NURS 316 FINAL EXAM Complete Practice Test Bank — 300 Questions With Verified Answers &
Detailed Rationales
TABLE OF CONTENTS
| Section | Domain | Questions |
|---------|-------|-----------|
| I | Professional Nursing Concepts & Scope of Practice | 1–30 |
| II | Health Assessment & Physical Examination | 31–60 |
| III | Pathophysiology & Disease Processes | 61–95 |
| IV | Pharmacology & Medication Administration | 96–125 |
| V | Fluid, Electrolyte & Acid-Base Balance | 126–150 |
| VI | Perioperative & Intraoperative Nursing Care | 151–175 |
| VII | Pain Management & Comfort Care | 176–195 |
| VIII | Immunology & Infectious Disease Management | 196–215 |
| IX | Psychosocial & Mental Health Concepts | 216–235 |
| X | Leadership, Delegation & Management | 236–260 |
| XI | Evidence-Based Practice & Research | 261–280 |
| XII | Comprehensive NGN-Style Case Studies | 281–300 |
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EXAM OVERVIEW
Course: NURS 316 – Advanced Medical-Surgical Nursing
Institution: Nursing Program (University/College Level)
,Total Questions: 300
Format: Multiple-choice, NGN case studies, ordered response, fill-in-the-blank
Academic Year: 2025/2026
Key Content Areas:
- Professional Nursing Concepts – Scope of practice, ethical/legal issues, patient advocacy
- Health Assessment – History-taking, physical examination, diagnostic testing
- Pathophysiology – Disease processes, cellular adaptation, inflammation, healing
- Pharmacology – Medication classifications, adverse effects, drug interactions
- Fluid & Electrolytes – Imbalances, IV therapy, acid-base disorders
- Perioperative Care – Pre-op, intra-op, post-op nursing care
- Pain Management – Assessment, pharmacological/non-pharmacological interventions
- Immunology & Infection – Immune response, infection control, antibiotics
- Psychosocial – Therapeutic communication, mental health, coping mechanisms
- Leadership/Delegation – Prioritization, assignment, delegation, conflict resolution
- Evidence-Based Practice – Research, clinical guidelines, quality improvement
- NGN Case Studies – Extended clinical scenarios with multiple question types
Course Description:
NURS 316 builds on foundational nursing knowledge, integrating pathophysiology,
pharmacology, and clinical reasoning to manage adult clients with complex medical-surgical
conditions. This course emphasizes critical thinking, evidence-based practice, and professional
nursing standards.
---
SECTION I: PROFESSIONAL NURSING CONCEPTS & SCOPE OF PRACTICE
,Questions 1–30
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Question 1
A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's hemoglobin is 7.2 g/dL, and the provider has ordered a transfusion. Which of the
following actions should the nurse take?
A) Administer the transfusion and document the client's refusal
B) Respect the client's decision and notify the provider of the refusal
C) Ask the client's family to convince the client to accept the transfusion
D) Administer the transfusion with a court order
Correct Answer: B
Rationale: A competent adult client has the right to refuse medical treatment, even if it is life-
sustaining. The nurse must respect the client's autonomy, notify the provider, and document the
refusal. Administering against the client's will (A) constitutes battery. Family members (C)
cannot override a competent adult's decision.
---
Question 2
A nurse is preparing to delegate a task to an assistive personnel (AP). Which of the following
tasks is within the AP's scope of practice?
A) Administering oral medications
, B) Assisting a client with ambulation
C) Inserting a Foley catheter
D) Performing a sterile dressing change
Correct Answer: B
Rationale: Assisting with ambulation is within the AP's scope of practice. Administering
medications (A), inserting a catheter (C), and performing sterile dressing changes (D) require
nursing judgment and are not appropriate to delegate.
---
Question 3
A nurse is caring for a client who is scheduled for surgery and has signed an informed consent
form. The client now states, "I don't remember what the surgeon said about the risks." Which of
the following actions should the nurse take?
A) Explain the risks of the procedure to the client
B) Notify the surgeon that the client has questions
C) Ask the client to sign the consent form again
D) Proceed with the surgery
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits,
and alternatives. It is the surgeon's responsibility to provide this information. The nurse should
notify the surgeon so that the client's questions can be addressed.
Detailed Rationales
TABLE OF CONTENTS
| Section | Domain | Questions |
|---------|-------|-----------|
| I | Professional Nursing Concepts & Scope of Practice | 1–30 |
| II | Health Assessment & Physical Examination | 31–60 |
| III | Pathophysiology & Disease Processes | 61–95 |
| IV | Pharmacology & Medication Administration | 96–125 |
| V | Fluid, Electrolyte & Acid-Base Balance | 126–150 |
| VI | Perioperative & Intraoperative Nursing Care | 151–175 |
| VII | Pain Management & Comfort Care | 176–195 |
| VIII | Immunology & Infectious Disease Management | 196–215 |
| IX | Psychosocial & Mental Health Concepts | 216–235 |
| X | Leadership, Delegation & Management | 236–260 |
| XI | Evidence-Based Practice & Research | 261–280 |
| XII | Comprehensive NGN-Style Case Studies | 281–300 |
---
EXAM OVERVIEW
Course: NURS 316 – Advanced Medical-Surgical Nursing
Institution: Nursing Program (University/College Level)
,Total Questions: 300
Format: Multiple-choice, NGN case studies, ordered response, fill-in-the-blank
Academic Year: 2025/2026
Key Content Areas:
- Professional Nursing Concepts – Scope of practice, ethical/legal issues, patient advocacy
- Health Assessment – History-taking, physical examination, diagnostic testing
- Pathophysiology – Disease processes, cellular adaptation, inflammation, healing
- Pharmacology – Medication classifications, adverse effects, drug interactions
- Fluid & Electrolytes – Imbalances, IV therapy, acid-base disorders
- Perioperative Care – Pre-op, intra-op, post-op nursing care
- Pain Management – Assessment, pharmacological/non-pharmacological interventions
- Immunology & Infection – Immune response, infection control, antibiotics
- Psychosocial – Therapeutic communication, mental health, coping mechanisms
- Leadership/Delegation – Prioritization, assignment, delegation, conflict resolution
- Evidence-Based Practice – Research, clinical guidelines, quality improvement
- NGN Case Studies – Extended clinical scenarios with multiple question types
Course Description:
NURS 316 builds on foundational nursing knowledge, integrating pathophysiology,
pharmacology, and clinical reasoning to manage adult clients with complex medical-surgical
conditions. This course emphasizes critical thinking, evidence-based practice, and professional
nursing standards.
---
SECTION I: PROFESSIONAL NURSING CONCEPTS & SCOPE OF PRACTICE
,Questions 1–30
---
Question 1
A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's hemoglobin is 7.2 g/dL, and the provider has ordered a transfusion. Which of the
following actions should the nurse take?
A) Administer the transfusion and document the client's refusal
B) Respect the client's decision and notify the provider of the refusal
C) Ask the client's family to convince the client to accept the transfusion
D) Administer the transfusion with a court order
Correct Answer: B
Rationale: A competent adult client has the right to refuse medical treatment, even if it is life-
sustaining. The nurse must respect the client's autonomy, notify the provider, and document the
refusal. Administering against the client's will (A) constitutes battery. Family members (C)
cannot override a competent adult's decision.
---
Question 2
A nurse is preparing to delegate a task to an assistive personnel (AP). Which of the following
tasks is within the AP's scope of practice?
A) Administering oral medications
, B) Assisting a client with ambulation
C) Inserting a Foley catheter
D) Performing a sterile dressing change
Correct Answer: B
Rationale: Assisting with ambulation is within the AP's scope of practice. Administering
medications (A), inserting a catheter (C), and performing sterile dressing changes (D) require
nursing judgment and are not appropriate to delegate.
---
Question 3
A nurse is caring for a client who is scheduled for surgery and has signed an informed consent
form. The client now states, "I don't remember what the surgeon said about the risks." Which of
the following actions should the nurse take?
A) Explain the risks of the procedure to the client
B) Notify the surgeon that the client has questions
C) Ask the client to sign the consent form again
D) Proceed with the surgery
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits,
and alternatives. It is the surgeon's responsibility to provide this information. The nurse should
notify the surgeon so that the client's questions can be addressed.
