NUR 180 NEWEST 2026 EXAM 2 COMPREHENSIVE
NURSING FUNDAMENTALS & MEDICAL-SURGICAL EXAM
300 MULTIPLE CHOICE QUESTIONS WITH ANSWERS AND
RATIONALES
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Table of content
Section 1: MEDICATION ADMINISTRATION &PHARMACOLOGY ……… (Questions 1-40)
Section 2: FLUID & ELECTROLYTE BALANCE…………………. (Questions 41-70)
Section 3: RESPIRATORY SYSTEM & OXYGENATION ………... (Questions 71-110)
Section 4: CARDIAC SYSTEM & HEMODYNAMICS ………… (Questions 111-140)
Section 5: NEUROLOGICAL SYSTEM ……...………... (Questions 141-170)
Section 6: GASTROINTESTINAL SYSTEM & NUTRITION………………... (Questions 171-210)
Section 7: RENAL & URINARY SYSTEM …………. (Questions 211-240)
Section 8: ENDOCRINE SYSTEM …………………… (Questions 241-270)
Section 9: MUSCULOSKELETAL SYSTEM ……………………………………. (Questions 271-300)
SECTION 1: MEDICATION ADMINISTRATION & PHARMACOLOGY (Questions 1-40)
Question 1
A nurse is preparing to administer a medication that has a "Do Not Crush"
warning. The patient has difficulty swallowing tablets. What is the appropriate
nursing action?
A. Crush the tablet and mix with applesauce
B. Request a liquid formulation from the pharmacy
,C. Dissolve the tablet in water
D. Administer the tablet with a full glass of water
Correct Answer: B
Rationale: "Do Not Crush" medications should never be crushed, chewed, or
dissolved because they may be extended-release, enteric-coated, or sublingual
formulations. Crushing can alter absorption, cause toxicity (dumping of extended-
release dose), or inactivate the drug. The nurse should request an alternative
formulation from the pharmacy.
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Question 2
A patient is receiving a continuous heparin infusion. The patient's aPTT level is
120 seconds (therapeutic range 60-80 seconds). What is the priority nursing
action?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Hold the heparin infusion and notify the provider
D. Continue the infusion as ordered
Correct Answer: C
Rationale: An aPTT of 120 seconds is significantly supratherapeutic, placing the
patient at high risk for bleeding. The nurse should hold the heparin infusion and
notify the provider immediately.
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Question 3
A nurse is preparing to administer an intramuscular (IM) injection using the Z-
track method. This technique is used primarily to:
A. Reduce pain during injection
B. Prevent tracking of medication into subcutaneous tissue
C. Increase medication absorption rate
D. Reduce the risk of infection
Correct Answer: B
Rationale: The Z-track method displaces the skin and subcutaneous tissue laterally
before injection, then releases it after the needle is withdrawn. This creates a
zigzag path that seals the medication in the muscle and prevents leakage into
subcutaneous tissue, especially important for irritating medications.
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Question 4
What is the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
, Correct Answer: B
Rationale: Protamine sulfate is the specific antidote for heparin. It binds to
heparin to form a stable complex, neutralizing its anticoagulant effect. Vitamin K
is the antidote for warfarin.
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Question 5
A nurse is administering furosemide to a patient with heart failure. Which
laboratory value requires the closest monitoring?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss
(hypokalemia), which can lead to cardiac dysrhythmias. Potassium levels must be
monitored and supplemented as needed.
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Question 6
NURSING FUNDAMENTALS & MEDICAL-SURGICAL EXAM
300 MULTIPLE CHOICE QUESTIONS WITH ANSWERS AND
RATIONALES
---
Table of content
Section 1: MEDICATION ADMINISTRATION &PHARMACOLOGY ……… (Questions 1-40)
Section 2: FLUID & ELECTROLYTE BALANCE…………………. (Questions 41-70)
Section 3: RESPIRATORY SYSTEM & OXYGENATION ………... (Questions 71-110)
Section 4: CARDIAC SYSTEM & HEMODYNAMICS ………… (Questions 111-140)
Section 5: NEUROLOGICAL SYSTEM ……...………... (Questions 141-170)
Section 6: GASTROINTESTINAL SYSTEM & NUTRITION………………... (Questions 171-210)
Section 7: RENAL & URINARY SYSTEM …………. (Questions 211-240)
Section 8: ENDOCRINE SYSTEM …………………… (Questions 241-270)
Section 9: MUSCULOSKELETAL SYSTEM ……………………………………. (Questions 271-300)
SECTION 1: MEDICATION ADMINISTRATION & PHARMACOLOGY (Questions 1-40)
Question 1
A nurse is preparing to administer a medication that has a "Do Not Crush"
warning. The patient has difficulty swallowing tablets. What is the appropriate
nursing action?
A. Crush the tablet and mix with applesauce
B. Request a liquid formulation from the pharmacy
,C. Dissolve the tablet in water
D. Administer the tablet with a full glass of water
Correct Answer: B
Rationale: "Do Not Crush" medications should never be crushed, chewed, or
dissolved because they may be extended-release, enteric-coated, or sublingual
formulations. Crushing can alter absorption, cause toxicity (dumping of extended-
release dose), or inactivate the drug. The nurse should request an alternative
formulation from the pharmacy.
---
Question 2
A patient is receiving a continuous heparin infusion. The patient's aPTT level is
120 seconds (therapeutic range 60-80 seconds). What is the priority nursing
action?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Hold the heparin infusion and notify the provider
D. Continue the infusion as ordered
Correct Answer: C
Rationale: An aPTT of 120 seconds is significantly supratherapeutic, placing the
patient at high risk for bleeding. The nurse should hold the heparin infusion and
notify the provider immediately.
,---
Question 3
A nurse is preparing to administer an intramuscular (IM) injection using the Z-
track method. This technique is used primarily to:
A. Reduce pain during injection
B. Prevent tracking of medication into subcutaneous tissue
C. Increase medication absorption rate
D. Reduce the risk of infection
Correct Answer: B
Rationale: The Z-track method displaces the skin and subcutaneous tissue laterally
before injection, then releases it after the needle is withdrawn. This creates a
zigzag path that seals the medication in the muscle and prevents leakage into
subcutaneous tissue, especially important for irritating medications.
---
Question 4
What is the antidote for heparin overdose?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
, Correct Answer: B
Rationale: Protamine sulfate is the specific antidote for heparin. It binds to
heparin to form a stable complex, neutralizing its anticoagulant effect. Vitamin K
is the antidote for warfarin.
---
Question 5
A nurse is administering furosemide to a patient with heart failure. Which
laboratory value requires the closest monitoring?
A. Hemoglobin
B. Potassium
C. Platelet count
D. Calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss
(hypokalemia), which can lead to cardiac dysrhythmias. Potassium levels must be
monitored and supplemented as needed.
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Question 6
