1|Page
NUR 1211 MEDICAL SURGICAL EXAM NEWEST 2025/
2026 TEST BANK| 2 VERSIONS (VERSIONS A & B)
WITH COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (BRAND NEW!!)
A patient who is being treated for pneumonia starts complaining of
sudden shortness of breath. An arterial blood gas (ABG) is drawn. The
ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24
mm Hg. What does the ABG reflect?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis -Correct Answer- A) Respiratory acidosis
The pH is below 7.40, PaCO2 is greater than 40, and the HCO3 is
normal; therefore, it is a respiratory acidosis, and compensation by the
kidneys has not begun, which indicates this was probably an acute event.
The HCO3 of 24 is within the normal range so it is not metabolic
alkalosis. The pH of 7.21 indicates an acidosis, not alkalosis. The pH of
7.21 indicates it is an acidosis but the HCO3 of 24 is within the normal
range, ruling out metabolic acidosis.
A nurse in the neurologic ICU has orders to infuse a hypertonic solution
into a patient with increased intracranial pressure. This solution will
increase the number of dissolved particles in the patient's blood, creating
pressure for fluids in the tissues to shift into the capillaries and increase
pg. 1
,2|Page
the blood volume. This process is best described as which of the
following?
A) Hydrostatic pressure
B) Osmosis and osmolality
C) Diffusion
D) Active transport -Correct Answer- B) Osmosis and osmolality
Osmosis is the movement of fluid from a region of low solute
concentration to a region of high solute concentration across a
semipermeable membrane. Hydrostatic pressure refers to changes in
water or volume related to water pressure. Diffusion is the movement of
solutes from an area of greater concentration to lesser concentration; the
solutes in an intact vascular system are unable to move so diffusion
normally should not be taking place. Active transport is the movement of
molecules against the concentration gradient and requires adenosine
triphosphate (ATP) as an energy source; this process typically takes
place at the cellular level and is not involved in vascular volume
changes.
You are the surgical nurse caring for a 65-year-old female patient who is
postoperative day 1 following a thyroidectomy. During your shift
assessment, the patient complains of tingling in her lips and fingers. She
tells you that she has an intermittent spasm in her wrist and hand and she
exhibits increased muscle tone. What electrolyte imbalance should you
first suspect?
A) Hypophosphatemia
B) Hypocalcemia
pg. 2
,3|Page
C) Hypermagnesemia
D) Hyperkalemia -Correct Answer- B) Hypocalcemia
Tetany is the most characteristic manifestation of hypocalcemia and
hypomagnesemia. Sensations of tingling may occur in the tips of the
fingers, around the mouth, and, less commonly, in the feet.
Hypophosphatemia creates central nervous dysfunction, resulting in
seizures and coma. Hypermagnesemia creates hypoactive reflexes and
somnolence. Signs of hyperkalemia include paresthesias and anxiety.
The baroreceptors, located in the left atrium and the carotid and aortic
arches, respond to changes in the circulating blood volume and regulate
sympathetic and parasympathetic neural activity as well as endocrine
activities. Sympathetic stimulation constricts renal arterioles, causing
what effect?
A) Decrease in the release of aldosterone
B) Increase of filtration in the Loop of Henle
C) Decrease in the reabsorption of sodium
D) Decrease in glomerular filtration -Correct Answer- D) Decrease in
glomerular filtration
Sympathetic stimulation constricts renal arterioles; this decreases
glomerular filtration, increases the release of aldosterone, and increases
sodium and water reabsorption. None of the other listed options occurs
with increased sympathetic stimulation.
You are the nurse caring for a 77-year-old male patient who has been
involved in a motor vehicle accident. You and your colleague note that
pg. 3
, 4|Page
the patient's labs indicate minimally elevated serum creatinine levels,
which your colleague dismisses. What can this increase in creatinine
indicate in older adults?
A) Substantially reduced renal function
B) Acute kidney injury
C) Decreased cardiac output
D) Alterations in ratio of body fluids to muscle mass -Correct Answer-
A) Substantially reduced renal function
Normal physiologic changes of aging, including reduced cardiac, renal,
and respiratory function, and reserve and alterations in the ratio of body
fluids to muscle mass, may alter the responses of elderly people to fluid
and electrolyte changes and acid-base disturbances. Renal function
declines with age, as do muscle mass and daily exogenous creatinine
production. Therefore, high-normal and minimally elevated serum
creatinine values may indicate substantially reduced renal function in
older adults. Acute kidney injury is likely to cause a more significant
increase in serum creatinine.
You are the nurse caring for a patient who is to receive IV daunorubicin,
a chemotherapeutic agent. You start the infusion and check the insertion
site as per protocol. During your most recent check, you note that the IV
has infiltrated so you stop the infusion. What is your main concern with
this infiltration?
A) Extravasation of the medication
B) Discomfort to the patient
C) Blanching at the site
pg. 4
NUR 1211 MEDICAL SURGICAL EXAM NEWEST 2025/
2026 TEST BANK| 2 VERSIONS (VERSIONS A & B)
WITH COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (BRAND NEW!!)
A patient who is being treated for pneumonia starts complaining of
sudden shortness of breath. An arterial blood gas (ABG) is drawn. The
ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24
mm Hg. What does the ABG reflect?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis
D) Metabolic acidosis -Correct Answer- A) Respiratory acidosis
The pH is below 7.40, PaCO2 is greater than 40, and the HCO3 is
normal; therefore, it is a respiratory acidosis, and compensation by the
kidneys has not begun, which indicates this was probably an acute event.
The HCO3 of 24 is within the normal range so it is not metabolic
alkalosis. The pH of 7.21 indicates an acidosis, not alkalosis. The pH of
7.21 indicates it is an acidosis but the HCO3 of 24 is within the normal
range, ruling out metabolic acidosis.
A nurse in the neurologic ICU has orders to infuse a hypertonic solution
into a patient with increased intracranial pressure. This solution will
increase the number of dissolved particles in the patient's blood, creating
pressure for fluids in the tissues to shift into the capillaries and increase
pg. 1
,2|Page
the blood volume. This process is best described as which of the
following?
A) Hydrostatic pressure
B) Osmosis and osmolality
C) Diffusion
D) Active transport -Correct Answer- B) Osmosis and osmolality
Osmosis is the movement of fluid from a region of low solute
concentration to a region of high solute concentration across a
semipermeable membrane. Hydrostatic pressure refers to changes in
water or volume related to water pressure. Diffusion is the movement of
solutes from an area of greater concentration to lesser concentration; the
solutes in an intact vascular system are unable to move so diffusion
normally should not be taking place. Active transport is the movement of
molecules against the concentration gradient and requires adenosine
triphosphate (ATP) as an energy source; this process typically takes
place at the cellular level and is not involved in vascular volume
changes.
You are the surgical nurse caring for a 65-year-old female patient who is
postoperative day 1 following a thyroidectomy. During your shift
assessment, the patient complains of tingling in her lips and fingers. She
tells you that she has an intermittent spasm in her wrist and hand and she
exhibits increased muscle tone. What electrolyte imbalance should you
first suspect?
A) Hypophosphatemia
B) Hypocalcemia
pg. 2
,3|Page
C) Hypermagnesemia
D) Hyperkalemia -Correct Answer- B) Hypocalcemia
Tetany is the most characteristic manifestation of hypocalcemia and
hypomagnesemia. Sensations of tingling may occur in the tips of the
fingers, around the mouth, and, less commonly, in the feet.
Hypophosphatemia creates central nervous dysfunction, resulting in
seizures and coma. Hypermagnesemia creates hypoactive reflexes and
somnolence. Signs of hyperkalemia include paresthesias and anxiety.
The baroreceptors, located in the left atrium and the carotid and aortic
arches, respond to changes in the circulating blood volume and regulate
sympathetic and parasympathetic neural activity as well as endocrine
activities. Sympathetic stimulation constricts renal arterioles, causing
what effect?
A) Decrease in the release of aldosterone
B) Increase of filtration in the Loop of Henle
C) Decrease in the reabsorption of sodium
D) Decrease in glomerular filtration -Correct Answer- D) Decrease in
glomerular filtration
Sympathetic stimulation constricts renal arterioles; this decreases
glomerular filtration, increases the release of aldosterone, and increases
sodium and water reabsorption. None of the other listed options occurs
with increased sympathetic stimulation.
You are the nurse caring for a 77-year-old male patient who has been
involved in a motor vehicle accident. You and your colleague note that
pg. 3
, 4|Page
the patient's labs indicate minimally elevated serum creatinine levels,
which your colleague dismisses. What can this increase in creatinine
indicate in older adults?
A) Substantially reduced renal function
B) Acute kidney injury
C) Decreased cardiac output
D) Alterations in ratio of body fluids to muscle mass -Correct Answer-
A) Substantially reduced renal function
Normal physiologic changes of aging, including reduced cardiac, renal,
and respiratory function, and reserve and alterations in the ratio of body
fluids to muscle mass, may alter the responses of elderly people to fluid
and electrolyte changes and acid-base disturbances. Renal function
declines with age, as do muscle mass and daily exogenous creatinine
production. Therefore, high-normal and minimally elevated serum
creatinine values may indicate substantially reduced renal function in
older adults. Acute kidney injury is likely to cause a more significant
increase in serum creatinine.
You are the nurse caring for a patient who is to receive IV daunorubicin,
a chemotherapeutic agent. You start the infusion and check the insertion
site as per protocol. During your most recent check, you note that the IV
has infiltrated so you stop the infusion. What is your main concern with
this infiltration?
A) Extravasation of the medication
B) Discomfort to the patient
C) Blanching at the site
pg. 4
