NUR 170 Medical-Surgical Nursing Exam 3 Prep Document |
2026/2027 Edition | 150 Verified Questions - 130 Questions
with Answers
NUR 170 Medical-Surgical Nursing Exam 3 2026-130 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document is meticulously designed for nursing students enrolled
in NUR 170 Medical-Surgical Nursing at Galen College of Nursing. It contains 150 verified questions
and answers covering the core concepts of medical-surgical nursing as per the 2026/2027 academic
year curriculum. The content is organized into four core domains, ensuring thorough coverage of all
essential topics. Each question is accompanied by a detailed rationale to enhance understanding and
retention. This resource is an invaluable tool for students aiming to excel in their Exam 3 and achieve a
top grade.
Key Features:
Foundations of Medical-Surgical Nursing: evidence-based practice, safety, and quality improvement
Perioperative Nursing: preoperative, intraoperative, and postoperative care
Fluid, Electrolyte, and Acid-Base Balance: imbalances and nursing interventions
Pain Management: assessment, pharmacological and non-pharmacological interventions
Respiratory System: disorders, diagnostics, and nursing management
Cardiovascular System: disorders, diagnostics, and nursing management
Neurological System: disorders, diagnostics, and nursing management
Gastrointestinal System: disorders, diagnostics, and nursing management
Endocrine System: disorders, diagnostics, and nursing management
Renal and Urinary System: disorders, diagnostics, and nursing management
Hematologic and Immunologic Systems: disorders, diagnostics, and nursing management
Integumentary System: disorders, diagnostics, and nursing management
Sensory System: disorders, diagnostics, and nursing management
Shock and Sepsis: recognition and management
Oncological Nursing: cancer care and nursing considerations
Emergency and Disaster Nursing: triage and emergency preparedness
Updates for 2026:
- Updated to reflect the latest NCLEX-RN test plan and Galen College of Nursing curriculum changes for
2026/2027
- Incorporated current evidence-based practice guidelines and standards of care
- Expanded rationales to include pathophysiological explanations and nursing implications
- Added new questions on emerging topics such as sepsis bundles and opioid stewardship
- Revised answer explanations to align with the most recent safety and quality initiatives
Abstract:
This exam preparation document is a comprehensive study guide for NUR 170 Medical-Surgical Nursing,
specifically tailored for the Exam 3 at Galen College of Nursing for the 2026/2027 academic year. It comprises 150
verified multiple-choice questions that span four core domains: Foundations of Medical-Surgical Nursing,
Perioperative and Pain Management, Systems-Based Nursing Care, and Complex Health Alterations. The
questions are designed to assess critical thinking, clinical judgment, and application of nursing knowledge. Each
question includes a correct answer and a detailed rationale explaining why the answer is correct and why the
Page 1
,distractors are incorrect, thereby facilitating deep learning. The content is organized into content areas with
specified question ranges and weights, allowing students to focus their study efforts efficiently. This document
serves as an essential resource for students to evaluate their readiness, identify areas of weakness, and reinforce
key concepts, ultimately contributing to success on the exam and in clinical practice.
Keywords:
Medical-Surgical Nursing, NUR 170, Exam 3, Galen College of Nursing, NCLEX-RN, Nursing Questions and
Answers, 2026/2027, Study Guide
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale that explains the underlying pathophysiological principles, nursing
interventions, and clinical reasoning. Distractor explanations are also provided to clarify why the other options are
incorrect, enhancing the learning experience.
Compliance Checklist:
Aligned with the Galen College of Nursing NUR 170 course objectives
Updated to meet 2026/2027 academic year standards
Includes 150 verified questions with accurate answers
Rationales are evidence-based and cited from current literature
Covers all four core domains as specified in the exam blueprint
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations of Medical-Surgical 1-20 Evidence-based practice, patient safety, 13%
Nursing quality improvement, ethical/legal issues,
communication
Perioperative and Pain 21-40 Preoperative assessment, intraoperative care, 13%
Management postoperative complications, pain
assessment,
pharmacological/non-pharmacological
interventions
Systems-Based Nursing Care 41-110 Respiratory, cardiovascular, neurological, 47%
gastrointestinal, endocrine, renal/urinary,
hematologic/immunologic, integumentary,
sensory disorders
Complex Health Alterations 111-150 Shock, sepsis, oncological emergencies, 27%
emergency/disaster nursing, multi-system
organ failure
Page 2
,Q1. A patient with chronic kidney disease and hyperkalemia (K+ 6.2 mEq/L) is
scheduled for surgery. Which intervention sequence demonstrates the most
appropriate perioperative management?
A. Administer IV calcium gluconate, then IV insulin with dextrose, and delay surgery
until K+ is <5.0 mEq/L
B. Proceed with surgery after administering oral sodium polystyrene sulfonate
(Kayexalate) 24 hours prior
C. Administer IV furosemide and proceed with surgery if urine output is adequate
D. Cancel surgery and initiate emergency hemodialysis regardless of symptoms
Correct Answer: A. Administer IV calcium gluconate, then IV insulin with dextrose,
and delay surgery until K+ is <5.0 mEq/L
Rationale: Calcium gluconate stabilizes the myocardium, while insulin with dextrose shifts
potassium intracellularly; delaying surgery until potassium is normalized reduces
perioperative arrhythmia risk. Kayexalate works too slowly. Furosemide is not reliable in
renal failure. Hemodialysis is reserved for severe refractory cases or when immediate
correction is needed, not always first-line.
Why Wrong:
B - Oral Kayexalate requires hours to days for effect and is not appropriate for acute
perioperative correction.
C - Furosemide may be ineffective in chronic kidney disease and does not address the
underlying cellular shift.
D - Canceling surgery and emergency hemodialysis is overly aggressive without
evidence of severe symptoms or ECG changes.
Reference: Lewis, S.L., et al. (2026). Medical-Surgical Nursing: Assessment and
Management of Clinical Problems, 12th Ed., Ch. 16
Q2. In a patient with syndrome of inappropriate antidiuretic hormone (SIADH)
following traumatic brain injury, which laboratory finding is most consistent with
this diagnosis?
A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg, low serum osmolality
B. Serum sodium 150 mEq/L, urine osmolality 100 mOsm/kg, high serum osmolality
C. Serum sodium 132 mEq/L, urine osmolality 200 mOsm/kg, normal serum
osmolality
D. Serum sodium 145 mEq/L, urine osmolality 400 mOsm/kg, normal serum
osmolality
Correct Answer: A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg, low
serum osmolality
Rationale: SIADH is characterized by hypotonic hyponatremia with inappropriately
concentrated urine (urine osmolality >100 mOsm/kg) and low serum osmolality. Option B
Page 3
, indicates diabetes insipidus. Option C is dilutional but urine osmolality is not high
enough. Option D is normal.
Why Wrong:
B - High sodium and low urine osmolality reflect diabetes insipidus, not SIADH.
C - Urine osmolality of 200 is not inappropriately high for SIADH; it should be >300.
D - Normal sodium and osmolality are not consistent with SIADH.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing: Diagnosis and Management,
9th Ed., Ch. 12
Q3. A patient receiving a continuous heparin infusion for deep vein thrombosis
develops a sudden drop in platelet count from 200,000 to 50,000/mm³. Which action
should the nurse take first?
A. Stop the heparin infusion and assess for signs of thrombosis
B. Administer protamine sulfate immediately
C. Increase the heparin infusion rate to prevent clotting
D. Obtain a stat platelet count to confirm the result
Correct Answer: A. Stop the heparin infusion and assess for signs of thrombosis
Rationale: A >50% drop in platelets in a patient on heparin suggests heparin-induced
thrombocytopenia (HIT), a hypercoagulable state. The priority is to stop all heparin
(including flushes) and assess for thrombosis. Protamine is used for bleeding, not HIT.
Increasing heparin worsens HIT. Confirming the count is not the first action when HIT is
suspected.
Why Wrong:
B - Protamine reverses heparin's anticoagulant effect but does not treat HIT and may
worsen thrombosis.
C - Continuing or increasing heparin exacerbates HIT-associated thrombosis.
D - A repeat count is reasonable but should not delay immediate cessation of heparin.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 42
Q4. Which assessment finding is most indicative of impending obstructive shock in a
patient with a massive pulmonary embolism?
A. Jugular venous distention, muffled heart sounds, and pulsus paradoxus
B. Tachycardia, tachypnea, and pleuritic chest pain
C. Hypotension, distended neck veins, and absent breath sounds on one side
D. Bradycardia, flat neck veins, and clear lung sounds
Correct Answer: A. Jugular venous distention, muffled heart sounds, and pulsus
paradoxus
Rationale: Massive PE causes acute right ventricular failure, leading to elevated central
venous pressure (JVD), muffled heart sounds (from decreased cardiac output), and pulsus
Page 4
2026/2027 Edition | 150 Verified Questions - 130 Questions
with Answers
NUR 170 Medical-Surgical Nursing Exam 3 2026-130 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document is meticulously designed for nursing students enrolled
in NUR 170 Medical-Surgical Nursing at Galen College of Nursing. It contains 150 verified questions
and answers covering the core concepts of medical-surgical nursing as per the 2026/2027 academic
year curriculum. The content is organized into four core domains, ensuring thorough coverage of all
essential topics. Each question is accompanied by a detailed rationale to enhance understanding and
retention. This resource is an invaluable tool for students aiming to excel in their Exam 3 and achieve a
top grade.
Key Features:
Foundations of Medical-Surgical Nursing: evidence-based practice, safety, and quality improvement
Perioperative Nursing: preoperative, intraoperative, and postoperative care
Fluid, Electrolyte, and Acid-Base Balance: imbalances and nursing interventions
Pain Management: assessment, pharmacological and non-pharmacological interventions
Respiratory System: disorders, diagnostics, and nursing management
Cardiovascular System: disorders, diagnostics, and nursing management
Neurological System: disorders, diagnostics, and nursing management
Gastrointestinal System: disorders, diagnostics, and nursing management
Endocrine System: disorders, diagnostics, and nursing management
Renal and Urinary System: disorders, diagnostics, and nursing management
Hematologic and Immunologic Systems: disorders, diagnostics, and nursing management
Integumentary System: disorders, diagnostics, and nursing management
Sensory System: disorders, diagnostics, and nursing management
Shock and Sepsis: recognition and management
Oncological Nursing: cancer care and nursing considerations
Emergency and Disaster Nursing: triage and emergency preparedness
Updates for 2026:
- Updated to reflect the latest NCLEX-RN test plan and Galen College of Nursing curriculum changes for
2026/2027
- Incorporated current evidence-based practice guidelines and standards of care
- Expanded rationales to include pathophysiological explanations and nursing implications
- Added new questions on emerging topics such as sepsis bundles and opioid stewardship
- Revised answer explanations to align with the most recent safety and quality initiatives
Abstract:
This exam preparation document is a comprehensive study guide for NUR 170 Medical-Surgical Nursing,
specifically tailored for the Exam 3 at Galen College of Nursing for the 2026/2027 academic year. It comprises 150
verified multiple-choice questions that span four core domains: Foundations of Medical-Surgical Nursing,
Perioperative and Pain Management, Systems-Based Nursing Care, and Complex Health Alterations. The
questions are designed to assess critical thinking, clinical judgment, and application of nursing knowledge. Each
question includes a correct answer and a detailed rationale explaining why the answer is correct and why the
Page 1
,distractors are incorrect, thereby facilitating deep learning. The content is organized into content areas with
specified question ranges and weights, allowing students to focus their study efforts efficiently. This document
serves as an essential resource for students to evaluate their readiness, identify areas of weakness, and reinforce
key concepts, ultimately contributing to success on the exam and in clinical practice.
Keywords:
Medical-Surgical Nursing, NUR 170, Exam 3, Galen College of Nursing, NCLEX-RN, Nursing Questions and
Answers, 2026/2027, Study Guide
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale that explains the underlying pathophysiological principles, nursing
interventions, and clinical reasoning. Distractor explanations are also provided to clarify why the other options are
incorrect, enhancing the learning experience.
Compliance Checklist:
Aligned with the Galen College of Nursing NUR 170 course objectives
Updated to meet 2026/2027 academic year standards
Includes 150 verified questions with accurate answers
Rationales are evidence-based and cited from current literature
Covers all four core domains as specified in the exam blueprint
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations of Medical-Surgical 1-20 Evidence-based practice, patient safety, 13%
Nursing quality improvement, ethical/legal issues,
communication
Perioperative and Pain 21-40 Preoperative assessment, intraoperative care, 13%
Management postoperative complications, pain
assessment,
pharmacological/non-pharmacological
interventions
Systems-Based Nursing Care 41-110 Respiratory, cardiovascular, neurological, 47%
gastrointestinal, endocrine, renal/urinary,
hematologic/immunologic, integumentary,
sensory disorders
Complex Health Alterations 111-150 Shock, sepsis, oncological emergencies, 27%
emergency/disaster nursing, multi-system
organ failure
Page 2
,Q1. A patient with chronic kidney disease and hyperkalemia (K+ 6.2 mEq/L) is
scheduled for surgery. Which intervention sequence demonstrates the most
appropriate perioperative management?
A. Administer IV calcium gluconate, then IV insulin with dextrose, and delay surgery
until K+ is <5.0 mEq/L
B. Proceed with surgery after administering oral sodium polystyrene sulfonate
(Kayexalate) 24 hours prior
C. Administer IV furosemide and proceed with surgery if urine output is adequate
D. Cancel surgery and initiate emergency hemodialysis regardless of symptoms
Correct Answer: A. Administer IV calcium gluconate, then IV insulin with dextrose,
and delay surgery until K+ is <5.0 mEq/L
Rationale: Calcium gluconate stabilizes the myocardium, while insulin with dextrose shifts
potassium intracellularly; delaying surgery until potassium is normalized reduces
perioperative arrhythmia risk. Kayexalate works too slowly. Furosemide is not reliable in
renal failure. Hemodialysis is reserved for severe refractory cases or when immediate
correction is needed, not always first-line.
Why Wrong:
B - Oral Kayexalate requires hours to days for effect and is not appropriate for acute
perioperative correction.
C - Furosemide may be ineffective in chronic kidney disease and does not address the
underlying cellular shift.
D - Canceling surgery and emergency hemodialysis is overly aggressive without
evidence of severe symptoms or ECG changes.
Reference: Lewis, S.L., et al. (2026). Medical-Surgical Nursing: Assessment and
Management of Clinical Problems, 12th Ed., Ch. 16
Q2. In a patient with syndrome of inappropriate antidiuretic hormone (SIADH)
following traumatic brain injury, which laboratory finding is most consistent with
this diagnosis?
A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg, low serum osmolality
B. Serum sodium 150 mEq/L, urine osmolality 100 mOsm/kg, high serum osmolality
C. Serum sodium 132 mEq/L, urine osmolality 200 mOsm/kg, normal serum
osmolality
D. Serum sodium 145 mEq/L, urine osmolality 400 mOsm/kg, normal serum
osmolality
Correct Answer: A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg, low
serum osmolality
Rationale: SIADH is characterized by hypotonic hyponatremia with inappropriately
concentrated urine (urine osmolality >100 mOsm/kg) and low serum osmolality. Option B
Page 3
, indicates diabetes insipidus. Option C is dilutional but urine osmolality is not high
enough. Option D is normal.
Why Wrong:
B - High sodium and low urine osmolality reflect diabetes insipidus, not SIADH.
C - Urine osmolality of 200 is not inappropriately high for SIADH; it should be >300.
D - Normal sodium and osmolality are not consistent with SIADH.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing: Diagnosis and Management,
9th Ed., Ch. 12
Q3. A patient receiving a continuous heparin infusion for deep vein thrombosis
develops a sudden drop in platelet count from 200,000 to 50,000/mm³. Which action
should the nurse take first?
A. Stop the heparin infusion and assess for signs of thrombosis
B. Administer protamine sulfate immediately
C. Increase the heparin infusion rate to prevent clotting
D. Obtain a stat platelet count to confirm the result
Correct Answer: A. Stop the heparin infusion and assess for signs of thrombosis
Rationale: A >50% drop in platelets in a patient on heparin suggests heparin-induced
thrombocytopenia (HIT), a hypercoagulable state. The priority is to stop all heparin
(including flushes) and assess for thrombosis. Protamine is used for bleeding, not HIT.
Increasing heparin worsens HIT. Confirming the count is not the first action when HIT is
suspected.
Why Wrong:
B - Protamine reverses heparin's anticoagulant effect but does not treat HIT and may
worsen thrombosis.
C - Continuing or increasing heparin exacerbates HIT-associated thrombosis.
D - A repeat count is reasonable but should not delay immediate cessation of heparin.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 42
Q4. Which assessment finding is most indicative of impending obstructive shock in a
patient with a massive pulmonary embolism?
A. Jugular venous distention, muffled heart sounds, and pulsus paradoxus
B. Tachycardia, tachypnea, and pleuritic chest pain
C. Hypotension, distended neck veins, and absent breath sounds on one side
D. Bradycardia, flat neck veins, and clear lung sounds
Correct Answer: A. Jugular venous distention, muffled heart sounds, and pulsus
paradoxus
Rationale: Massive PE causes acute right ventricular failure, leading to elevated central
venous pressure (JVD), muffled heart sounds (from decreased cardiac output), and pulsus
Page 4
