NU 155 FINAL EXAM (2026/2027) | MEDICAL-SURGICAL
NURSING I | GALEN (PDF):
EXAMS OF NURSING COMPREHENSIVE ASSESSMENT
Nursing Comprehensive Assessment • 100 Questions
100% VERIFIED
Introduction
The NU 155 Final Examination in Medical-Surgical Nursing I evaluates a nursing student’s
command of foundational adult care concepts across major body systems. Rather than testing recall
in isolation, the examination emphasizes applied professional judgment through realistic clinical
scenarios drawn from eight core domains: Fluid and Electrolyte Imbalances; Acid-Base Balance and
Arterial Blood Gases; Perioperative Nursing Care; Inflammation, Immunity, and Infection Control;
Respiratory Disorders and Nursing Interventions; Cardiovascular Alterations and Hemodynamics;
Gastrointestinal and Hepatic Disorders; and Renal and Urinary Tract Dysfunction. Each scenario
reflects decisions nurses encounter when balancing fluid and acid-base stability, surgical recovery,
infection barriers, and organ-system support. Successful performance verifies a candidate’s
competence for academic progression and confirms the sound judgment required for medical-
surgical nursing clinical execution.
Question 1. A patient with serum sodium of one hundred eighteen shows:
A. Dry mucous membranes only
B. Cerebral edema symptoms like confusion and seizures
C. Flaccid paralysis exclusively
D. Deep bone aching
Correct Answer: B — Cerebral edema symptoms like confusion and seizures
Rationale: Hypo-osmolar water shifts into brain cells. The alternatives miss neurologic
priority.
Question 2. The earliest sign of hyperkalemia on ECG is:
A. Shortened ST segment
B. Tall peaked T waves
C. Sawtooth flutter waves
D. Osborn wave appearance
Correct Answer: B — Tall peaked T waves
Rationale: Potassium elevation peaks repolarization first. Later changes widen QRS.
Question 3. Chvostek sign is elicited by:
A. Percussing the costovertebral angle
, B. Inflating a cuff on the arm
C. Tapping the facial nerve in front of the ear
D. Palpating the thyroid cartilage
Correct Answer: C — Tapping the facial nerve in front of the ear
Rationale: Facial twitching marks hypocalcemic irritability. The cuff elicits Trousseau.
Question 4. Third-spacing fluid shift means:
A. Fluid excreted rapidly
B. Pure intracellular dehydration
C. Fluid trapped in interstitial compartments
D. Fluid inside vessels excess
Correct Answer: C — Fluid trapped in interstitial compartments
Rationale: Sequestered fluid leaves circulation without exiting the body. The alternatives
mislocate it.
Question 5. Isotonic fluid replacement examples include:
A. Half-normal saline
B. Lactated Ringer solution
C. Free water boluses
D. Three percent saline
Correct Answer: B — Lactated Ringer solution
Rationale: Balanced crystalloids mirror plasma tonicity. The others are hypo- or hypertonic.
Question 6. A patient on loop diuretics risks which electrolyte loss pattern?
A. Protein excess loading
B. Potassium with magnesium depletion
C. Chloride accumulation solely
D. Sodium retention with calcium surge
Correct Answer: B — Potassium with magnesium depletion
Rationale: Loop agents waste potassium and magnesium. Retention patterns are opposite.
Question 7. Signs of extracellular fluid volume excess include:
A. Crackles with jugular vein distention
B. Poor skin turgor with dry tongue
C. Weight loss with oliguria resolution
D. Flat neck veins with hypotension
Correct Answer: A — Crackles with jugular vein distention
Rationale: Overload floods lungs and venous systems. Deficit signs are opposite.
Question 8. Hypomagnesemia commonly accompanies:
, A. Routine daily multivitamins
B. Alcohol use disorder with poor intake
C. Excessive nut consumption
D. Chronic constipation treatment
Correct Answer: B — Alcohol use disorder with poor intake
Rationale: Poor nutrition and diuresis deplete magnesium. Dietary surplus raises it.
Question 9. The normal serum calcium ionized fraction is regulated primarily by:
A. Parathyroid hormone
B. Insulin
C. Thyroxine
D. Aldosterone
Correct Answer: A — Parathyroid hormone
Rationale: Parathyroid hormone liberates skeletal calcium. The others target different
metabolism.
Question 10. Replacing sodium too rapidly risks:
A. Pontine demyelination
B. Simple headache relief
C. Permanent immunity
D. Immediate cure of edema
Correct Answer: A — Pontine demyelination
Rationale: Osmotic correction speed destroys myelin. Gradual correction protects the pons.
Question 11. A chloride level rising with bicarbonate falling suggests:
A. Metabolic acidosis compensation attempt
B. Pure anion gap closure
C. Normal electrolyte picture
D. Respiratory alkalosis certainty
Correct Answer: A — Metabolic acidosis compensation attempt
Rationale: Inverse chloride-bicarbonate pairing marks acid-base disturbance. Interpretation
requires gases.
Question 12. Daily weight is the most reliable indicator of:
A. Caloric intake accuracy
B. Fluid balance trend
C. Protein status
D. Bone density change
Correct Answer: B — Fluid balance trend
Rationale: A kilogram approximates a liter of fluid. Other domains shift slower.
NURSING I | GALEN (PDF):
EXAMS OF NURSING COMPREHENSIVE ASSESSMENT
Nursing Comprehensive Assessment • 100 Questions
100% VERIFIED
Introduction
The NU 155 Final Examination in Medical-Surgical Nursing I evaluates a nursing student’s
command of foundational adult care concepts across major body systems. Rather than testing recall
in isolation, the examination emphasizes applied professional judgment through realistic clinical
scenarios drawn from eight core domains: Fluid and Electrolyte Imbalances; Acid-Base Balance and
Arterial Blood Gases; Perioperative Nursing Care; Inflammation, Immunity, and Infection Control;
Respiratory Disorders and Nursing Interventions; Cardiovascular Alterations and Hemodynamics;
Gastrointestinal and Hepatic Disorders; and Renal and Urinary Tract Dysfunction. Each scenario
reflects decisions nurses encounter when balancing fluid and acid-base stability, surgical recovery,
infection barriers, and organ-system support. Successful performance verifies a candidate’s
competence for academic progression and confirms the sound judgment required for medical-
surgical nursing clinical execution.
Question 1. A patient with serum sodium of one hundred eighteen shows:
A. Dry mucous membranes only
B. Cerebral edema symptoms like confusion and seizures
C. Flaccid paralysis exclusively
D. Deep bone aching
Correct Answer: B — Cerebral edema symptoms like confusion and seizures
Rationale: Hypo-osmolar water shifts into brain cells. The alternatives miss neurologic
priority.
Question 2. The earliest sign of hyperkalemia on ECG is:
A. Shortened ST segment
B. Tall peaked T waves
C. Sawtooth flutter waves
D. Osborn wave appearance
Correct Answer: B — Tall peaked T waves
Rationale: Potassium elevation peaks repolarization first. Later changes widen QRS.
Question 3. Chvostek sign is elicited by:
A. Percussing the costovertebral angle
, B. Inflating a cuff on the arm
C. Tapping the facial nerve in front of the ear
D. Palpating the thyroid cartilage
Correct Answer: C — Tapping the facial nerve in front of the ear
Rationale: Facial twitching marks hypocalcemic irritability. The cuff elicits Trousseau.
Question 4. Third-spacing fluid shift means:
A. Fluid excreted rapidly
B. Pure intracellular dehydration
C. Fluid trapped in interstitial compartments
D. Fluid inside vessels excess
Correct Answer: C — Fluid trapped in interstitial compartments
Rationale: Sequestered fluid leaves circulation without exiting the body. The alternatives
mislocate it.
Question 5. Isotonic fluid replacement examples include:
A. Half-normal saline
B. Lactated Ringer solution
C. Free water boluses
D. Three percent saline
Correct Answer: B — Lactated Ringer solution
Rationale: Balanced crystalloids mirror plasma tonicity. The others are hypo- or hypertonic.
Question 6. A patient on loop diuretics risks which electrolyte loss pattern?
A. Protein excess loading
B. Potassium with magnesium depletion
C. Chloride accumulation solely
D. Sodium retention with calcium surge
Correct Answer: B — Potassium with magnesium depletion
Rationale: Loop agents waste potassium and magnesium. Retention patterns are opposite.
Question 7. Signs of extracellular fluid volume excess include:
A. Crackles with jugular vein distention
B. Poor skin turgor with dry tongue
C. Weight loss with oliguria resolution
D. Flat neck veins with hypotension
Correct Answer: A — Crackles with jugular vein distention
Rationale: Overload floods lungs and venous systems. Deficit signs are opposite.
Question 8. Hypomagnesemia commonly accompanies:
, A. Routine daily multivitamins
B. Alcohol use disorder with poor intake
C. Excessive nut consumption
D. Chronic constipation treatment
Correct Answer: B — Alcohol use disorder with poor intake
Rationale: Poor nutrition and diuresis deplete magnesium. Dietary surplus raises it.
Question 9. The normal serum calcium ionized fraction is regulated primarily by:
A. Parathyroid hormone
B. Insulin
C. Thyroxine
D. Aldosterone
Correct Answer: A — Parathyroid hormone
Rationale: Parathyroid hormone liberates skeletal calcium. The others target different
metabolism.
Question 10. Replacing sodium too rapidly risks:
A. Pontine demyelination
B. Simple headache relief
C. Permanent immunity
D. Immediate cure of edema
Correct Answer: A — Pontine demyelination
Rationale: Osmotic correction speed destroys myelin. Gradual correction protects the pons.
Question 11. A chloride level rising with bicarbonate falling suggests:
A. Metabolic acidosis compensation attempt
B. Pure anion gap closure
C. Normal electrolyte picture
D. Respiratory alkalosis certainty
Correct Answer: A — Metabolic acidosis compensation attempt
Rationale: Inverse chloride-bicarbonate pairing marks acid-base disturbance. Interpretation
requires gases.
Question 12. Daily weight is the most reliable indicator of:
A. Caloric intake accuracy
B. Fluid balance trend
C. Protein status
D. Bone density change
Correct Answer: B — Fluid balance trend
Rationale: A kilogram approximates a liter of fluid. Other domains shift slower.
