Medical-Surgical Nursing: Promoting Wellness Exam 1 2026 |WCU
1. A nurse is providing preoperative teaching to a client who is scheduled for a
surgical procedure. Which of the following roles is the primary responsibility of
the nurse regarding informed consent?
A. Obtaining the client’s signature and witnessing the signing
B. Explaining the risks and benefits of the procedure to the client
C. Describing alternative treatments available to the surgery
D. Discussing the expected outcomes and potential complications
Answer: A
Rationale: The surgeon is responsible for explaining the procedure, risks, and alternatives.
The nurse’s role is to witness the signature and ensure the client was given the
information.
2. A client is diagnosed with malignant hyperthermia during surgery. Which of
the following medications should the nurse prepare to administer?
A. Dantrolene sodium
B. Succinylcholine
C. Atropine sulfate
D. Epinephrine
Answer: A
Rationale: Dantrolene is the specific muscle relaxant used to treat the metabolic crisis of
malignant hyperthermia.
,3. A nurse is reviewing the laboratory results of a client with a potassium level
of 6.2 mEq/L. Which of the following ECG changes should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Inverted T waves
D. Tall peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes peaked T waves and widened QRS complexes,
whereas hypokalemia causes U waves.
4. A client presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. How should the nurse interpret these arterial blood gas (ABG) results?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: A
Rationale: A low pH (<7.35) indicates acidosis. An elevated PaCO2 (>45) indicates a
respiratory cause for the acidosis.
5. Which of the following is a late sign of fluid volume deficit in an older adult
client?
A. Poor skin turgor
B. Hypotension
C. Concentrated urine
D. Tachycardia
Answer: B
Rationale: While tachycardia and poor turgor occur early, hypotension is often a later sign
of significant volume depletion in the elderly.
, 6. A client is 2 days postoperative and reports sudden chest pain and shortness
of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Myocardial infarction
Answer: C
Rationale: Sudden onset of chest pain and dyspnea postoperatively is a classic
presentation of pulmonary embolism, often originating from a DVT.
7. A nurse is assessing a client with hypocalcemia. Which of the following
findings is consistent with this electrolyte imbalance?
A. Negative Chvostek’s sign
B. Hyporeflexia
C. Muscle tetany and cramping
D. Constipation
Answer: C
Rationale: Hypocalcemia causes increased neuromuscular excitability, leading to tetany,
cramps, and positive Trousseau/Chvostek signs.
8. A client has been NPO for 12 hours before surgery. The nurse notes the client
has a heart rate of 110 bpm and a blood pressure of 90/60 mmHg. Which is the
priority intervention?
A. Administer an antiemetic
B. Increase the rate of IV fluids as ordered
C. Encourage oral fluid intake
D. Reassess vitals in 30 minutes
Answer: B
1. A nurse is providing preoperative teaching to a client who is scheduled for a
surgical procedure. Which of the following roles is the primary responsibility of
the nurse regarding informed consent?
A. Obtaining the client’s signature and witnessing the signing
B. Explaining the risks and benefits of the procedure to the client
C. Describing alternative treatments available to the surgery
D. Discussing the expected outcomes and potential complications
Answer: A
Rationale: The surgeon is responsible for explaining the procedure, risks, and alternatives.
The nurse’s role is to witness the signature and ensure the client was given the
information.
2. A client is diagnosed with malignant hyperthermia during surgery. Which of
the following medications should the nurse prepare to administer?
A. Dantrolene sodium
B. Succinylcholine
C. Atropine sulfate
D. Epinephrine
Answer: A
Rationale: Dantrolene is the specific muscle relaxant used to treat the metabolic crisis of
malignant hyperthermia.
,3. A nurse is reviewing the laboratory results of a client with a potassium level
of 6.2 mEq/L. Which of the following ECG changes should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Inverted T waves
D. Tall peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes peaked T waves and widened QRS complexes,
whereas hypokalemia causes U waves.
4. A client presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24
mEq/L. How should the nurse interpret these arterial blood gas (ABG) results?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: A
Rationale: A low pH (<7.35) indicates acidosis. An elevated PaCO2 (>45) indicates a
respiratory cause for the acidosis.
5. Which of the following is a late sign of fluid volume deficit in an older adult
client?
A. Poor skin turgor
B. Hypotension
C. Concentrated urine
D. Tachycardia
Answer: B
Rationale: While tachycardia and poor turgor occur early, hypotension is often a later sign
of significant volume depletion in the elderly.
, 6. A client is 2 days postoperative and reports sudden chest pain and shortness
of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Myocardial infarction
Answer: C
Rationale: Sudden onset of chest pain and dyspnea postoperatively is a classic
presentation of pulmonary embolism, often originating from a DVT.
7. A nurse is assessing a client with hypocalcemia. Which of the following
findings is consistent with this electrolyte imbalance?
A. Negative Chvostek’s sign
B. Hyporeflexia
C. Muscle tetany and cramping
D. Constipation
Answer: C
Rationale: Hypocalcemia causes increased neuromuscular excitability, leading to tetany,
cramps, and positive Trousseau/Chvostek signs.
8. A client has been NPO for 12 hours before surgery. The nurse notes the client
has a heart rate of 110 bpm and a blood pressure of 90/60 mmHg. Which is the
priority intervention?
A. Administer an antiemetic
B. Increase the rate of IV fluids as ordered
C. Encourage oral fluid intake
D. Reassess vitals in 30 minutes
Answer: B
