NUR 171 – EXAM 1 – 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 Concepts
Pain Management Principles
Acute and Chronic Wound Care
Immunology and Infection Control
Oxygenation and Respiratory Function
Legal, Ethical, and Professional Standards
Health Assessment and Clinical Decision-Making
INTRODUCTION
*This comprehensive examination is designed to assess foundational knowledge in medical-surgical nursing for
NUR 171. It evaluates competency in fluid and electrolyte balance, perioperative care, pain management, wound
healing, immunology, oxygenation, and professional ethics. Each multiple‑choice question targets clinical
reasoning and real‑world application required for safe, patient‑centered care. Scenario‑based items challenge
the learner to prioritize nursing actions, interpret clinical data, and apply evidence‑based standards. Correct
answers are verified with rationales to reinforce understanding. This assessment mirrors the complexity of the
NCLEX‑style examination and prepares the student for successful decision‑making in the clinical setting.*
SECTION ONE: QUESTIONS 1–100
,Question 1
A nurse reviews an older adult’s laboratory results. Which serum sodium level indicates hyponatremia?
A. 148 mEq/L
B. 135 mEq/L
C. 130 mEq/L
D. 142 mEq/L
🟢C
🔴 RATIONALE: Hyponatremia is defined as serum sodium below 135 mEq/L. A level of 130 mEq/L is below the
normal range (135–145 mEq/L) and indicates hyponatremia.
Question 2
A postoperative patient reports incisional pain rated 8/10. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient’s respiratory rate is 8 breaths/min. What is the priority nursing action?
A. Administer naloxone
B. Encourage deep breathing
C. Continue monitoring
D. Apply oxygen at 2 L/min
🟢A
🔴 RATIONALE: A respiratory rate of 8 breaths/min after opioid administration indicates respiratory depression.
Naloxone is an opioid antagonist that reverses this life‑threatening effect, making it the priority intervention.
Question 3
A patient with heart failure has an order for furosemide. Which assessment finding requires immediate nursing
action?
A. Weight gain of 0.5 kg in 24 hours
B. Serum potassium of 3.2 mEq/L
,C. Blood pressure of 130/80 mm Hg
D. Urine output of 200 mL over 4 hours
🟢B
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. A serum potassium of 3.2 mEq/L is
below normal (3.5–5.0 mEq/L) and increases risk for dysrhythmias, requiring prompt intervention.
Question 4
Which finding in a patient receiving a blood transfusion is most indicative of an acute hemolytic reaction?
A. Urticaria on the chest
B. Temperature of 37.2°C (99°F)
C. Low back pain and dark urine
D. Wheezing and stridor
🟢C
🔴 RATIONALE: Acute hemolytic reactions occur from ABO incompatibility. Low back pain (from renal damage)
and dark urine (hemoglobinuria) are hallmark signs. This is a medical emergency.
Question 5
A nurse is teaching a patient about postoperative deep breathing exercises. Which statement by the patient
indicates correct understanding?
A. “I will take shallow breaths to avoid pain.”
B. “I should hold my breath for 30 seconds each time.”
C. “I will use the incentive spirometer every hour while awake.”
D. “I only need to do the exercises if I feel short of breath.”
🟢C
🔴 RATIONALE: Incentive spirometry promotes lung expansion and prevents atelectasis. Using it every hour
while awake ensures regular alveolar recruitment, which is the standard postoperative respiratory intervention.
, Question 6
A patient has a nasogastric tube to low intermittent suction following bowel surgery. Which electrolyte
imbalance is this patient most at risk for developing?
A. Hypercalcemia
B. Hyponatremia
C. Hyperchloremia
D. Hypokalemia
🟢D
🔴 RATIONALE: Nasogastric suction removes gastric fluids rich in potassium and hydrogen ions, leading to
hypokalemia and metabolic alkalosis. Hypokalemia is a common and serious complication.
Question 7
During an abdominal assessment, the nurse notes a pulsatile mass in the periumbilical area. What is the most
appropriate action?
A. Palpate the mass to determine size
B. Auscultate for bruits
C. Notify the healthcare provider immediately
D. Measure the mass with a tape measure
🟢C
🔴 RATIONALE: A pulsatile periumbilical mass suggests an abdominal aortic aneurysm. Palpation can risk
rupture. Immediate notification of the provider is required, and the mass should not be palpated.
Question 8
A patient with a pressure injury has a wound with yellow slough, moderate drainage, and a foul odor. Which
dressing type is most appropriate for this wound?
A. Dry gauze
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
CORE DOMAINS
Fluid and Electrolyte Balance
Perioperative Nursing Concepts
Pain Management Principles
Acute and Chronic Wound Care
Immunology and Infection Control
Oxygenation and Respiratory Function
Legal, Ethical, and Professional Standards
Health Assessment and Clinical Decision-Making
INTRODUCTION
*This comprehensive examination is designed to assess foundational knowledge in medical-surgical nursing for
NUR 171. It evaluates competency in fluid and electrolyte balance, perioperative care, pain management, wound
healing, immunology, oxygenation, and professional ethics. Each multiple‑choice question targets clinical
reasoning and real‑world application required for safe, patient‑centered care. Scenario‑based items challenge
the learner to prioritize nursing actions, interpret clinical data, and apply evidence‑based standards. Correct
answers are verified with rationales to reinforce understanding. This assessment mirrors the complexity of the
NCLEX‑style examination and prepares the student for successful decision‑making in the clinical setting.*
SECTION ONE: QUESTIONS 1–100
,Question 1
A nurse reviews an older adult’s laboratory results. Which serum sodium level indicates hyponatremia?
A. 148 mEq/L
B. 135 mEq/L
C. 130 mEq/L
D. 142 mEq/L
🟢C
🔴 RATIONALE: Hyponatremia is defined as serum sodium below 135 mEq/L. A level of 130 mEq/L is below the
normal range (135–145 mEq/L) and indicates hyponatremia.
Question 2
A postoperative patient reports incisional pain rated 8/10. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient’s respiratory rate is 8 breaths/min. What is the priority nursing action?
A. Administer naloxone
B. Encourage deep breathing
C. Continue monitoring
D. Apply oxygen at 2 L/min
🟢A
🔴 RATIONALE: A respiratory rate of 8 breaths/min after opioid administration indicates respiratory depression.
Naloxone is an opioid antagonist that reverses this life‑threatening effect, making it the priority intervention.
Question 3
A patient with heart failure has an order for furosemide. Which assessment finding requires immediate nursing
action?
A. Weight gain of 0.5 kg in 24 hours
B. Serum potassium of 3.2 mEq/L
,C. Blood pressure of 130/80 mm Hg
D. Urine output of 200 mL over 4 hours
🟢B
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. A serum potassium of 3.2 mEq/L is
below normal (3.5–5.0 mEq/L) and increases risk for dysrhythmias, requiring prompt intervention.
Question 4
Which finding in a patient receiving a blood transfusion is most indicative of an acute hemolytic reaction?
A. Urticaria on the chest
B. Temperature of 37.2°C (99°F)
C. Low back pain and dark urine
D. Wheezing and stridor
🟢C
🔴 RATIONALE: Acute hemolytic reactions occur from ABO incompatibility. Low back pain (from renal damage)
and dark urine (hemoglobinuria) are hallmark signs. This is a medical emergency.
Question 5
A nurse is teaching a patient about postoperative deep breathing exercises. Which statement by the patient
indicates correct understanding?
A. “I will take shallow breaths to avoid pain.”
B. “I should hold my breath for 30 seconds each time.”
C. “I will use the incentive spirometer every hour while awake.”
D. “I only need to do the exercises if I feel short of breath.”
🟢C
🔴 RATIONALE: Incentive spirometry promotes lung expansion and prevents atelectasis. Using it every hour
while awake ensures regular alveolar recruitment, which is the standard postoperative respiratory intervention.
, Question 6
A patient has a nasogastric tube to low intermittent suction following bowel surgery. Which electrolyte
imbalance is this patient most at risk for developing?
A. Hypercalcemia
B. Hyponatremia
C. Hyperchloremia
D. Hypokalemia
🟢D
🔴 RATIONALE: Nasogastric suction removes gastric fluids rich in potassium and hydrogen ions, leading to
hypokalemia and metabolic alkalosis. Hypokalemia is a common and serious complication.
Question 7
During an abdominal assessment, the nurse notes a pulsatile mass in the periumbilical area. What is the most
appropriate action?
A. Palpate the mass to determine size
B. Auscultate for bruits
C. Notify the healthcare provider immediately
D. Measure the mass with a tape measure
🟢C
🔴 RATIONALE: A pulsatile periumbilical mass suggests an abdominal aortic aneurysm. Palpation can risk
rupture. Immediate notification of the provider is required, and the mass should not be palpated.
Question 8
A patient with a pressure injury has a wound with yellow slough, moderate drainage, and a foul odor. Which
dressing type is most appropriate for this wound?
A. Dry gauze
