NUR 215 Midterm Exam Prep Document | 2026/2027 Edition
| 150 Verified Questions - 100 Questions with Answers
NUR 215 Midterm Exam 2026-100 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document is meticulously designed for nursing students at
Arizona College of Nursing preparing for the NUR 215 midterm examination. It encompasses 150
verified questions that reflect the latest 2026/2027 curriculum, covering all critical domains of
medical-surgical nursing. Each question is accompanied by detailed rationales and evidence-based
explanations to enhance understanding and retention. This resource is an essential tool for achieving a
top score and mastering the core competencies required for nursing practice.
Key Features:
Foundations of Medical-Surgical Nursing: Evidence-based practice, safety, and quality improvement
Health Assessment and Clinical Judgment: Comprehensive physical assessment, diagnostic reasoning, and
documentation
Perioperative Nursing Care: Preoperative, intraoperative, and postoperative nursing interventions
Fluid, Electrolyte, and Acid-Base Balance: Imbalances, replacement therapies, and monitoring
Pain Management: Pharmacological and non-pharmacological interventions, patient-controlled analgesia
Cardiovascular System: Assessment, common disorders (e.g., hypertension, heart failure, MI), and nursing care
Respiratory System: Assessment, common disorders (e.g., COPD, pneumonia, asthma), and nursing care
Neurological System: Assessment, common disorders (e.g., stroke, seizures, increased ICP), and nursing care
Renal and Urinary System: Assessment, common disorders (e.g., renal failure, UTIs), and nursing care
Gastrointestinal System: Assessment, common disorders (e.g., ulcers, hepatitis, pancreatitis), and nursing care
Endocrine System: Assessment, common disorders (e.g., diabetes, thyroid disorders), and nursing care
Hematologic and Immunologic Systems: Assessment, common disorders (e.g., anemia, leukemia, HIV/AIDS),
and nursing care
Integumentary System: Assessment, common disorders (e.g., burns, wounds, skin infections), and nursing care
Sensory System: Assessment, common disorders (e.g., vision and hearing loss), and nursing care
Shock and Sepsis: Pathophysiology, stages, and nursing management
Emergency and Disaster Nursing: Triage, prioritization, and crisis intervention
Updates for 2026:
- Incorporated 2026-2027 NCLEX-RN test plan updates and current clinical guidelines
- Revised rationales to reflect the latest evidence-based practice standards
- Added new questions on COVID-19 and post-acute sequelae management
- Enhanced distractors to better simulate critical thinking and prioritization scenarios
- Updated pharmacology content to include newly approved medications and safety alerts
Abstract:
This exam preparation document for NUR 215 at Arizona College of Nursing is a meticulously curated collection
of 150 verified questions designed to mirror the midterm examination's scope and difficulty. The content is
organized into comprehensive sections covering all major body systems and nursing concepts, from foundational
principles to complex multi-system disorders. Each question is crafted to assess not only recall but also
application, analysis, and clinical judgment, aligning with the NCLEX-RN test plan. Detailed rationales are
provided for both correct and incorrect options, facilitating a deep understanding of the underlying
pathophysiology and nursing interventions. This resource is an indispensable aid for students aiming to excel in
Page 1
,their midterm and build a solid foundation for future nursing practice. The 2026/2027 edition includes updated
guidelines, new pharmacological agents, and contemporary issues such as pandemic response and telehealth,
ensuring relevance and currency.
Keywords:
NUR 215, Medical-Surgical Nursing, Midterm Exam, Arizona College of Nursing, NCLEX-RN, Evidence-Based
Practice, Clinical Judgment, 2026/2027
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale explaining the underlying principles and why the other options are
incorrect. Rationales are referenced with current evidence-based sources and include nursing implications to
reinforce clinical application.
Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and Arizona College of Nursing curriculum
All questions reviewed by experienced nursing educators for accuracy and clarity
Rationales cite current evidence-based practice guidelines and standards
Includes a variety of question types: multiple choice, select all that apply, and ordered response
Updated to reflect 2026-2027 clinical practice and pharmacological updates
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations and Perioperative 1-20 Evidence-based practice, safety, 13%
Care perioperative nursing
Fluids, Electrolytes, and 21-35 Imbalances, replacement therapy, ABG 10%
Acid-Base interpretation
Pain Management 36-45 Pharmacological interventions, PCA, 7%
non-pharmacological
Cardiovascular System 46-65 Hypertension, heart failure, MI, arrhythmias 13%
Respiratory System 66-80 COPD, pneumonia, asthma, oxygen therapy 10%
Neurological System 81-95 Stroke, seizures, increased ICP, meningitis 10%
Renal and Urinary System 96-105 Renal failure, UTIs, dialysis, urinary 7%
catheter care
Gastrointestinal System 106-115 Ulcers, hepatitis, pancreatitis, bowel 7%
obstruction
Endocrine System 116-125 Diabetes, thyroid disorders, adrenal 7%
insufficiency
Hematologic and Immunologic 126-135 Anemia, leukemia, HIV/AIDS, transfusion 7%
Systems reactions
Integumentary and Sensory 136-145 Burns, wound care, vision/hearing disorders 7%
Systems
Shock, Sepsis, and Emergency 146-150 Shock stages, sepsis management, triage 3%
Nursing
Page 2
,Q1. A patient on a continuous heparin infusion develops a sudden drop in platelet
count from 180,000 to 55,000/mm³ with new thrombotic lesions. Which intervention
is most appropriate?
A. Continue heparin and monitor platelets daily
B. Discontinue heparin and start argatroban
C. Administer protamine sulfate immediately
D. Switch to enoxaparin at therapeutic dose
Correct Answer: B. Discontinue heparin and start argatroban
Rationale: This presentation is consistent with heparin-induced thrombocytopenia (HIT),
a life-threatening immune-mediated reaction. All heparin products, including enoxaparin,
must be stopped. Argatroban, a direct thrombin inhibitor, is the preferred alternative
anticoagulant. Protamine only reverses heparin's anticoagulant effect, not HIT, and would
not address the thrombosis.
Why Wrong:
A - Continuing heparin with HIT can lead to fatal thrombosis; immediate cessation is
mandatory.
C - Protamine reverses heparin's anticoagulant effect but does not treat the
immune-mediated HIT process.
D - Enoxaparin is a low-molecular-weight heparin and cross-reacts with HIT
antibodies, so it is contraindicated.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q2. In a patient with septic shock and a serum lactate of 6 mmol/L, which
hemodynamic parameter is most indicative of adequate resuscitation?
A. Central venous pressure of 12 mm Hg
B. Mean arterial pressure of 70 mm Hg
C. ScvO of 72%
D. Urine output of 0.6 mL/kg/hr
Correct Answer: C. ScvO of 72%
Rationale: In septic shock, the Surviving Sepsis Campaign emphasizes normalization of
ScvO (70%) as a marker of adequate tissue oxygenation, especially with elevated lactate.
MAP 65 mm Hg and urine output 0.5 mL/kg/hr are also targets, but the question asks for
the parameter most indicative of adequate resuscitation in the context of high lactate,
which reflects oxygen delivery/consumption balance.
Why Wrong:
A - CVP is no longer recommended as a primary resuscitation target due to poor
correlation with volume status.
B - MAP is a perfusion pressure target but does not directly reflect tissue oxygenation
or lactate clearance.
Page 3
, D - Urine output is a late indicator of renal perfusion and less sensitive than ScvO for
early resuscitation.
Reference: Surviving Sepsis Campaign (2021). Critical Care Medicine.
Q3. A patient prescribed a monoamine oxidase inhibitor (MAOI) for
treatment-resistant depression reports new use of an over-the-counter cold remedy.
Which ingredient poses the greatest risk?
A. Dextromethorphan
B. Guaifenesin
C. Phenylephrine
D. Diphenhydramine
Correct Answer: C. Phenylephrine
Rationale: Phenylephrine is a sympathomimetic that can precipitate a hypertensive crisis
when combined with MAOIs due to increased norepinephrine at the synapse.
Dextromethorphan also poses a risk of serotonin syndrome, but the question asks for the
greatest risk-hypertensive crisis is more immediately life-threatening. Guaifenesin and
diphenhydramine have minimal interaction.
Why Wrong:
A - Dextromethorphan can cause serotonin syndrome, but the most severe acute risk
with MAOIs is hypertensive crisis.
B - Guaifenesin is an expectorant with no significant interaction with MAOIs.
D - Diphenhydramine is an antihistamine with no direct sympathomimetic effect.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 16.
Q4. A nurse is caring for a patient with heart failure and a new prescription for
sacubitril/valsartan. Which laboratory value warrants immediate collaboration with
the provider?
A. Serum potassium 5.4 mEq/L
B. BUN 22 mg/dL
C. Hemoglobin 12.5 g/dL
D. ALT 45 U/L
Correct Answer: A. Serum potassium 5.4 mEq/L
Rationale: Sacubitril/valsartan, an ARNI, can cause hyperkalemia. A potassium of 5.4
mEq/L is above the normal range and requires prompt evaluation, especially in heart
failure patients who may also be on other potassium-sparing agents. The other values are
within normal limits.
Why Wrong:
B - BUN 22 mg/dL is mildly elevated but not immediately concerning without other
signs of renal impairment.
Page 4
| 150 Verified Questions - 100 Questions with Answers
NUR 215 Midterm Exam 2026-100 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document is meticulously designed for nursing students at
Arizona College of Nursing preparing for the NUR 215 midterm examination. It encompasses 150
verified questions that reflect the latest 2026/2027 curriculum, covering all critical domains of
medical-surgical nursing. Each question is accompanied by detailed rationales and evidence-based
explanations to enhance understanding and retention. This resource is an essential tool for achieving a
top score and mastering the core competencies required for nursing practice.
Key Features:
Foundations of Medical-Surgical Nursing: Evidence-based practice, safety, and quality improvement
Health Assessment and Clinical Judgment: Comprehensive physical assessment, diagnostic reasoning, and
documentation
Perioperative Nursing Care: Preoperative, intraoperative, and postoperative nursing interventions
Fluid, Electrolyte, and Acid-Base Balance: Imbalances, replacement therapies, and monitoring
Pain Management: Pharmacological and non-pharmacological interventions, patient-controlled analgesia
Cardiovascular System: Assessment, common disorders (e.g., hypertension, heart failure, MI), and nursing care
Respiratory System: Assessment, common disorders (e.g., COPD, pneumonia, asthma), and nursing care
Neurological System: Assessment, common disorders (e.g., stroke, seizures, increased ICP), and nursing care
Renal and Urinary System: Assessment, common disorders (e.g., renal failure, UTIs), and nursing care
Gastrointestinal System: Assessment, common disorders (e.g., ulcers, hepatitis, pancreatitis), and nursing care
Endocrine System: Assessment, common disorders (e.g., diabetes, thyroid disorders), and nursing care
Hematologic and Immunologic Systems: Assessment, common disorders (e.g., anemia, leukemia, HIV/AIDS),
and nursing care
Integumentary System: Assessment, common disorders (e.g., burns, wounds, skin infections), and nursing care
Sensory System: Assessment, common disorders (e.g., vision and hearing loss), and nursing care
Shock and Sepsis: Pathophysiology, stages, and nursing management
Emergency and Disaster Nursing: Triage, prioritization, and crisis intervention
Updates for 2026:
- Incorporated 2026-2027 NCLEX-RN test plan updates and current clinical guidelines
- Revised rationales to reflect the latest evidence-based practice standards
- Added new questions on COVID-19 and post-acute sequelae management
- Enhanced distractors to better simulate critical thinking and prioritization scenarios
- Updated pharmacology content to include newly approved medications and safety alerts
Abstract:
This exam preparation document for NUR 215 at Arizona College of Nursing is a meticulously curated collection
of 150 verified questions designed to mirror the midterm examination's scope and difficulty. The content is
organized into comprehensive sections covering all major body systems and nursing concepts, from foundational
principles to complex multi-system disorders. Each question is crafted to assess not only recall but also
application, analysis, and clinical judgment, aligning with the NCLEX-RN test plan. Detailed rationales are
provided for both correct and incorrect options, facilitating a deep understanding of the underlying
pathophysiology and nursing interventions. This resource is an indispensable aid for students aiming to excel in
Page 1
,their midterm and build a solid foundation for future nursing practice. The 2026/2027 edition includes updated
guidelines, new pharmacological agents, and contemporary issues such as pandemic response and telehealth,
ensuring relevance and currency.
Keywords:
NUR 215, Medical-Surgical Nursing, Midterm Exam, Arizona College of Nursing, NCLEX-RN, Evidence-Based
Practice, Clinical Judgment, 2026/2027
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale explaining the underlying principles and why the other options are
incorrect. Rationales are referenced with current evidence-based sources and include nursing implications to
reinforce clinical application.
Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and Arizona College of Nursing curriculum
All questions reviewed by experienced nursing educators for accuracy and clarity
Rationales cite current evidence-based practice guidelines and standards
Includes a variety of question types: multiple choice, select all that apply, and ordered response
Updated to reflect 2026-2027 clinical practice and pharmacological updates
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations and Perioperative 1-20 Evidence-based practice, safety, 13%
Care perioperative nursing
Fluids, Electrolytes, and 21-35 Imbalances, replacement therapy, ABG 10%
Acid-Base interpretation
Pain Management 36-45 Pharmacological interventions, PCA, 7%
non-pharmacological
Cardiovascular System 46-65 Hypertension, heart failure, MI, arrhythmias 13%
Respiratory System 66-80 COPD, pneumonia, asthma, oxygen therapy 10%
Neurological System 81-95 Stroke, seizures, increased ICP, meningitis 10%
Renal and Urinary System 96-105 Renal failure, UTIs, dialysis, urinary 7%
catheter care
Gastrointestinal System 106-115 Ulcers, hepatitis, pancreatitis, bowel 7%
obstruction
Endocrine System 116-125 Diabetes, thyroid disorders, adrenal 7%
insufficiency
Hematologic and Immunologic 126-135 Anemia, leukemia, HIV/AIDS, transfusion 7%
Systems reactions
Integumentary and Sensory 136-145 Burns, wound care, vision/hearing disorders 7%
Systems
Shock, Sepsis, and Emergency 146-150 Shock stages, sepsis management, triage 3%
Nursing
Page 2
,Q1. A patient on a continuous heparin infusion develops a sudden drop in platelet
count from 180,000 to 55,000/mm³ with new thrombotic lesions. Which intervention
is most appropriate?
A. Continue heparin and monitor platelets daily
B. Discontinue heparin and start argatroban
C. Administer protamine sulfate immediately
D. Switch to enoxaparin at therapeutic dose
Correct Answer: B. Discontinue heparin and start argatroban
Rationale: This presentation is consistent with heparin-induced thrombocytopenia (HIT),
a life-threatening immune-mediated reaction. All heparin products, including enoxaparin,
must be stopped. Argatroban, a direct thrombin inhibitor, is the preferred alternative
anticoagulant. Protamine only reverses heparin's anticoagulant effect, not HIT, and would
not address the thrombosis.
Why Wrong:
A - Continuing heparin with HIT can lead to fatal thrombosis; immediate cessation is
mandatory.
C - Protamine reverses heparin's anticoagulant effect but does not treat the
immune-mediated HIT process.
D - Enoxaparin is a low-molecular-weight heparin and cross-reacts with HIT
antibodies, so it is contraindicated.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 34.
Q2. In a patient with septic shock and a serum lactate of 6 mmol/L, which
hemodynamic parameter is most indicative of adequate resuscitation?
A. Central venous pressure of 12 mm Hg
B. Mean arterial pressure of 70 mm Hg
C. ScvO of 72%
D. Urine output of 0.6 mL/kg/hr
Correct Answer: C. ScvO of 72%
Rationale: In septic shock, the Surviving Sepsis Campaign emphasizes normalization of
ScvO (70%) as a marker of adequate tissue oxygenation, especially with elevated lactate.
MAP 65 mm Hg and urine output 0.5 mL/kg/hr are also targets, but the question asks for
the parameter most indicative of adequate resuscitation in the context of high lactate,
which reflects oxygen delivery/consumption balance.
Why Wrong:
A - CVP is no longer recommended as a primary resuscitation target due to poor
correlation with volume status.
B - MAP is a perfusion pressure target but does not directly reflect tissue oxygenation
or lactate clearance.
Page 3
, D - Urine output is a late indicator of renal perfusion and less sensitive than ScvO for
early resuscitation.
Reference: Surviving Sepsis Campaign (2021). Critical Care Medicine.
Q3. A patient prescribed a monoamine oxidase inhibitor (MAOI) for
treatment-resistant depression reports new use of an over-the-counter cold remedy.
Which ingredient poses the greatest risk?
A. Dextromethorphan
B. Guaifenesin
C. Phenylephrine
D. Diphenhydramine
Correct Answer: C. Phenylephrine
Rationale: Phenylephrine is a sympathomimetic that can precipitate a hypertensive crisis
when combined with MAOIs due to increased norepinephrine at the synapse.
Dextromethorphan also poses a risk of serotonin syndrome, but the question asks for the
greatest risk-hypertensive crisis is more immediately life-threatening. Guaifenesin and
diphenhydramine have minimal interaction.
Why Wrong:
A - Dextromethorphan can cause serotonin syndrome, but the most severe acute risk
with MAOIs is hypertensive crisis.
B - Guaifenesin is an expectorant with no significant interaction with MAOIs.
D - Diphenhydramine is an antihistamine with no direct sympathomimetic effect.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 16.
Q4. A nurse is caring for a patient with heart failure and a new prescription for
sacubitril/valsartan. Which laboratory value warrants immediate collaboration with
the provider?
A. Serum potassium 5.4 mEq/L
B. BUN 22 mg/dL
C. Hemoglobin 12.5 g/dL
D. ALT 45 U/L
Correct Answer: A. Serum potassium 5.4 mEq/L
Rationale: Sacubitril/valsartan, an ARNI, can cause hyperkalemia. A potassium of 5.4
mEq/L is above the normal range and requires prompt evaluation, especially in heart
failure patients who may also be on other potassium-sparing agents. The other values are
within normal limits.
Why Wrong:
B - BUN 22 mg/dL is mildly elevated but not immediately concerning without other
signs of renal impairment.
Page 4
