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NUR 170 – MED SURG EXAM 1–4 BUNDLE 100 sure Questions
with Complete Solutions & Rationales
Content Areas:
• Exam 1: Foundations, Fluids & Electrolytes, Acid-Base,
Perioperative
• Exam 2: Cardiovascular, Respiratory, Hematology
• Exam 3: Neurological, Musculoskeletal, Renal/Urinary
• Exam 4: Gastrointestinal, Endocrine, Oncology,
Shock/Sepsis
EXAM 1: FOUNDATIONS, FLUIDS & ELECTROLYTES, ACID-BASE,
PERIOPERATIVE (Questions 1–25)
Question 1
A client has a serum sodium of 155 mEq/L. Which assessment
finding is most likely?
A. Edema
B. Thirst and dry mucous membranes
C. Muscle weakness
D. Bradycardia
Answer: B
Rationale: Hypernatremia (normal 135–145) causes cellular
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dehydration, leading to thirst, dry mucous membranes, and
neurological symptoms.
Question 2
Which of the following is the normal serum potassium range?
A. 2.5–4.0 mEq/L
B. 3.5–5.0 mEq/L
C. 5.5–7.0 mEq/L
D. 1.0–3.0 mEq/L
Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L.
Question 3
A client has a potassium level of 6.5 mEq/L. Which ECG change
is most concerning?
A. U waves
B. Peaked T waves and widened QRS
C. Prolonged PR interval only
D. ST depression only
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS,
and can lead to ventricular fibrillation/cardiac arrest.
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Question 4
Which acid-base imbalance is caused by prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting causes loss of hydrochloric acid, leading to
metabolic alkalosis.
Question 5
Which of the following is a sign of hypocalcemia?
A. Positive Chvostek's and Trousseau's signs
B. Decreased deep tendon reflexes
C. Bradycardia
D. Constipation
Answer: A
Rationale: Hypocalcemia causes neuromuscular irritability,
positive Chvostek's (facial twitch) and Trousseau's (carpal
spasm).
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Question 6
A client with respiratory acidosis has which ABG finding?
A. pH 7.30, PaCO₂ 50, HCO₃ 24
B. pH 7.48, PaCO₂ 35, HCO₃ 28
C. pH 7.35, PaCO₂ 40, HCO₃ 24
D. pH 7.45, PaCO₂ 30, HCO₃ 22
Answer: A
Rationale: Respiratory acidosis is low pH with elevated PaCO₂;
HCO₃ may be normal or elevated if compensated.
Question 7
Which of the following is the priority nursing action for a client
with hypovolemic shock?
A. Administer vasopressors first
B. Administer isotonic crystalloids and identify the source of
blood/fluid loss
C. Place in Trendelenburg
D. Give oral fluids
Answer: B
Rationale: Fluid resuscitation with isotonic crystalloids and
controlling the source of loss are priorities in hypovolemic
shock.
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NUR 170 – MED SURG EXAM 1–4 BUNDLE 100 sure Questions
with Complete Solutions & Rationales
Content Areas:
• Exam 1: Foundations, Fluids & Electrolytes, Acid-Base,
Perioperative
• Exam 2: Cardiovascular, Respiratory, Hematology
• Exam 3: Neurological, Musculoskeletal, Renal/Urinary
• Exam 4: Gastrointestinal, Endocrine, Oncology,
Shock/Sepsis
EXAM 1: FOUNDATIONS, FLUIDS & ELECTROLYTES, ACID-BASE,
PERIOPERATIVE (Questions 1–25)
Question 1
A client has a serum sodium of 155 mEq/L. Which assessment
finding is most likely?
A. Edema
B. Thirst and dry mucous membranes
C. Muscle weakness
D. Bradycardia
Answer: B
Rationale: Hypernatremia (normal 135–145) causes cellular
1|Page
, Page |2
dehydration, leading to thirst, dry mucous membranes, and
neurological symptoms.
Question 2
Which of the following is the normal serum potassium range?
A. 2.5–4.0 mEq/L
B. 3.5–5.0 mEq/L
C. 5.5–7.0 mEq/L
D. 1.0–3.0 mEq/L
Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L.
Question 3
A client has a potassium level of 6.5 mEq/L. Which ECG change
is most concerning?
A. U waves
B. Peaked T waves and widened QRS
C. Prolonged PR interval only
D. ST depression only
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS,
and can lead to ventricular fibrillation/cardiac arrest.
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Question 4
Which acid-base imbalance is caused by prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting causes loss of hydrochloric acid, leading to
metabolic alkalosis.
Question 5
Which of the following is a sign of hypocalcemia?
A. Positive Chvostek's and Trousseau's signs
B. Decreased deep tendon reflexes
C. Bradycardia
D. Constipation
Answer: A
Rationale: Hypocalcemia causes neuromuscular irritability,
positive Chvostek's (facial twitch) and Trousseau's (carpal
spasm).
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Question 6
A client with respiratory acidosis has which ABG finding?
A. pH 7.30, PaCO₂ 50, HCO₃ 24
B. pH 7.48, PaCO₂ 35, HCO₃ 28
C. pH 7.35, PaCO₂ 40, HCO₃ 24
D. pH 7.45, PaCO₂ 30, HCO₃ 22
Answer: A
Rationale: Respiratory acidosis is low pH with elevated PaCO₂;
HCO₃ may be normal or elevated if compensated.
Question 7
Which of the following is the priority nursing action for a client
with hypovolemic shock?
A. Administer vasopressors first
B. Administer isotonic crystalloids and identify the source of
blood/fluid loss
C. Place in Trendelenburg
D. Give oral fluids
Answer: B
Rationale: Fluid resuscitation with isotonic crystalloids and
controlling the source of loss are priorities in hypovolemic
shock.
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