives of the procedure. If the patient does not
understand the surgery, the nurse must notify the surgeon before the patient signs
the form.
2. A patient is diagnosed with hypokalemia. Which of the following assessment
findings should the nurse prioritize?
A. Inverted T-waves on an EKG
B. Hyperactive bowel sounds
,C. Increased deep tendon reflexes
D. Weight gain of 2 lbs in 24 hours
Correct Answer: A
Expert Explanation: Hypokalemia affects cardiac conduction and can lead to life-
threatening arrhythmias. Common EKG changes include inverted T-waves, ST-
segment depression, and the presence of U-waves. Monitoring cardiac status is the
highest priority for a patient with low potassium levels.
3. Which intervention is most effective for preventing atelectasis in a postoperative
patient?
A. Administering prophylactic antibiotics
B. Maintaining a strict bed rest protocol
C. Limiting fluid intake to reduce secretions
D. Frequent use of an incentive spirometer
Correct Answer: D
Expert Explanation: Incentive spirometry encourages deep breathing and helps
expand collapsed alveoli after surgery. This practice is essential for improving gas
exchange and preventing postoperative pneumonia. The nurse should instruct the
patient to perform this 10 times every hour while awake.
,4. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 52, HCO3 25. Which
acid-base imbalance is present?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Correct Answer: C
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. The bicarbonate level is within the normal
range, indicating no compensation has occurred yet. This pattern is commonly seen
in patients with hypoventilation or COPD.
5. What is the priority nursing action for a patient experiencing a suspected
pulmonary embolism?
A. Start a new peripheral IV line.
B. Prepare the patient for a chest X-ray.
C. Administer oxygen via nasal cannula.
D. Obtain a sputum culture specimen.
Correct Answer: C
, Expert Explanation: Immediate administration of oxygen is critical to address
hypoxemia caused by a pulmonary embolism. The nurse should also elevate the
head of the bed to assist with respiratory effort. Following oxygenation, the nurse
should notify the rapid response team or the physician.
6. A patient is receiving 3% sodium chloride IV for severe hyponatremia. The nurse
should monitor for which complication?
A. Hypotension
B. Fluid volume deficit
C. Fluid volume overload
D. Cerebral edema
Correct Answer: C
Expert Explanation: Hypertonic solutions like 3% NaCl pull fluid from the cells into
the vascular space, increasing the risk of fluid overload. The nurse must monitor for
signs such as crackles in the lungs, shortness of breath, and neck vein distension.
These solutions must be administered slowly and monitored closely in an intensive
care setting.
7. Which sign is indicative of hypocalcemia?
A. Negative Trousseau’s sign
B. Positive Chvostek’s sign
