NU 155 Medical-Surgical Nursing I Comprehensive Exam
Prep | 2026/2027 Edition | 200 Verified Questions
NU 155 Medical-Surgical Nursing I Exams 1-3 & Final 2026-2027 | Questions and Answers Already Graded A+ |
100% Verified Solutions with Rationales | Updated Per Latest Guidelines
This comprehensive exam prep document contains 200 verified questions covering all major content
areas for NU 155 Medical-Surgical Nursing I. Designed for the 2026/2027 academic year, it includes
rationales and verified answers to support mastery of surgical nursing, fluid and electrolyte balance,
perioperative care, and more. Perfect for exam preparation and achieving a high score.
Key Features:
Perioperative Nursing Care
Fluid and Electrolyte Imbalances
Wound Healing and Infection Control
Pain Management and Pharmacology
Cardiovascular and Respiratory Conditions
Gastrointestinal and Renal Disorders
Updates for 2026:
- Updated to reflect 2026/2027 NCLEX and ATI guidelines
- Revised rationales with evidence-based practice references
- Added new questions on COVID-19 and post-surgical complications
- Enhanced distractor explanations for critical thinking
- Aligned with latest ANA Scope and Standards
Abstract:
This document offers a rigorous review of NU 155 Medical-Surgical Nursing I, integrating core concepts required
for safe and effective patient care. The 200 verified questions span perioperative care, fluid and electrolyte
management, wound healing, and pain control. Each answer includes a rationale grounded in current literature
and clinical guidelines. The content is organized to build progressive understanding from foundational to complex
scenarios. Special emphasis is placed on prioritization, delegation, and interprofessional collaboration. By
studying these questions, students develop critical thinking skills essential for nursing practice. This resource is an
indispensable tool for exam success and clinical competence.
Keywords:
Medical-Surgical Nursing, Perioperative Care, Fluid and Electrolytes, Wound Healing, Pain Management, NCLEX
Preparation, Rationales, Nursing Exams
Answer Format:
Each question is followed by a verified correct answer and a detailed rationale explaining why it is correct and why
other options are incorrect. Distractors are analyzed to clarify common misconceptions, ensuring comprehensive
understanding.
Compliance Checklist:
All answers verified by subject matter experts
Updated per 2026/2027 NCLEX test plan
Rationales cite current evidence-based practice
Aligns with ATI and HESI testing formats
Includes prioritization and delegation content
Page 1
, Covers all major medical-surgical nursing topics
Content Area Overview:
Content Area Questions Key Topics Weight
Perioperative Nursing 1-40 Preoperative assessment, Intraoperative care, 20%
Postoperative complications, Anesthesia
Fluid and Electrolyte Balance 41-80 IV therapy, Electrolyte imbalances, 20%
Acid-base balance, Fluid volume
deficits/excess
Wound Healing and Pain 81-120 Wound assessment, Infection control, Pain 20%
Management scales, Pharmacological interventions
Cardiovascular and Respiratory 121-160 Hypertension, Heart failure, Pneumonia, 20%
Disorders COPD, Post-op cardiac monitoring
Gastrointestinal and Renal 161-200 Bowel obstruction, Ostomy care, Acute 20%
Disorders kidney injury, Urinary tract infections
Page 2
,Q1. A patient receiving continuous nasogastric suction at 100 mL/hour has a serum
sodium of 128 mEq/L, potassium 3.2 mEq/L, and chloride 88 mEq/L. Which
intravenous fluid should the nurse anticipate being prescribed to address these
imbalances?
A. Lactated Ringer's solution at 125 mL/hour
B. 5% dextrose in 0.45% normal saline with 20 mEq KCl at 75 mL/hour
C. 0.9% normal saline with 10 mEq KCl at 150 mL/hour
D. Plasmalyte A (multiple electrolytes) at 100 mL/hour
Correct Answer: C. 0.9% normal saline with 10 mEq KCl at 150 mL/hour
Rationale: The patient has hyponatremia (128), hypokalemia (3.2), and hypochloremia
(88) from loss of gastric fluids (rich in sodium, potassium, and chloride). 0.9% normal
saline is isotonic and corrects sodium and chloride deficits; adding KCl addresses
hypokalemia. Lactated Ringer's provides potassium but may worsen hyponatremia due to
lower sodium content (130 mEq/L). 5% dextrose in 0.45% normal saline is hypotonic and
inappropriate for hyponatremia. Plasmalyte A has sodium 140 mEq/L but has less
chloride and no added potassium.
Why Wrong:
A - Lactated Ringer's has lower sodium (130 mEq/L) and may not adequately correct
severe hyponatremia.
B - 0.45% normal saline is hypotonic and could worsen hyponatremia; also dextrose
may cause hyperglycemia.
D - Plasmalyte A lacks concentrated potassium and provides only balanced electrolyte
replacement without additional KCl.
Reference: Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2021). Medical-Surgical
Nursing: Concepts for Interprofessional Collaborative Care, 10th Ed., Ch. 13.
Q2. Arterial blood gas results: pH 7.25, PaCO2 60 mm Hg, HCO3- 26 mEq/L. Which
condition best explains these findings?
A. Acute respiratory acidosis with no metabolic compensation
B. Chronic respiratory acidosis with partial metabolic compensation
C. Metabolic alkalosis with respiratory compensation
D. Combined respiratory and metabolic acidosis
Correct Answer: A. Acute respiratory acidosis with no metabolic compensation
Rationale: The pH is acidic (7.25) with elevated PaCO2 (60) indicating respiratory
acidosis. HCO3- is normal (26), suggesting no metabolic compensation has occurred. In
acute respiratory acidosis, HCO3- remains normal because renal compensation takes
24-48 hours. Chronic respiratory acidosis would show elevated HCO3- (expected
compensation: 1 mEq/L increase per 10 mm Hg PaCO2 above 40 -> 60 yields +2, so
HCO3- ~26, but chronic would be >30 with full compensation). Partial compensation
would show HCO3- >26 but still pH <7.35. Metabolic alkalosis would have high pH and
high HCO3-.
Page 3
, Why Wrong:
B - Chronic respiratory acidosis would have HCO3- >30 mEq/L due to renal retention
of bicarbonate.
C - Metabolic alkalosis would have elevated pH and HCO3-; here pH is low.
D - Combined acidosis would require both low HCO3- and high PaCO2; HCO3- is
normal.
Reference: Cappell, K. A., & Nettina, J. M. (2023). Lippincott Manual of Nursing
Practice, 11th Ed., Ch. 11.
Q3. A patient is scheduled for an elective laparoscopic cholecystectomy. The nurse
reviews the preoperative orders. Which prescription should the nurse question?
A. Enoxaparin 40 mg subcutaneously once daily starting the evening before surgery
B. Ceftriaxone 1 g intravenously within 60 minutes of surgical incision
C. Metoclopramide 10 mg intravenously just before induction of anesthesia
D. Aspirin 325 mg orally daily as prescribed for coronary artery disease, to be taken on
the morning of surgery
Correct Answer: D. Aspirin 325 mg orally daily as prescribed for coronary artery
disease, to be taken on the morning of surgery
Rationale: Aspirin irreversibly inhibits platelet aggregation and increases bleeding risk.
Guidelines recommend discontinuing aspirin 5-7 days before elective surgery unless the
risk of thrombotic event outweighs. Taking aspirin on the morning of surgery is
contraindicated for a routine laparoscopic cholecystectomy. Enoxaparin is appropriate for
thromboembolism prophylaxis. Ceftriaxone as prophylactic antibiotic is appropriate
(within 60 min). Metoclopramide is used to reduce aspiration risk.
Why Wrong:
A - Enoxaparin is appropriate for VTE prophylaxis in surgical patients, especially
with laparoscopic surgery.
B - Ceftriaxone is a recommended prophylactic antibiotic for biliary surgery,
administered within 60 minutes of incision.
C - Metoclopramide is used to enhance gastric emptying and reduce aspiration risk
before surgery.
Reference: Association of periOperative Registered Nurses (AORN). (2022). Guidelines
for Perioperative Practice. 'Medication Safety' section.
Q4. A patient with severe peripheral neuropathy from diabetes reports burning pain
in the feet unrelieved by acetaminophen and ibuprofen. Which pharmacologic agent
should the nurse anticipate as first-line therapy for this neuropathic pain?
A. Gabapentin
B. Oxycodone
C. Amitriptyline
Page 4
Prep | 2026/2027 Edition | 200 Verified Questions
NU 155 Medical-Surgical Nursing I Exams 1-3 & Final 2026-2027 | Questions and Answers Already Graded A+ |
100% Verified Solutions with Rationales | Updated Per Latest Guidelines
This comprehensive exam prep document contains 200 verified questions covering all major content
areas for NU 155 Medical-Surgical Nursing I. Designed for the 2026/2027 academic year, it includes
rationales and verified answers to support mastery of surgical nursing, fluid and electrolyte balance,
perioperative care, and more. Perfect for exam preparation and achieving a high score.
Key Features:
Perioperative Nursing Care
Fluid and Electrolyte Imbalances
Wound Healing and Infection Control
Pain Management and Pharmacology
Cardiovascular and Respiratory Conditions
Gastrointestinal and Renal Disorders
Updates for 2026:
- Updated to reflect 2026/2027 NCLEX and ATI guidelines
- Revised rationales with evidence-based practice references
- Added new questions on COVID-19 and post-surgical complications
- Enhanced distractor explanations for critical thinking
- Aligned with latest ANA Scope and Standards
Abstract:
This document offers a rigorous review of NU 155 Medical-Surgical Nursing I, integrating core concepts required
for safe and effective patient care. The 200 verified questions span perioperative care, fluid and electrolyte
management, wound healing, and pain control. Each answer includes a rationale grounded in current literature
and clinical guidelines. The content is organized to build progressive understanding from foundational to complex
scenarios. Special emphasis is placed on prioritization, delegation, and interprofessional collaboration. By
studying these questions, students develop critical thinking skills essential for nursing practice. This resource is an
indispensable tool for exam success and clinical competence.
Keywords:
Medical-Surgical Nursing, Perioperative Care, Fluid and Electrolytes, Wound Healing, Pain Management, NCLEX
Preparation, Rationales, Nursing Exams
Answer Format:
Each question is followed by a verified correct answer and a detailed rationale explaining why it is correct and why
other options are incorrect. Distractors are analyzed to clarify common misconceptions, ensuring comprehensive
understanding.
Compliance Checklist:
All answers verified by subject matter experts
Updated per 2026/2027 NCLEX test plan
Rationales cite current evidence-based practice
Aligns with ATI and HESI testing formats
Includes prioritization and delegation content
Page 1
, Covers all major medical-surgical nursing topics
Content Area Overview:
Content Area Questions Key Topics Weight
Perioperative Nursing 1-40 Preoperative assessment, Intraoperative care, 20%
Postoperative complications, Anesthesia
Fluid and Electrolyte Balance 41-80 IV therapy, Electrolyte imbalances, 20%
Acid-base balance, Fluid volume
deficits/excess
Wound Healing and Pain 81-120 Wound assessment, Infection control, Pain 20%
Management scales, Pharmacological interventions
Cardiovascular and Respiratory 121-160 Hypertension, Heart failure, Pneumonia, 20%
Disorders COPD, Post-op cardiac monitoring
Gastrointestinal and Renal 161-200 Bowel obstruction, Ostomy care, Acute 20%
Disorders kidney injury, Urinary tract infections
Page 2
,Q1. A patient receiving continuous nasogastric suction at 100 mL/hour has a serum
sodium of 128 mEq/L, potassium 3.2 mEq/L, and chloride 88 mEq/L. Which
intravenous fluid should the nurse anticipate being prescribed to address these
imbalances?
A. Lactated Ringer's solution at 125 mL/hour
B. 5% dextrose in 0.45% normal saline with 20 mEq KCl at 75 mL/hour
C. 0.9% normal saline with 10 mEq KCl at 150 mL/hour
D. Plasmalyte A (multiple electrolytes) at 100 mL/hour
Correct Answer: C. 0.9% normal saline with 10 mEq KCl at 150 mL/hour
Rationale: The patient has hyponatremia (128), hypokalemia (3.2), and hypochloremia
(88) from loss of gastric fluids (rich in sodium, potassium, and chloride). 0.9% normal
saline is isotonic and corrects sodium and chloride deficits; adding KCl addresses
hypokalemia. Lactated Ringer's provides potassium but may worsen hyponatremia due to
lower sodium content (130 mEq/L). 5% dextrose in 0.45% normal saline is hypotonic and
inappropriate for hyponatremia. Plasmalyte A has sodium 140 mEq/L but has less
chloride and no added potassium.
Why Wrong:
A - Lactated Ringer's has lower sodium (130 mEq/L) and may not adequately correct
severe hyponatremia.
B - 0.45% normal saline is hypotonic and could worsen hyponatremia; also dextrose
may cause hyperglycemia.
D - Plasmalyte A lacks concentrated potassium and provides only balanced electrolyte
replacement without additional KCl.
Reference: Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2021). Medical-Surgical
Nursing: Concepts for Interprofessional Collaborative Care, 10th Ed., Ch. 13.
Q2. Arterial blood gas results: pH 7.25, PaCO2 60 mm Hg, HCO3- 26 mEq/L. Which
condition best explains these findings?
A. Acute respiratory acidosis with no metabolic compensation
B. Chronic respiratory acidosis with partial metabolic compensation
C. Metabolic alkalosis with respiratory compensation
D. Combined respiratory and metabolic acidosis
Correct Answer: A. Acute respiratory acidosis with no metabolic compensation
Rationale: The pH is acidic (7.25) with elevated PaCO2 (60) indicating respiratory
acidosis. HCO3- is normal (26), suggesting no metabolic compensation has occurred. In
acute respiratory acidosis, HCO3- remains normal because renal compensation takes
24-48 hours. Chronic respiratory acidosis would show elevated HCO3- (expected
compensation: 1 mEq/L increase per 10 mm Hg PaCO2 above 40 -> 60 yields +2, so
HCO3- ~26, but chronic would be >30 with full compensation). Partial compensation
would show HCO3- >26 but still pH <7.35. Metabolic alkalosis would have high pH and
high HCO3-.
Page 3
, Why Wrong:
B - Chronic respiratory acidosis would have HCO3- >30 mEq/L due to renal retention
of bicarbonate.
C - Metabolic alkalosis would have elevated pH and HCO3-; here pH is low.
D - Combined acidosis would require both low HCO3- and high PaCO2; HCO3- is
normal.
Reference: Cappell, K. A., & Nettina, J. M. (2023). Lippincott Manual of Nursing
Practice, 11th Ed., Ch. 11.
Q3. A patient is scheduled for an elective laparoscopic cholecystectomy. The nurse
reviews the preoperative orders. Which prescription should the nurse question?
A. Enoxaparin 40 mg subcutaneously once daily starting the evening before surgery
B. Ceftriaxone 1 g intravenously within 60 minutes of surgical incision
C. Metoclopramide 10 mg intravenously just before induction of anesthesia
D. Aspirin 325 mg orally daily as prescribed for coronary artery disease, to be taken on
the morning of surgery
Correct Answer: D. Aspirin 325 mg orally daily as prescribed for coronary artery
disease, to be taken on the morning of surgery
Rationale: Aspirin irreversibly inhibits platelet aggregation and increases bleeding risk.
Guidelines recommend discontinuing aspirin 5-7 days before elective surgery unless the
risk of thrombotic event outweighs. Taking aspirin on the morning of surgery is
contraindicated for a routine laparoscopic cholecystectomy. Enoxaparin is appropriate for
thromboembolism prophylaxis. Ceftriaxone as prophylactic antibiotic is appropriate
(within 60 min). Metoclopramide is used to reduce aspiration risk.
Why Wrong:
A - Enoxaparin is appropriate for VTE prophylaxis in surgical patients, especially
with laparoscopic surgery.
B - Ceftriaxone is a recommended prophylactic antibiotic for biliary surgery,
administered within 60 minutes of incision.
C - Metoclopramide is used to enhance gastric emptying and reduce aspiration risk
before surgery.
Reference: Association of periOperative Registered Nurses (AORN). (2022). Guidelines
for Perioperative Practice. 'Medication Safety' section.
Q4. A patient with severe peripheral neuropathy from diabetes reports burning pain
in the feet unrelieved by acetaminophen and ibuprofen. Which pharmacologic agent
should the nurse anticipate as first-line therapy for this neuropathic pain?
A. Gabapentin
B. Oxycodone
C. Amitriptyline
Page 4
