AVN 2035 MED SURG 3 MIDTERM
PRACTICE QUESTIONS 1-100 WITH
CORRECT ANSWERS AND
RATIONALES 2026 | INSTANT
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Core Domains
• Cardiovascular Disorders (Heart Failure, MI, Dysrhythmias, Valvular
Disease, Hypertension)
• Respiratory Disorders (COPD, Pneumonia, ARDS, PE, Mechanical
Ventilation)
• Neurological Disorders (Stroke, Seizures, Increased ICP, Head Injury,
Parkinson's)
• Renal and Urinary Disorders (AKI, CKD, Dialysis, UTIs, Renal Calculi)
• Gastrointestinal Disorders (Cirrhosis, Pancreatitis, Hepatitis, GI
Bleeding, Ostomy Care)
• Endocrine Disorders (Diabetes Mellitus, DKA, HHNS, Thyroid Disorders,
Adrenal Insufficiency)
• Hematologic and Immunologic Disorders (Anemia, DIC, HIV/AIDS,
Transfusion Reactions)
• Shock, Sepsis, and Multisystem Organ Failure
• Perioperative and Emergency Nursing Care
• Pain Management and Palliative Care
,Introduction
This comprehensive assessment is designed to prepare nursing students for the
AVN 2035 Medical-Surgical Nursing III Midterm Examination. It evaluates
advanced knowledge of complex multisystem adult health problems including
cardiovascular, respiratory, neurological, renal, gastrointestinal, and endocrine
disorders. The exam employs multiple-choice, NCLEX-style questions with
clinical scenarios that test prioritization, clinical judgment, and evidence-
based nursing interventions. Emphasis is placed on real-world application,
patient safety, and critical decision-making to ensure students are ready for
both course examinations and clinical practice.
SECTION ONE: QUESTIONS 1-100
Question 1
A client with heart failure is prescribed furosemide (Lasix). Which assessment
finding indicates the medication is having the desired therapeutic effect?
A. Increased peripheral edema
B. Decreased jugular venous distention
C. Elevated blood pressure
D. Crackles in lung bases
B
RATIONALE: Furosemide is a loop diuretic that reduces fluid volume.
Decreased jugular venous distention indicates effective reduction of fluid
overload. Peripheral edema should decrease, not increase. Blood pressure
typically decreases with diuresis. Crackles in lung bases indicate pulmonary
congestion, which should improve with effective diuretic therapy.
,Question 2
A client with COPD has an SpO2 of 88% on room air. Which intervention
should the nurse implement FIRST?
A. Administer high-flow oxygen at 15 L/min
B. Administer low-flow oxygen at 2 L/min via nasal cannula
C. Place the client in a supine position
D. Prepare for immediate intubation
B
RATIONALE: Clients with COPD often rely on hypoxic drive to stimulate
breathing. Low-flow oxygen (1-3 L/min) should be administered to maintain
SpO2 at 88-92% without suppressing respiratory drive. High-flow oxygen can
cause respiratory depression. Supine positioning worsens ventilation.
Intubation is not first-line.
Question 3
A client with acute kidney injury (AKI) has a serum potassium level of 6.8
mEq/L. Which intervention should the nurse implement FIRST?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Prepare the client for emergency hemodialysis
C. Place the client on a cardiac monitor
D. Restrict all oral intake
C
RATIONALE: Hyperkalemia (K+ > 6.0) can cause fatal cardiac
dysrhythmias. The priority is to place the client on a cardiac monitor to detect
ECG changes (peaked T waves, wide QRS) while preparing for other
treatments.
, Question 4
A client with cirrhosis develops increasing abdominal girth and discomfort.
Which medication order is MOST appropriate?
A. Furosemide
B. Spironolactone
C. Beta-blockers
D. Albumin
B
RATIONALE: Spironolactone, a potassium-sparing diuretic, is the
preferred diuretic for ascites in cirrhosis because it does not precipitate
hypokalemia, which can worsen hepatic encephalopathy.
Question 5
Which ECG finding is MOST characteristic of hypokalemia?
A. Tall, peaked T waves
B. Prominent U waves
C. Widened QRS complex
D. ST-segment elevation
B
RATIONALE: Hypokalemia typically causes flattened T waves and
prominent U waves on ECG, which can precede dangerous dysrhythmias. Tall
peaked T waves are characteristic of hyperkalemia.
Question 6
A client with diabetes mellitus type 1 is experiencing diabetic ketoacidosis
(DKA). Which laboratory finding is consistent with this diagnosis?
PRACTICE QUESTIONS 1-100 WITH
CORRECT ANSWERS AND
RATIONALES 2026 | INSTANT
DOWNLOAD PDF
Core Domains
• Cardiovascular Disorders (Heart Failure, MI, Dysrhythmias, Valvular
Disease, Hypertension)
• Respiratory Disorders (COPD, Pneumonia, ARDS, PE, Mechanical
Ventilation)
• Neurological Disorders (Stroke, Seizures, Increased ICP, Head Injury,
Parkinson's)
• Renal and Urinary Disorders (AKI, CKD, Dialysis, UTIs, Renal Calculi)
• Gastrointestinal Disorders (Cirrhosis, Pancreatitis, Hepatitis, GI
Bleeding, Ostomy Care)
• Endocrine Disorders (Diabetes Mellitus, DKA, HHNS, Thyroid Disorders,
Adrenal Insufficiency)
• Hematologic and Immunologic Disorders (Anemia, DIC, HIV/AIDS,
Transfusion Reactions)
• Shock, Sepsis, and Multisystem Organ Failure
• Perioperative and Emergency Nursing Care
• Pain Management and Palliative Care
,Introduction
This comprehensive assessment is designed to prepare nursing students for the
AVN 2035 Medical-Surgical Nursing III Midterm Examination. It evaluates
advanced knowledge of complex multisystem adult health problems including
cardiovascular, respiratory, neurological, renal, gastrointestinal, and endocrine
disorders. The exam employs multiple-choice, NCLEX-style questions with
clinical scenarios that test prioritization, clinical judgment, and evidence-
based nursing interventions. Emphasis is placed on real-world application,
patient safety, and critical decision-making to ensure students are ready for
both course examinations and clinical practice.
SECTION ONE: QUESTIONS 1-100
Question 1
A client with heart failure is prescribed furosemide (Lasix). Which assessment
finding indicates the medication is having the desired therapeutic effect?
A. Increased peripheral edema
B. Decreased jugular venous distention
C. Elevated blood pressure
D. Crackles in lung bases
B
RATIONALE: Furosemide is a loop diuretic that reduces fluid volume.
Decreased jugular venous distention indicates effective reduction of fluid
overload. Peripheral edema should decrease, not increase. Blood pressure
typically decreases with diuresis. Crackles in lung bases indicate pulmonary
congestion, which should improve with effective diuretic therapy.
,Question 2
A client with COPD has an SpO2 of 88% on room air. Which intervention
should the nurse implement FIRST?
A. Administer high-flow oxygen at 15 L/min
B. Administer low-flow oxygen at 2 L/min via nasal cannula
C. Place the client in a supine position
D. Prepare for immediate intubation
B
RATIONALE: Clients with COPD often rely on hypoxic drive to stimulate
breathing. Low-flow oxygen (1-3 L/min) should be administered to maintain
SpO2 at 88-92% without suppressing respiratory drive. High-flow oxygen can
cause respiratory depression. Supine positioning worsens ventilation.
Intubation is not first-line.
Question 3
A client with acute kidney injury (AKI) has a serum potassium level of 6.8
mEq/L. Which intervention should the nurse implement FIRST?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Prepare the client for emergency hemodialysis
C. Place the client on a cardiac monitor
D. Restrict all oral intake
C
RATIONALE: Hyperkalemia (K+ > 6.0) can cause fatal cardiac
dysrhythmias. The priority is to place the client on a cardiac monitor to detect
ECG changes (peaked T waves, wide QRS) while preparing for other
treatments.
, Question 4
A client with cirrhosis develops increasing abdominal girth and discomfort.
Which medication order is MOST appropriate?
A. Furosemide
B. Spironolactone
C. Beta-blockers
D. Albumin
B
RATIONALE: Spironolactone, a potassium-sparing diuretic, is the
preferred diuretic for ascites in cirrhosis because it does not precipitate
hypokalemia, which can worsen hepatic encephalopathy.
Question 5
Which ECG finding is MOST characteristic of hypokalemia?
A. Tall, peaked T waves
B. Prominent U waves
C. Widened QRS complex
D. ST-segment elevation
B
RATIONALE: Hypokalemia typically causes flattened T waves and
prominent U waves on ECG, which can precede dangerous dysrhythmias. Tall
peaked T waves are characteristic of hyperkalemia.
Question 6
A client with diabetes mellitus type 1 is experiencing diabetic ketoacidosis
(DKA). Which laboratory finding is consistent with this diagnosis?
