NUR 170 Medical-Surgical Nursing Exam 2 Study Guide 2026 Galen
College
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which
assessment finding should the nurse prioritize?
A. Muscle weakness and leg cramps
B. Hyperactive bowel sounds
C. Flattened T waves and presence of U waves on ECG
D. Increased deep tendon reflexes
Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias, characterized by flattened T waves and U waves.
2. Which sign is a clinical indicator of hypocalcemia?
A. Positive Chvostek’s sign
B. Negative Romberg test
C. Diminished deep tendon reflexes
D. Bounding peripheral pulses
Answer: A
Rationale: Chvostek’s sign, a facial twitching after tapping the facial nerve, is a classic sign
of hypocalcemia due to neuromuscular irritability.
,3. A patient with a bowel obstruction has been vomiting for 2 days. Which acid-
base imbalance is this patient at highest risk for?
A. Metabolic Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: A
Rationale: Vomiting causes a loss of gastric acid (hydrochloric acid), leading to an increase
in serum bicarbonate and metabolic alkalosis.
4. An arterial blood gas (ABG) report shows: pH 7.30, PaCO2 52, HCO3 24. How
should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory
cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
5. What is the primary goal of the ‘Time Out’ performed in the operating room?
A. To allow the surgeon to rest
B. To count all sponges and needles
C. To ensure the correct patient, site, and procedure
D. To administer the induction anesthetic
Answer: C
Rationale: The Universal Protocol ‘Time Out’ is a safety measure to prevent wrong-site,
wrong-procedure, and wrong-person surgery.
, 6. A postoperative patient reports sudden chest pain and shortness of breath.
The nurse suspects a pulmonary embolism. What is the priority action?
A. Increase the IV fluid rate
B. Ask the patient to use the incentive spirometer
C. Apply oxygen and notify the provider
D. Administer an oral analgesic
Answer: C
Rationale: Sudden respiratory distress post-op suggests PE; immediate oxygenation and
medical notification are critical interventions.
7. Which medication is the antidote for malignant hyperthermia?
A. Naloxone
B. Atropine
C. Dantrolene
D. Flumazenil
Answer: C
Rationale: Dantrolene is a skeletal muscle relaxant used specifically to treat the life-
threatening crisis of malignant hyperthermia.
8. A nurse is caring for a patient with a sodium level of 118 mEq/L. Which
complication is the patient at greatest risk for?
A. Cardiac arrest
B. Seizures and cerebral edema
C. Acute kidney injury
D. Tetany
Answer: B
Rationale: Severe hyponatremia (< 120 mEq/L) causes water to shift into brain cells,
leading to cerebral edema and potential seizures.
College
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which
assessment finding should the nurse prioritize?
A. Muscle weakness and leg cramps
B. Hyperactive bowel sounds
C. Flattened T waves and presence of U waves on ECG
D. Increased deep tendon reflexes
Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias, characterized by flattened T waves and U waves.
2. Which sign is a clinical indicator of hypocalcemia?
A. Positive Chvostek’s sign
B. Negative Romberg test
C. Diminished deep tendon reflexes
D. Bounding peripheral pulses
Answer: A
Rationale: Chvostek’s sign, a facial twitching after tapping the facial nerve, is a classic sign
of hypocalcemia due to neuromuscular irritability.
,3. A patient with a bowel obstruction has been vomiting for 2 days. Which acid-
base imbalance is this patient at highest risk for?
A. Metabolic Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: A
Rationale: Vomiting causes a loss of gastric acid (hydrochloric acid), leading to an increase
in serum bicarbonate and metabolic alkalosis.
4. An arterial blood gas (ABG) report shows: pH 7.30, PaCO2 52, HCO3 24. How
should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory
cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
5. What is the primary goal of the ‘Time Out’ performed in the operating room?
A. To allow the surgeon to rest
B. To count all sponges and needles
C. To ensure the correct patient, site, and procedure
D. To administer the induction anesthetic
Answer: C
Rationale: The Universal Protocol ‘Time Out’ is a safety measure to prevent wrong-site,
wrong-procedure, and wrong-person surgery.
, 6. A postoperative patient reports sudden chest pain and shortness of breath.
The nurse suspects a pulmonary embolism. What is the priority action?
A. Increase the IV fluid rate
B. Ask the patient to use the incentive spirometer
C. Apply oxygen and notify the provider
D. Administer an oral analgesic
Answer: C
Rationale: Sudden respiratory distress post-op suggests PE; immediate oxygenation and
medical notification are critical interventions.
7. Which medication is the antidote for malignant hyperthermia?
A. Naloxone
B. Atropine
C. Dantrolene
D. Flumazenil
Answer: C
Rationale: Dantrolene is a skeletal muscle relaxant used specifically to treat the life-
threatening crisis of malignant hyperthermia.
8. A nurse is caring for a patient with a sodium level of 118 mEq/L. Which
complication is the patient at greatest risk for?
A. Cardiac arrest
B. Seizures and cerebral edema
C. Acute kidney injury
D. Tetany
Answer: B
Rationale: Severe hyponatremia (< 120 mEq/L) causes water to shift into brain cells,
leading to cerebral edema and potential seizures.
