NU 170 EXAM 4 PRACTICE EXAM – QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS |
LATEST EXAM UPDATE 2026/2027
Core Domains:
Pharmacology and Medication Administration
Fluid and Electrolyte Balance
Perioperative Nursing Care
Pain Management
Wound Care and Infection Control
Legal and Ethical Nursing Practice
End-of-Life and Palliative Care
Emergency and Disaster Preparedness
Introduction
This comprehensive examination is designed to rigorously assess your foundational
knowledge and clinical application skills in medical-surgical nursing. The questions
cover a broad spectrum of essential topics, including pharmacological interventions,
fluid and electrolyte management, and perioperative care, challenging you to
integrate theoretical concepts with practical, real-world scenarios. You will
encounter a variety of multiple-choice questions, from straightforward recall of key
facts to complex, scenario-based problems requiring critical thinking and sound
clinical judgment. Success on this exam reflects your ability to prioritize patient
safety, apply evidence-based practice, and make effective decisions in diverse
healthcare situations. Prepare to demonstrate your readiness for advanced nursing
practice by applying your knowledge to ensure optimal patient outcomes.
════════════════════════════════════
SECTION ONE: QUESTIONS 1–50
,════════════════════════════════════
1. A patient is prescribed 1000 mL of normal saline to infuse over 8 hours. The
IV tubing has a drop factor of 15 gtts/mL. At what rate in drops per minute
(gtts/min) should the nurse set the infusion?
A. 31 gtts/min
B. 25 gtts/min
C. 125 gtts/min
D. 50 gtts/min
🟢 Correct Answer: A. 31 gtts/min
🔴 Explanation: The formula is (Total Volume in mL / Time in minutes) x Drop
factor = gtts/min. (1000 mL / 480 minutes) x 15 gtts/mL = 31.25 gtts/min, which
rounds to 31 gtts/min.
2. A patient with chronic kidney disease has a serum potassium level of 6.2
mEq/L. Which of the following findings is most consistent with this electrolyte
imbalance?
A. Flattened T waves on ECG
B. Muscle weakness and fatigue
C. Cardiac dysrhythmias and peaked T waves
D. Hypoactive bowel sounds
🟢 Correct Answer: C. Cardiac dysrhythmias and peaked T waves
🔴 Explanation: Hyperkalemia (K+ > 5.0 mEq/L) commonly presents with peaked,
narrow T waves on an ECG and can lead to life-threatening cardiac dysrhythmias.
3. A nurse is preparing to administer a blood transfusion to a patient. Which of
the following actions is most important to prevent a transfusion reaction?
,A. Infuse the blood over 1 hour.
B. Verify patient identity using two unique identifiers.
C. Premedicate with diphenhydramine.
D. Check the expiration date on the blood product.
🟢 Correct Answer: B. Verify patient identity using two unique identifiers.
🔴 Explanation: The most critical step in preventing a transfusion reaction is to
correctly identify the patient and match them to the blood product using two
unique identifiers (e.g., name and date of birth).
4. A patient is postoperative day one following a total hip arthroplasty. Which
of the following interventions is most effective for preventing a deep vein
thrombosis (DVT)?
A. Sequential compression devices (SCDs)
B. Early ambulation
C. Administering enoxaparin as prescribed
D. Range-of-motion exercises
🟢 Correct Answer: C. Administering enoxaparin as prescribed
🔴 Explanation: While all options are components of DVT prophylaxis,
pharmacological prophylaxis with low-molecular-weight heparin (e.g., enoxaparin)
is the most effective intervention for preventing thromboembolic events in high-
risk patients.
5. A patient is experiencing an acute asthma attack. The nurse administers a
bronchodilator via nebulizer. Which of the following outcomes indicates the
medication has been effective?
A. Respiratory rate increases from 18 to 24 breaths/min.
B. Peak expiratory flow rate (PEFR) improves.
, C. Patient reports chest tightness.
D. Oxygen saturation decreases to 91%.
🟢 Correct Answer: B. Peak expiratory flow rate (PEFR) improves.
🔴 Explanation: An improvement in the PEFR is an objective measurement of
increased airflow and indicates that the bronchodilator is effectively opening the
airways.
6. A nurse is providing discharge education to a patient prescribed warfarin
(Coumadin). Which of the following patient statements indicates the need for
further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will have my blood drawn for an INR as scheduled."
C. "I will increase my intake of leafy green vegetables."
D. "I will report any unusual bruising or bleeding."
🟢 Correct Answer: C. "I will increase my intake of leafy green vegetables."
🔴 Explanation: Warfarin works by inhibiting vitamin K-dependent clotting
factors. Increasing intake of leafy green vegetables, which are high in vitamin K,
can antagonize the drug's effect and lead to an unstable INR.
7. A patient with a new colostomy is concerned about the odor from the pouch.
Which of the following instructions should the nurse provide?
A. "Place a few drops of liquid antacid in the pouch."
B. "Apply a skin barrier powder around the stoma."
C. "Change the pouch immediately after every meal."
D. "Use a pouch with a charcoal filter."
🟢 Correct Answer: D. "Use a pouch with a charcoal filter."
WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS |
LATEST EXAM UPDATE 2026/2027
Core Domains:
Pharmacology and Medication Administration
Fluid and Electrolyte Balance
Perioperative Nursing Care
Pain Management
Wound Care and Infection Control
Legal and Ethical Nursing Practice
End-of-Life and Palliative Care
Emergency and Disaster Preparedness
Introduction
This comprehensive examination is designed to rigorously assess your foundational
knowledge and clinical application skills in medical-surgical nursing. The questions
cover a broad spectrum of essential topics, including pharmacological interventions,
fluid and electrolyte management, and perioperative care, challenging you to
integrate theoretical concepts with practical, real-world scenarios. You will
encounter a variety of multiple-choice questions, from straightforward recall of key
facts to complex, scenario-based problems requiring critical thinking and sound
clinical judgment. Success on this exam reflects your ability to prioritize patient
safety, apply evidence-based practice, and make effective decisions in diverse
healthcare situations. Prepare to demonstrate your readiness for advanced nursing
practice by applying your knowledge to ensure optimal patient outcomes.
════════════════════════════════════
SECTION ONE: QUESTIONS 1–50
,════════════════════════════════════
1. A patient is prescribed 1000 mL of normal saline to infuse over 8 hours. The
IV tubing has a drop factor of 15 gtts/mL. At what rate in drops per minute
(gtts/min) should the nurse set the infusion?
A. 31 gtts/min
B. 25 gtts/min
C. 125 gtts/min
D. 50 gtts/min
🟢 Correct Answer: A. 31 gtts/min
🔴 Explanation: The formula is (Total Volume in mL / Time in minutes) x Drop
factor = gtts/min. (1000 mL / 480 minutes) x 15 gtts/mL = 31.25 gtts/min, which
rounds to 31 gtts/min.
2. A patient with chronic kidney disease has a serum potassium level of 6.2
mEq/L. Which of the following findings is most consistent with this electrolyte
imbalance?
A. Flattened T waves on ECG
B. Muscle weakness and fatigue
C. Cardiac dysrhythmias and peaked T waves
D. Hypoactive bowel sounds
🟢 Correct Answer: C. Cardiac dysrhythmias and peaked T waves
🔴 Explanation: Hyperkalemia (K+ > 5.0 mEq/L) commonly presents with peaked,
narrow T waves on an ECG and can lead to life-threatening cardiac dysrhythmias.
3. A nurse is preparing to administer a blood transfusion to a patient. Which of
the following actions is most important to prevent a transfusion reaction?
,A. Infuse the blood over 1 hour.
B. Verify patient identity using two unique identifiers.
C. Premedicate with diphenhydramine.
D. Check the expiration date on the blood product.
🟢 Correct Answer: B. Verify patient identity using two unique identifiers.
🔴 Explanation: The most critical step in preventing a transfusion reaction is to
correctly identify the patient and match them to the blood product using two
unique identifiers (e.g., name and date of birth).
4. A patient is postoperative day one following a total hip arthroplasty. Which
of the following interventions is most effective for preventing a deep vein
thrombosis (DVT)?
A. Sequential compression devices (SCDs)
B. Early ambulation
C. Administering enoxaparin as prescribed
D. Range-of-motion exercises
🟢 Correct Answer: C. Administering enoxaparin as prescribed
🔴 Explanation: While all options are components of DVT prophylaxis,
pharmacological prophylaxis with low-molecular-weight heparin (e.g., enoxaparin)
is the most effective intervention for preventing thromboembolic events in high-
risk patients.
5. A patient is experiencing an acute asthma attack. The nurse administers a
bronchodilator via nebulizer. Which of the following outcomes indicates the
medication has been effective?
A. Respiratory rate increases from 18 to 24 breaths/min.
B. Peak expiratory flow rate (PEFR) improves.
, C. Patient reports chest tightness.
D. Oxygen saturation decreases to 91%.
🟢 Correct Answer: B. Peak expiratory flow rate (PEFR) improves.
🔴 Explanation: An improvement in the PEFR is an objective measurement of
increased airflow and indicates that the bronchodilator is effectively opening the
airways.
6. A nurse is providing discharge education to a patient prescribed warfarin
(Coumadin). Which of the following patient statements indicates the need for
further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will have my blood drawn for an INR as scheduled."
C. "I will increase my intake of leafy green vegetables."
D. "I will report any unusual bruising or bleeding."
🟢 Correct Answer: C. "I will increase my intake of leafy green vegetables."
🔴 Explanation: Warfarin works by inhibiting vitamin K-dependent clotting
factors. Increasing intake of leafy green vegetables, which are high in vitamin K,
can antagonize the drug's effect and lead to an unstable INR.
7. A patient with a new colostomy is concerned about the odor from the pouch.
Which of the following instructions should the nurse provide?
A. "Place a few drops of liquid antacid in the pouch."
B. "Apply a skin barrier powder around the stoma."
C. "Change the pouch immediately after every meal."
D. "Use a pouch with a charcoal filter."
🟢 Correct Answer: D. "Use a pouch with a charcoal filter."
