Page 1 of 161
NUR 170 Exam 1: Concepts of Medical-Surgical
Nursing Exam Questions & Rationales
VERIFIED SOLUTIONS LATEST UPDATE THIS
YEAR
NUR 170 Exam 1: Concepts of Medical-Surgical Nursing
Exam Coverage Summary
Based on Galen College of Nursing's NUR 170 curriculum, Exam 1 covers foundational medical-
surgical nursing concepts including:
• Infection Control & Asepsis: Surgical vs. medical asepsis, sterile field principles, open-
gloving method, PPE, surgical hand scrub
• Pain Assessment & Management: Pain scales, acute vs. chronic pain characteristics,
pharmacological interventions, the patient's self-report as the gold standard
• Fluid & Electrolyte Balance: Dehydration risk factors, acid-base imbalances (metabolic
alkalosis from vomiting, respiratory alkalosis from hyperventilation)
• Perioperative Care: Pre-op assessment, informed consent, post-op complications,
malignant hyperthermia, blood transfusion reactions
• Communication & Patient Education: Schramm communication model, therapeutic
communication techniques, HIPAA compliance
• Hematologic Disorders: Sickle cell anemia triggers and management, iron deficiency
anemia, vitamin B12 deficiency
QUESTIONS 1-50
1. The nurse is assessing clients for risk factors leading to dehydration. Which client is at
greatest risk for dehydration?
A) An 83-year-old with congestive heart failure
B) A 36-year-old prescribed long-term steroid therapy
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C) A 76-year-old who is cognitively impaired
D) A 55-year-old who recently received intravenous fluids
Answer: C) Older adults have less total body water than younger adults, making them more
susceptible to dehydration. Cognitive impairment further increases risk because the client
cannot obtain fluids independently or communicate their need for fluids. Heart failure carries
risk for both fluid imbalances, but cognitive impairment presents a more immediate high-risk
scenario .
2. A patient with a 5-day history of nausea and vomiting presents to the emergency
department. What blood gas results would the nurse expect?
A) Decreased pH and increased HCO3
B) Increased pH and increased HCO3
C) Decreased pH and increased CO2
D) Increased pH and decreased CO2
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Answer: B) Prolonged vomiting causes loss of gastric acid (hydrochloric acid), leading to
metabolic alkalosis. This results in elevated pH and elevated bicarbonate (HCO3). Symptoms
include hypoventilation and tachycardia .
3. A patient with a fractured femur from a motor vehicle accident rates pain 9/10 and
appears hysterical. What ABG results would the nurse expect?
A) pH 7.30, CO2 48, HCO3 25
B) pH 7.52, CO2 38, HCO3 30
C) pH 7.48, CO2 31, HCO3 23
D) pH 7.33, CO2 37, HCO3 20
Answer: C) Acute severe pain and hysteria cause hyperventilation, leading to respiratory
alkalosis characterized by high pH (>7.45) and low PaCO2 (<35 mmHg). HCO3 remains normal in
acute respiratory alkalosis. Option C shows pH 7.48 with PaCO2 31 .
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4. A nurse is preparing a sterile field. Which actions contaminate the sterile field? (Select all
that apply)
A) A cotton ball dampened with sterile normal saline is placed on the field
B) A contaminated instrument touches the outer edge of the sterile field
C) A sterile instrument is dropped onto the near side of the sterile field
D) The nurse turns to address the client's question
E) The procedure is postponed for 30 minutes
F) A liquid is poured into a sterile container from a distance of 25 cm
Answer: A, D, E, F) A cotton ball not individually wrapped sterile contaminates the field. Turning
away breaks sterility because the field is no longer visible. Postponing 30 minutes increases
contamination risk. Liquids should be poured from 4-6 inches (10-15 cm), not 25 cm, to avoid
splashing .
5. What is the goal of surgical asepsis?
NUR 170 Exam 1: Concepts of Medical-Surgical
Nursing Exam Questions & Rationales
VERIFIED SOLUTIONS LATEST UPDATE THIS
YEAR
NUR 170 Exam 1: Concepts of Medical-Surgical Nursing
Exam Coverage Summary
Based on Galen College of Nursing's NUR 170 curriculum, Exam 1 covers foundational medical-
surgical nursing concepts including:
• Infection Control & Asepsis: Surgical vs. medical asepsis, sterile field principles, open-
gloving method, PPE, surgical hand scrub
• Pain Assessment & Management: Pain scales, acute vs. chronic pain characteristics,
pharmacological interventions, the patient's self-report as the gold standard
• Fluid & Electrolyte Balance: Dehydration risk factors, acid-base imbalances (metabolic
alkalosis from vomiting, respiratory alkalosis from hyperventilation)
• Perioperative Care: Pre-op assessment, informed consent, post-op complications,
malignant hyperthermia, blood transfusion reactions
• Communication & Patient Education: Schramm communication model, therapeutic
communication techniques, HIPAA compliance
• Hematologic Disorders: Sickle cell anemia triggers and management, iron deficiency
anemia, vitamin B12 deficiency
QUESTIONS 1-50
1. The nurse is assessing clients for risk factors leading to dehydration. Which client is at
greatest risk for dehydration?
A) An 83-year-old with congestive heart failure
B) A 36-year-old prescribed long-term steroid therapy
,Page 2 of 161
C) A 76-year-old who is cognitively impaired
D) A 55-year-old who recently received intravenous fluids
Answer: C) Older adults have less total body water than younger adults, making them more
susceptible to dehydration. Cognitive impairment further increases risk because the client
cannot obtain fluids independently or communicate their need for fluids. Heart failure carries
risk for both fluid imbalances, but cognitive impairment presents a more immediate high-risk
scenario .
2. A patient with a 5-day history of nausea and vomiting presents to the emergency
department. What blood gas results would the nurse expect?
A) Decreased pH and increased HCO3
B) Increased pH and increased HCO3
C) Decreased pH and increased CO2
D) Increased pH and decreased CO2
,Page 3 of 161
Answer: B) Prolonged vomiting causes loss of gastric acid (hydrochloric acid), leading to
metabolic alkalosis. This results in elevated pH and elevated bicarbonate (HCO3). Symptoms
include hypoventilation and tachycardia .
3. A patient with a fractured femur from a motor vehicle accident rates pain 9/10 and
appears hysterical. What ABG results would the nurse expect?
A) pH 7.30, CO2 48, HCO3 25
B) pH 7.52, CO2 38, HCO3 30
C) pH 7.48, CO2 31, HCO3 23
D) pH 7.33, CO2 37, HCO3 20
Answer: C) Acute severe pain and hysteria cause hyperventilation, leading to respiratory
alkalosis characterized by high pH (>7.45) and low PaCO2 (<35 mmHg). HCO3 remains normal in
acute respiratory alkalosis. Option C shows pH 7.48 with PaCO2 31 .
, Page 4 of 161
4. A nurse is preparing a sterile field. Which actions contaminate the sterile field? (Select all
that apply)
A) A cotton ball dampened with sterile normal saline is placed on the field
B) A contaminated instrument touches the outer edge of the sterile field
C) A sterile instrument is dropped onto the near side of the sterile field
D) The nurse turns to address the client's question
E) The procedure is postponed for 30 minutes
F) A liquid is poured into a sterile container from a distance of 25 cm
Answer: A, D, E, F) A cotton ball not individually wrapped sterile contaminates the field. Turning
away breaks sterility because the field is no longer visible. Postponing 30 minutes increases
contamination risk. Liquids should be poured from 4-6 inches (10-15 cm), not 25 cm, to avoid
splashing .
5. What is the goal of surgical asepsis?
