Med Surg Exam 1 - Mock Test (60 Questions with Answers)

Question-and-answer flashcards based on the lecture notes for exam prep.

What is the normal sodium (Na) range?

135–145 mEq/L

What are the neurological symptoms of hyponatremia?

Headache, confusion, lethargy, seizures, dizziness.

What EKG change is associated with hyperkalemia?

Peaked T waves.

Which electrolyte imbalance is known to cause positive Chvostek’s and Trousseau’s signs?

Hypocalcemia.

What is the normal potassium (K) range?

3.5–5.0 mEq/L

If a patient is on digoxin, which electrolyte must be monitored and why?

Potassium – low K predisposes to digoxin toxicity.

What is the golden rule of IV potassium administration?

NEVER push potassium IV (risk of cardiac arrest).

What is the normal magnesium (Mg²+) range?

1.8–2.6 mg/dL

What are common signs of fluid volume overload (FVO)?

Edema, crackles, JVD, bounding pulse, weight gain.

What orthostatic change indicates orthostatic hypotension?

Drop in SBP ≥20 mmHg or DBP ≥10 mmHg upon standing.

Which medications should be held before surgery?

Anticoagulants, diuretics, tranquilizers, adrenal steroids, mycin antibiotics.

What is the nurse’s role in informed consent?

Witness signature only; refer surgery questions to the surgeon.

What is the purpose of a surgical 'time out'?

Confirm patient ID, surgical site, and procedure to prevent errors.

What are two common postop pulmonary complications and their prevention?

Atelectasis & pneumonia – prevented by IS, TCDB, early ambulation.

What score determines readiness for PACU discharge?

Aldrete score of 8–10.

What’s the correct technique for incentive spirometry?

Patient should INHALE, not exhale.

What is the primary cause of HF?

Atherosclerosis (↑afterload).

Left-sided HF primarily affects which organ?

Lungs – dyspnea, crackles, orthopnea.

What are hallmark symptoms of right-sided HF?

Ascites, JVD, peripheral edema, hepatomegaly.

What lab is the key diagnostic indicator for HF?

BNP (↑ with worsening HF).

When should a HF patient report weight gain?

2–3 lbs in 24 hrs or 5 lbs in a week.

What is the sodium restriction for HF?

2 g/day.

Why are fluids restricted in HF?

To prevent fluid overload and worsening symptoms.

What is the action of ACE inhibitors?

Reduce afterload, prevent remodeling via RAAS blockade.

What is the biggest risk of digoxin therapy?

Digoxin toxicity – N/V, vision changes, bradycardia.

Why are diuretics used in HF?

Reduce preload and FVO.

How should daily weights be done in HF patients?

Same time daily, same clothes, after voiding.

What signals worsening left-sided HF?

Pulmonary edema (pink frothy sputum, severe dyspnea).

What are the 5 Ps of arterial insufficiency?

Pain, Pallor, Pulselessness, Paresthesia, Paralysis.

Describe the skin in arterial insufficiency.

Dry, shiny, hairless, thick toenails, rubor when dangling.

Where are arterial ulcers usually located?

Toes, feet, lateral malleolus.

Where are venous ulcers usually located?

Medial malleolus, lower leg.

Which vascular condition improves with leg elevation?

Venous insufficiency.

Which vascular condition worsens with elevation but improves with dependency?

Arterial insufficiency.

What are risk factors for PAD?

Smoking, DM, HTN, hyperlipidemia, obesity.

What are hallmark signs of PAD?

Intermittent claudication, 6 Ps, poor wound healing.

What must be monitored after arterial revascularization?

Distal pulses, color, temp, sensation q15 min initially.

What is Raynaud’s disease and its triggers?

Vasospasm of fingers/toes; triggered by cold, stress, caffeine, smoking.

What are the 3 P’s of hyperglycemia?

Polyuria, polydipsia, polyphagia.

What blood glucose level defines hypoglycemia?

Which type of DM is autoimmune beta-cell destruction?

Type 1 diabetes.

Which type of DM is linked to obesity and insulin resistance?

Type 2 diabetes.

What is the normal fasting glucose for non-diabetics?

70–100 mg/dL.

What is a normal A1C for non-diabetics?

What are the sick day rules for diabetics?

Continue insulin, monitor glucose/ketones, hydrate, monitor symptoms.

How many carbs should a diabetic eat before exercise?

15 g with protein if glucose low-normal.

What are foot care instructions for diabetics?

Inspect daily, no lotion between toes, cut nails straight across.

What is the onset/peak/duration of rapid-acting insulin?

Onset 15 min, Peak 1 hr, Duration 3–5 hrs.

What is lipodystrophy and how is it prevented?

Fat changes at injection sites – prevented by rotating sites.

What are hallmark signs of DKA?

Ketones in urine, fruity breath, Kussmaul respirations, acidosis.

What value defines HTN?

≥130/80 mmHg.

What are the HTN classifications?

Normal, Elevated, Stage 1, Stage 2, Crisis.

What lifestyle changes should be taught for HTN?

DASH diet, weight loss, exercise, smoking cessation, limit alcohol.

What are microvascular complications of HTN?

Retinopathy, nephropathy.

What are macrovascular complications of HTN?

Stroke, CAD, PAD.

What are first-line meds for HTN?

Thiazides, ACE inhibitors, ARBs, CCBs.

What is a hypertensive emergency?

180/120 mmHg with target organ damage.

What is hypertensive urgency?

180/120 mmHg without organ damage.

What is the goal of medical management in HTN?

Prevent complications like stroke, MI, kidney failure.

What labs should be monitored with ACE inhibitors and ARBs?

Potassium and creatinine.