NUR 171 – FINAL EXAM – CONCEPTS OF MEDICAL-SURGICAL NURSING – GALEN COLLEGE OF NURSING
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains of Examination
1. Fluid and Electrolyte Balance
2. Perioperative Nursing Care
3. Pain Management
4. Wound Care and Pressure Injuries
5. Cardiovascular Disorders
6. Respiratory Disorders
7. Endocrine Disorders
8. Gastrointestinal Disorders
9. Renal and Urinary Disorders
10. Infection Control and Immunity
Introduction
*This comprehensive examination is designed to assess the essential knowledge, clinical reasoning, and
decision-making skills required for success in NUR 171 – Concepts of Medical-Surgical Nursing. The exam
evaluates foundational theory, applied professional knowledge, regulatory compliance, ethics, and real-world
clinical judgment. Each multiple-choice question presents a realistic patient scenario, requiring the student to
prioritize, analyze data, and select the safest, most evidence-based intervention. Emphasis is placed on critical
thinking, pharmacological safety, interprofessional communication, and patient-centered care. This assessment
,mirrors the complexity of the NCLEX-RN and prepares students for competent, compassionate practice in
medical-surgical settings.*
SECTION ONE – QUESTIONS 1 TO 100
Question 1
A nurse is assessing a patient with chronic heart failure. Which finding most strongly indicates worsening fluid
overload?
A. Blood pressure 118/76 mm Hg
B. Jugular venous distention
C. Pedal pulses 2+ bilaterally
D. Weight gain of 0.5 kg in 24 hours
🟢B
🔴 RATIONALE: Jugular venous distention directly reflects increased central venous pressure from fluid volume
excess in heart failure. BP may be normal; pedal pulse strength is not a fluid status indicator. 0.5 kg weight gain
in 24 hours is minimal and not the most significant sign.
Question 2
A postoperative patient reports pain of 8 on a 0–10 scale. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient reports pain 7 and is drowsy with a respiratory rate of 10 breaths/min. What is the
priority action?
,A. Administer naloxone per protocol
B. Encourage deep breathing and coughing
C. Document the findings and continue to monitor
D. Apply a warm compress to the surgical site
🟢A
🔴 RATIONALE: Respiratory rate of 10 with drowsiness indicates possible opioid-induced respiratory
depression. Naloxone is an opioid antagonist and is the priority to reverse life-threatening depression.
Nonpharmacologic measures and documentation are secondary.
Question 3
A nurse is caring for a patient with a stage 3 pressure injury on the sacrum. Which intervention is most
important?
A. Massage the surrounding skin every shift
B. Cleanse the wound with hydrogen peroxide
C. Apply a moisture-retentive dressing
D. Position patient flat on back to reduce shear
🟢C
🔴 RATIONALE: Stage 3 pressure injuries require a moist wound environment for granulation. Moisture-
retentive dressings support healing. Massage damages tissue; hydrogen peroxide is cytotoxic; flat positioning
increases pressure on sacrum.
Question 4
A patient with diabetes mellitus type 2 has a blood glucose level of 48 mg/dL and is conscious but confused.
, What should the nurse administer first?
A. 15 g of oral glucose gel
B. 50 mL of 50% dextrose IV push
C. 1 mg of glucagon subcutaneously
D. 4 oz of orange juice with 2 teaspoons of sugar
🟢A
🔴 RATIONALE: For a conscious but confused patient with hypoglycemia, oral glucose (15 g) is the
recommended first-line treatment per guidelines. IV dextrose is for unconscious patients; glucagon is for those
unable to take oral; juice alone lacks measured carbohydrate.
Question 5
A nurse is preparing a patient for a colonoscopy. Which statement indicates that the patient understands the
preparation?
A. “I will stop all medications one week before.”
B. “I can have clear liquids up to 2 hours before.”
C. “I should expect to drink a bowel-cleansing solution.”
D. “I will not need any special diet the day before.”
🟢C
🔴 RATIONALE: Bowel-cleansing solution is standard prep for visualization. Medications like anticoagulants may
be adjusted but not all stopped. Clear liquids are permitted only up to 2 hours before if specified; clear liquid
diet typically required day prior.
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains of Examination
1. Fluid and Electrolyte Balance
2. Perioperative Nursing Care
3. Pain Management
4. Wound Care and Pressure Injuries
5. Cardiovascular Disorders
6. Respiratory Disorders
7. Endocrine Disorders
8. Gastrointestinal Disorders
9. Renal and Urinary Disorders
10. Infection Control and Immunity
Introduction
*This comprehensive examination is designed to assess the essential knowledge, clinical reasoning, and
decision-making skills required for success in NUR 171 – Concepts of Medical-Surgical Nursing. The exam
evaluates foundational theory, applied professional knowledge, regulatory compliance, ethics, and real-world
clinical judgment. Each multiple-choice question presents a realistic patient scenario, requiring the student to
prioritize, analyze data, and select the safest, most evidence-based intervention. Emphasis is placed on critical
thinking, pharmacological safety, interprofessional communication, and patient-centered care. This assessment
,mirrors the complexity of the NCLEX-RN and prepares students for competent, compassionate practice in
medical-surgical settings.*
SECTION ONE – QUESTIONS 1 TO 100
Question 1
A nurse is assessing a patient with chronic heart failure. Which finding most strongly indicates worsening fluid
overload?
A. Blood pressure 118/76 mm Hg
B. Jugular venous distention
C. Pedal pulses 2+ bilaterally
D. Weight gain of 0.5 kg in 24 hours
🟢B
🔴 RATIONALE: Jugular venous distention directly reflects increased central venous pressure from fluid volume
excess in heart failure. BP may be normal; pedal pulse strength is not a fluid status indicator. 0.5 kg weight gain
in 24 hours is minimal and not the most significant sign.
Question 2
A postoperative patient reports pain of 8 on a 0–10 scale. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient reports pain 7 and is drowsy with a respiratory rate of 10 breaths/min. What is the
priority action?
,A. Administer naloxone per protocol
B. Encourage deep breathing and coughing
C. Document the findings and continue to monitor
D. Apply a warm compress to the surgical site
🟢A
🔴 RATIONALE: Respiratory rate of 10 with drowsiness indicates possible opioid-induced respiratory
depression. Naloxone is an opioid antagonist and is the priority to reverse life-threatening depression.
Nonpharmacologic measures and documentation are secondary.
Question 3
A nurse is caring for a patient with a stage 3 pressure injury on the sacrum. Which intervention is most
important?
A. Massage the surrounding skin every shift
B. Cleanse the wound with hydrogen peroxide
C. Apply a moisture-retentive dressing
D. Position patient flat on back to reduce shear
🟢C
🔴 RATIONALE: Stage 3 pressure injuries require a moist wound environment for granulation. Moisture-
retentive dressings support healing. Massage damages tissue; hydrogen peroxide is cytotoxic; flat positioning
increases pressure on sacrum.
Question 4
A patient with diabetes mellitus type 2 has a blood glucose level of 48 mg/dL and is conscious but confused.
, What should the nurse administer first?
A. 15 g of oral glucose gel
B. 50 mL of 50% dextrose IV push
C. 1 mg of glucagon subcutaneously
D. 4 oz of orange juice with 2 teaspoons of sugar
🟢A
🔴 RATIONALE: For a conscious but confused patient with hypoglycemia, oral glucose (15 g) is the
recommended first-line treatment per guidelines. IV dextrose is for unconscious patients; glucagon is for those
unable to take oral; juice alone lacks measured carbohydrate.
Question 5
A nurse is preparing a patient for a colonoscopy. Which statement indicates that the patient understands the
preparation?
A. “I will stop all medications one week before.”
B. “I can have clear liquids up to 2 hours before.”
C. “I should expect to drink a bowel-cleansing solution.”
D. “I will not need any special diet the day before.”
🟢C
🔴 RATIONALE: Bowel-cleansing solution is standard prep for visualization. Medications like anticoagulants may
be adjusted but not all stopped. Clear liquids are permitted only up to 2 hours before if specified; clear liquid
diet typically required day prior.
