NU158 | NU 158 Medical-Surgical Nursing I
Midterm v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A patient is admitted with severe vomiting and diarrhea for three days. Which
clinical manifestation should the nurse expect to find during the assessment?
A. Distended neck veins
B. Decreased blood pressure and tachycardia
C. Increased skin turgor
D. Bounding peripheral pulses
Correct Answer: B
Expert Explanation: Severe vomiting and diarrhea lead to fluid volume deficit or
hypovolemia. This condition typically results in orthostatic hypotension, decreased
blood pressure, and a compensatory increase in heart rate. The body attempts to
maintain cardiac output by increasing the rate when the volume is low.
2. When interpreting arterial blood gas (ABG) results, the nurse notes a pH of 7.30, a
PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L. Which acid-base imbalance is
occurring?
A. Respiratory acidosis
B. Metabolic acidosis
,C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: A
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. Since the bicarbonate level is within the
normal range, the imbalance is primarily respiratory in nature. This condition often
occurs due to hypoventilation or obstructive lung diseases.
3. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which
cardiac rhythm change is the most common sign of this electrolyte imbalance?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Inverted P waves
Correct Answer: A
Expert Explanation: Hyperkalemia is defined as a serum potassium level greater
than 5.0 mEq/L. Tall, peaked T waves are a classic early sign of hyperkalemia on an
electrocardiogram. If left untreated, this can progress to cardiac arrest or life-
threatening arrhythmias.
,4. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign and Trousseau’s sign?
A. Hypocalcemia
B. Hypermagnesemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: A
Expert Explanation: Hypocalcemia causes increased neuromuscular excitability,
leading to tetany. Chvostek’s sign is elicited by tapping the facial nerve, while
Trousseau’s sign involves a carpal spasm after inflating a blood pressure cuff. These
are critical assessment markers for patients with low serum calcium levels.
5. A patient is scheduled for elective surgery. Who is legally responsible for obtaining
the informed consent from the patient?
A. The surgeon
B. The surgical technician
C. The registered nurse
D. The anesthesiologist
Correct Answer: A
, Expert Explanation: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives to the patient. The nurse’s role is to witness the patient’s
signature and ensure the patient understands what they are signing. If the patient
has questions about the procedure itself, the nurse must notify the surgeon.
6. During the postoperative period, a patient develops a wound evisceration. What
should be the nurse’s immediate action?
A. Push the organs back into the abdominal cavity
B. Cover the wound with sterile saline-soaked dressings
C. Cover the wound with a dry sterile dressing
D. Instruct the patient to cough and clear secretions
Correct Answer: B
Expert Explanation: Evisceration is a medical emergency where abdominal organs
protrude through a surgical incision. The nurse must cover the exposed organs with
sterile, moist saline dressings to prevent them from drying out or becoming
necrotic. The patient should be kept in a low-Fowler’s position with knees flexed
while waiting for the surgical team.
7. A patient presents with a serum sodium level of 128 mEq/L. Which symptom is the
nurse most likely to observe?
A. Extreme thirst and dry mucous membranes
Midterm v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A patient is admitted with severe vomiting and diarrhea for three days. Which
clinical manifestation should the nurse expect to find during the assessment?
A. Distended neck veins
B. Decreased blood pressure and tachycardia
C. Increased skin turgor
D. Bounding peripheral pulses
Correct Answer: B
Expert Explanation: Severe vomiting and diarrhea lead to fluid volume deficit or
hypovolemia. This condition typically results in orthostatic hypotension, decreased
blood pressure, and a compensatory increase in heart rate. The body attempts to
maintain cardiac output by increasing the rate when the volume is low.
2. When interpreting arterial blood gas (ABG) results, the nurse notes a pH of 7.30, a
PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L. Which acid-base imbalance is
occurring?
A. Respiratory acidosis
B. Metabolic acidosis
,C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: A
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45
mmHg indicates a respiratory cause. Since the bicarbonate level is within the
normal range, the imbalance is primarily respiratory in nature. This condition often
occurs due to hypoventilation or obstructive lung diseases.
3. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which
cardiac rhythm change is the most common sign of this electrolyte imbalance?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Inverted P waves
Correct Answer: A
Expert Explanation: Hyperkalemia is defined as a serum potassium level greater
than 5.0 mEq/L. Tall, peaked T waves are a classic early sign of hyperkalemia on an
electrocardiogram. If left untreated, this can progress to cardiac arrest or life-
threatening arrhythmias.
,4. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign and Trousseau’s sign?
A. Hypocalcemia
B. Hypermagnesemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: A
Expert Explanation: Hypocalcemia causes increased neuromuscular excitability,
leading to tetany. Chvostek’s sign is elicited by tapping the facial nerve, while
Trousseau’s sign involves a carpal spasm after inflating a blood pressure cuff. These
are critical assessment markers for patients with low serum calcium levels.
5. A patient is scheduled for elective surgery. Who is legally responsible for obtaining
the informed consent from the patient?
A. The surgeon
B. The surgical technician
C. The registered nurse
D. The anesthesiologist
Correct Answer: A
, Expert Explanation: The surgeon is responsible for explaining the procedure, risks,
benefits, and alternatives to the patient. The nurse’s role is to witness the patient’s
signature and ensure the patient understands what they are signing. If the patient
has questions about the procedure itself, the nurse must notify the surgeon.
6. During the postoperative period, a patient develops a wound evisceration. What
should be the nurse’s immediate action?
A. Push the organs back into the abdominal cavity
B. Cover the wound with sterile saline-soaked dressings
C. Cover the wound with a dry sterile dressing
D. Instruct the patient to cough and clear secretions
Correct Answer: B
Expert Explanation: Evisceration is a medical emergency where abdominal organs
protrude through a surgical incision. The nurse must cover the exposed organs with
sterile, moist saline dressings to prevent them from drying out or becoming
necrotic. The patient should be kept in a low-Fowler’s position with knees flexed
while waiting for the surgical team.
7. A patient presents with a serum sodium level of 128 mEq/L. Which symptom is the
nurse most likely to observe?
A. Extreme thirst and dry mucous membranes
