NURS 201 Medical-Surgical Nursing - Module Exam 1 (Week 3) 2026
|WCU
1. A nurse is reviewing the preoperative laboratory results for a patient
scheduled for elective surgery. Which finding should be reported to the surgeon
immediately?
A. Serum potassium level of 3.2 mEq/L
B. White blood cell count of 11,000/mm3
C. Hemoglobin level of 12.5 g/dL
D. Serum creatinine level of 0.9 mg/dL
Answer: A
Rationale: A potassium level of 3.2 mEq/L is low (hypokalemia) and increases the risk of
cardiac dysrhythmias during anesthesia; other values are within normal or near-normal
ranges for a preoperative patient.
2. During a surgical procedure, the patient develops a heart rate of 140 bpm,
muscle rigidity, and a rapidly rising core temperature. Which medication should
the nurse anticipate administering?
A. Naloxone
B. Atropine sulfate
C. Dantrolene sodium
D. Succinylcholine
Answer: C
Rationale: These are classic signs of Malignant Hyperthermia, a life-threatening anesthetic
complication. Dantrolene sodium is the specific skeletal muscle relaxant used to treat this
condition.
,3. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis, uncompensated
B. Metabolic alkalosis, partially compensated
C. Respiratory acidosis, uncompensated
D. Respiratory alkalosis, fully compensated
Answer: C
Rationale: The pH is low (<7.35) indicating acidosis. The PaCO2 is high (>45 mmHg)
matching the acidotic state, while the HCO3 is normal, indicating an uncompensated
respiratory acidosis.
4. A patient with a history of heart failure presents with peripheral edema,
crackles in the lungs, and a weight gain of 3 kg in 48 hours. Which acid-base
imbalance is this patient at highest risk for if they are receiving high-dose loop
diuretics?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: D
Rationale: Loop diuretics cause the loss of hydrogen ions and potassium, which often leads
to metabolic alkalosis.
, 5. A nurse is caring for a patient with a serum sodium level of 118 mEq/L. Which
nursing intervention is the highest priority?
A. Encouraging oral fluid intake
B. Increasing dietary sodium intake
C. Administering hypotonic IV fluids
D. Initiating seizure precautions
Answer: D
Rationale: Severe hyponatremia (<120 mEq/L) can cause cerebral edema and increased
intracranial pressure, placing the patient at extreme risk for seizures and coma.
6. Which assessment finding in a patient with hyperkalemia is most concerning
to the nurse?
A. Peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Muscle weakness in the lower extremities
D. Hypotension
Answer: A
Rationale: Hyperkalemia significantly affects cardiac conduction; peaked T waves are an
early sign of potassium toxicity that can progress to ventricular fibrillation or cardiac
arrest.
7. A patient undergoing chemotherapy has a neutrophil count of 450/mm3.
Which action should the nurse include in the plan of care?
A. Administering prophylactic iron supplements
B. Encouraging the patient to eat fresh salads
C. Assessing the patient’s temperature every 4 hours
D. Using a firm toothbrush for oral hygiene
Answer: C
|WCU
1. A nurse is reviewing the preoperative laboratory results for a patient
scheduled for elective surgery. Which finding should be reported to the surgeon
immediately?
A. Serum potassium level of 3.2 mEq/L
B. White blood cell count of 11,000/mm3
C. Hemoglobin level of 12.5 g/dL
D. Serum creatinine level of 0.9 mg/dL
Answer: A
Rationale: A potassium level of 3.2 mEq/L is low (hypokalemia) and increases the risk of
cardiac dysrhythmias during anesthesia; other values are within normal or near-normal
ranges for a preoperative patient.
2. During a surgical procedure, the patient develops a heart rate of 140 bpm,
muscle rigidity, and a rapidly rising core temperature. Which medication should
the nurse anticipate administering?
A. Naloxone
B. Atropine sulfate
C. Dantrolene sodium
D. Succinylcholine
Answer: C
Rationale: These are classic signs of Malignant Hyperthermia, a life-threatening anesthetic
complication. Dantrolene sodium is the specific skeletal muscle relaxant used to treat this
condition.
,3. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis, uncompensated
B. Metabolic alkalosis, partially compensated
C. Respiratory acidosis, uncompensated
D. Respiratory alkalosis, fully compensated
Answer: C
Rationale: The pH is low (<7.35) indicating acidosis. The PaCO2 is high (>45 mmHg)
matching the acidotic state, while the HCO3 is normal, indicating an uncompensated
respiratory acidosis.
4. A patient with a history of heart failure presents with peripheral edema,
crackles in the lungs, and a weight gain of 3 kg in 48 hours. Which acid-base
imbalance is this patient at highest risk for if they are receiving high-dose loop
diuretics?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: D
Rationale: Loop diuretics cause the loss of hydrogen ions and potassium, which often leads
to metabolic alkalosis.
, 5. A nurse is caring for a patient with a serum sodium level of 118 mEq/L. Which
nursing intervention is the highest priority?
A. Encouraging oral fluid intake
B. Increasing dietary sodium intake
C. Administering hypotonic IV fluids
D. Initiating seizure precautions
Answer: D
Rationale: Severe hyponatremia (<120 mEq/L) can cause cerebral edema and increased
intracranial pressure, placing the patient at extreme risk for seizures and coma.
6. Which assessment finding in a patient with hyperkalemia is most concerning
to the nurse?
A. Peaked T waves on the ECG
B. Hyperactive bowel sounds
C. Muscle weakness in the lower extremities
D. Hypotension
Answer: A
Rationale: Hyperkalemia significantly affects cardiac conduction; peaked T waves are an
early sign of potassium toxicity that can progress to ventricular fibrillation or cardiac
arrest.
7. A patient undergoing chemotherapy has a neutrophil count of 450/mm3.
Which action should the nurse include in the plan of care?
A. Administering prophylactic iron supplements
B. Encouraging the patient to eat fresh salads
C. Assessing the patient’s temperature every 4 hours
D. Using a firm toothbrush for oral hygiene
Answer: C
