NUR 171 – EXAM 3 – CONCEPTS OF MEDICAL-SURGICAL NURSING QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid & Electrolyte Balance
- Perioperative Nursing Care
- Pain Management
- Wound Care & Pressure Injuries
- Oxygenation & Respiratory Support
- Endocrine Disorders (Diabetes, Thyroid)
- Gastrointestinal & Nutrition
- Infection Control & Immunity
- Legal/Ethical Standards in Med-Surg Nursing
- Clinical Judgment & Patient Safety
Introduction
This comprehensive examination assesses foundational and applied knowledge in medical-surgical nursing
concepts essential for clinical practice. It evaluates critical thinking, regulatory compliance, ethical decision-
making, and real-world scenario application. The format includes multiple-choice questions that require analysis
of patient presentations, prioritization of care, and selection of evidence-based interventions. Each question is
designed to mirror NCLEX-style reasoning and clinical judgment. Emphasis is placed on safety, patient advocacy,
interdisciplinary collaboration, and professional standards. Successful completion demonstrates readiness for
complex patient management in acute and chronic care settings.
,SECTION ONE: QUESTIONS 1–100
Question 1
A postoperative patient reports sudden sharp chest pain and dyspnea. The nurse notes tachycardia and
hypoxemia. Which action should the nurse take first?
A. Administer prescribed morphine sulfate
B. Apply supplemental oxygen
C. Obtain a stat electrocardiogram
D. Notify the rapid response team
🟢B
🔴 RATIONALE: The priority is correcting hypoxemia. Applying oxygen supports tissue perfusion while further
assessment occurs. Morphine is for pain but not first. ECG and RRT notification follow after stabilizing
oxygenation.
Question 2
A patient with diabetes mellitus type 2 has a blood glucose level of 48 mg/dL and is unconscious. What is the
nurse’s priority intervention?
A. Administer glucagon intramuscularly
B. Give 15 g of oral carbohydrates
C. Start an IV infusion of 0.9% normal saline
D. Recheck blood glucose in 15 minutes
🟢A
,🔴 RATIONALE: Unconscious patient cannot safely swallow; glucagon IM raises blood glucose rapidly. Oral
carbohydrates are contraindicated. NS does not correct hypoglycemia. Delaying treatment is unsafe.
Question 3
A nurse is caring for a patient receiving morphine via patient-controlled analgesia (PCA). Which assessment
finding requires immediate intervention?
A. Pain score of 4 out of 10
B. Respiratory rate of 8 breaths/min
C. Patient reports nausea
D. Sedation score of 2
🟢B
🔴 RATIONALE: Respiratory rate of 8 indicates opioid-induced respiratory depression, a life-threatening adverse
effect. Pain 4/10 is expected. Nausea is common but not emergent. Sedation score 2 is acceptable on some
scales.
Question 4
Which finding in a patient with a pressure injury on the sacrum suggests wound infection?
A. Serosanguineous drainage
B. Pale, friable granulation tissue
C. Well-approximated wound edges
D. Increased pain and purulent discharge
🟢D
, 🔴 RATIONALE: New or increased pain with purulent drainage indicates infection. Serosanguineous drainage is
normal. Friable tissue suggests poor healing but not specific infection. Well-approximated edges are for
healed/closed wounds.
Question 5
A patient with heart failure has jugular venous distention, crackles in lung bases, and 3+ pitting edema. Which
serum laboratory value is most concerning?
A. Sodium 135 mEq/L
B. Potassium 3.2 mEq/L
C. BNP 900 pg/mL
D. Creatinine 0.9 mg/dL
🟢C
🔴 RATIONALE: BNP >500 pg/mL indicates acute decompensated heart failure. Hypokalemia (3.2) needs
treatment but is not the most concerning here. Sodium is normal. Creatinine is normal.
Question 6
Before administering digoxin, the nurse checks the apical pulse for 60 seconds. The rate is 52 beats/min. What is
the appropriate action?
A. Administer the digoxin as ordered
B. Hold the dose and notify the provider
C. Give half the dose and recheck in 30 minutes
D. Apply oxygen and administer atropine
🟢B
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid & Electrolyte Balance
- Perioperative Nursing Care
- Pain Management
- Wound Care & Pressure Injuries
- Oxygenation & Respiratory Support
- Endocrine Disorders (Diabetes, Thyroid)
- Gastrointestinal & Nutrition
- Infection Control & Immunity
- Legal/Ethical Standards in Med-Surg Nursing
- Clinical Judgment & Patient Safety
Introduction
This comprehensive examination assesses foundational and applied knowledge in medical-surgical nursing
concepts essential for clinical practice. It evaluates critical thinking, regulatory compliance, ethical decision-
making, and real-world scenario application. The format includes multiple-choice questions that require analysis
of patient presentations, prioritization of care, and selection of evidence-based interventions. Each question is
designed to mirror NCLEX-style reasoning and clinical judgment. Emphasis is placed on safety, patient advocacy,
interdisciplinary collaboration, and professional standards. Successful completion demonstrates readiness for
complex patient management in acute and chronic care settings.
,SECTION ONE: QUESTIONS 1–100
Question 1
A postoperative patient reports sudden sharp chest pain and dyspnea. The nurse notes tachycardia and
hypoxemia. Which action should the nurse take first?
A. Administer prescribed morphine sulfate
B. Apply supplemental oxygen
C. Obtain a stat electrocardiogram
D. Notify the rapid response team
🟢B
🔴 RATIONALE: The priority is correcting hypoxemia. Applying oxygen supports tissue perfusion while further
assessment occurs. Morphine is for pain but not first. ECG and RRT notification follow after stabilizing
oxygenation.
Question 2
A patient with diabetes mellitus type 2 has a blood glucose level of 48 mg/dL and is unconscious. What is the
nurse’s priority intervention?
A. Administer glucagon intramuscularly
B. Give 15 g of oral carbohydrates
C. Start an IV infusion of 0.9% normal saline
D. Recheck blood glucose in 15 minutes
🟢A
,🔴 RATIONALE: Unconscious patient cannot safely swallow; glucagon IM raises blood glucose rapidly. Oral
carbohydrates are contraindicated. NS does not correct hypoglycemia. Delaying treatment is unsafe.
Question 3
A nurse is caring for a patient receiving morphine via patient-controlled analgesia (PCA). Which assessment
finding requires immediate intervention?
A. Pain score of 4 out of 10
B. Respiratory rate of 8 breaths/min
C. Patient reports nausea
D. Sedation score of 2
🟢B
🔴 RATIONALE: Respiratory rate of 8 indicates opioid-induced respiratory depression, a life-threatening adverse
effect. Pain 4/10 is expected. Nausea is common but not emergent. Sedation score 2 is acceptable on some
scales.
Question 4
Which finding in a patient with a pressure injury on the sacrum suggests wound infection?
A. Serosanguineous drainage
B. Pale, friable granulation tissue
C. Well-approximated wound edges
D. Increased pain and purulent discharge
🟢D
, 🔴 RATIONALE: New or increased pain with purulent drainage indicates infection. Serosanguineous drainage is
normal. Friable tissue suggests poor healing but not specific infection. Well-approximated edges are for
healed/closed wounds.
Question 5
A patient with heart failure has jugular venous distention, crackles in lung bases, and 3+ pitting edema. Which
serum laboratory value is most concerning?
A. Sodium 135 mEq/L
B. Potassium 3.2 mEq/L
C. BNP 900 pg/mL
D. Creatinine 0.9 mg/dL
🟢C
🔴 RATIONALE: BNP >500 pg/mL indicates acute decompensated heart failure. Hypokalemia (3.2) needs
treatment but is not the most concerning here. Sodium is normal. Creatinine is normal.
Question 6
Before administering digoxin, the nurse checks the apical pulse for 60 seconds. The rate is 52 beats/min. What is
the appropriate action?
A. Administer the digoxin as ordered
B. Hold the dose and notify the provider
C. Give half the dose and recheck in 30 minutes
D. Apply oxygen and administer atropine
🟢B
