BSN Medical-Surgical Nursing 1 — Questions and Answers
Question 1: A patient returns from a left-sided cardiac catheterization via the femoral artery. Which assessment finding requires immediate nursing intervention?
- Absence of dorsalis pedis pulse in the left foot (Correct answer)
- Blood pressure of 128/80 mmHg in the right arm
- Patient reporting a need to void
- Mild bruising at the puncture site
Correct answer: Absence of dorsalis pedis pulse in the left foot
Loss of the pulse distal to the puncture site indicates arterial occlusion or hematoma compression, requiring immediate notification of the provider.
Question 2: A patient with chronic kidney disease (CKD) has a potassium level of 6.4 mEq/L. Which assessment finding is most concerning?
- Tall peaked T waves on the ECG (Correct answer)
- Serum sodium of 138 mEq/L
- Urine output of 40 mL/hr
- Blood pressure of 148/90 mmHg
Correct answer: Tall peaked T waves on the ECG
Peaked T waves are an early ECG sign of hyperkalemia, which can progress to life-threatening dysrhythmias if not treated.
Question 3: A patient with a history of COPD is admitted with an acute exacerbation. The nurse notes an SpO2 of 85% and respiratory rate of 28 breaths/min. What is the priority nursing action?
- Apply supplemental oxygen at 2 L/min via nasal cannula and reassess (Correct answer)
- Administer oxygen at 100% via non-rebreather mask immediately
- Prepare for immediate endotracheal intubation
- Obtain an ABG and wait for results before intervening
Correct answer: Apply supplemental oxygen at 2 L/min via nasal cannula and reassess
COPD patients depend on hypoxic drive; low-flow oxygen (1–2 L/min) corrects dangerous hypoxemia without suppressing respiratory drive.
Question 4: A postoperative patient who had abdominal surgery 2 days ago reports sudden onset of severe shortness of breath, chest pain, and apprehension. The nurse suspects pulmonary embolism. Which action takes priority?
- Administer oxygen and notify the provider immediately (Correct answer)
- Encourage the patient to take slow, deep breaths
- Position the patient in Trendelenburg to improve perfusion
- Obtain a 12-lead ECG before calling the provider
Correct answer: Administer oxygen and notify the provider immediately
Suspected pulmonary embolism is a medical emergency; administering oxygen to treat hypoxemia and immediately notifying the provider are the priority actions.
Question 5: A patient with type 1 diabetes mellitus develops Kussmaul respirations, fruity breath, and blood glucose of 480 mg/dL. These findings are consistent with:
- Diabetic ketoacidosis (DKA) (Correct answer)
- Hyperosmolar hyperglycemic state (HHS)
- Hypoglycemic coma
- Somogyi effect
Correct answer: Diabetic ketoacidosis (DKA)
DKA is characterized by hyperglycemia, ketosis, acidosis, Kussmaul respirations, and fruity (acetone) breath in type 1 diabetes.
Question 6: A patient with a fractured pelvis is at greatest risk for which complication?
- Hemorrhage (Correct answer)
- Fat embolism
- Deep vein thrombosis
- Compartment syndrome
Correct answer: Hemorrhage
The pelvic region is highly vascular; pelvic fractures can cause massive internal hemorrhage that is rapidly life-threatening.
BSN Medical-Surgical Nursing 1
A patient returns from a left-sided cardiac catheterization via the femoral artery.
Which assessment finding requires immediate nursing intervention?