NUR 170 Medical-Surgical Nursing | Exam 2 Study Guide (2026) Galen
College
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Increased thirst and dry mucous membranes
B. Hypertension and bradycardia
C. Seizures and altered mental status
D. Hyporeflexia and muscle weakness
Answer: C
Rationale: Hyponatremia (Sodium < 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema, which presents as seizures, confusion, and lethargy.
2. Which ECG change is most characteristic of a patient with a potassium level of
6.2 mEq/L?
A. Presence of U waves
B. Flattened T waves
C. Tall, peaked T waves
D. Prolonged ST segment
Answer: C
Rationale: Hyperkalemia (Potassium > 5.0 mEq/L) typically manifests as tall, peaked T
waves on an ECG.
,3. A nurse is assessing a patient and notes a positive Chvostek’s sign. Which
electrolyte imbalance does this indicate?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia.
4. Interpretation of these ABG results: pH 7.28, PaCO2 55, HCO3 24.
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45), and the
HCO3 is normal, indicating the primary cause is respiratory.
5. Which IV fluid is considered hypotonic?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% NS
Answer: B
Rationale: 0.45% Normal Saline (Half-Normal Saline) has a lower osmolarity than blood
and is a hypotonic solution.
, 6. What is the primary responsibility of the nurse regarding informed consent
for surgery?
A. Explaining the risks and benefits of the procedure
B. Witnessing the patient’s signature on the form
C. Providing alternative treatment options
D. Determining the patient’s capacity to consent
Answer: B
Rationale: The surgeon is responsible for explaining the procedure. The nurse witnesses
that the signature is authentic and the patient appears competent.
7. During the ‘Time-Out’ in the operating room, what must be verified?
A. The surgeon’s credentials
B. The patient’s insurance coverage
C. The total estimated blood loss
D. Correct patient, site, and procedure
Answer: D
Rationale: The Universal Protocol ‘Time-Out’ is a safety pause to verify the right patient,
right site, and right procedure before starting.
8. A postoperative patient has a heart rate of 115 bpm, BP 88/52 mmHg, and
cool clammy skin. Which condition should the nurse suspect?
A. Pulmonary embolism
B. Malignant hyperthermia
C. Fluid volume excess
D. Hypovolemic shock
Answer: D
Rationale: Tachycardia, hypotension, and cool, clammy skin are classic signs of decreased
perfusion often caused by hemorrhage or dehydration post-surgery.
College
1. A patient presents with a serum sodium level of 128 mEq/L. Which clinical
manifestation should the nurse prioritize?
A. Increased thirst and dry mucous membranes
B. Hypertension and bradycardia
C. Seizures and altered mental status
D. Hyporeflexia and muscle weakness
Answer: C
Rationale: Hyponatremia (Sodium < 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema, which presents as seizures, confusion, and lethargy.
2. Which ECG change is most characteristic of a patient with a potassium level of
6.2 mEq/L?
A. Presence of U waves
B. Flattened T waves
C. Tall, peaked T waves
D. Prolonged ST segment
Answer: C
Rationale: Hyperkalemia (Potassium > 5.0 mEq/L) typically manifests as tall, peaked T
waves on an ECG.
,3. A nurse is assessing a patient and notes a positive Chvostek’s sign. Which
electrolyte imbalance does this indicate?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypocalcemia
D. Hyponatremia
Answer: C
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia.
4. Interpretation of these ABG results: pH 7.28, PaCO2 55, HCO3 24.
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Rationale: The pH is low (<7.35), indicating acidosis. The PaCO2 is high (>45), and the
HCO3 is normal, indicating the primary cause is respiratory.
5. Which IV fluid is considered hypotonic?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in 0.9% NS
Answer: B
Rationale: 0.45% Normal Saline (Half-Normal Saline) has a lower osmolarity than blood
and is a hypotonic solution.
, 6. What is the primary responsibility of the nurse regarding informed consent
for surgery?
A. Explaining the risks and benefits of the procedure
B. Witnessing the patient’s signature on the form
C. Providing alternative treatment options
D. Determining the patient’s capacity to consent
Answer: B
Rationale: The surgeon is responsible for explaining the procedure. The nurse witnesses
that the signature is authentic and the patient appears competent.
7. During the ‘Time-Out’ in the operating room, what must be verified?
A. The surgeon’s credentials
B. The patient’s insurance coverage
C. The total estimated blood loss
D. Correct patient, site, and procedure
Answer: D
Rationale: The Universal Protocol ‘Time-Out’ is a safety pause to verify the right patient,
right site, and right procedure before starting.
8. A postoperative patient has a heart rate of 115 bpm, BP 88/52 mmHg, and
cool clammy skin. Which condition should the nurse suspect?
A. Pulmonary embolism
B. Malignant hyperthermia
C. Fluid volume excess
D. Hypovolemic shock
Answer: D
Rationale: Tachycardia, hypotension, and cool, clammy skin are classic signs of decreased
perfusion often caused by hemorrhage or dehydration post-surgery.
