MEDSURG 1 FINAL EXAM 2026-2027
QUESTIONS AND ANSWERS WITH
RATIONALE GRADED A+
What is a major advantage when medication is administered intravenously?
Safer than administering by oral or intramuscular route
Less expensive than oral route
Better maintained at a therapeutic blood level
Lower incidence of allergy than other routes
Better maintained at a therapeutic blood level
RATIONALE: Patients who receive intravenous medications can be better ensured
of a more constant therapeutic blood level.
What signs of infiltration should be assessed by a nurse?
Burning sensation and no feeling at the site
Burning sensation, pain, and puffy
Red streak up the arm
Pain, heat, and puffy
Burning sensation, pain, and puffy
,RATIONALE: Intravenous fluid in the immediate tissues causes pain and swelling
of the adjacent tissues.
A physician prescribes a hypertonic intravenous line for an extremely edematous
patient. What solution should the nurse anticipate to be prescribed?
D5W in 0.25 NS
10% glucose in water
D5W in NS
Lactated Ringer solution
10% glucose in water
RATIONALE: D5W in 0.25 NS is hypotonic. D5W in NS and lactated Ringer
solution are isotonic. 10% glucose is hypertonic.
A nurse has a patient with a central line. The insertion site is covered by an
occlusive dressing with yesterday's date. The nurse is to give an intravenous drug
through the central line. What should be the initial action of the nurse?
Use any of the three ports for delivery.
Check dilution of the drug.
Change the occlusive dressing.
Affirm catheter placement by withdrawing 10 mL of blood.
Check dilution of the drug.
,RATIONALE: Checking the drug for the proper dilution is essential. The dressing
is not due to be changed. Drawing 10 mL of blood for site placement is excessive.
Only two of the ports, which are color coded, are to be used for drug, fluid, or
blood administration.
A nurse assesses for signs of infected phlebitis. How should the nurse most
accurately describe this complication when documenting?
Pale, cool skin with swelling at the puncture site
Rupture of the cannula with a lump under the skin
Firm, cool, raised, painful area at the puncture site; oozing and purulent drainage
Puncture site red, warm, with an oozing drainage
Puncture site red, warm, with an oozing drainage
RATIONALE: Infection causes redness, warmth, and drainage from the
intravenous site. Red streaks following the path of the vein may be visible.
A patient is to receive ampicillin (Unasyn) IV piggyback in 100 mL of fluid every
8 hours. The main intravenous (IV) line of D5W is running at 80 mL/hr and is on
time. A nurse's responsibility is to calculate the total 24-hour intake. At the end of
the 24-hour shift, how much IV intake should the nurse document that the patient
has received?
2220 mL
800 mL
1920 mL
300 mL
, 2220 mL
RATIONALE: 80 mL/hr × 24 hr = 1920 mL; 100 mL × 3 = 300 mL. Therefore,
1920 mL + 300 mL = 2220 mL in 24 hours.
A nurse clarifies that electrolytes, such as sodium and potassium (K+), break down
into smaller particles when dissolved. What are these smaller particles?
Molecules
Elements
Ions
Cells
Ions
RATIONALE: Electrolytes dissolved in water are called ions.
Older adults are at risk for dehydration because of reduced thirst and aging
kidneys. What should the nurse assess as an early indicator of dehydration?
Concentrated urine
Reduced skin turgor
Disorientation
Constipation
Constipation
QUESTIONS AND ANSWERS WITH
RATIONALE GRADED A+
What is a major advantage when medication is administered intravenously?
Safer than administering by oral or intramuscular route
Less expensive than oral route
Better maintained at a therapeutic blood level
Lower incidence of allergy than other routes
Better maintained at a therapeutic blood level
RATIONALE: Patients who receive intravenous medications can be better ensured
of a more constant therapeutic blood level.
What signs of infiltration should be assessed by a nurse?
Burning sensation and no feeling at the site
Burning sensation, pain, and puffy
Red streak up the arm
Pain, heat, and puffy
Burning sensation, pain, and puffy
,RATIONALE: Intravenous fluid in the immediate tissues causes pain and swelling
of the adjacent tissues.
A physician prescribes a hypertonic intravenous line for an extremely edematous
patient. What solution should the nurse anticipate to be prescribed?
D5W in 0.25 NS
10% glucose in water
D5W in NS
Lactated Ringer solution
10% glucose in water
RATIONALE: D5W in 0.25 NS is hypotonic. D5W in NS and lactated Ringer
solution are isotonic. 10% glucose is hypertonic.
A nurse has a patient with a central line. The insertion site is covered by an
occlusive dressing with yesterday's date. The nurse is to give an intravenous drug
through the central line. What should be the initial action of the nurse?
Use any of the three ports for delivery.
Check dilution of the drug.
Change the occlusive dressing.
Affirm catheter placement by withdrawing 10 mL of blood.
Check dilution of the drug.
,RATIONALE: Checking the drug for the proper dilution is essential. The dressing
is not due to be changed. Drawing 10 mL of blood for site placement is excessive.
Only two of the ports, which are color coded, are to be used for drug, fluid, or
blood administration.
A nurse assesses for signs of infected phlebitis. How should the nurse most
accurately describe this complication when documenting?
Pale, cool skin with swelling at the puncture site
Rupture of the cannula with a lump under the skin
Firm, cool, raised, painful area at the puncture site; oozing and purulent drainage
Puncture site red, warm, with an oozing drainage
Puncture site red, warm, with an oozing drainage
RATIONALE: Infection causes redness, warmth, and drainage from the
intravenous site. Red streaks following the path of the vein may be visible.
A patient is to receive ampicillin (Unasyn) IV piggyback in 100 mL of fluid every
8 hours. The main intravenous (IV) line of D5W is running at 80 mL/hr and is on
time. A nurse's responsibility is to calculate the total 24-hour intake. At the end of
the 24-hour shift, how much IV intake should the nurse document that the patient
has received?
2220 mL
800 mL
1920 mL
300 mL
, 2220 mL
RATIONALE: 80 mL/hr × 24 hr = 1920 mL; 100 mL × 3 = 300 mL. Therefore,
1920 mL + 300 mL = 2220 mL in 24 hours.
A nurse clarifies that electrolytes, such as sodium and potassium (K+), break down
into smaller particles when dissolved. What are these smaller particles?
Molecules
Elements
Ions
Cells
Ions
RATIONALE: Electrolytes dissolved in water are called ions.
Older adults are at risk for dehydration because of reduced thirst and aging
kidneys. What should the nurse assess as an early indicator of dehydration?
Concentrated urine
Reduced skin turgor
Disorientation
Constipation
Constipation
