NUR 171 – CONCEPTS OF MEDICAL-SURGICAL NURSING] QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid and Electrolyte Balance
- Perioperative Nursing Care
- Pain Management
- Infection Control and Immunity
- Endocrine and Metabolic Disorders
- Cardiovascular and Respiratory Function
- Gastrointestinal and Renal Disorders
- Neurological and Sensory Impairment
- Legal, Ethical, and Professional Nursing Standards
Introduction
*This comprehensive examination is designed to assess mastery of NUR 171 – Concepts of Medical-Surgical
Nursing. It evaluates foundational theory, clinical reasoning, and applied knowledge required for safe,
competent practice. Questions include multiple-choice and scenario-based formats that emphasize real-world
application, prioritization, delegation, and clinical decision-making. Each item reflects regulatory standards,
ethical principles, and evidence-based guidelines. Successful completion demonstrates readiness for complex
medical-surgical nursing situations, including identification of complications, intervention selection, and patient
education. Use this assessment to validate understanding and prepare for high-stakes testing environments.*
SECTION ONE: QUESTIONS 1–100
,1. A patient with heart failure reports sudden weight gain of 3 kg in 48 hours, shortness of breath when walking
to the bathroom, and +3 pitting edema in both lower extremities. What is the nurse’s priority action?
A. Restrict oral fluids to 1 L per day
B. Administer furosemide as prescribed
C. Elevate the legs above heart level
D. Teach low-sodium diet principles
🟢 B. Administer furosemide as prescribed
🔴 RATIONALE: The patient shows acute fluid volume overload (weight gain, dyspnea, edema). Loop diuretics
like furosemide rapidly reduce preload and pulmonary congestion. Elevating legs worsens venous return; fluid
restriction and diet teaching are slower, secondary interventions.
2. A nurse is caring for a postoperative patient on patient-controlled analgesia (PCA) with morphine. The
patient’s respiratory rate drops to 8 breaths/minute and oxygen saturation is 85%. Which action should the
nurse take first?
A. Administer naloxone per protocol
B. Increase oxygen via nasal cannula
C. Stop the PCA infusion
D. Arouse the patient with sternal rub
🟢 A. Administer naloxone per protocol
🔴 RATIONALE: Respiratory rate <10 with hypoxia indicates opioid-induced respiratory depression. Naloxone is
the antidote and must be given immediately to reverse effects. Stopping PCA alone does not reverse already-
circulating morphine; arousal is insufficient; oxygen alone does not address hypoventilation.
,3. A diabetic patient with a foot ulcer has purulent drainage, redness, and warmth. The wound culture is
pending. Which order should the nurse question?
A. Cleanse with normal saline
B. Obtain wound culture
C. Apply dry sterile dressing
D. Restrict dietary protein to 0.6 g/kg/day
🟢 D. Restrict dietary protein to 0.6 g/kg/day
🔴 RATIONALE: Protein restriction is contraindicated in wound healing because amino acids are needed for
tissue repair. The other options are appropriate for infected diabetic foot ulcers pending culture results.
4. During a sterile dressing change, the nurse drops the sterile gauze onto the outer edge of the sterile field.
What is the correct action?
A. Pick up the gauze with sterile forceps
B. Continue using the gauze if no visible contamination
C. Discard the gauze and obtain a new one
D. Flip the gauze over to the clean side
🟢 C. Discard the gauze and obtain a new one
🔴 RATIONALE: The outer 1-inch border of a sterile field is considered non-sterile. Any item touching that area
is contaminated and must be discarded. Maintaining aseptic technique prevents infection.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which electrocardiogram
change is most concerning?
, A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
🟢 B. Peaked T waves
🔴 RATIONALE: Peaked T waves are the earliest and most specific ECG sign of hyperkalemia and can precede
life-threatening arrhythmias. Prolonged PR and flat P waves occur later. ST depression is non-specific. U waves
suggest hypokalemia.
6. The nurse is preparing a patient for colonoscopy. The patient reports drinking 240 mL of clear apple juice 2
hours ago. What should the nurse do?
A. Cancel the procedure and reschedule
B. Proceed as planned if juice was <300 mL
C. Notify the anesthesia provider immediately
D. Administer a prokinetic medication to empty the stomach
🟢 C. Notify the anesthesia provider immediately
🔴 RATIONALE: Current guidelines require NPO for clear liquids at least 2 hours before sedation; however,
many facilities require strict NPO after midnight. The safest action is to notify anesthesia to evaluate risk of
aspiration. The nurse should not independently cancel or proceed.
7. A patient is ordered enoxaparin 40 mg subcutaneously once daily for DVT prophylaxis. Which technique is
correct?
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid and Electrolyte Balance
- Perioperative Nursing Care
- Pain Management
- Infection Control and Immunity
- Endocrine and Metabolic Disorders
- Cardiovascular and Respiratory Function
- Gastrointestinal and Renal Disorders
- Neurological and Sensory Impairment
- Legal, Ethical, and Professional Nursing Standards
Introduction
*This comprehensive examination is designed to assess mastery of NUR 171 – Concepts of Medical-Surgical
Nursing. It evaluates foundational theory, clinical reasoning, and applied knowledge required for safe,
competent practice. Questions include multiple-choice and scenario-based formats that emphasize real-world
application, prioritization, delegation, and clinical decision-making. Each item reflects regulatory standards,
ethical principles, and evidence-based guidelines. Successful completion demonstrates readiness for complex
medical-surgical nursing situations, including identification of complications, intervention selection, and patient
education. Use this assessment to validate understanding and prepare for high-stakes testing environments.*
SECTION ONE: QUESTIONS 1–100
,1. A patient with heart failure reports sudden weight gain of 3 kg in 48 hours, shortness of breath when walking
to the bathroom, and +3 pitting edema in both lower extremities. What is the nurse’s priority action?
A. Restrict oral fluids to 1 L per day
B. Administer furosemide as prescribed
C. Elevate the legs above heart level
D. Teach low-sodium diet principles
🟢 B. Administer furosemide as prescribed
🔴 RATIONALE: The patient shows acute fluid volume overload (weight gain, dyspnea, edema). Loop diuretics
like furosemide rapidly reduce preload and pulmonary congestion. Elevating legs worsens venous return; fluid
restriction and diet teaching are slower, secondary interventions.
2. A nurse is caring for a postoperative patient on patient-controlled analgesia (PCA) with morphine. The
patient’s respiratory rate drops to 8 breaths/minute and oxygen saturation is 85%. Which action should the
nurse take first?
A. Administer naloxone per protocol
B. Increase oxygen via nasal cannula
C. Stop the PCA infusion
D. Arouse the patient with sternal rub
🟢 A. Administer naloxone per protocol
🔴 RATIONALE: Respiratory rate <10 with hypoxia indicates opioid-induced respiratory depression. Naloxone is
the antidote and must be given immediately to reverse effects. Stopping PCA alone does not reverse already-
circulating morphine; arousal is insufficient; oxygen alone does not address hypoventilation.
,3. A diabetic patient with a foot ulcer has purulent drainage, redness, and warmth. The wound culture is
pending. Which order should the nurse question?
A. Cleanse with normal saline
B. Obtain wound culture
C. Apply dry sterile dressing
D. Restrict dietary protein to 0.6 g/kg/day
🟢 D. Restrict dietary protein to 0.6 g/kg/day
🔴 RATIONALE: Protein restriction is contraindicated in wound healing because amino acids are needed for
tissue repair. The other options are appropriate for infected diabetic foot ulcers pending culture results.
4. During a sterile dressing change, the nurse drops the sterile gauze onto the outer edge of the sterile field.
What is the correct action?
A. Pick up the gauze with sterile forceps
B. Continue using the gauze if no visible contamination
C. Discard the gauze and obtain a new one
D. Flip the gauze over to the clean side
🟢 C. Discard the gauze and obtain a new one
🔴 RATIONALE: The outer 1-inch border of a sterile field is considered non-sterile. Any item touching that area
is contaminated and must be discarded. Maintaining aseptic technique prevents infection.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which electrocardiogram
change is most concerning?
, A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
🟢 B. Peaked T waves
🔴 RATIONALE: Peaked T waves are the earliest and most specific ECG sign of hyperkalemia and can precede
life-threatening arrhythmias. Prolonged PR and flat P waves occur later. ST depression is non-specific. U waves
suggest hypokalemia.
6. The nurse is preparing a patient for colonoscopy. The patient reports drinking 240 mL of clear apple juice 2
hours ago. What should the nurse do?
A. Cancel the procedure and reschedule
B. Proceed as planned if juice was <300 mL
C. Notify the anesthesia provider immediately
D. Administer a prokinetic medication to empty the stomach
🟢 C. Notify the anesthesia provider immediately
🔴 RATIONALE: Current guidelines require NPO for clear liquids at least 2 hours before sedation; however,
many facilities require strict NPO after midnight. The safest action is to notify anesthesia to evaluate risk of
aspiration. The nurse should not independently cancel or proceed.
7. A patient is ordered enoxaparin 40 mg subcutaneously once daily for DVT prophylaxis. Which technique is
correct?
