NUR 212 Exam 1 Preparation
Practice Questions and Study Guide
Edition
100 Practice Questions Aligned with
NUR 212 Course Syllabus | NCLEX-RN Test Plan | QSEN Competencies | Nursing Standards (2026/2027)
Cognitive Distribution: 20% Recall · 50% Application · 30% Analysis
Question Style: 75% Scenario-Based · 25% Direct Knowledge
Includes: 20 Priority-Setting Questions · 10 Pharmacology Questions · 10 Lab Value Interpretation Questions
Medical-Surgical Nursing I | NUR 212 Certification Preparation Series
,NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
About This Study Guide
This comprehensive 100-question examination preparation guide is designed for nursing students enrolled in NUR
212 Medical-Surgical Nursing I. Each question is aligned with the NUR 212 course syllabus, the NCLEX-RN Test
Plan (2026/2027 edition), the QSEN Competencies (Patient-Centered Care, Teamwork & Collaboration,
Evidence-Based Practice, Quality Improvement, Safety, and Informatics), and current nursing standards of practice.
The exam is structured into eight sections covering health assessment and the nursing process; perioperative nursing;
fluid, electrolyte, and acid-base imbalances; cardiovascular disorders; respiratory disorders; gastrointestinal
disorders; renal and genitourinary disorders; and pharmacology. Cognitive complexity follows the NCLEX-RN
blueprint: approximately 20% recall (knowledge), 50% application (procedural and decision-driven), and 30%
analysis (prioritization, clinical reasoning, and critical thinking). Approximately 75% of questions are
scenario-based, mirroring real-world clinical situations.
Each question is followed by four options (A-D) with exactly one correct answer marked *[CORRECT]*, a
'Correct Answer' line, and a 2-4 sentence rationale citing the governing NUR 212 curriculum principle, NCLEX-RN
standard, and evidence-based medical-surgical nursing literature. Use this guide as both a self-assessment tool and a
structured study reference for NUR 212 Exam 1 preparation.
Section 1: Health Assessment & Nursing Process
ADPIE nursing process, physical assessment techniques, vital signs, pain assessment, SBAR, delegation,
cultural competence, health literacy, documentation — 15 questions.
Q1. A nurse is assessing four assigned clients at the start of a shift. Which client should the nurse assess
first?
A. A client 2 days postoperative who reports incisional pain rated 6/10.
B. A client receiving IV heparin for a DVT who reports new chest pain and shortness of breath.
*[CORRECT]*
C. A client with heart failure whose weight has increased 1 kg since yesterday.
D. A client with pneumonia who has a productive cough and an oral temperature of 100.4°F.
Correct Answer: B
Rationale: New chest pain and dyspnea in a client on heparin for DVT suggests possible pulmonary embolism, a
life-threatening complication requiring immediate assessment and intervention (NCLEX-RN prioritization, ABC
framework). Pain (Option A), heart failure weight gain (Option C), and pneumonia with low-grade fever (Option D)
are important but not immediately life-threatening. The ABCs and acute change in condition establish Option B as the
highest priority.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 2
,NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
Q2. A nurse is performing a physical assessment using the four primary techniques. Which technique
should be performed first during abdominal assessment?
A. Auscultation, followed by percussion and palpation, with inspection throughout. *[CORRECT]*
B. Palpation first to identify tender areas, followed by auscultation.
C. Percussion first to assess organ size, followed by palpation.
D. Deep palpation first to assess for masses, followed by light palpation.
Correct Answer: A
Rationale: For abdominal assessment, the correct sequence is inspection, auscultation, percussion, then palpation.
Auscultation is performed before palpation and percussion because bowel sounds can be altered by manual
stimulation of the abdomen. Performing palpation first (Option B, D) or percussion first (Option C) risks producing
false findings and is incorrect technique.
Q3. A nurse is using the nursing process (ADPIE) to plan care for a newly admitted client with heart
failure. Which activity represents the 'Planning' phase?
A. Auscultating lung sounds and reviewing morning laboratory results.
B. Formulating the nursing diagnosis 'Fluid Volume Excess related to compromised regulatory mechanism.'
C. Establishing the goal 'Client will have clear lung sounds and lose 1 lb/day by discharge.' *[CORRECT]*
D. Administering furosemide 40 mg IV push as ordered.
Correct Answer: C
Rationale: The Planning phase of the nursing process (ADPIE) involves setting measurable, client-centered
goals/outcomes and developing a plan of care. Option A is Assessment; Option B is Diagnosis; Option D is
Implementation. Option C is the only choice that establishes a measurable outcome with timeframe, which is the
Planning phase.
Q4. A nurse is delegating care to a nursing assistant (UAP). Which task is appropriate to delegate to the
UAP?
A. Administering an oral narcotic analgesic to a postoperative client.
B. Performing the initial admission assessment for a new client.
C. Ambulating a stable client who is 1 day postoperative from an appendectomy. *[CORRECT]*
D. Teaching a client about a new diagnosis of diabetes mellitus.
Correct Answer: C
Rationale: Delegation principles (ANA Five Rights of Delegation; NCSBN) hold that the nurse may delegate tasks
that are within the UAP's scope, do not require clinical judgment, and involve stable clients with predictable
outcomes. Ambulating a stable postoperative client is appropriate. Administering narcotics (Option A), initial
admission assessments (Option B), and teaching (Option D) require nursing knowledge and judgment and cannot be
delegated.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 3
, NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
Q5. A nurse is assessing a client's pain. Which statement by the nurse reflects the most appropriate
approach?
A. "Your vital signs are stable, so you can't be in much pain."
B. "Pain is what you say it is; please rate your pain on this 0-10 scale." *[CORRECT]*
C. "Most people with your condition rate pain around 4/10."
D. "I'll give you pain medication first and then ask about your pain level."
Correct Answer: B
Rationale: Pain is the fifth vital sign and is subjective; the client's self-report is the gold standard (APS, AHRQ,
NCLEX-RN). Option A denies the client's subjective report. Option C introduces a normative comparison that may
invalidate the client's experience. Option D prevents accurate assessment before intervention. Option B reflects the
principle 'pain is what the client says it is.'
Q6. A nurse is using SBAR to communicate with a provider about a client who has a new onset of
confusion. Which statement represents the 'Recommendation' component of SBAR?
A. "The client is a 78-year-old admitted with pneumonia."
B. "The client is more confused than baseline and the pulse oximeter is reading 88% on room air."
C. "I think the client may be hypoxic and could have an acute change in condition."
D. "I would like you to come evaluate the client and order an arterial blood gas and oxygen therapy."
*[CORRECT]*
Correct Answer: D
Rationale: SBAR = Situation, Background, Assessment, Recommendation. Option D is a clear, specific
Recommendation. Option A is Situation (brief identification), Option B is Background/Assessment data, and Option
C is the nurse's Assessment/conclusion. The Recommendation must state the desired action clearly and specifically.
Q7. A nurse is caring for a client from a culture with high-context communication style. Which
approach is most appropriate for promoting effective communication?
A. Speak loudly and use direct, blunt language to ensure understanding.
B. Maintain eye contact and use clear, direct statements to demonstrate respect.
C. Observe nonverbal cues, allow time for response, and consider involving a family spokesperson if
culturally appropriate. *[CORRECT]*
D. Limit communication to written materials to avoid misunderstanding.
Correct Answer: C
Rationale: Cultural competence (QSEN; Giger & Davidhizar's Transcultural Assessment) requires understanding
that high-context cultures rely on nonverbal communication, context, and relationships. Loud or blunt communication
(Option A) can be disrespectful; direct eye contact may be inappropriate in some cultures (Option B); and
written-only communication (Option D) ignores verbal and nonverbal assessment. Option C reflects culturally
sensitive practice.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 4
Practice Questions and Study Guide
Edition
100 Practice Questions Aligned with
NUR 212 Course Syllabus | NCLEX-RN Test Plan | QSEN Competencies | Nursing Standards (2026/2027)
Cognitive Distribution: 20% Recall · 50% Application · 30% Analysis
Question Style: 75% Scenario-Based · 25% Direct Knowledge
Includes: 20 Priority-Setting Questions · 10 Pharmacology Questions · 10 Lab Value Interpretation Questions
Medical-Surgical Nursing I | NUR 212 Certification Preparation Series
,NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
About This Study Guide
This comprehensive 100-question examination preparation guide is designed for nursing students enrolled in NUR
212 Medical-Surgical Nursing I. Each question is aligned with the NUR 212 course syllabus, the NCLEX-RN Test
Plan (2026/2027 edition), the QSEN Competencies (Patient-Centered Care, Teamwork & Collaboration,
Evidence-Based Practice, Quality Improvement, Safety, and Informatics), and current nursing standards of practice.
The exam is structured into eight sections covering health assessment and the nursing process; perioperative nursing;
fluid, electrolyte, and acid-base imbalances; cardiovascular disorders; respiratory disorders; gastrointestinal
disorders; renal and genitourinary disorders; and pharmacology. Cognitive complexity follows the NCLEX-RN
blueprint: approximately 20% recall (knowledge), 50% application (procedural and decision-driven), and 30%
analysis (prioritization, clinical reasoning, and critical thinking). Approximately 75% of questions are
scenario-based, mirroring real-world clinical situations.
Each question is followed by four options (A-D) with exactly one correct answer marked *[CORRECT]*, a
'Correct Answer' line, and a 2-4 sentence rationale citing the governing NUR 212 curriculum principle, NCLEX-RN
standard, and evidence-based medical-surgical nursing literature. Use this guide as both a self-assessment tool and a
structured study reference for NUR 212 Exam 1 preparation.
Section 1: Health Assessment & Nursing Process
ADPIE nursing process, physical assessment techniques, vital signs, pain assessment, SBAR, delegation,
cultural competence, health literacy, documentation — 15 questions.
Q1. A nurse is assessing four assigned clients at the start of a shift. Which client should the nurse assess
first?
A. A client 2 days postoperative who reports incisional pain rated 6/10.
B. A client receiving IV heparin for a DVT who reports new chest pain and shortness of breath.
*[CORRECT]*
C. A client with heart failure whose weight has increased 1 kg since yesterday.
D. A client with pneumonia who has a productive cough and an oral temperature of 100.4°F.
Correct Answer: B
Rationale: New chest pain and dyspnea in a client on heparin for DVT suggests possible pulmonary embolism, a
life-threatening complication requiring immediate assessment and intervention (NCLEX-RN prioritization, ABC
framework). Pain (Option A), heart failure weight gain (Option C), and pneumonia with low-grade fever (Option D)
are important but not immediately life-threatening. The ABCs and acute change in condition establish Option B as the
highest priority.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 2
,NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
Q2. A nurse is performing a physical assessment using the four primary techniques. Which technique
should be performed first during abdominal assessment?
A. Auscultation, followed by percussion and palpation, with inspection throughout. *[CORRECT]*
B. Palpation first to identify tender areas, followed by auscultation.
C. Percussion first to assess organ size, followed by palpation.
D. Deep palpation first to assess for masses, followed by light palpation.
Correct Answer: A
Rationale: For abdominal assessment, the correct sequence is inspection, auscultation, percussion, then palpation.
Auscultation is performed before palpation and percussion because bowel sounds can be altered by manual
stimulation of the abdomen. Performing palpation first (Option B, D) or percussion first (Option C) risks producing
false findings and is incorrect technique.
Q3. A nurse is using the nursing process (ADPIE) to plan care for a newly admitted client with heart
failure. Which activity represents the 'Planning' phase?
A. Auscultating lung sounds and reviewing morning laboratory results.
B. Formulating the nursing diagnosis 'Fluid Volume Excess related to compromised regulatory mechanism.'
C. Establishing the goal 'Client will have clear lung sounds and lose 1 lb/day by discharge.' *[CORRECT]*
D. Administering furosemide 40 mg IV push as ordered.
Correct Answer: C
Rationale: The Planning phase of the nursing process (ADPIE) involves setting measurable, client-centered
goals/outcomes and developing a plan of care. Option A is Assessment; Option B is Diagnosis; Option D is
Implementation. Option C is the only choice that establishes a measurable outcome with timeframe, which is the
Planning phase.
Q4. A nurse is delegating care to a nursing assistant (UAP). Which task is appropriate to delegate to the
UAP?
A. Administering an oral narcotic analgesic to a postoperative client.
B. Performing the initial admission assessment for a new client.
C. Ambulating a stable client who is 1 day postoperative from an appendectomy. *[CORRECT]*
D. Teaching a client about a new diagnosis of diabetes mellitus.
Correct Answer: C
Rationale: Delegation principles (ANA Five Rights of Delegation; NCSBN) hold that the nurse may delegate tasks
that are within the UAP's scope, do not require clinical judgment, and involve stable clients with predictable
outcomes. Ambulating a stable postoperative client is appropriate. Administering narcotics (Option A), initial
admission assessments (Option B), and teaching (Option D) require nursing knowledge and judgment and cannot be
delegated.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 3
, NUR 212 Exam 1 Prep 2026/2027 Medical-Surgical Nursing I
Q5. A nurse is assessing a client's pain. Which statement by the nurse reflects the most appropriate
approach?
A. "Your vital signs are stable, so you can't be in much pain."
B. "Pain is what you say it is; please rate your pain on this 0-10 scale." *[CORRECT]*
C. "Most people with your condition rate pain around 4/10."
D. "I'll give you pain medication first and then ask about your pain level."
Correct Answer: B
Rationale: Pain is the fifth vital sign and is subjective; the client's self-report is the gold standard (APS, AHRQ,
NCLEX-RN). Option A denies the client's subjective report. Option C introduces a normative comparison that may
invalidate the client's experience. Option D prevents accurate assessment before intervention. Option B reflects the
principle 'pain is what the client says it is.'
Q6. A nurse is using SBAR to communicate with a provider about a client who has a new onset of
confusion. Which statement represents the 'Recommendation' component of SBAR?
A. "The client is a 78-year-old admitted with pneumonia."
B. "The client is more confused than baseline and the pulse oximeter is reading 88% on room air."
C. "I think the client may be hypoxic and could have an acute change in condition."
D. "I would like you to come evaluate the client and order an arterial blood gas and oxygen therapy."
*[CORRECT]*
Correct Answer: D
Rationale: SBAR = Situation, Background, Assessment, Recommendation. Option D is a clear, specific
Recommendation. Option A is Situation (brief identification), Option B is Background/Assessment data, and Option
C is the nurse's Assessment/conclusion. The Recommendation must state the desired action clearly and specifically.
Q7. A nurse is caring for a client from a culture with high-context communication style. Which
approach is most appropriate for promoting effective communication?
A. Speak loudly and use direct, blunt language to ensure understanding.
B. Maintain eye contact and use clear, direct statements to demonstrate respect.
C. Observe nonverbal cues, allow time for response, and consider involving a family spokesperson if
culturally appropriate. *[CORRECT]*
D. Limit communication to written materials to avoid misunderstanding.
Correct Answer: C
Rationale: Cultural competence (QSEN; Giger & Davidhizar's Transcultural Assessment) requires understanding
that high-context cultures rely on nonverbal communication, context, and relationships. Loud or blunt communication
(Option A) can be disrespectful; direct eye contact may be inappropriate in some cultures (Option B); and
written-only communication (Option D) ignores verbal and nonverbal assessment. Option C reflects culturally
sensitive practice.
Aligned with NUR 212 Syllabus, NCLEX-RN Test Plan, and QSEN Competencies Page 4
