NU 155 Final Exam Medical-Surgical
Nursing I (2026) PDF | Galen
Questions and Ansẉers with
rationales 2026\2027 update
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A client with a history of heart failure is admitted with weight gain,
shortness of breath, and bilateral ankle edema. Which intervention
should the nurse implement first?
A) Administer furosemide as prescribed.
B) Place the client in a high-Fowler's position.
C) Obtain a chest x-ray.
D) Assess the client's dietary intake.
Answer: B
Rationale: Placing the client in a high-Fowler's position immediately
reduces venous return to the heart and relieves dyspnea by
maximizing lung expansion. This is the first, independent nursing
action before medications or diagnostics are performed.
A nurse is reviewing the laboratory results of a client receiving total
parenteral nutrition (TPN). Which finding requires immediate
intervention by the nurse?
A) Serum glucose of 180 mg/dL
B) Serum osmolality of 290 mOsm/kg
C) Serum potassium of 3.0 mEq/L
D) Serum triglycerides of 150 mg/dL
Answer: C
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia,
which can lead to lethal cardiac dysrhythmias. TPN stimulates
insulin release, driving potassium into the cells and rapidly
depleting serum levels. This requires immediate intervention.
A client is admitted with dehydration. Which assessment finding is
most consistent with this condition?
A) Distended neck veins
B) Bradycardia
,C) Increased urine specific gravity
D) Decreased blood urea nitrogen (BUN)
Answer: C
Rationale: Dehydration leads to a decreased volume of fluid in the
kidneys, causing the urine to become highly concentrated, which is
reflected by an increased urine specific gravity. BUN increases, heart
rate increases, and neck veins are flat.
A postoperative client has a nasogastric (NG) tube connected to low
continuous suction. The nurse monitors this client for which
potential complication?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: B
Rationale: NG suction removes gastric acid (hydrochloric acid). The
loss of hydrogen ions leads to an accumulation of bicarbonate in the
blood, causing metabolic alkalosis.
Which client is at the highest risk for developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) A client with severe burns
B) A client with small cell lung cancer
C) A client with diabetes insipidus
D) A client with Cushing's syndrome
Answer: B
Rationale: Small cell lung cancer is a well-known cause of ectopic
ADH production, leading to SIADH. This causes water retention,
dilutional hyponatremia, and decreased serum osmolality.
, A nurse is caring for a client with hypercalcemia. Which assessment
finding should the nurse expect?
A) Positive Trousseau's sign
B) Muscle tremors
C) Constipation
D) Hypoactive deep tendon reflexes
Answer: C
Rationale: Hypercalcemia decreases smooth muscle tone and
motility, leading to constipation. Positive Trousseau's sign, muscle
tremors, and hypoactive reflexes are associated with hypocalcemia.
A client with hypokalemia is prescribed intravenous potassium
chloride. Which nursing action is most critical?
A) Administer the medication as a rapid IV bolus.
B) Monitor the client for deep vein thrombosis.
C) Ensure the infusion rate does not exceed 10 mEq/hr.
D) Assess the client for hyperactive bowel sounds.
Answer: C
Rationale: IV potassium must never be given as a bolus because it
can cause sudden cardiac arrest. The infusion rate should generally
not exceed 10 mEq/hr to prevent severe hyperkalemia.
A client is diagnosed with respiratory acidosis. Which arterial blood
gas (ABG) result supports this diagnosis?
A) pH 7.50, PaCO2 30 mm Hg
B) pH 7.30, PaCO2 50 mm Hg
C) pH 7.48, HCO3- 32 mEq/L
D) pH 7.25, HCO3- 18 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a decreased pH
(below 7.35) and an increased PaCO2 (above 45 mm Hg), indicating
carbon dioxide retention.
Nursing I (2026) PDF | Galen
Questions and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
A client with a history of heart failure is admitted with weight gain,
shortness of breath, and bilateral ankle edema. Which intervention
should the nurse implement first?
A) Administer furosemide as prescribed.
B) Place the client in a high-Fowler's position.
C) Obtain a chest x-ray.
D) Assess the client's dietary intake.
Answer: B
Rationale: Placing the client in a high-Fowler's position immediately
reduces venous return to the heart and relieves dyspnea by
maximizing lung expansion. This is the first, independent nursing
action before medications or diagnostics are performed.
A nurse is reviewing the laboratory results of a client receiving total
parenteral nutrition (TPN). Which finding requires immediate
intervention by the nurse?
A) Serum glucose of 180 mg/dL
B) Serum osmolality of 290 mOsm/kg
C) Serum potassium of 3.0 mEq/L
D) Serum triglycerides of 150 mg/dL
Answer: C
Rationale: A potassium level of 3.0 mEq/L indicates hypokalemia,
which can lead to lethal cardiac dysrhythmias. TPN stimulates
insulin release, driving potassium into the cells and rapidly
depleting serum levels. This requires immediate intervention.
A client is admitted with dehydration. Which assessment finding is
most consistent with this condition?
A) Distended neck veins
B) Bradycardia
,C) Increased urine specific gravity
D) Decreased blood urea nitrogen (BUN)
Answer: C
Rationale: Dehydration leads to a decreased volume of fluid in the
kidneys, causing the urine to become highly concentrated, which is
reflected by an increased urine specific gravity. BUN increases, heart
rate increases, and neck veins are flat.
A postoperative client has a nasogastric (NG) tube connected to low
continuous suction. The nurse monitors this client for which
potential complication?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: B
Rationale: NG suction removes gastric acid (hydrochloric acid). The
loss of hydrogen ions leads to an accumulation of bicarbonate in the
blood, causing metabolic alkalosis.
Which client is at the highest risk for developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) A client with severe burns
B) A client with small cell lung cancer
C) A client with diabetes insipidus
D) A client with Cushing's syndrome
Answer: B
Rationale: Small cell lung cancer is a well-known cause of ectopic
ADH production, leading to SIADH. This causes water retention,
dilutional hyponatremia, and decreased serum osmolality.
, A nurse is caring for a client with hypercalcemia. Which assessment
finding should the nurse expect?
A) Positive Trousseau's sign
B) Muscle tremors
C) Constipation
D) Hypoactive deep tendon reflexes
Answer: C
Rationale: Hypercalcemia decreases smooth muscle tone and
motility, leading to constipation. Positive Trousseau's sign, muscle
tremors, and hypoactive reflexes are associated with hypocalcemia.
A client with hypokalemia is prescribed intravenous potassium
chloride. Which nursing action is most critical?
A) Administer the medication as a rapid IV bolus.
B) Monitor the client for deep vein thrombosis.
C) Ensure the infusion rate does not exceed 10 mEq/hr.
D) Assess the client for hyperactive bowel sounds.
Answer: C
Rationale: IV potassium must never be given as a bolus because it
can cause sudden cardiac arrest. The infusion rate should generally
not exceed 10 mEq/hr to prevent severe hyperkalemia.
A client is diagnosed with respiratory acidosis. Which arterial blood
gas (ABG) result supports this diagnosis?
A) pH 7.50, PaCO2 30 mm Hg
B) pH 7.30, PaCO2 50 mm Hg
C) pH 7.48, HCO3- 32 mEq/L
D) pH 7.25, HCO3- 18 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a decreased pH
(below 7.35) and an increased PaCO2 (above 45 mm Hg), indicating
carbon dioxide retention.
