Medical Surgical NurSiNg
coMpreheNSive FiNal exaM detailed
BluepriNt oN excretioN, regulatioN
& MetaBoliSM, aNd
Fluid/electrolyte BalaNce with 167
actual exaM QueStioNS aNd veriFied
aNSwerS For 2026/2027
Exam Title: Medical Surgical Nursing Comprehensive Final Exam: Detailed Blueprint on
Excretion, Regulation & Metabolism, and Fluid/Electrolyte Balance with 167 Actual Exam
Questions and Verified Answers for 2026/2027 – LATEST ALL VERSIONS ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+ 2026/2027 WITH FREE PRACTICE TEST SETS
Total Questions: 167
Program Type: PN
Creator Name: Teresa Crowder (Blueprint) & AI-Enhanced
Type: Proctored
Created Date: 9/7/2026
Time Per Question: 2.5 Minutes
Calculator: ON
Concept/Exemplar Based: ON
,Section 1: Excretion (Renal/Urinary)
1. Nephritis/Nephrotic Syndrome
Question: A nurse is assessing a client with acute glomerulonephritis. Which of the following
findings should the nurse expect?
A. Polyuria and dehydration
B. Hypotension and tachycardia
C. Hematuria and hypertension
D. Glycosuria and polyphagia
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. Hematuria and hypertension
Rationale: Acute glomerulonephritis is an inflammation of the glomeruli, often following a
streptococcal infection. The primary manifestations are hematuria (blood in the urine, often
smoky or tea-colored), proteinuria, edema (particularly periorbital), and hypertension due to
fluid retention and reduced glomerular filtration rate. Polyuria and dehydration are not typical;
oliguria is more common.
Question: A client with nephrotic syndrome is at risk for which of the following complications?
A. Hyperkalemia
B. Deep vein thrombosis
C. Hypercalcemia
D. Metabolic alkalosis
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Deep vein thrombosis
Rationale: Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia,
hyperlipidemia, and edema. The loss of proteins in the urine leads to a loss of clotting factors
and antithrombin III, while the liver compensates by increasing the production of various
proteins, including fibrinogen and other clotting factors. This imbalance creates a
,hypercoagulable state, placing the client at a high risk for thrombus formation, such as a deep
vein thrombosis (DVT) or renal vein thrombosis.
Question: Which dietary instruction should the nurse include for a client with nephrotic
syndrome?
A. "Increase your intake of potassium-rich foods."
B. "Follow a low-protein diet."
C. "Restrict your sodium intake."
D. "Increase your fluid intake to 3 liters per day."
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. "Restrict your sodium intake."
Rationale: A primary goal in managing nephrotic syndrome is to control edema. Dietary sodium
restriction is crucial to prevent further fluid retention. While protein is lost in the urine, a high-
protein diet is generally not recommended as it can increase the workload on the kidneys. Fluid
restriction may be necessary depending on the severity of the edema. Potassium levels can vary,
so restriction is not a universal instruction.
Question: A nurse is caring for a client with chronic glomerulonephritis. Which laboratory value
is most important for the nurse to monitor?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum chloride
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ A. Serum potassium
Rationale: In chronic glomerulonephritis, the kidneys' ability to excrete potassium is impaired as
the glomerular filtration rate (GFR) declines. This can lead to hyperkalemia, which is a life-
threatening condition that can cause fatal cardiac dysrhythmias. Therefore, monitoring serum
, potassium is a critical priority. While other electrolytes are also important, the immediate life-
threat of hyperkalemia makes it the most critical to monitor.
2. Inflammatory Bowel Disease (IBD)
Question: A client with Crohn's disease is experiencing frequent, bloody diarrhea. Which of the
following is a priority nursing concern?
A. Imbalanced nutrition: less than body requirements
B. Fluid volume deficit
C. Impaired skin integrity
D. Activity intolerance
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Fluid volume deficit
Rationale: Frequent, bloody diarrhea, as seen in Crohn's disease and ulcerative colitis, leads to
significant fluid and electrolyte loss. The immediate priority is to assess and manage fluid
volume deficit to prevent hypovolemic shock and electrolyte imbalances, which can be life-
threatening. While nutrition and skin integrity are important long-term concerns, fluid
resuscitation is the priority.
Question: Which of the following clinical manifestations is more characteristic of ulcerative
colitis (UC) than Crohn's disease?
A. Fistula formation
B. Skip lesions
C. Continuous inflammation starting in the rectum
D. Malabsorption
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. Continuous inflammation starting in the
rectum
Rationale: Ulcerative colitis (UC) is characterized by continuous inflammation that begins in the
rectum and extends proximally through the colon. In contrast, Crohn's disease is characterized
coMpreheNSive FiNal exaM detailed
BluepriNt oN excretioN, regulatioN
& MetaBoliSM, aNd
Fluid/electrolyte BalaNce with 167
actual exaM QueStioNS aNd veriFied
aNSwerS For 2026/2027
Exam Title: Medical Surgical Nursing Comprehensive Final Exam: Detailed Blueprint on
Excretion, Regulation & Metabolism, and Fluid/Electrolyte Balance with 167 Actual Exam
Questions and Verified Answers for 2026/2027 – LATEST ALL VERSIONS ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+ 2026/2027 WITH FREE PRACTICE TEST SETS
Total Questions: 167
Program Type: PN
Creator Name: Teresa Crowder (Blueprint) & AI-Enhanced
Type: Proctored
Created Date: 9/7/2026
Time Per Question: 2.5 Minutes
Calculator: ON
Concept/Exemplar Based: ON
,Section 1: Excretion (Renal/Urinary)
1. Nephritis/Nephrotic Syndrome
Question: A nurse is assessing a client with acute glomerulonephritis. Which of the following
findings should the nurse expect?
A. Polyuria and dehydration
B. Hypotension and tachycardia
C. Hematuria and hypertension
D. Glycosuria and polyphagia
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. Hematuria and hypertension
Rationale: Acute glomerulonephritis is an inflammation of the glomeruli, often following a
streptococcal infection. The primary manifestations are hematuria (blood in the urine, often
smoky or tea-colored), proteinuria, edema (particularly periorbital), and hypertension due to
fluid retention and reduced glomerular filtration rate. Polyuria and dehydration are not typical;
oliguria is more common.
Question: A client with nephrotic syndrome is at risk for which of the following complications?
A. Hyperkalemia
B. Deep vein thrombosis
C. Hypercalcemia
D. Metabolic alkalosis
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Deep vein thrombosis
Rationale: Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia,
hyperlipidemia, and edema. The loss of proteins in the urine leads to a loss of clotting factors
and antithrombin III, while the liver compensates by increasing the production of various
proteins, including fibrinogen and other clotting factors. This imbalance creates a
,hypercoagulable state, placing the client at a high risk for thrombus formation, such as a deep
vein thrombosis (DVT) or renal vein thrombosis.
Question: Which dietary instruction should the nurse include for a client with nephrotic
syndrome?
A. "Increase your intake of potassium-rich foods."
B. "Follow a low-protein diet."
C. "Restrict your sodium intake."
D. "Increase your fluid intake to 3 liters per day."
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. "Restrict your sodium intake."
Rationale: A primary goal in managing nephrotic syndrome is to control edema. Dietary sodium
restriction is crucial to prevent further fluid retention. While protein is lost in the urine, a high-
protein diet is generally not recommended as it can increase the workload on the kidneys. Fluid
restriction may be necessary depending on the severity of the edema. Potassium levels can vary,
so restriction is not a universal instruction.
Question: A nurse is caring for a client with chronic glomerulonephritis. Which laboratory value
is most important for the nurse to monitor?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum chloride
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ A. Serum potassium
Rationale: In chronic glomerulonephritis, the kidneys' ability to excrete potassium is impaired as
the glomerular filtration rate (GFR) declines. This can lead to hyperkalemia, which is a life-
threatening condition that can cause fatal cardiac dysrhythmias. Therefore, monitoring serum
, potassium is a critical priority. While other electrolytes are also important, the immediate life-
threat of hyperkalemia makes it the most critical to monitor.
2. Inflammatory Bowel Disease (IBD)
Question: A client with Crohn's disease is experiencing frequent, bloody diarrhea. Which of the
following is a priority nursing concern?
A. Imbalanced nutrition: less than body requirements
B. Fluid volume deficit
C. Impaired skin integrity
D. Activity intolerance
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ B. Fluid volume deficit
Rationale: Frequent, bloody diarrhea, as seen in Crohn's disease and ulcerative colitis, leads to
significant fluid and electrolyte loss. The immediate priority is to assess and manage fluid
volume deficit to prevent hypovolemic shock and electrolyte imbalances, which can be life-
threatening. While nutrition and skin integrity are important long-term concerns, fluid
resuscitation is the priority.
Question: Which of the following clinical manifestations is more characteristic of ulcerative
colitis (UC) than Crohn's disease?
A. Fistula formation
B. Skip lesions
C. Continuous inflammation starting in the rectum
D. Malabsorption
✔✔✔ CORRECT 100% ANSWER 📌✔❤❤ C. Continuous inflammation starting in the
rectum
Rationale: Ulcerative colitis (UC) is characterized by continuous inflammation that begins in the
rectum and extends proximally through the colon. In contrast, Crohn's disease is characterized
