NUR 170 Final Exam | Concepts of Medical-
Surgical Nursing (2026) Q&A | Galen College
1. A nurse is assessing a patient before hanging an IV solution of 0.9%
NaCl with KCl. Which assessment finding should cause the nurse to hold
the IV and contact the provider?
A) Blood pressure 118/76 mmHg
B) Urine output 8 mL/hr
C) Heart rate 88 beats/min
D) Respiratory rate 16 breaths/min
Correct Answer: Urine output 8 mL/hr
Rationale: Potassium is primarily excreted by the kidneys. A urine output
of 8 mL/hr indicates severe oliguria and possible acute kidney injury.
Administering potassium to a patient with impaired renal function can lead
to life-threatening hyperkalemia. The IV must be held and the provider
notified immediately.
2. The nurse is admitting an older adult with decompensated CHF.
Assessment reveals adventitious lung sounds, dyspnea, and orthopnea.
Which physician order should the nurse question?
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Correct Answer: Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Rationale: The patient's symptoms indicate pulmonary edema and fluid
overload from heart failure. Administering 500 mL of normal saline at 125
mL/hr would increase intravascular volume, worsening the heart failure
,and pulmonary congestion. The nurse should question this order and
anticipate diuretics or fluid restriction.
3. The patient has recent bilateral above-the-knee amputations and has
developed C. difficile diarrhea. Which assessments should the nurse use to
detect fluid volume deficit? (Select all that apply.)
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Measure blood pressure in the lower extremities
Correct Answer: Observe for flatness of neck veins when supine,
Measure rate and character of pulse, Test for skin turgor
Rationale: In hypovolemia, decreased intravascular volume leads to low
central venous pressure, causing flat neck veins even when supine.
Hypovolemia triggers tachycardia with a weak, thready pulse. Dehydration
reduces skin elasticity, and poor skin turgor is a key sign of fluid deficit.
Blood pressure in lower extremities is not a standard assessment for fluid
volume deficit.
4. Which finding in a patient receiving tube feedings should prompt the
nurse to request a serum sodium concentration?
A) Decreased level of consciousness
B) Increased appetite
C) Warm, dry skin
D) Bradycardia
Correct Answer: Decreased level of consciousness
Rationale: Tube feedings can cause fluid and electrolyte imbalances,
including hypernatremia or hyponatremia. Both conditions can cause
neurological symptoms. A sudden decrease in level of consciousness is a
,critical sign of severe sodium imbalance and requires immediate serum
sodium assessment.
5. A nurse is caring for a patient prescribed peripheral intravenous
therapy. Which task is appropriate to delegate to the nursing assistant?
A) Recording intake and output
B) Inserting the IV catheter
C) Assessing the IV site for infiltration
D) Calculating the IV flow rate
Correct Answer: Recording intake and output
Rationale: Measuring and recording intake and output is within the
nursing assistant's scope of practice. IV insertion, medication
administration, and IV site assessment are RN/LPN responsibilities.
Delegation must be based on state nurse practice acts and facility
policies.
6. A patient is experiencing dehydration. The majority of the patient's total
water volume exists in which compartment?
A) Intracellular
B) Interstitial
C) Intravascular
D) Transcellular
Correct Answer: Intracellular
Rationale: Intracellular fluid (ICF) contains approximately two-thirds
(about 66%) of total body water. Extracellular fluid (ECF), which includes
intravascular and interstitial compartments, contains the remaining one-
third. Dehydration primarily affects ECF volume initially.
, 7. A patient receiving chemotherapy has gained 5 lbs in 2 days. Which
assessment question is most appropriate?
A) "How many times a day do you urinate?"
B) "Are you eating more than usual?"
C) "Have you been walking more?"
D) "Are you sleeping well at night?"
Correct Answer: "How many times a day do you urinate?"
Rationale: Rapid weight gain suggests fluid retention, possibly from heart
failure or renal issues. Decreased urine output may indicate acute kidney
injury. The nurse should also assess for edema and shortness of breath to
evaluate fluid status.
8. The nurse is caring for a patient who was started on total parenteral
nutrition (TPN) 2 days ago. The patient reports blurred vision, increased
thirst, and frequent urination. What is the nurse's priority action?
A) Slow the TPN infusion
B) Obtain serum electrolyte levels
C) Assess vital signs
D) Assess blood glucose level
Correct Answer: Assess blood glucose level
Rationale: Blurred vision, thirst, and frequent urination are classic signs
of hyperglycemia. TPN contains high concentrations of dextrose, which
can cause elevated blood glucose levels. Checking the blood glucose level
is the priority assessment before implementing interventions.
9. A client with a history of heart failure is prescribed furosemide. Which
food choice indicates the client understands teaching about potassium
replacement?
A) Applesauce
Surgical Nursing (2026) Q&A | Galen College
1. A nurse is assessing a patient before hanging an IV solution of 0.9%
NaCl with KCl. Which assessment finding should cause the nurse to hold
the IV and contact the provider?
A) Blood pressure 118/76 mmHg
B) Urine output 8 mL/hr
C) Heart rate 88 beats/min
D) Respiratory rate 16 breaths/min
Correct Answer: Urine output 8 mL/hr
Rationale: Potassium is primarily excreted by the kidneys. A urine output
of 8 mL/hr indicates severe oliguria and possible acute kidney injury.
Administering potassium to a patient with impaired renal function can lead
to life-threatening hyperkalemia. The IV must be held and the provider
notified immediately.
2. The nurse is admitting an older adult with decompensated CHF.
Assessment reveals adventitious lung sounds, dyspnea, and orthopnea.
Which physician order should the nurse question?
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Correct Answer: Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Rationale: The patient's symptoms indicate pulmonary edema and fluid
overload from heart failure. Administering 500 mL of normal saline at 125
mL/hr would increase intravascular volume, worsening the heart failure
,and pulmonary congestion. The nurse should question this order and
anticipate diuretics or fluid restriction.
3. The patient has recent bilateral above-the-knee amputations and has
developed C. difficile diarrhea. Which assessments should the nurse use to
detect fluid volume deficit? (Select all that apply.)
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Measure blood pressure in the lower extremities
Correct Answer: Observe for flatness of neck veins when supine,
Measure rate and character of pulse, Test for skin turgor
Rationale: In hypovolemia, decreased intravascular volume leads to low
central venous pressure, causing flat neck veins even when supine.
Hypovolemia triggers tachycardia with a weak, thready pulse. Dehydration
reduces skin elasticity, and poor skin turgor is a key sign of fluid deficit.
Blood pressure in lower extremities is not a standard assessment for fluid
volume deficit.
4. Which finding in a patient receiving tube feedings should prompt the
nurse to request a serum sodium concentration?
A) Decreased level of consciousness
B) Increased appetite
C) Warm, dry skin
D) Bradycardia
Correct Answer: Decreased level of consciousness
Rationale: Tube feedings can cause fluid and electrolyte imbalances,
including hypernatremia or hyponatremia. Both conditions can cause
neurological symptoms. A sudden decrease in level of consciousness is a
,critical sign of severe sodium imbalance and requires immediate serum
sodium assessment.
5. A nurse is caring for a patient prescribed peripheral intravenous
therapy. Which task is appropriate to delegate to the nursing assistant?
A) Recording intake and output
B) Inserting the IV catheter
C) Assessing the IV site for infiltration
D) Calculating the IV flow rate
Correct Answer: Recording intake and output
Rationale: Measuring and recording intake and output is within the
nursing assistant's scope of practice. IV insertion, medication
administration, and IV site assessment are RN/LPN responsibilities.
Delegation must be based on state nurse practice acts and facility
policies.
6. A patient is experiencing dehydration. The majority of the patient's total
water volume exists in which compartment?
A) Intracellular
B) Interstitial
C) Intravascular
D) Transcellular
Correct Answer: Intracellular
Rationale: Intracellular fluid (ICF) contains approximately two-thirds
(about 66%) of total body water. Extracellular fluid (ECF), which includes
intravascular and interstitial compartments, contains the remaining one-
third. Dehydration primarily affects ECF volume initially.
, 7. A patient receiving chemotherapy has gained 5 lbs in 2 days. Which
assessment question is most appropriate?
A) "How many times a day do you urinate?"
B) "Are you eating more than usual?"
C) "Have you been walking more?"
D) "Are you sleeping well at night?"
Correct Answer: "How many times a day do you urinate?"
Rationale: Rapid weight gain suggests fluid retention, possibly from heart
failure or renal issues. Decreased urine output may indicate acute kidney
injury. The nurse should also assess for edema and shortness of breath to
evaluate fluid status.
8. The nurse is caring for a patient who was started on total parenteral
nutrition (TPN) 2 days ago. The patient reports blurred vision, increased
thirst, and frequent urination. What is the nurse's priority action?
A) Slow the TPN infusion
B) Obtain serum electrolyte levels
C) Assess vital signs
D) Assess blood glucose level
Correct Answer: Assess blood glucose level
Rationale: Blurred vision, thirst, and frequent urination are classic signs
of hyperglycemia. TPN contains high concentrations of dextrose, which
can cause elevated blood glucose levels. Checking the blood glucose level
is the priority assessment before implementing interventions.
9. A client with a history of heart failure is prescribed furosemide. Which
food choice indicates the client understands teaching about potassium
replacement?
A) Applesauce
