NU158 | NU 158 Medical-Surgical Nursing I Exam 1
v1 | Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A patient is admitted with a serum sodium level of 124 mEq/L. Which nursing
intervention is the highest priority?
A. Implementing seizure precautions and monitoring neurological status
B. Encouraging the patient to drink more water
C. Administering a dose of oral diuretics
D. Checking the patient’s temperature every 4 hours
Correct Answer: A
Expert Explanation: Severe hyponatremia can lead to cerebral edema and
increased intracranial pressure. This condition places the patient at significant risk
for seizures and permanent neurological damage. Implementing safety measures
like seizure precautions is a critical nursing responsibility to prevent injury.
2. When interpreting arterial blood gas (ABG) results, the nurse notes a pH of 7.30, a
PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L. How should the nurse interpret these
findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
,C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH is below 7.35, indicating acidosis, while the PaCO2 is
elevated above 45 mmHg, which is the respiratory component. Since the
bicarbonate level is within the normal range, the imbalance is originating from the
respiratory system. This finding is typical in patients who are hypoventilating or
have obstructive lung diseases.
3. A nurse is reviewing the preoperative checklist for a patient scheduled for surgery.
Who is ultimately responsible for obtaining the patient’s informed consent?
A. The circulating nurse
B. The surgeon
C. The surgical technician
D. The anesthesiologist
Correct Answer: B
Expert Explanation: The surgeon is legally responsible for explaining the
procedure, risks, benefits, and alternatives to the patient. While a nurse may witness
the signature, they do not provide the primary education required for legal consent.
,If the patient has questions about the surgery itself, the nurse must notify the
surgeon to return and clarify.
4. A patient has a serum potassium level of 6.2 mEq/L. Which of the following ECG
changes should the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Correct Answer: B
Expert Explanation: Hyperkalemia significantly affects cardiac conduction and
repolarization. Tall, peaked T waves are one of the earliest and most characteristic
ECG changes associated with high potassium levels. If left untreated, this can
progress to wide QRS complexes and life-threatening ventricular arrhythmias.
5. During the inflammatory process, which chemical mediator is primarily responsible
for increasing capillary permeability and causing vasodilation?
A. Epinephrine
B. Insulin
C. Cortisol
, D. Histamine
Correct Answer: D
Expert Explanation: Histamine is released by mast cells immediately following
tissue injury. It acts to dilate blood vessels and increase the permeability of the
capillaries to allow white blood cells and proteins to reach the site. This process
results in the classic signs of inflammation: redness, heat, and swelling.
6. A patient is 2 days postoperative and complains of sudden chest pain and shortness
of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary Embolism
C. Pneumonia
D. Incisional pain
Correct Answer: B
Expert Explanation: Sudden onset of shortness of breath and chest pain in a
postoperative patient is a classic sign of a pulmonary embolism. Patients are at high
risk for deep vein thrombosis (DVT) due to immobility during and after surgery.
Immediate intervention is required because this is a life-threatening medical
emergency.
v1 | Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A patient is admitted with a serum sodium level of 124 mEq/L. Which nursing
intervention is the highest priority?
A. Implementing seizure precautions and monitoring neurological status
B. Encouraging the patient to drink more water
C. Administering a dose of oral diuretics
D. Checking the patient’s temperature every 4 hours
Correct Answer: A
Expert Explanation: Severe hyponatremia can lead to cerebral edema and
increased intracranial pressure. This condition places the patient at significant risk
for seizures and permanent neurological damage. Implementing safety measures
like seizure precautions is a critical nursing responsibility to prevent injury.
2. When interpreting arterial blood gas (ABG) results, the nurse notes a pH of 7.30, a
PaCO2 of 52 mmHg, and an HCO3 of 24 mEq/L. How should the nurse interpret these
findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
,C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH is below 7.35, indicating acidosis, while the PaCO2 is
elevated above 45 mmHg, which is the respiratory component. Since the
bicarbonate level is within the normal range, the imbalance is originating from the
respiratory system. This finding is typical in patients who are hypoventilating or
have obstructive lung diseases.
3. A nurse is reviewing the preoperative checklist for a patient scheduled for surgery.
Who is ultimately responsible for obtaining the patient’s informed consent?
A. The circulating nurse
B. The surgeon
C. The surgical technician
D. The anesthesiologist
Correct Answer: B
Expert Explanation: The surgeon is legally responsible for explaining the
procedure, risks, benefits, and alternatives to the patient. While a nurse may witness
the signature, they do not provide the primary education required for legal consent.
,If the patient has questions about the surgery itself, the nurse must notify the
surgeon to return and clarify.
4. A patient has a serum potassium level of 6.2 mEq/L. Which of the following ECG
changes should the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Correct Answer: B
Expert Explanation: Hyperkalemia significantly affects cardiac conduction and
repolarization. Tall, peaked T waves are one of the earliest and most characteristic
ECG changes associated with high potassium levels. If left untreated, this can
progress to wide QRS complexes and life-threatening ventricular arrhythmias.
5. During the inflammatory process, which chemical mediator is primarily responsible
for increasing capillary permeability and causing vasodilation?
A. Epinephrine
B. Insulin
C. Cortisol
, D. Histamine
Correct Answer: D
Expert Explanation: Histamine is released by mast cells immediately following
tissue injury. It acts to dilate blood vessels and increase the permeability of the
capillaries to allow white blood cells and proteins to reach the site. This process
results in the classic signs of inflammation: redness, heat, and swelling.
6. A patient is 2 days postoperative and complains of sudden chest pain and shortness
of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary Embolism
C. Pneumonia
D. Incisional pain
Correct Answer: B
Expert Explanation: Sudden onset of shortness of breath and chest pain in a
postoperative patient is a classic sign of a pulmonary embolism. Patients are at high
risk for deep vein thrombosis (DVT) due to immobility during and after surgery.
Immediate intervention is required because this is a life-threatening medical
emergency.
