NUR 242 EXAM 1 | MEDICAL SURGICAL NURSING
CONCEPTS GALEN COLLEGE OF NURSING | 170
HIGH YIELD QUESTIONS WITH 100% ACCURATE
SOLUTIONS AND RATIONALES | A+ GRADE
(NEW!!!)
CHAPTER 01: FLUID & ELECTROLYTE BALANCE
1. A nurse is assessing a client for signs of dehydration. Which of the following findings is the most reliable
indicator of fluid status?
A. Skin turgor
B. Daily weight
C. Thirst
D. Blood pressure
Rationale: Daily weight on the same scale at the same time is the most reliable indicator of fluid status — 1 kg of
weight change equals approximately 1 liter of fluid. Skin turgor is less reliable in older adults (option A). Thirst (C)
and blood pressure changes (D) are late signs of dehydration.
2. A nurse is caring for a client who has fluid volume overload. Which of the following assessment findings should
the nurse expect? (Select all that apply)
A. Thready pulse
B. Bounding pulse
C. Distended neck veins
D. Moist crackles in lung bases
Page | 1 SUCCESS!!!
,E. Poor skin turgor
Rationale: Key features of fluid overload include bounding pulse, distended neck veins, moist crackles on
auscultation, and weight gain. Thready pulse and poor skin turgor are signs of dehydration, not fluid overload.
3. A client has an ileostomy and is also prescribed long-term corticosteroids. The nurse should assess for which of
the following?
A. Only dehydration risk
B. Only fluid overload risk
C. Both dehydration and fluid overload
D. Neither imbalance
Rationale: An ileostomy puts the client at risk for dehydration (fluid loss), while long-term corticosteroid use can
cause fluid overload. The nurse must assess for BOTH imbalances simultaneously — not just one.
4. A nurse is reviewing a client's laboratory results. Which of the following serum potassium levels would require
immediate intervention?
A. 3.8 mEq/L
B. 4.2 mEq/L
C. 5.1 mEq/L
D. 6.0 mEq/L
Rationale: Normal serum potassium is 3.5-5.0 mEq/L. A level of 6.0 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias (peaked T waves, widened QRS). This requires immediate intervention.
Page | 2 SUCCESS!!!
,5. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance should the nurse monitor
most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia can lead to muscle weakness
and cardiac arrhythmias. The nurse should monitor serum potassium levels and encourage potassium-rich foods or
supplements as prescribed.
6. A client is receiving IV potassium chloride. Which of the following findings requires immediate intervention?
A. Serum potassium level 3.8 mEq/L
B. Infusion site pain and phlebitis
C. Infusion rate 10 mEq/hour
D. Client report of mild nausea
Rationale: IV potassium is highly irritating to veins. Pain or phlebitis requires stopping or slowing the infusion and
possibly changing the IV site. The maximum safe peripheral IV potassium infusion rate is 10 mEq/hour, and a
potassium level of 3.8 is within normal range.
7. A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which of the following ECG
changes should the nurse expect?
A. Flattened T waves
B. Peaked T waves
Page | 3 SUCCESS!!!
, C. U waves
D. Prolonged QT interval
Rationale: Hyperkalemia causes characteristic peaked (tented) T waves on ECG. Flattened T waves and U waves are
seen in hypokalemia. Prolonged QT interval can occur with hypocalcemia or certain medications.
CHAPTER 02: ACID-BASE BALANCE
8. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.32, PaCO₂ 48 mm Hg, HCO₃ 24 mEq/L.
The nurse should interpret these findings as which of the following?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: pH is low (normal 7.35-7.45), indicating acidosis. PaCO₂ is elevated (normal 35-45 mm Hg), indicating a
respiratory cause. HCO₃ is within normal range (22-26 mEq/L), indicating no metabolic compensation yet. This is
uncompensated respiratory acidosis.
9. A client with diabetic ketoacidosis (DKA) has the following ABG results: pH 7.28, PaCO₂ 30 mm Hg, HCO₃ 16
mEq/L. The nurse should interpret these findings as which of the following?
A. Metabolic acidosis with respiratory compensation
B. Respiratory acidosis with metabolic compensation
C. Metabolic alkalosis with respiratory compensation
D. Respiratory alkalosis with metabolic compensation
Page | 4 SUCCESS!!!
CONCEPTS GALEN COLLEGE OF NURSING | 170
HIGH YIELD QUESTIONS WITH 100% ACCURATE
SOLUTIONS AND RATIONALES | A+ GRADE
(NEW!!!)
CHAPTER 01: FLUID & ELECTROLYTE BALANCE
1. A nurse is assessing a client for signs of dehydration. Which of the following findings is the most reliable
indicator of fluid status?
A. Skin turgor
B. Daily weight
C. Thirst
D. Blood pressure
Rationale: Daily weight on the same scale at the same time is the most reliable indicator of fluid status — 1 kg of
weight change equals approximately 1 liter of fluid. Skin turgor is less reliable in older adults (option A). Thirst (C)
and blood pressure changes (D) are late signs of dehydration.
2. A nurse is caring for a client who has fluid volume overload. Which of the following assessment findings should
the nurse expect? (Select all that apply)
A. Thready pulse
B. Bounding pulse
C. Distended neck veins
D. Moist crackles in lung bases
Page | 1 SUCCESS!!!
,E. Poor skin turgor
Rationale: Key features of fluid overload include bounding pulse, distended neck veins, moist crackles on
auscultation, and weight gain. Thready pulse and poor skin turgor are signs of dehydration, not fluid overload.
3. A client has an ileostomy and is also prescribed long-term corticosteroids. The nurse should assess for which of
the following?
A. Only dehydration risk
B. Only fluid overload risk
C. Both dehydration and fluid overload
D. Neither imbalance
Rationale: An ileostomy puts the client at risk for dehydration (fluid loss), while long-term corticosteroid use can
cause fluid overload. The nurse must assess for BOTH imbalances simultaneously — not just one.
4. A nurse is reviewing a client's laboratory results. Which of the following serum potassium levels would require
immediate intervention?
A. 3.8 mEq/L
B. 4.2 mEq/L
C. 5.1 mEq/L
D. 6.0 mEq/L
Rationale: Normal serum potassium is 3.5-5.0 mEq/L. A level of 6.0 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias (peaked T waves, widened QRS). This requires immediate intervention.
Page | 2 SUCCESS!!!
,5. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance should the nurse monitor
most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia can lead to muscle weakness
and cardiac arrhythmias. The nurse should monitor serum potassium levels and encourage potassium-rich foods or
supplements as prescribed.
6. A client is receiving IV potassium chloride. Which of the following findings requires immediate intervention?
A. Serum potassium level 3.8 mEq/L
B. Infusion site pain and phlebitis
C. Infusion rate 10 mEq/hour
D. Client report of mild nausea
Rationale: IV potassium is highly irritating to veins. Pain or phlebitis requires stopping or slowing the infusion and
possibly changing the IV site. The maximum safe peripheral IV potassium infusion rate is 10 mEq/hour, and a
potassium level of 3.8 is within normal range.
7. A client with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which of the following ECG
changes should the nurse expect?
A. Flattened T waves
B. Peaked T waves
Page | 3 SUCCESS!!!
, C. U waves
D. Prolonged QT interval
Rationale: Hyperkalemia causes characteristic peaked (tented) T waves on ECG. Flattened T waves and U waves are
seen in hypokalemia. Prolonged QT interval can occur with hypocalcemia or certain medications.
CHAPTER 02: ACID-BASE BALANCE
8. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.32, PaCO₂ 48 mm Hg, HCO₃ 24 mEq/L.
The nurse should interpret these findings as which of the following?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: pH is low (normal 7.35-7.45), indicating acidosis. PaCO₂ is elevated (normal 35-45 mm Hg), indicating a
respiratory cause. HCO₃ is within normal range (22-26 mEq/L), indicating no metabolic compensation yet. This is
uncompensated respiratory acidosis.
9. A client with diabetic ketoacidosis (DKA) has the following ABG results: pH 7.28, PaCO₂ 30 mm Hg, HCO₃ 16
mEq/L. The nurse should interpret these findings as which of the following?
A. Metabolic acidosis with respiratory compensation
B. Respiratory acidosis with metabolic compensation
C. Metabolic alkalosis with respiratory compensation
D. Respiratory alkalosis with metabolic compensation
Page | 4 SUCCESS!!!
