Saudi Prometric Nursing Medical-Surgical Nursing 2

Question 1

A patient is admitted with diabetic ketoacidosis (DKA). Which arterial blood gas result is expected?

Accepted Answer

pH 7.28, PaCO2 28, HCO3 14 (metabolic acidosis with respiratory compensation)

Answer

DKA causes metabolic acidosis from ketone accumulation. Expected ABG findings are low pH (<7.35), low HCO3 (<18), and low PaCO2 due to compensatory hyperventilation (Kussmaul respirations), which attempts to blow off CO2 to raise pH.

Question 2

A nurse is caring for a patient with acute pancreatitis. Which position provides the most comfort?

Accepted Answer

Fetal position (knees drawn to chest)

Answer

The fetal position (knees drawn to chest, leaning forward) reduces tension on the retroperitoneal space and alleviates pain from pancreatic inflammation. This position is a characteristic finding in acute pancreatitis history.

Question 3

A post-operative patient reports sudden chest pain and shortness of breath on day 2 after hip replacement surgery. The nurse should first suspect:

Accepted Answer

Pulmonary embolism

Answer

Sudden chest pain, dyspnea, tachycardia, and hypoxia in a post-orthopedic surgery patient are classic signs of pulmonary embolism (PE) due to deep vein thrombosis (DVT). Virchow's triad (stasis, hypercoagulability, vessel damage) is present post-surgery.

Question 4

The nurse is caring for a patient in acute liver failure. Which laboratory finding is of greatest concern?

Accepted Answer

INR of 4.5

Answer

An INR of 4.5 indicates severely impaired coagulation, as the liver produces clotting factors. This level significantly increases bleeding risk. While elevated ALT and bilirubin indicate liver damage, coagulopathy represents the most immediate life-threatening concern.

Question 5

A patient with chronic renal failure has a serum potassium of 6.2 mEq/L. Which ECG change should the nurse monitor for?

Accepted Answer

Tall peaked T waves

Answer

Hyperkalemia first manifests on ECG as tall, peaked (tent-shaped) T waves. As potassium rises further, PR interval prolongation, widened QRS, and eventually ventricular fibrillation can occur. Tall T waves are the earliest ECG sign.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Medical-Surgical Nursing 2