NU158 | NU 158 Medical-Surgical Nursing I
Midterm v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A nurse is assessing a patient with a serum sodium level of 128 mEq/L. Which
clinical manifestation is the priority for the nurse to monitor?
A. Dry mucous membranes
B. Confusion and seizures
C. Increased thirst
D. Weight gain
Correct Answer: B
Expert Explanation: Hyponatremia is defined as a serum sodium level below 135
mEq/L, which can lead to cerebral edema. The brain is highly sensitive to changes in
sodium levels, making neurological assessments the priority for patient safety.
Monitoring for confusion or seizure activity is essential to prevent permanent
neurological damage in these patients.
2. When administering intravenous potassium chloride to a patient with hypokalemia,
which action is most important for the nurse to take?
A. Administer the medication via IV bolus or push
B. Instruct the patient to increase dietary sodium
,C. Restrict fluid intake during the infusion
D. Ensure the infusion rate does not exceed 10-20 mEq/hour
Correct Answer: D
Expert Explanation: Potassium chloride must always be diluted and administered
via an infusion pump to prevent cardiac arrest. The maximum recommended
infusion rate is typically 10 to 20 mEq per hour to ensure safe electrolyte correction.
Rapid administration or IV bolus of potassium is lethal and is never an acceptable
nursing practice.
3. A patient is scheduled for surgery and has just signed the informed consent form.
What is the nurse’s primary responsibility regarding this document?
A. Explaining the risks and benefits of the procedure
B. Witnessing the signature and ensuring the patient is competent
C. Obtaining the patient’s signature on the form
D. Deciding if the surgery is necessary for the patient
Correct Answer: B
Expert Explanation: The nurse’s role in informed consent is to act as a witness to
the patient’s signature and verify that the patient is signing voluntarily. It is the
surgeon’s responsibility to explain the procedure, risks, benefits, and alternatives to
,the patient. If the nurse notices the patient does not understand the procedure, they
must notify the surgeon before the patient goes to surgery.
4. A postoperative patient reports sudden sharp chest pain and shortness of breath.
Which complication should the nurse suspect first?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Incisional pain
Correct Answer: C
Expert Explanation: Pulmonary embolism is a life-threatening complication often
caused by a deep vein thrombosis dislodging and traveling to the lungs. Sudden
onset of chest pain and dyspnea are hallmark signs that require immediate medical
intervention. The nurse should stabilize the patient’s oxygenation and notify the
rapid response team or the surgeon immediately.
5. Which arterial blood gas (ABG) result indicates that a patient is experiencing
respiratory acidosis?
A. pH 7.48, PaCO2 45, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
, C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.30, PaCO2 50, HCO3 24
Correct Answer: D
Expert Explanation: Respiratory acidosis is characterized by a pH lower than 7.35
and a PaCO2 greater than 45 mmHg. This condition occurs when the lungs cannot
effectively remove carbon dioxide, leading to an accumulation of acid in the blood.
Common causes include hypoventilation, COPD, or respiratory depression from
anesthesia or opioids.
6. An elderly patient is admitted with a diagnosis of dehydration. Which physiological
change in the older adult increases their risk for fluid volume deficit?
A. Increased sensation of thirst
B. Increased skin elasticity and turgor
C. Improved kidney concentration ability
D. Decreased total body water and thirst perception
Correct Answer: D
Expert Explanation: As individuals age, they naturally experience a decrease in
total body water and a diminished thirst mechanism, making them prone to
dehydration. Their kidneys also become less efficient at concentrating urine, which
Midterm v2 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A nurse is assessing a patient with a serum sodium level of 128 mEq/L. Which
clinical manifestation is the priority for the nurse to monitor?
A. Dry mucous membranes
B. Confusion and seizures
C. Increased thirst
D. Weight gain
Correct Answer: B
Expert Explanation: Hyponatremia is defined as a serum sodium level below 135
mEq/L, which can lead to cerebral edema. The brain is highly sensitive to changes in
sodium levels, making neurological assessments the priority for patient safety.
Monitoring for confusion or seizure activity is essential to prevent permanent
neurological damage in these patients.
2. When administering intravenous potassium chloride to a patient with hypokalemia,
which action is most important for the nurse to take?
A. Administer the medication via IV bolus or push
B. Instruct the patient to increase dietary sodium
,C. Restrict fluid intake during the infusion
D. Ensure the infusion rate does not exceed 10-20 mEq/hour
Correct Answer: D
Expert Explanation: Potassium chloride must always be diluted and administered
via an infusion pump to prevent cardiac arrest. The maximum recommended
infusion rate is typically 10 to 20 mEq per hour to ensure safe electrolyte correction.
Rapid administration or IV bolus of potassium is lethal and is never an acceptable
nursing practice.
3. A patient is scheduled for surgery and has just signed the informed consent form.
What is the nurse’s primary responsibility regarding this document?
A. Explaining the risks and benefits of the procedure
B. Witnessing the signature and ensuring the patient is competent
C. Obtaining the patient’s signature on the form
D. Deciding if the surgery is necessary for the patient
Correct Answer: B
Expert Explanation: The nurse’s role in informed consent is to act as a witness to
the patient’s signature and verify that the patient is signing voluntarily. It is the
surgeon’s responsibility to explain the procedure, risks, benefits, and alternatives to
,the patient. If the nurse notices the patient does not understand the procedure, they
must notify the surgeon before the patient goes to surgery.
4. A postoperative patient reports sudden sharp chest pain and shortness of breath.
Which complication should the nurse suspect first?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Incisional pain
Correct Answer: C
Expert Explanation: Pulmonary embolism is a life-threatening complication often
caused by a deep vein thrombosis dislodging and traveling to the lungs. Sudden
onset of chest pain and dyspnea are hallmark signs that require immediate medical
intervention. The nurse should stabilize the patient’s oxygenation and notify the
rapid response team or the surgeon immediately.
5. Which arterial blood gas (ABG) result indicates that a patient is experiencing
respiratory acidosis?
A. pH 7.48, PaCO2 45, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
, C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.30, PaCO2 50, HCO3 24
Correct Answer: D
Expert Explanation: Respiratory acidosis is characterized by a pH lower than 7.35
and a PaCO2 greater than 45 mmHg. This condition occurs when the lungs cannot
effectively remove carbon dioxide, leading to an accumulation of acid in the blood.
Common causes include hypoventilation, COPD, or respiratory depression from
anesthesia or opioids.
6. An elderly patient is admitted with a diagnosis of dehydration. Which physiological
change in the older adult increases their risk for fluid volume deficit?
A. Increased sensation of thirst
B. Increased skin elasticity and turgor
C. Improved kidney concentration ability
D. Decreased total body water and thirst perception
Correct Answer: D
Expert Explanation: As individuals age, they naturally experience a decrease in
total body water and a diminished thirst mechanism, making them prone to
dehydration. Their kidneys also become less efficient at concentrating urine, which
