,NUR 170 Exam 4 | Concepts of Medical-Surgical Nursing
(2026/2027) PDF | Nursing | Galen
1. A client with decompensated heart failure has crackles, dyspnea, and
orthopnea. Which provider order should the nurse question?
A) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
B) Furosemide 40 mg IV push
C) Oxygen 2 L/min via nasal cannula
D) Daily weights
Correct Answer: A) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Rationale: The client has pulmonary edema from fluid overload. Normal saline is
isotonic and would worsen heart failure and pulmonary congestion.
Furosemide, oxygen, and daily weights are appropriate. The nurse should
question the IV fluid order and anticipate diuresis.
2. Before hanging an IV solution of 0.9% NaCl with potassium chloride, which
assessment finding should cause the nurse to hold the IV and contact the
provider?
A) Blood pressure 140/90 mm Hg
B) Urine output 8 mL/hr
C) Heart rate 88 bpm
D) Temperature 98.6°F
Correct Answer: B) Urine output 8 mL/hr
,Rationale: Potassium is excreted by the kidneys. A urine output of 8 mL/hr
indicates severe oliguria and risk for hyperkalemia if potassium is given. The IV
must be held and the provider notified to prevent life-threatening
dysrhythmias.
3. A client has bilateral above-the-knee amputations and C. difficile diarrhea.
Which assessments detect fluid volume deficit?
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Assess for peripheral edema
Correct Answer: C) Test for skin turgor
Rationale: Fluid volume deficit causes poor skin turgor, flat neck veins, and
weak, rapid pulse. Peripheral edema indicates fluid excess. The nurse should
assess skin turgor, neck veins, and pulse character to identify dehydration.
4. A client is brought to the emergency department after an intentional
acetaminophen overdose. Which medication is the specific antidote to prevent
acute hepatic necrosis?
A) Naloxone
B) Flumazenil
C) Activated charcoal
D) Acetylcysteine
Correct Answer: D) Acetylcysteine
, Rationale: Acetylcysteine is the specific antidote for acetaminophen toxicity. It
replenishes glutathione and detoxifies NAPQI. Naloxone reverses opioids and
flumazenil reverses benzodiazepines. Activated charcoal may be used but is not
the specific antidote.
5. A client with heart failure is receiving intravenous furosemide. Which finding
indicates the medication is effective?
A) Increased urine output
B) Decreased blood pressure
C) Decreased heart rate
D) Increased respiratory rate
Correct Answer: A) Increased urine output
Rationale: Furosemide is a loop diuretic that removes excess fluid. Increased
urine output indicates effective diuresis. Decreased blood pressure may occur
but is not the primary indicator of effectiveness.
6. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which medication should the nurse anticipate?
A) Potassium chloride
B) Sodium polystyrene sulfonate
C) Spironolactone
D) Furosemide
(2026/2027) PDF | Nursing | Galen
1. A client with decompensated heart failure has crackles, dyspnea, and
orthopnea. Which provider order should the nurse question?
A) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
B) Furosemide 40 mg IV push
C) Oxygen 2 L/min via nasal cannula
D) Daily weights
Correct Answer: A) Intravenous 500 mL of 0.9% NaCl at 125 mL/hr
Rationale: The client has pulmonary edema from fluid overload. Normal saline is
isotonic and would worsen heart failure and pulmonary congestion.
Furosemide, oxygen, and daily weights are appropriate. The nurse should
question the IV fluid order and anticipate diuresis.
2. Before hanging an IV solution of 0.9% NaCl with potassium chloride, which
assessment finding should cause the nurse to hold the IV and contact the
provider?
A) Blood pressure 140/90 mm Hg
B) Urine output 8 mL/hr
C) Heart rate 88 bpm
D) Temperature 98.6°F
Correct Answer: B) Urine output 8 mL/hr
,Rationale: Potassium is excreted by the kidneys. A urine output of 8 mL/hr
indicates severe oliguria and risk for hyperkalemia if potassium is given. The IV
must be held and the provider notified to prevent life-threatening
dysrhythmias.
3. A client has bilateral above-the-knee amputations and C. difficile diarrhea.
Which assessments detect fluid volume deficit?
A) Observe for flatness of neck veins when supine
B) Measure rate and character of pulse
C) Test for skin turgor
D) Assess for peripheral edema
Correct Answer: C) Test for skin turgor
Rationale: Fluid volume deficit causes poor skin turgor, flat neck veins, and
weak, rapid pulse. Peripheral edema indicates fluid excess. The nurse should
assess skin turgor, neck veins, and pulse character to identify dehydration.
4. A client is brought to the emergency department after an intentional
acetaminophen overdose. Which medication is the specific antidote to prevent
acute hepatic necrosis?
A) Naloxone
B) Flumazenil
C) Activated charcoal
D) Acetylcysteine
Correct Answer: D) Acetylcysteine
, Rationale: Acetylcysteine is the specific antidote for acetaminophen toxicity. It
replenishes glutathione and detoxifies NAPQI. Naloxone reverses opioids and
flumazenil reverses benzodiazepines. Activated charcoal may be used but is not
the specific antidote.
5. A client with heart failure is receiving intravenous furosemide. Which finding
indicates the medication is effective?
A) Increased urine output
B) Decreased blood pressure
C) Decreased heart rate
D) Increased respiratory rate
Correct Answer: A) Increased urine output
Rationale: Furosemide is a loop diuretic that removes excess fluid. Increased
urine output indicates effective diuresis. Decreased blood pressure may occur
but is not the primary indicator of effectiveness.
6. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which medication should the nurse anticipate?
A) Potassium chloride
B) Sodium polystyrene sulfonate
C) Spironolactone
D) Furosemide
