NSG 300/NSG300 Exam 4 V2 | Foundations
of Nursing Q&A with Rationale | Grand
Canyon University
1. A nurse is reviewing the lab results of a patient with a pH of 7.32, PaCO2 of 50 mmHg, and
HCO3 of 25 mEq/L. Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: B
Expert Explanation: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated
above 45 mmHg, which points toward a respiratory cause. Because the bicarbonate level is
within the normal range, this is an uncompensated respiratory acidosis often seen in
hypoventilation.
2. Which clinical manifestation should the nurse expect in a patient experiencing
hypokalemia?
A. Muscle weakness and leg cramps
B. Tall peaked T-waves
C. Hyperactive bowel sounds
,D. Positive Trousseau’s sign
Correct Answer: A
Expert Explanation: Hypokalemia affects neuromuscular function, leading to muscle
weakness and potential respiratory distress. Low potassium levels often result in
decreased gastrointestinal motility rather than hyperactive sounds. On an ECG,
hypokalemia typically shows flat or inverted T-waves rather than peaked ones.
3. During the preoperative assessment, the patient reveals they have been taking aspirin
daily. Why is this significant for the surgical team?
A. It can increase the risk of intraoperative bleeding.
B. It may increase the risk of postoperative infection.
C. It interferes with the metabolism of anesthetic agents.
D. It causes dangerous hypertension during induction.
Correct Answer: A
Expert Explanation: Aspirin is an antiplatelet agent that inhibits platelet aggregation for
the life of the platelet. This medication significantly increases the risk of excessive bleeding
during and after surgical procedures. Surgeons usually require patients to stop taking
aspirin at least 7 to 10 days before an elective surgery.
4. A nurse is caring for an older adult with presbycusis. Which communication technique is
most effective?
A. Shouting loudly into the patient’s ear
, B. Speaking in a low-pitched, clear voice
C. Speaking in a higher pitch
D. Using rapid speech to maintain attention
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Speaking in a lower pitch helps the patient hear
more clearly as those frequencies are often better preserved. Shouting should be avoided
as it can distort sound and may be perceived as aggressive.
5. A patient is diagnosed with hypervolemia. Which of the following physical assessment
findings supports this diagnosis?
A. Flat neck veins when supine
B. Dry mucous membranes
C. Poor skin turgor
D. Bounding pulse and hypertension
Correct Answer: D
Expert Explanation: Hypervolemia, or fluid volume excess, leads to increased vascular
pressure. This results in clinical signs such as a bounding pulse, elevated blood pressure,
and jugular venous distention. In contrast, dry mucous membranes and poor turgor are
signs of fluid volume deficit.
of Nursing Q&A with Rationale | Grand
Canyon University
1. A nurse is reviewing the lab results of a patient with a pH of 7.32, PaCO2 of 50 mmHg, and
HCO3 of 25 mEq/L. Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: B
Expert Explanation: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated
above 45 mmHg, which points toward a respiratory cause. Because the bicarbonate level is
within the normal range, this is an uncompensated respiratory acidosis often seen in
hypoventilation.
2. Which clinical manifestation should the nurse expect in a patient experiencing
hypokalemia?
A. Muscle weakness and leg cramps
B. Tall peaked T-waves
C. Hyperactive bowel sounds
,D. Positive Trousseau’s sign
Correct Answer: A
Expert Explanation: Hypokalemia affects neuromuscular function, leading to muscle
weakness and potential respiratory distress. Low potassium levels often result in
decreased gastrointestinal motility rather than hyperactive sounds. On an ECG,
hypokalemia typically shows flat or inverted T-waves rather than peaked ones.
3. During the preoperative assessment, the patient reveals they have been taking aspirin
daily. Why is this significant for the surgical team?
A. It can increase the risk of intraoperative bleeding.
B. It may increase the risk of postoperative infection.
C. It interferes with the metabolism of anesthetic agents.
D. It causes dangerous hypertension during induction.
Correct Answer: A
Expert Explanation: Aspirin is an antiplatelet agent that inhibits platelet aggregation for
the life of the platelet. This medication significantly increases the risk of excessive bleeding
during and after surgical procedures. Surgeons usually require patients to stop taking
aspirin at least 7 to 10 days before an elective surgery.
4. A nurse is caring for an older adult with presbycusis. Which communication technique is
most effective?
A. Shouting loudly into the patient’s ear
, B. Speaking in a low-pitched, clear voice
C. Speaking in a higher pitch
D. Using rapid speech to maintain attention
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Speaking in a lower pitch helps the patient hear
more clearly as those frequencies are often better preserved. Shouting should be avoided
as it can distort sound and may be perceived as aggressive.
5. A patient is diagnosed with hypervolemia. Which of the following physical assessment
findings supports this diagnosis?
A. Flat neck veins when supine
B. Dry mucous membranes
C. Poor skin turgor
D. Bounding pulse and hypertension
Correct Answer: D
Expert Explanation: Hypervolemia, or fluid volume excess, leads to increased vascular
pressure. This results in clinical signs such as a bounding pulse, elevated blood pressure,
and jugular venous distention. In contrast, dry mucous membranes and poor turgor are
signs of fluid volume deficit.
