NUR 170 Exam 3 Medical-Surgical Nursing Study Guide 2026 Galen
College
1. A nurse is assessing a patient with a suspected fluid volume deficit. Which
clinical manifestation should the nurse expect to find?
A. Distended neck veins
B. Orthostatic hypotension
C. Increased blood pressure
D. Full, bounding pulse
Answer: B
Rationale: Orthostatic hypotension is a hallmark sign of fluid volume deficit due to
decreased circulating blood volume. Distended neck veins and bounding pulses are signs of
fluid volume excess.
2. A patient’s ECG shows tall, peaked T-waves. Which electrolyte imbalance
should the nurse suspect?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: B
Rationale: Hyperkalemia (high potassium) leads to characteristic ECG changes including
tall, peaked T-waves, prolonged PR intervals, and widened QRS complexes.
,3. Which intervention is a priority for a patient with a serum sodium level of 125
mEq/L?
A. Encourage increased water intake
B. Administer a diuretic
C. Provide a high-salt diet
D. Implement seizure precautions
Answer: D
Rationale: Hyponatremia (below 135 mEq/L) can cause cerebral edema and increase the
risk of seizures; therefore, safety and seizure precautions are the priority.
4. A nurse observes a patient’s hand spasm when the blood pressure cuff is
inflated. This finding is known as:
A. Chvostek’s sign
B. Kernig’s sign
C. Homans’ sign
D. Trousseau’s sign
Answer: D
Rationale: Trousseau’s sign is a carpal spasm induced by inflating a blood pressure cuff
above systolic pressure, indicating hypocalcemia.
5. A patient has a magnesium level of 3.2 mEq/L. Which assessment finding is
most likely?
A. Hyperactive deep tendon reflexes
B. Tachycardia
C. Insomnia
D. Diminished deep tendon reflexes
Answer: D
Rationale: Hypermagnesemia (above 2.1 mEq/L) acts as a central nervous system
depressant, leading to diminished or absent deep tendon reflexes.
, 6. Which ABG result is consistent with a patient experiencing a severe asthma
attack?
A. pH 7.48, PaCO2 30, HCO3 24
B. pH 7.32, PaCO2 38, HCO3 18
C. pH 7.30, PaCO2 55, HCO3 26
D. pH 7.50, PaCO2 40, HCO3 32
Answer: C
Rationale: Respiratory acidosis (low pH, high PaCO2) occurs when gas exchange is
impaired, as seen in a severe asthma attack or COPD.
7. A patient has been vomiting for 24 hours. Which acid-base imbalance is the
patient at risk for?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: B
Rationale: Vomiting results in the loss of gastric acid (hydrochloric acid), which leads to an
increase in serum bicarbonate and metabolic alkalosis.
8. A patient is hyperventilating due to an anxiety attack. Which ABG finding
should the nurse anticipate?
A. pH 7.35, PaCO2 40
B. pH 7.31, PaCO2 50
C. pH 7.52, PaCO2 28
D. pH 7.25, PaCO2 30
Answer: C
Rationale: Hyperventilation causes excessive blowing off of CO2, leading to respiratory
alkalosis (high pH, low PaCO2).
College
1. A nurse is assessing a patient with a suspected fluid volume deficit. Which
clinical manifestation should the nurse expect to find?
A. Distended neck veins
B. Orthostatic hypotension
C. Increased blood pressure
D. Full, bounding pulse
Answer: B
Rationale: Orthostatic hypotension is a hallmark sign of fluid volume deficit due to
decreased circulating blood volume. Distended neck veins and bounding pulses are signs of
fluid volume excess.
2. A patient’s ECG shows tall, peaked T-waves. Which electrolyte imbalance
should the nurse suspect?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: B
Rationale: Hyperkalemia (high potassium) leads to characteristic ECG changes including
tall, peaked T-waves, prolonged PR intervals, and widened QRS complexes.
,3. Which intervention is a priority for a patient with a serum sodium level of 125
mEq/L?
A. Encourage increased water intake
B. Administer a diuretic
C. Provide a high-salt diet
D. Implement seizure precautions
Answer: D
Rationale: Hyponatremia (below 135 mEq/L) can cause cerebral edema and increase the
risk of seizures; therefore, safety and seizure precautions are the priority.
4. A nurse observes a patient’s hand spasm when the blood pressure cuff is
inflated. This finding is known as:
A. Chvostek’s sign
B. Kernig’s sign
C. Homans’ sign
D. Trousseau’s sign
Answer: D
Rationale: Trousseau’s sign is a carpal spasm induced by inflating a blood pressure cuff
above systolic pressure, indicating hypocalcemia.
5. A patient has a magnesium level of 3.2 mEq/L. Which assessment finding is
most likely?
A. Hyperactive deep tendon reflexes
B. Tachycardia
C. Insomnia
D. Diminished deep tendon reflexes
Answer: D
Rationale: Hypermagnesemia (above 2.1 mEq/L) acts as a central nervous system
depressant, leading to diminished or absent deep tendon reflexes.
, 6. Which ABG result is consistent with a patient experiencing a severe asthma
attack?
A. pH 7.48, PaCO2 30, HCO3 24
B. pH 7.32, PaCO2 38, HCO3 18
C. pH 7.30, PaCO2 55, HCO3 26
D. pH 7.50, PaCO2 40, HCO3 32
Answer: C
Rationale: Respiratory acidosis (low pH, high PaCO2) occurs when gas exchange is
impaired, as seen in a severe asthma attack or COPD.
7. A patient has been vomiting for 24 hours. Which acid-base imbalance is the
patient at risk for?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: B
Rationale: Vomiting results in the loss of gastric acid (hydrochloric acid), which leads to an
increase in serum bicarbonate and metabolic alkalosis.
8. A patient is hyperventilating due to an anxiety attack. Which ABG finding
should the nurse anticipate?
A. pH 7.35, PaCO2 40
B. pH 7.31, PaCO2 50
C. pH 7.52, PaCO2 28
D. pH 7.25, PaCO2 30
Answer: C
Rationale: Hyperventilation causes excessive blowing off of CO2, leading to respiratory
alkalosis (high pH, low PaCO2).
