MED- SURG FINAL EXAM PRACTICE QUESTIONS | FROM
QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The nurse is conducting a post-operative assessment of a client on the first day after renal
surgery. Which of the following findings would be most important for the nurse to report to the
physician?
a. Temperature= 99.8 F
b. Urine output 20 ml/hr
c. Absence of bowel sounds
d. A 2'2" inch area of serous sanguineous drainage on the flank dressing Answer: b. Urine
output 20 ml/hr
The nurse assesses the client who has chronic renal failure and notes the following: crackles in
the lung bases, elevated blood pressure and weight gain of 2 pounds in 1 day. Based on these
data, which of the following nursing diagnoses is appropriate?
a. Excess fluid volume related to the kidney's inability to maintain fluid balance
b. Increased cardiac output related to fluid overload
c. Ineffective tissue perfusion related to interrupted arterial blood flow
d. Ineffective therapeutic regimen management related to lack of knowledge about therapy
Answer: a. Excess fluid volume related to the kidney's inability to maintain fluid balance
The client with chronic renal failure complains of feeling nauseated at least part of every day.
The nurse should explain that the nausea is the result of:
a. Acidosis caused by the medications
b. Accumulation of waste products in the blood
c. Chronic anemia and fatigue
d. Excess fluid load Answer: b. Accumulation of waste products in the blood
Which of the following nursing interventions should be included in the client's care plan during
dialysis therapy?
a. Limit the client's visitors
b. Monitor client's blood pressure
c. Pad the side rails of the bed
d. Keep the client NPO Answer: b. Monitor client's blood pressure
What is the most potentially dangerous complication of peritoneal dialysis?
a. Abdominal pain
b. Gastrointestinal bleeding
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,c. Peritonitis
d. Muscle cramps Answer: c. Peritonitis
The nurse helps the client with chronic renal failure develop a home diet plan with the goal of
helping the client maintain adequate nutritional intake. Which of the following diets would be
most appropriate for a client with chronic renal failure?
a. High carbohydrate, high protein
b. High calcium, high potassium, high protein
c. Low protein, low sodium, low potassium
d. Low protein, high potassium Answer: c. Low protein, low sodium, low potassium
The client's with which of the following medical histories is at the greatest risk of developing
renal failure?
a. Polycystic kidney disease
b. DM with poorly controlled hypertension
c. Vascular disorders
d. Respiratory infections Answer: b. DM with poorly controlled hypertension
A high- carbohydrate, low-protein diet is prescribed for the client with acute renal failure. The
rationale for the high- carbohydrate diet is that carbohydrate will:
a. Act as a diureetic
b. Reduce demands in the liver
c. Helps maintains urine acidity
d. Prevent the development of ketosis Answer: d. Prevent the development of ketosis
The client with acute renal failure asks thee nurse for a snack. Because the client's potassium
level is elevated, which of the following snacks would be most appropriate?
a. A gelatin dessert
b. Yogurt
c. An orange
d. Peanuts Answer: a. A gelatin dessert
In the oliguric phase of acute renal failure, the nurse should anticipate the development off
which of the following complications?
a. Pulmonary edema
b. Metabolic alkalosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, c. Hypotension
d. Hypokalemia Answer: a. Pulmonary edema
The client in acute renal failure has an external cannula inserted in the forearm for hemodialysis.
Which of the following nursing measures is appropriate for the care of the client?
a. Use the unaffected arm for blood pressure measurement
b. Draw blood from the cannula for routine laboratory work
c. Percuss the cannula for bruits each shift
d. Inject heparin into the cannula each shift Answer: a. Use the unaffected arm for blood
pressure measurement
The nurse initiates the client's first hemodialysis treatment. the client develops a headache,
confusion, and nausea. These symptoms indicate which of the following potential
complications?
a. Disequilibrium syndrome
b. Myocardial infarction
c. Air embolism
d. Peritonitis Answer: a. Disequilibrium syndrome
The client with acute renal failure is recovering and asks the nurse, "will my kidneys ever
function normally again?" The nurse's response is based on knowledge that the client's renal
status will most likely:
a. Continue to improve over a period of weeks
b. Result in need for permanent hemodialysis
c. Improve only if the client receives a renal transplant
d. Result in end-stage renal failure Answer: a. Continue to improve over a period of weeks
The transplant nurse is assessing a client during a post-transplant follow-up appointment. Which
of the following signs and symptoms may indicate organ rejection?
a. Hypotension, polyuria, dramatic weight loss and tenderness over the transplanted kidney
b. Polyuria, hypothermia, edema, and hypotension
c. Increasing blood pressure, oliguria, fever, and weight gain
d. Edema, hypothermia, oliguria, and numbness over the transplanted kidney Answer: c.
Increasing blood pressure, oliguria, fever, and weight gain
The client has returned from the PACU to the step down unit after a unilateral nephrectomy
related to cancer. The nurse is developing a care plan for this client. What is the priority nursing
diagnosis for thee client following a nephrectomy?
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,The nurse is conducting a post-operative assessment of a client on the first day after renal
surgery. Which of the following findings would be most important for the nurse to report to the
physician?
a. Temperature= 99.8 F
b. Urine output 20 ml/hr
c. Absence of bowel sounds
d. A 2'2" inch area of serous sanguineous drainage on the flank dressing Answer: b. Urine
output 20 ml/hr
The nurse assesses the client who has chronic renal failure and notes the following: crackles in
the lung bases, elevated blood pressure and weight gain of 2 pounds in 1 day. Based on these
data, which of the following nursing diagnoses is appropriate?
a. Excess fluid volume related to the kidney's inability to maintain fluid balance
b. Increased cardiac output related to fluid overload
c. Ineffective tissue perfusion related to interrupted arterial blood flow
d. Ineffective therapeutic regimen management related to lack of knowledge about therapy
Answer: a. Excess fluid volume related to the kidney's inability to maintain fluid balance
The client with chronic renal failure complains of feeling nauseated at least part of every day.
The nurse should explain that the nausea is the result of:
a. Acidosis caused by the medications
b. Accumulation of waste products in the blood
c. Chronic anemia and fatigue
d. Excess fluid load Answer: b. Accumulation of waste products in the blood
Which of the following nursing interventions should be included in the client's care plan during
dialysis therapy?
a. Limit the client's visitors
b. Monitor client's blood pressure
c. Pad the side rails of the bed
d. Keep the client NPO Answer: b. Monitor client's blood pressure
What is the most potentially dangerous complication of peritoneal dialysis?
a. Abdominal pain
b. Gastrointestinal bleeding
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,c. Peritonitis
d. Muscle cramps Answer: c. Peritonitis
The nurse helps the client with chronic renal failure develop a home diet plan with the goal of
helping the client maintain adequate nutritional intake. Which of the following diets would be
most appropriate for a client with chronic renal failure?
a. High carbohydrate, high protein
b. High calcium, high potassium, high protein
c. Low protein, low sodium, low potassium
d. Low protein, high potassium Answer: c. Low protein, low sodium, low potassium
The client's with which of the following medical histories is at the greatest risk of developing
renal failure?
a. Polycystic kidney disease
b. DM with poorly controlled hypertension
c. Vascular disorders
d. Respiratory infections Answer: b. DM with poorly controlled hypertension
A high- carbohydrate, low-protein diet is prescribed for the client with acute renal failure. The
rationale for the high- carbohydrate diet is that carbohydrate will:
a. Act as a diureetic
b. Reduce demands in the liver
c. Helps maintains urine acidity
d. Prevent the development of ketosis Answer: d. Prevent the development of ketosis
The client with acute renal failure asks thee nurse for a snack. Because the client's potassium
level is elevated, which of the following snacks would be most appropriate?
a. A gelatin dessert
b. Yogurt
c. An orange
d. Peanuts Answer: a. A gelatin dessert
In the oliguric phase of acute renal failure, the nurse should anticipate the development off
which of the following complications?
a. Pulmonary edema
b. Metabolic alkalosis
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, c. Hypotension
d. Hypokalemia Answer: a. Pulmonary edema
The client in acute renal failure has an external cannula inserted in the forearm for hemodialysis.
Which of the following nursing measures is appropriate for the care of the client?
a. Use the unaffected arm for blood pressure measurement
b. Draw blood from the cannula for routine laboratory work
c. Percuss the cannula for bruits each shift
d. Inject heparin into the cannula each shift Answer: a. Use the unaffected arm for blood
pressure measurement
The nurse initiates the client's first hemodialysis treatment. the client develops a headache,
confusion, and nausea. These symptoms indicate which of the following potential
complications?
a. Disequilibrium syndrome
b. Myocardial infarction
c. Air embolism
d. Peritonitis Answer: a. Disequilibrium syndrome
The client with acute renal failure is recovering and asks the nurse, "will my kidneys ever
function normally again?" The nurse's response is based on knowledge that the client's renal
status will most likely:
a. Continue to improve over a period of weeks
b. Result in need for permanent hemodialysis
c. Improve only if the client receives a renal transplant
d. Result in end-stage renal failure Answer: a. Continue to improve over a period of weeks
The transplant nurse is assessing a client during a post-transplant follow-up appointment. Which
of the following signs and symptoms may indicate organ rejection?
a. Hypotension, polyuria, dramatic weight loss and tenderness over the transplanted kidney
b. Polyuria, hypothermia, edema, and hypotension
c. Increasing blood pressure, oliguria, fever, and weight gain
d. Edema, hypothermia, oliguria, and numbness over the transplanted kidney Answer: c.
Increasing blood pressure, oliguria, fever, and weight gain
The client has returned from the PACU to the step down unit after a unilateral nephrectomy
related to cancer. The nurse is developing a care plan for this client. What is the priority nursing
diagnosis for thee client following a nephrectomy?
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
