NU158 | NU 158 Medical-Surgical Nursing I
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A nurse is caring for a patient who has a serum potassium level of 6.2 mEq/L. Which
of the following EKG changes should the nurse expect to observe?
A. Tall peaked T waves
B. Prominent U waves
C. ST-segment depression
D. Inverted T waves
Correct Answer: A
Expert Explanation: Hyperkalemia is defined as a potassium level greater than 5.0
mEq/L and can cause significant cardiac conductivity changes. Tall peaked T waves
are a classic early sign of hyperkalemia on an EKG. Failure to address this electrolyte
imbalance can lead to lethal arrhythmias such as ventricular fibrillation.
2. Which patient is at the highest risk for developing respiratory acidosis?
A. A patient experiencing a panic attack and hyperventilating
B. A patient with a nasogastric tube set to low intermittent suction
C. A patient with chronic obstructive pulmonary disease (COPD)
D. A patient who has been taking excessive amounts of antacids
,Correct Answer: C
Expert Explanation: Respiratory acidosis occurs when there is a retention of
carbon dioxide due to hypoventilation. Patients with COPD often suffer from chronic
air trapping and impaired gas exchange, leading to high CO2 levels. This condition
requires careful monitoring of the patient’s arterial blood gases and respiratory
effort.
3. The nurse is preparing to administer 0.45% sodium chloride (1/2 NS) to a patient.
This type of intravenous solution is classified as:
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Correct Answer: B
Expert Explanation: Hypotonic solutions have a lower osmolarity than the
intracellular fluid, causing water to move into the cells. 0.45% sodium chloride is a
common hypotonic solution used to treat cellular dehydration. It is important to
monitor for signs of fluid volume deficit or cerebral edema when administering
these fluids.
,4. During the preoperative assessment, a patient reports a severe allergy to avocados
and bananas. Which action should the nurse take first?
A. Notify the surgical team and the anesthesiologist of a potential latex allergy.
B. Document the allergy in the patient’s medical record only.
C. Ask the patient if they have ever had a reaction to a blood pressure medication.
D. Advise the patient to avoid eating these fruits for 24 hours before surgery.
Correct Answer: A
Expert Explanation: Cross-reactivity exists between certain foods like avocados,
bananas, and kiwis and latex. A patient reporting these allergies is at a significantly
higher risk for an intraoperative latex hypersensitivity reaction. The nurse must
communicate this immediately to ensure a latex-free environment is maintained for
the patient.
5. A nurse is providing discharge instructions to a patient who underwent a
laparotomy. The patient asks why they need to use an incentive spirometer. What is
the best response?
A. It promotes deep breathing and prevents the collapse of small air sacs in the
lungs.
B. It is used to prevent the development of blood clots in your legs.
, C. It helps to strengthen your abdominal muscles after surgery.
D. It measures how much oxygen is currently in your bloodstream.
Correct Answer: A
Expert Explanation: Incentive spirometry is a critical post-operative intervention
used to prevent atelectasis, which is the collapse of alveoli. By encouraging deep
inspiration, the device helps keep the lungs expanded and promotes effective gas
exchange. This reduces the overall risk of the patient developing post-operative
pneumonia.
6. Which electrolyte imbalance is most closely associated with a positive Chvostek’s
sign?
A. Hypocalcemia
B. Hypermagnesemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: A
Expert Explanation: Chvostek’s sign is an assessment finding where tapping on the
facial nerve triggers a twitch of the facial muscles. This phenomenon is caused by
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A nurse is caring for a patient who has a serum potassium level of 6.2 mEq/L. Which
of the following EKG changes should the nurse expect to observe?
A. Tall peaked T waves
B. Prominent U waves
C. ST-segment depression
D. Inverted T waves
Correct Answer: A
Expert Explanation: Hyperkalemia is defined as a potassium level greater than 5.0
mEq/L and can cause significant cardiac conductivity changes. Tall peaked T waves
are a classic early sign of hyperkalemia on an EKG. Failure to address this electrolyte
imbalance can lead to lethal arrhythmias such as ventricular fibrillation.
2. Which patient is at the highest risk for developing respiratory acidosis?
A. A patient experiencing a panic attack and hyperventilating
B. A patient with a nasogastric tube set to low intermittent suction
C. A patient with chronic obstructive pulmonary disease (COPD)
D. A patient who has been taking excessive amounts of antacids
,Correct Answer: C
Expert Explanation: Respiratory acidosis occurs when there is a retention of
carbon dioxide due to hypoventilation. Patients with COPD often suffer from chronic
air trapping and impaired gas exchange, leading to high CO2 levels. This condition
requires careful monitoring of the patient’s arterial blood gases and respiratory
effort.
3. The nurse is preparing to administer 0.45% sodium chloride (1/2 NS) to a patient.
This type of intravenous solution is classified as:
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Correct Answer: B
Expert Explanation: Hypotonic solutions have a lower osmolarity than the
intracellular fluid, causing water to move into the cells. 0.45% sodium chloride is a
common hypotonic solution used to treat cellular dehydration. It is important to
monitor for signs of fluid volume deficit or cerebral edema when administering
these fluids.
,4. During the preoperative assessment, a patient reports a severe allergy to avocados
and bananas. Which action should the nurse take first?
A. Notify the surgical team and the anesthesiologist of a potential latex allergy.
B. Document the allergy in the patient’s medical record only.
C. Ask the patient if they have ever had a reaction to a blood pressure medication.
D. Advise the patient to avoid eating these fruits for 24 hours before surgery.
Correct Answer: A
Expert Explanation: Cross-reactivity exists between certain foods like avocados,
bananas, and kiwis and latex. A patient reporting these allergies is at a significantly
higher risk for an intraoperative latex hypersensitivity reaction. The nurse must
communicate this immediately to ensure a latex-free environment is maintained for
the patient.
5. A nurse is providing discharge instructions to a patient who underwent a
laparotomy. The patient asks why they need to use an incentive spirometer. What is
the best response?
A. It promotes deep breathing and prevents the collapse of small air sacs in the
lungs.
B. It is used to prevent the development of blood clots in your legs.
, C. It helps to strengthen your abdominal muscles after surgery.
D. It measures how much oxygen is currently in your bloodstream.
Correct Answer: A
Expert Explanation: Incentive spirometry is a critical post-operative intervention
used to prevent atelectasis, which is the collapse of alveoli. By encouraging deep
inspiration, the device helps keep the lungs expanded and promotes effective gas
exchange. This reduces the overall risk of the patient developing post-operative
pneumonia.
6. Which electrolyte imbalance is most closely associated with a positive Chvostek’s
sign?
A. Hypocalcemia
B. Hypermagnesemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: A
Expert Explanation: Chvostek’s sign is an assessment finding where tapping on the
facial nerve triggers a twitch of the facial muscles. This phenomenon is caused by
