NU 155
Exam 1: Medical-Surgical Nursing I
Comprehensive Multiple-Choice Examination
60 Questions | 7 Sections
April 15, 2026
, Table of Contents
Section I: Fluid & Electrolyte Imbalances .......................................................................................... 3
Section II: Acid-Base Disorders ........................................................................................................... 8
Section III: Intravenous Therapy ...................................................................................................... 11
Section IV: Blood Transfusion Therapy ........................................................................................... 14
Section V: Nutrition & Hydration ..................................................................................................... 16
Section VI: Inflammation & Infection Control ................................................................................ 19
Section VII: Perioperative Nursing ................................................................................................... 21
Section I: Fluid & Electrolyte Imbalances.................................................................................... 3
Section II: Acid-Base Disorders ..................................................................................................... 8
Section III: Intravenous Therapy .................................................................................................. 11
Section IV: Blood Transfusion Therapy ..................................................................................... 14
Section V: Nutrition & Hydration.................................................................................................. 16
Section VI: Inflammation & Infection Control ........................................................................... 19
Section VII: Perioperative Nursing .............................................................................................. 21
(Word will auto-generate the Table of Contents when opened.
, NU 155 Exam 1 | Medical-Surgical Nursing I
Section I: Fluid & Electrolyte Imbalances
1. A nurse is caring for a 72-year-old patient admitted with severe dehydration after 3 days of
vomiting and diarrhea. Which fluid compartment is most significantly affected in this patient?
A) Intracellular fluid (ICF) B) Extracellular fluid (ECF)
C) Transcellular fluid D) Interstitial fluid only
Correct Answer: B
Rationale: Dehydration primarily affects the extracellular fluid compartment because water is lost
from both the interstitial space and the vascular compartment. The ICF may eventually be affected as
fluid shifts occur, but the initial and most significant loss is from the ECF, leading to symptoms such
as tachycardia, decreased urine output, and dry mucous membranes.
2. A patient with hypervolemia presents with crackles in the lungs, jugular vein distention (JVD), and
a weight gain of 2.5 kg over 2 days. Which intervention should the nurse implement first?
A) Administer prescribed diuretics B) Restrict sodium and fluid intake
C) Elevate the head of the bed to semi-Fowler's D) Obtain a stat basic metabolic panel
position
Correct Answer: C
Rationale: Elevating the head of the bed to semi-Fowler's (45°) position is the first nursing action
because it immediately reduces venous return, relieves dyspnea, and maximizes lung expansion. This
is a priority over medication administration and laboratory tests, as it provides immediate relief of
respiratory distress. The nurse should then notify the provider and implement fluid and sodium
restrictions.
3. A patient with serum sodium of 125 mEq/L is confused, lethargic, and has muscle twitching. The
nurse understands these findings are consistent with which condition?
A) Hypernatremia B) Hyponatremia
C) Hypokalemia D) Hypercalcemia
Correct Answer: B
Rationale: A serum sodium of 125 mEq/L (normal 135-145 mEq/L) indicates hyponatremia.
Neurological manifestations such as confusion, lethargy, seizures, and coma are the most significant
clinical findings because hyponatremia causes cerebral edema as water shifts into the brain cells.
Muscle twitching may also occur due to altered neuronal excitability. Severe hyponatremia is a
medical emergency requiring careful correction.
3
Exam 1: Medical-Surgical Nursing I
Comprehensive Multiple-Choice Examination
60 Questions | 7 Sections
April 15, 2026
, Table of Contents
Section I: Fluid & Electrolyte Imbalances .......................................................................................... 3
Section II: Acid-Base Disorders ........................................................................................................... 8
Section III: Intravenous Therapy ...................................................................................................... 11
Section IV: Blood Transfusion Therapy ........................................................................................... 14
Section V: Nutrition & Hydration ..................................................................................................... 16
Section VI: Inflammation & Infection Control ................................................................................ 19
Section VII: Perioperative Nursing ................................................................................................... 21
Section I: Fluid & Electrolyte Imbalances.................................................................................... 3
Section II: Acid-Base Disorders ..................................................................................................... 8
Section III: Intravenous Therapy .................................................................................................. 11
Section IV: Blood Transfusion Therapy ..................................................................................... 14
Section V: Nutrition & Hydration.................................................................................................. 16
Section VI: Inflammation & Infection Control ........................................................................... 19
Section VII: Perioperative Nursing .............................................................................................. 21
(Word will auto-generate the Table of Contents when opened.
, NU 155 Exam 1 | Medical-Surgical Nursing I
Section I: Fluid & Electrolyte Imbalances
1. A nurse is caring for a 72-year-old patient admitted with severe dehydration after 3 days of
vomiting and diarrhea. Which fluid compartment is most significantly affected in this patient?
A) Intracellular fluid (ICF) B) Extracellular fluid (ECF)
C) Transcellular fluid D) Interstitial fluid only
Correct Answer: B
Rationale: Dehydration primarily affects the extracellular fluid compartment because water is lost
from both the interstitial space and the vascular compartment. The ICF may eventually be affected as
fluid shifts occur, but the initial and most significant loss is from the ECF, leading to symptoms such
as tachycardia, decreased urine output, and dry mucous membranes.
2. A patient with hypervolemia presents with crackles in the lungs, jugular vein distention (JVD), and
a weight gain of 2.5 kg over 2 days. Which intervention should the nurse implement first?
A) Administer prescribed diuretics B) Restrict sodium and fluid intake
C) Elevate the head of the bed to semi-Fowler's D) Obtain a stat basic metabolic panel
position
Correct Answer: C
Rationale: Elevating the head of the bed to semi-Fowler's (45°) position is the first nursing action
because it immediately reduces venous return, relieves dyspnea, and maximizes lung expansion. This
is a priority over medication administration and laboratory tests, as it provides immediate relief of
respiratory distress. The nurse should then notify the provider and implement fluid and sodium
restrictions.
3. A patient with serum sodium of 125 mEq/L is confused, lethargic, and has muscle twitching. The
nurse understands these findings are consistent with which condition?
A) Hypernatremia B) Hyponatremia
C) Hypokalemia D) Hypercalcemia
Correct Answer: B
Rationale: A serum sodium of 125 mEq/L (normal 135-145 mEq/L) indicates hyponatremia.
Neurological manifestations such as confusion, lethargy, seizures, and coma are the most significant
clinical findings because hyponatremia causes cerebral edema as water shifts into the brain cells.
Muscle twitching may also occur due to altered neuronal excitability. Severe hyponatremia is a
medical emergency requiring careful correction.
3
