1|Page
NUR 170 Exam 1 Med Surg 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% Latest
Already Graded A+
Question 1
A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired therapeutic
effect?
A) Decreased peripheral edema
B) Increased blood pressure
C) Increased heart rate
D) Decreased urine output
Answer: A) Decreased peripheral edema
Explanation: Furosemide is a loop diuretic that reduces fluid overload by
promoting renal excretion of water and electrolytes. The therapeutic
goal in heart failure is to reduce preload and relieve symptoms of
congestion, such as peripheral edema, pulmonary crackles, and
dyspnea. Decreased peripheral edema directly reflects successful
diuresis. Increased blood pressure is not the primary goal; in fact, blood
,2|Page
pressure may slightly decrease. Increased heart rate and decreased
urine output are adverse or unrelated findings.
Question 2
A postoperative client reports sudden chest pain and shortness of
breath. The nurse notes tachycardia and hypotension. Which condition
should the nurse suspect first?
A) Atelectasis
B) Pulmonary embolism
C) Wound infection
D) Gastric reflux
Answer: B) Pulmonary embolism
Explanation: Sudden chest pain, dyspnea, tachycardia, and hypotension
in a postoperative client are classic signs of a pulmonary embolism (PE),
often resulting from a deep vein thrombosis that has dislodged.
Atelectasis typically presents with low-grade fever and crackles, not
sudden severe symptoms. Wound infection would manifest with
localized redness, warmth, and purulent drainage. Gastric reflux causes
heartburn, not hypotension or tachycardia.
Question 3
Which dietary modification is most appropriate for a client with chronic
kidney disease who is not yet on dialysis?
A) High-protein, high-potassium diet
,3|Page
B) Low-protein, low-potassium diet
C) High-calcium, low-phosphorus diet
D) Low-sodium, high-fluid diet
Answer: B) Low-protein, low-potassium diet
Explanation: In chronic kidney disease, reduced glomerular filtration
leads to accumulation of waste products such as urea and creatinine. A
low-protein diet decreases nitrogenous waste. Potassium restriction is
necessary to prevent hyperkalemia, which can cause cardiac
arrhythmias. Phosphorus restriction, not high calcium, is also typical.
Fluid is often restricted, not encouraged, to prevent fluid overload.
Question 4
The nurse is caring for a client with diabetic ketoacidosis. Which
intravenous fluid should the nurse anticipate administering initially?
A) 0.9% normal saline
B) 0.45% normal saline
C) 5% dextrose in water
D) Lactated Ringer's solution
Answer: A) 0.9% normal saline
Explanation: In diabetic ketoacidosis (DKA), clients are severely
dehydrated due to osmotic diuresis from hyperglycemia. The initial fluid
of choice is isotonic 0.9% normal saline to rapidly restore intravascular
volume and improve tissue perfusion. Hypotonic solutions like 0.45%
, 4|Page
saline are used later if hypernatremia develops. Dextrose solutions are
not given until blood glucose falls near 250 mg/dL to prevent
hypoglycemia. Lactated Ringer's is generally avoided due to lactate
metabolism concerns.
Question 5
A client with cirrhosis is noted to have asterixis. What is the priority
nursing intervention?
A) Administer lactulose
B) Restrict dietary protein
C) Monitor serum ammonia levels
D) All of the above
Answer: D) All of the above
Explanation: Asterixis, or liver flap, is a sign of hepatic encephalopathy
due to elevated serum ammonia. Lactulose is given to acidify the bowel
and trap ammonia for excretion. Protein restriction reduces ammonia
production. Monitoring serum ammonia levels guides treatment. All
three interventions are appropriate and prioritized together.
Question 6
A client is receiving heparin infusion for a deep vein thrombosis. Which
laboratory value should the nurse monitor most closely?
A) aPTT
B) INR
NUR 170 Exam 1 Med Surg 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% Latest
Already Graded A+
Question 1
A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired therapeutic
effect?
A) Decreased peripheral edema
B) Increased blood pressure
C) Increased heart rate
D) Decreased urine output
Answer: A) Decreased peripheral edema
Explanation: Furosemide is a loop diuretic that reduces fluid overload by
promoting renal excretion of water and electrolytes. The therapeutic
goal in heart failure is to reduce preload and relieve symptoms of
congestion, such as peripheral edema, pulmonary crackles, and
dyspnea. Decreased peripheral edema directly reflects successful
diuresis. Increased blood pressure is not the primary goal; in fact, blood
,2|Page
pressure may slightly decrease. Increased heart rate and decreased
urine output are adverse or unrelated findings.
Question 2
A postoperative client reports sudden chest pain and shortness of
breath. The nurse notes tachycardia and hypotension. Which condition
should the nurse suspect first?
A) Atelectasis
B) Pulmonary embolism
C) Wound infection
D) Gastric reflux
Answer: B) Pulmonary embolism
Explanation: Sudden chest pain, dyspnea, tachycardia, and hypotension
in a postoperative client are classic signs of a pulmonary embolism (PE),
often resulting from a deep vein thrombosis that has dislodged.
Atelectasis typically presents with low-grade fever and crackles, not
sudden severe symptoms. Wound infection would manifest with
localized redness, warmth, and purulent drainage. Gastric reflux causes
heartburn, not hypotension or tachycardia.
Question 3
Which dietary modification is most appropriate for a client with chronic
kidney disease who is not yet on dialysis?
A) High-protein, high-potassium diet
,3|Page
B) Low-protein, low-potassium diet
C) High-calcium, low-phosphorus diet
D) Low-sodium, high-fluid diet
Answer: B) Low-protein, low-potassium diet
Explanation: In chronic kidney disease, reduced glomerular filtration
leads to accumulation of waste products such as urea and creatinine. A
low-protein diet decreases nitrogenous waste. Potassium restriction is
necessary to prevent hyperkalemia, which can cause cardiac
arrhythmias. Phosphorus restriction, not high calcium, is also typical.
Fluid is often restricted, not encouraged, to prevent fluid overload.
Question 4
The nurse is caring for a client with diabetic ketoacidosis. Which
intravenous fluid should the nurse anticipate administering initially?
A) 0.9% normal saline
B) 0.45% normal saline
C) 5% dextrose in water
D) Lactated Ringer's solution
Answer: A) 0.9% normal saline
Explanation: In diabetic ketoacidosis (DKA), clients are severely
dehydrated due to osmotic diuresis from hyperglycemia. The initial fluid
of choice is isotonic 0.9% normal saline to rapidly restore intravascular
volume and improve tissue perfusion. Hypotonic solutions like 0.45%
, 4|Page
saline are used later if hypernatremia develops. Dextrose solutions are
not given until blood glucose falls near 250 mg/dL to prevent
hypoglycemia. Lactated Ringer's is generally avoided due to lactate
metabolism concerns.
Question 5
A client with cirrhosis is noted to have asterixis. What is the priority
nursing intervention?
A) Administer lactulose
B) Restrict dietary protein
C) Monitor serum ammonia levels
D) All of the above
Answer: D) All of the above
Explanation: Asterixis, or liver flap, is a sign of hepatic encephalopathy
due to elevated serum ammonia. Lactulose is given to acidify the bowel
and trap ammonia for excretion. Protein restriction reduces ammonia
production. Monitoring serum ammonia levels guides treatment. All
three interventions are appropriate and prioritized together.
Question 6
A client is receiving heparin infusion for a deep vein thrombosis. Which
laboratory value should the nurse monitor most closely?
A) aPTT
B) INR
