NUR 180 NEWEST 2026 – FINAL EXAM COMPREHENSIVE CUMULATIVE
NURSING FUNDAMENTALS & MEDICAL-SURGICAL FINAL 200 VERIFIED
QUESTIONS WITH CORRECT ANSWERS AND DETAILED
RATIONALESGRADED A+ | NUR 180 FINAL EXAM PREP
(MOST RECENT!!)
TABLE OF CONTENTS
SECTION 1: FLUID, ELECTROLYTE, & ACID-BASE BALANCE ........... Questions 1–30
SECTION 2: PERIOPERATIVE & WOUND CARE ....................... Questions 31–60
SECTION 3: INFECTION CONTROL & SAFETY ....................... Questions 61–85
SECTION 4: PHARMACOLOGY & MEDICATION ADMINISTRATION ......... Questions 86–115
SECTION 5: OXYGENATION & RESPIRATORY CARE ................... Questions 116–140
SECTION 6: THE NURSING PROCESS & CRITICAL THINKING .......... Questions 141–165
SECTION 7: COMPREHENSIVE/MIXED REVIEW (PRIORITIZATION) ...... Questions 166–200
SECTION 1: FLUID, ELECTROLYTE, & ACID-BASE BALANCE (Questions 1–30)
Question 1
A patient with severe burns has a serum potassium of 6.2 mEq/L. Which
intervention should the nurse anticipate first?
A) Administer sodium polystyrene sulfonate (Kayexalate)
B) Administer IV calcium gluconate
C) Prepare for hemodialysis
D) Restrict dietary potassium
Correct Answer: B
Rationale: Hyperkalemia (>5.5 mEq/L) can cause life-threatening cardiac
arrhythmias. IV calcium gluconate stabilizes the cardiac membrane and is the
first-line emergency treatment. Kayexalate and dialysis remove potassium but
take time. Dietary restriction is for chronic management.
Question 2
1
,A patient with diabetic ketoacidosis has a serum pH of 7.25 and HCO3 of
14 mEq/L. The nurse expects the patient's respiratory pattern to be:
A) Slow, shallow breaths
B) Rapid, deep breaths (Kussmaul)
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: B
Rationale: Metabolic acidosis triggers Kussmaul respirations (deep, rapid) as
the lungs attempt to blow off CO2 to compensate. Slow/shallow breathing would
worsen acidosis. Cheyne-Stokes is seen with neurological injury.
Question 3
A patient has a serum sodium of 115 mEq/L and is having a seizure. Which IV
fluid should the nurse prepare?
A) 0.9% normal saline
B) 3% hypertonic saline
C) 0.45% normal saline
D) Lactated Ringer's
Correct Answer: B
Rationale: Severe hyponatremia with seizures requires rapid correction with
hypertonic (3%) saline to reduce cerebral edema. Isotonic fluids are too
dilute. 0.45% saline would worsen hyponatremia.
Question 4
The nurse is assessing a patient with hypokalemia. Which ECG change is most
2
,characteristic?
A) Peaked T waves
B) U waves
C) Wide QRS complex
D) Tall, tented T waves
Correct Answer: B
Rationale: Hypokalemia causes flattened T waves and prominent U waves. Peaked
T waves and wide QRS are seen in hyperkalemia.
Question 5
A patient with cirrhosis has ascites and is on spironolactone. Which lab value
should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. It can cause
hyperkalemia, especially in patients with liver or renal disease. Monitor
potassium and hold if >5.0 mEq/L.
Question 6
A patient has an arterial blood gas: pH 7.31, PaCO2 55, HCO3 26. The nurse
interprets this as:
3
, A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B
Rationale: Low pH (acidosis) with high PaCO2 (>45) indicates respiratory
acidosis. The HCO3 is normal (no compensation yet). This is acute
respiratory acidosis.
Question 7
A patient with prolonged NG suctioning has a pH of 7.50 and HCO3 of 34 mEq/L.
The nurse expects the PaCO2 to be:
A) Decreased (compensatory hyperventilation)
B) Increased (compensatory hypoventilation)
C) Normal
D) Unchanged
Correct Answer: B
Rationale: Metabolic alkalosis (high pH, high HCO3) triggers respiratory
compensation via hypoventilation to retain CO2, resulting in elevated PaCO2.
The body tries to lower pH back toward normal.
Question 8
Which food should the nurse recommend for a patient with hypomagnesemia?
A) White rice
B) Spinach
C) Applesauce
4
NURSING FUNDAMENTALS & MEDICAL-SURGICAL FINAL 200 VERIFIED
QUESTIONS WITH CORRECT ANSWERS AND DETAILED
RATIONALESGRADED A+ | NUR 180 FINAL EXAM PREP
(MOST RECENT!!)
TABLE OF CONTENTS
SECTION 1: FLUID, ELECTROLYTE, & ACID-BASE BALANCE ........... Questions 1–30
SECTION 2: PERIOPERATIVE & WOUND CARE ....................... Questions 31–60
SECTION 3: INFECTION CONTROL & SAFETY ....................... Questions 61–85
SECTION 4: PHARMACOLOGY & MEDICATION ADMINISTRATION ......... Questions 86–115
SECTION 5: OXYGENATION & RESPIRATORY CARE ................... Questions 116–140
SECTION 6: THE NURSING PROCESS & CRITICAL THINKING .......... Questions 141–165
SECTION 7: COMPREHENSIVE/MIXED REVIEW (PRIORITIZATION) ...... Questions 166–200
SECTION 1: FLUID, ELECTROLYTE, & ACID-BASE BALANCE (Questions 1–30)
Question 1
A patient with severe burns has a serum potassium of 6.2 mEq/L. Which
intervention should the nurse anticipate first?
A) Administer sodium polystyrene sulfonate (Kayexalate)
B) Administer IV calcium gluconate
C) Prepare for hemodialysis
D) Restrict dietary potassium
Correct Answer: B
Rationale: Hyperkalemia (>5.5 mEq/L) can cause life-threatening cardiac
arrhythmias. IV calcium gluconate stabilizes the cardiac membrane and is the
first-line emergency treatment. Kayexalate and dialysis remove potassium but
take time. Dietary restriction is for chronic management.
Question 2
1
,A patient with diabetic ketoacidosis has a serum pH of 7.25 and HCO3 of
14 mEq/L. The nurse expects the patient's respiratory pattern to be:
A) Slow, shallow breaths
B) Rapid, deep breaths (Kussmaul)
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: B
Rationale: Metabolic acidosis triggers Kussmaul respirations (deep, rapid) as
the lungs attempt to blow off CO2 to compensate. Slow/shallow breathing would
worsen acidosis. Cheyne-Stokes is seen with neurological injury.
Question 3
A patient has a serum sodium of 115 mEq/L and is having a seizure. Which IV
fluid should the nurse prepare?
A) 0.9% normal saline
B) 3% hypertonic saline
C) 0.45% normal saline
D) Lactated Ringer's
Correct Answer: B
Rationale: Severe hyponatremia with seizures requires rapid correction with
hypertonic (3%) saline to reduce cerebral edema. Isotonic fluids are too
dilute. 0.45% saline would worsen hyponatremia.
Question 4
The nurse is assessing a patient with hypokalemia. Which ECG change is most
2
,characteristic?
A) Peaked T waves
B) U waves
C) Wide QRS complex
D) Tall, tented T waves
Correct Answer: B
Rationale: Hypokalemia causes flattened T waves and prominent U waves. Peaked
T waves and wide QRS are seen in hyperkalemia.
Question 5
A patient with cirrhosis has ascites and is on spironolactone. Which lab value
should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. It can cause
hyperkalemia, especially in patients with liver or renal disease. Monitor
potassium and hold if >5.0 mEq/L.
Question 6
A patient has an arterial blood gas: pH 7.31, PaCO2 55, HCO3 26. The nurse
interprets this as:
3
, A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B
Rationale: Low pH (acidosis) with high PaCO2 (>45) indicates respiratory
acidosis. The HCO3 is normal (no compensation yet). This is acute
respiratory acidosis.
Question 7
A patient with prolonged NG suctioning has a pH of 7.50 and HCO3 of 34 mEq/L.
The nurse expects the PaCO2 to be:
A) Decreased (compensatory hyperventilation)
B) Increased (compensatory hypoventilation)
C) Normal
D) Unchanged
Correct Answer: B
Rationale: Metabolic alkalosis (high pH, high HCO3) triggers respiratory
compensation via hypoventilation to retain CO2, resulting in elevated PaCO2.
The body tries to lower pH back toward normal.
Question 8
Which food should the nurse recommend for a patient with hypomagnesemia?
A) White rice
B) Spinach
C) Applesauce
4
