NUR 170 EXAM 3 MED SURG | 165 STUDY
QUESTIONS AND ANSWERS + EXPERT
RATIONALES | 2026 UPDATED | 100% CORRECT
250 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 170 EXAM 3 MED SURG | 165 STUDY QUESTIONS AND ANSWERS + EXPERT RATIONALES | 2026
UPDATED | 100% CORRECT. It contains 250 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 250 Questions
Foundations - Application - NUR 170 3 MED SURG 165 Study AND Expert Rationales 2026 Updated 100
Correct Medical-surgical Nursing Undergraduate YEAR 3 Upper Division
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
NUR 170 3 MED SURG 165 1-42 Acute, Appropriate, Intervention, Finding, Shock
Study AND Expert Rationales
2026 Updated 100 Correct
Medical-surgical Nursing
Undergraduate YEAR 3
Upper Division
Acute 43-84 Finding, Develops, Appropriate, Kidney, Indicates
Appropriate 85-126 Finding, Acute, Laboratory, Kidney, Develops
Intervention 127-168 Acute, Finding, Appropriate, Develops, Shock
Develops 169-210 Finding, Acute, Disease, Syndrome, Indicates
Kidney 211-250 Finding, Receiving, Appropriate, Acute, Intervention
TOTAL 250 All questions include answers and detailed rationales
,Section A - NUR 170 3 MED SURG 165 Study AND Expert
Rationales 2026 Updated 100 Correct Medical-surgical
Nursing Undergraduate YEAR 3 Upper Division
Q1.
A patient with septic shock has a cardiac index of 2.1 L/min/m², systemic vascular
resistance of 600 dyn-s/cm, and mixed venous oxygen saturation of 55%. After fluid
resuscitation, which vasoactive agent should be initiated first?
A. Norepinephrine B. Epinephrine
C. Dobutamine D. Vasopressin
Correct: A - Norepinephrine
Rationale:The patient has vasodilatory shock with low SVR and low CI. Current guidelines
recommend norepinephrine as the first-line vasopressor to restore mean arterial pressure.
Epinephrine is second-line, dobutamine is added for persistent hypoperfusion despite
adequate MAP, and vasopressin is adjunctive.
Q2.
Which hemodynamic parameter most accurately reflects preload in a mechanically
ventilated patient with high positive end-expiratory pressure (PEEP) and suspected
hypovolemia?
A. Central venous pressure (CVP) B. Pulmonary artery occlusion pressure
(PAOP)
C. Right ventricular end-diastolic volume D. Stroke volume variation (SVV)
index (RVEDVI)
Correct: D - Stroke volume variation (SVV)
Rationale:SVV is a dynamic indicator of preload responsiveness and is more accurate than
static pressures (CVP, PAOP) in patients on mechanical ventilation with high PEEP. RVEDVI
is less reliable due to compliance changes. SVV >12% suggests fluid responsiveness.
Q3.
A patient with acute respiratory distress syndrome (ARDS) has a PaO/FiO ratio of 120 on
volume-controlled ventilation. Which ventilation strategy is most appropriate to improve
oxygenation while minimizing ventilator-induced lung injury?
A. Increase tidal volume to 8 mL/kg ideal B. Set PEEP to maintain plateau pressure
body weight 30 cm HO
Page 3
, Section A - NUR 170 3 MED SURG 165 Study AND Expert Rationales 2026 Updated 100 Correct Medical-surgical Nursing Undergraduate
YEAR 3 Upper Division
C. Use pressure-controlled ventilation with D. Decrease respiratory rate to reduce
peak pressure 35 cm HO auto-PEEP
Correct: B - Set PEEP to maintain plateau pressure 30 cm HO
Rationale:Low tidal volume (6 mL/kg) and adequate PEEP are key in ARDS. Setting PEEP to
maintain plateau pressure 30 cm HO is consistent with lung-protective ventilation. Higher tidal
volumes (8 mL/kg) may cause volutrauma. Pressure-controlled with peak pressure 35 may
exceed safe plateau.
Q4.
A patient with hyperkalemia (K 6.8 mEq/L) and ECG changes (peaked T waves) is being
treated. Which intervention should be initiated first to stabilize the cardiac membrane?
A. IV calcium gluconate B. IV insulin with dextrose
C. Sodium polystyrene sulfonate D. Hemodialysis
Correct: A - IV calcium gluconate
Rationale:Calcium gluconate antagonizes the effects of hyperkalemia on the cardiac
membrane, reducing the risk of ventricular arrhythmias. It works within minutes. Insulin with
dextrose shifts potassium intracellularly but takes longer, and dialysis is definitive but not
immediate.
Q5.
Which finding in a patient with syndrome of inappropriate antidiuretic hormone (SIADH) is
most consistent with euvolemic hyponatremia?
A. Decreased urine sodium (< 10 mEq/L) B. Increased urine osmolality (> 100
mOsm/kg)
C. Decreased serum uric acid D. Elevated BUN-to-creatinine ratio
Correct: B - Increased urine osmolality (> 100 mOsm/kg)
Rationale:SIADH is characterized by concentrated urine (urine osmolality >100 mOsm/kg)
and elevated urine sodium (>40 mEq/L) despite hyponatremia. Decreased uric acid may
occur but is not diagnostic. Hypovolemia would show low urine sodium and high
BUN/creatinine.
Q6.
A patient with cirrhosis and acute variceal bleeding is started on octreotide. What is the
primary mechanism by which this drug reduces portal pressure?
A. Constricts splanchnic arterioles via B. Inhibits glucagon and other vasodilatory
vasopressin receptors peptides
Page 4
QUESTIONS AND ANSWERS + EXPERT
RATIONALES | 2026 UPDATED | 100% CORRECT
250 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 170 EXAM 3 MED SURG | 165 STUDY QUESTIONS AND ANSWERS + EXPERT RATIONALES | 2026
UPDATED | 100% CORRECT. It contains 250 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 250 Questions
Foundations - Application - NUR 170 3 MED SURG 165 Study AND Expert Rationales 2026 Updated 100
Correct Medical-surgical Nursing Undergraduate YEAR 3 Upper Division
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
NUR 170 3 MED SURG 165 1-42 Acute, Appropriate, Intervention, Finding, Shock
Study AND Expert Rationales
2026 Updated 100 Correct
Medical-surgical Nursing
Undergraduate YEAR 3
Upper Division
Acute 43-84 Finding, Develops, Appropriate, Kidney, Indicates
Appropriate 85-126 Finding, Acute, Laboratory, Kidney, Develops
Intervention 127-168 Acute, Finding, Appropriate, Develops, Shock
Develops 169-210 Finding, Acute, Disease, Syndrome, Indicates
Kidney 211-250 Finding, Receiving, Appropriate, Acute, Intervention
TOTAL 250 All questions include answers and detailed rationales
,Section A - NUR 170 3 MED SURG 165 Study AND Expert
Rationales 2026 Updated 100 Correct Medical-surgical
Nursing Undergraduate YEAR 3 Upper Division
Q1.
A patient with septic shock has a cardiac index of 2.1 L/min/m², systemic vascular
resistance of 600 dyn-s/cm, and mixed venous oxygen saturation of 55%. After fluid
resuscitation, which vasoactive agent should be initiated first?
A. Norepinephrine B. Epinephrine
C. Dobutamine D. Vasopressin
Correct: A - Norepinephrine
Rationale:The patient has vasodilatory shock with low SVR and low CI. Current guidelines
recommend norepinephrine as the first-line vasopressor to restore mean arterial pressure.
Epinephrine is second-line, dobutamine is added for persistent hypoperfusion despite
adequate MAP, and vasopressin is adjunctive.
Q2.
Which hemodynamic parameter most accurately reflects preload in a mechanically
ventilated patient with high positive end-expiratory pressure (PEEP) and suspected
hypovolemia?
A. Central venous pressure (CVP) B. Pulmonary artery occlusion pressure
(PAOP)
C. Right ventricular end-diastolic volume D. Stroke volume variation (SVV)
index (RVEDVI)
Correct: D - Stroke volume variation (SVV)
Rationale:SVV is a dynamic indicator of preload responsiveness and is more accurate than
static pressures (CVP, PAOP) in patients on mechanical ventilation with high PEEP. RVEDVI
is less reliable due to compliance changes. SVV >12% suggests fluid responsiveness.
Q3.
A patient with acute respiratory distress syndrome (ARDS) has a PaO/FiO ratio of 120 on
volume-controlled ventilation. Which ventilation strategy is most appropriate to improve
oxygenation while minimizing ventilator-induced lung injury?
A. Increase tidal volume to 8 mL/kg ideal B. Set PEEP to maintain plateau pressure
body weight 30 cm HO
Page 3
, Section A - NUR 170 3 MED SURG 165 Study AND Expert Rationales 2026 Updated 100 Correct Medical-surgical Nursing Undergraduate
YEAR 3 Upper Division
C. Use pressure-controlled ventilation with D. Decrease respiratory rate to reduce
peak pressure 35 cm HO auto-PEEP
Correct: B - Set PEEP to maintain plateau pressure 30 cm HO
Rationale:Low tidal volume (6 mL/kg) and adequate PEEP are key in ARDS. Setting PEEP to
maintain plateau pressure 30 cm HO is consistent with lung-protective ventilation. Higher tidal
volumes (8 mL/kg) may cause volutrauma. Pressure-controlled with peak pressure 35 may
exceed safe plateau.
Q4.
A patient with hyperkalemia (K 6.8 mEq/L) and ECG changes (peaked T waves) is being
treated. Which intervention should be initiated first to stabilize the cardiac membrane?
A. IV calcium gluconate B. IV insulin with dextrose
C. Sodium polystyrene sulfonate D. Hemodialysis
Correct: A - IV calcium gluconate
Rationale:Calcium gluconate antagonizes the effects of hyperkalemia on the cardiac
membrane, reducing the risk of ventricular arrhythmias. It works within minutes. Insulin with
dextrose shifts potassium intracellularly but takes longer, and dialysis is definitive but not
immediate.
Q5.
Which finding in a patient with syndrome of inappropriate antidiuretic hormone (SIADH) is
most consistent with euvolemic hyponatremia?
A. Decreased urine sodium (< 10 mEq/L) B. Increased urine osmolality (> 100
mOsm/kg)
C. Decreased serum uric acid D. Elevated BUN-to-creatinine ratio
Correct: B - Increased urine osmolality (> 100 mOsm/kg)
Rationale:SIADH is characterized by concentrated urine (urine osmolality >100 mOsm/kg)
and elevated urine sodium (>40 mEq/L) despite hyponatremia. Decreased uric acid may
occur but is not diagnostic. Hypovolemia would show low urine sodium and high
BUN/creatinine.
Q6.
A patient with cirrhosis and acute variceal bleeding is started on octreotide. What is the
primary mechanism by which this drug reduces portal pressure?
A. Constricts splanchnic arterioles via B. Inhibits glucagon and other vasodilatory
vasopressin receptors peptides
Page 4
