NU 155 Medical-Surgical Nursing I Exam 3 Prep Document |
2026/2027 Edition | 150 Verified Questions - 130 Questions
with Answers
NU 155 Exam 3 2026-130 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified Solutions |
Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NU 155 Medical-Surgical Nursing I is
meticulously curated to align with the 2026/2027 academic year curriculum. It features 150 verified
questions with correct answers and detailed rationales, covering all major content areas from
perioperative care to complex multisystem disorders. Designed for nursing students seeking a
high-yield review, this resource ensures mastery of essential medical-surgical concepts and clinical
reasoning skills. Each question is formatted to mirror the style and difficulty of actual board
examinations, providing an authentic practice experience.
Key Features:
Foundations of Medical-Surgical Nursing: Evidence-based practice, legal/ethical issues, and nursing process
Perioperative Nursing: Preoperative, intraoperative, and postoperative care
Fluid, Electrolyte, and Acid-Base Balance: Imbalances and nursing interventions
Pain Management: Acute and chronic pain, pharmacological and non-pharmacological interventions
Respiratory System: Assessment, disorders (COPD, asthma, pneumonia), and management
Cardiovascular System: Assessment, disorders (MI, heart failure, hypertension), and management
Hematologic System: Anemias, coagulopathies, and blood component therapy
Neurologic System: Assessment, disorders (stroke, seizures, increased ICP), and management
Musculoskeletal System: Fractures, osteoporosis, and joint disorders
Gastrointestinal System: Assessment, disorders (GI bleed, pancreatitis, liver disease), and management
Endocrine System: Diabetes mellitus, thyroid disorders, and adrenal disorders
Renal and Urinary System: Acute kidney injury, chronic kidney disease, and urinary disorders
Integumentary System: Burns, wound healing, and skin disorders
Sensory System: Eye and ear disorders
Shock and Multisystem Disorders: Sepsis, SIRS, and MODS
Emergency and Disaster Nursing: Triage, disaster preparedness, and emergency care
Updates for 2026:
- Updated to reflect 2026/2027 NCSBN and AACN guidelines
- Incorporates latest evidence-based practice recommendations
- Revised rationales to align with current clinical protocols
- Added new questions on COVID-19 and post-acute sequelae
- Enhanced focus on patient safety and quality improvement initiatives
Abstract:
This exam preparation document for NU 155 Medical-Surgical Nursing I is an indispensable resource for nursing
students aiming to excel in their third examination. It contains 150 verified multiple-choice questions that
comprehensively cover the entire medical-surgical nursing curriculum, from foundational concepts to complex
multisystem disorders. Each question is accompanied by a correct answer and a detailed rationale that explains
the underlying pathophysiology, nursing interventions, and clinical reasoning. The content is organized into
logical sections, allowing for systematic review and targeted study. Updated to reflect the latest evidence-based
guidelines and the 2026/2027 academic year, this document ensures that students are well-prepared for both the
Page 1
,exam and clinical practice. The rationales are designed to enhance critical thinking and application of knowledge,
making this an essential tool for achieving a high score and developing clinical competence.
Keywords:
Medical-Surgical Nursing, NCLEX-RN, Exam Prep, Nursing Rationales, Clinical Reasoning, Evidence-Based
Practice, Patient Safety, 2026-2027
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 why it is correct and why the other options are incorrect. This
format reinforces learning and helps students understand the clinical reasoning behind each answer.
Compliance Checklist:
Aligns with 2026/2027 nursing curriculum standards
Includes 150 verified questions with rationales
Covers all major content areas of Medical-Surgical Nursing I
Reflects current evidence-based practice guidelines
Designed to simulate actual exam conditions
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations and Perioperative 1-15 Evidence-based practice, legal/ethical issues, 10%
Nursing perioperative phases
Fluid, Electrolyte, and 16-30 Fluid imbalances, electrolyte disturbances, 10%
Acid-Base Balance ABG interpretation
Pain Management 31-40 Pain assessment, pharmacological 7%
interventions, non-pharmacological
therapies
Respiratory System 41-60 COPD, asthma, pneumonia, respiratory 13%
assessment, oxygen therapy
Cardiovascular System 61-80 MI, heart failure, hypertension, cardiac 13%
assessment, ECG interpretation
Hematologic System 81-90 Anemias, coagulopathies, blood transfusions 7%
Neurologic System 91-105 Stroke, seizures, increased ICP, neurologic 10%
assessment
Musculoskeletal System 106-115 Fractures, osteoporosis, joint disorders, 7%
mobility
Gastrointestinal System 116-125 GI bleed, pancreatitis, liver disease, 7%
nutritional support
Endocrine System 126-135 Diabetes mellitus, thyroid disorders, adrenal 7%
disorders
Renal and Urinary System 136-145 Acute kidney injury, chronic kidney disease, 7%
urinary disorders
Integumentary, Sensory, Shock, 146-150 Burns, wound healing, eye/ear disorders, 2%
and Emergency shock, sepsis, triage
Page 2
,Q1. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is
prescribed fluid restriction, demeclocycline, and iv furosemide. Which laboratory
trend indicates effective treatment?
A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg
B. Serum sodium 136 mEq/L, urine osmolality 300 mOsm/kg
C. Serum sodium 150 mEq/L, urine osmolality 200 mOsm/kg
D. Serum sodium 130 mEq/L, urine osmolality 450 mOsm/kg
Correct Answer: B. Serum sodium 136 mEq/L, urine osmolality 300 mOsm/kg
Rationale: Effective treatment of SIADH increases serum sodium toward normal (135-145
mEq/L) and decreases urine osmolality toward normal (300-900 mOsm/kg, but lower than
plasma). Option B reflects correction. Option A shows persistent hyponatremia and
concentrated urine. Option C indicates hypernatremia from overcorrection. Option D still
shows hyponatremia and elevated urine osmolality.
Why Wrong:
A - Persistent hyponatremia and high urine osmolality indicate ongoing SIADH.
C - Hypernatremia suggests overcorrection, not effective balanced treatment.
D - Serum sodium remains low and urine osmolality high, showing inadequate
response.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 52.
Q2. Which finding most reliably indicates adequate tissue perfusion in a patient with
septic shock who has received a 30 mL/kg fluid bolus and is on norepinephrine?
A. Mean arterial pressure (MAP) 65 mm Hg
B. Central venous oxygen saturation (ScvO2) 70%
C. Urine output 0.5 mL/kg/hr
D. Serum lactate < 2 mmol/L
Correct Answer: B. Central venous oxygen saturation (ScvO2) 70%
Rationale: ScvO2 "e 70% reflects adequate oxygen delivery relative to consumption, a
direct marker of tissue perfusion. MAP, urine output, and lactate are indirect indicators
and can be normal despite ongoing tissue hypoxia. In early septic shock, ScvO2 is the most
reliable guide for resuscitation.
Why Wrong:
A - MAP is a pressure target, not direct evidence of tissue perfusion.
C - Urine output reflects renal perfusion but can be maintained in early shock.
D - Lactate may lag behind perfusion status and is affected by clearance.
Reference: Surviving Sepsis Campaign (2021). Critical Care Medicine, 49(11).
Page 3
, Q3. A patient with chronic kidney disease (CKD) stage 4 is prescribed sevelamer.
Which laboratory value is the best indicator of therapeutic effectiveness?
A. Serum calcium 8.2 mg/dL
B. Serum phosphorus 4.8 mg/dL
C. Serum PTH 120 pg/mL
D. Serum vitamin D 25-hydroxy 30 ng/mL
Correct Answer: B. Serum phosphorus 4.8 mg/dL
Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus in CKD.
Target phosphorus is 3.5-5.5 mg/dL for CKD stages 3-5. Option B is within that range.
Calcium, PTH, and vitamin D are secondary indicators but not direct measures of binder
efficacy.
Why Wrong:
A - Calcium is not the primary target of phosphate binders.
C - PTH reflects bone disease, not immediate phosphate binding.
D - Vitamin D levels are unrelated to sevelamer's mechanism.
Reference: KDIGO 2017 Clinical Practice Guideline Update for CKD-MBD.
Q4. A patient is receiving a continuous infusion of heparin for deep vein thrombosis.
The aPTT is 95 seconds (therapeutic range 60-80). The nurse notes a new onset of
flank pain and hematuria. What is the priority action?
A. Administer protamine sulfate
B. Stop the heparin infusion
C. Increase the heparin infusion rate
D. Obtain a CT scan of the abdomen
Correct Answer: B. Stop the heparin infusion
Rationale: Flank pain and hematuria in a patient on heparin suggest retroperitoneal
bleeding or renal hemorrhage. The priority is to stop the heparin infusion to prevent
further bleeding. Protamine sulfate may be given after stopping, but the immediate action
is cessation. Increasing the infusion would worsen bleeding. CT is diagnostic but not the
first action.
Why Wrong:
A - Protamine is an antidote but should be given after stopping the infusion and
confirming bleeding.
C - Increasing heparin would exacerbate hemorrhage.
D - Imaging is important but not the priority over stopping the drug.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 33.
Page 4
2026/2027 Edition | 150 Verified Questions - 130 Questions
with Answers
NU 155 Exam 3 2026-130 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified Solutions |
Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NU 155 Medical-Surgical Nursing I is
meticulously curated to align with the 2026/2027 academic year curriculum. It features 150 verified
questions with correct answers and detailed rationales, covering all major content areas from
perioperative care to complex multisystem disorders. Designed for nursing students seeking a
high-yield review, this resource ensures mastery of essential medical-surgical concepts and clinical
reasoning skills. Each question is formatted to mirror the style and difficulty of actual board
examinations, providing an authentic practice experience.
Key Features:
Foundations of Medical-Surgical Nursing: Evidence-based practice, legal/ethical issues, and nursing process
Perioperative Nursing: Preoperative, intraoperative, and postoperative care
Fluid, Electrolyte, and Acid-Base Balance: Imbalances and nursing interventions
Pain Management: Acute and chronic pain, pharmacological and non-pharmacological interventions
Respiratory System: Assessment, disorders (COPD, asthma, pneumonia), and management
Cardiovascular System: Assessment, disorders (MI, heart failure, hypertension), and management
Hematologic System: Anemias, coagulopathies, and blood component therapy
Neurologic System: Assessment, disorders (stroke, seizures, increased ICP), and management
Musculoskeletal System: Fractures, osteoporosis, and joint disorders
Gastrointestinal System: Assessment, disorders (GI bleed, pancreatitis, liver disease), and management
Endocrine System: Diabetes mellitus, thyroid disorders, and adrenal disorders
Renal and Urinary System: Acute kidney injury, chronic kidney disease, and urinary disorders
Integumentary System: Burns, wound healing, and skin disorders
Sensory System: Eye and ear disorders
Shock and Multisystem Disorders: Sepsis, SIRS, and MODS
Emergency and Disaster Nursing: Triage, disaster preparedness, and emergency care
Updates for 2026:
- Updated to reflect 2026/2027 NCSBN and AACN guidelines
- Incorporates latest evidence-based practice recommendations
- Revised rationales to align with current clinical protocols
- Added new questions on COVID-19 and post-acute sequelae
- Enhanced focus on patient safety and quality improvement initiatives
Abstract:
This exam preparation document for NU 155 Medical-Surgical Nursing I is an indispensable resource for nursing
students aiming to excel in their third examination. It contains 150 verified multiple-choice questions that
comprehensively cover the entire medical-surgical nursing curriculum, from foundational concepts to complex
multisystem disorders. Each question is accompanied by a correct answer and a detailed rationale that explains
the underlying pathophysiology, nursing interventions, and clinical reasoning. The content is organized into
logical sections, allowing for systematic review and targeted study. Updated to reflect the latest evidence-based
guidelines and the 2026/2027 academic year, this document ensures that students are well-prepared for both the
Page 1
,exam and clinical practice. The rationales are designed to enhance critical thinking and application of knowledge,
making this an essential tool for achieving a high score and developing clinical competence.
Keywords:
Medical-Surgical Nursing, NCLEX-RN, Exam Prep, Nursing Rationales, Clinical Reasoning, Evidence-Based
Practice, Patient Safety, 2026-2027
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 why it is correct and why the other options are incorrect. This
format reinforces learning and helps students understand the clinical reasoning behind each answer.
Compliance Checklist:
Aligns with 2026/2027 nursing curriculum standards
Includes 150 verified questions with rationales
Covers all major content areas of Medical-Surgical Nursing I
Reflects current evidence-based practice guidelines
Designed to simulate actual exam conditions
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations and Perioperative 1-15 Evidence-based practice, legal/ethical issues, 10%
Nursing perioperative phases
Fluid, Electrolyte, and 16-30 Fluid imbalances, electrolyte disturbances, 10%
Acid-Base Balance ABG interpretation
Pain Management 31-40 Pain assessment, pharmacological 7%
interventions, non-pharmacological
therapies
Respiratory System 41-60 COPD, asthma, pneumonia, respiratory 13%
assessment, oxygen therapy
Cardiovascular System 61-80 MI, heart failure, hypertension, cardiac 13%
assessment, ECG interpretation
Hematologic System 81-90 Anemias, coagulopathies, blood transfusions 7%
Neurologic System 91-105 Stroke, seizures, increased ICP, neurologic 10%
assessment
Musculoskeletal System 106-115 Fractures, osteoporosis, joint disorders, 7%
mobility
Gastrointestinal System 116-125 GI bleed, pancreatitis, liver disease, 7%
nutritional support
Endocrine System 126-135 Diabetes mellitus, thyroid disorders, adrenal 7%
disorders
Renal and Urinary System 136-145 Acute kidney injury, chronic kidney disease, 7%
urinary disorders
Integumentary, Sensory, Shock, 146-150 Burns, wound healing, eye/ear disorders, 2%
and Emergency shock, sepsis, triage
Page 2
,Q1. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is
prescribed fluid restriction, demeclocycline, and iv furosemide. Which laboratory
trend indicates effective treatment?
A. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg
B. Serum sodium 136 mEq/L, urine osmolality 300 mOsm/kg
C. Serum sodium 150 mEq/L, urine osmolality 200 mOsm/kg
D. Serum sodium 130 mEq/L, urine osmolality 450 mOsm/kg
Correct Answer: B. Serum sodium 136 mEq/L, urine osmolality 300 mOsm/kg
Rationale: Effective treatment of SIADH increases serum sodium toward normal (135-145
mEq/L) and decreases urine osmolality toward normal (300-900 mOsm/kg, but lower than
plasma). Option B reflects correction. Option A shows persistent hyponatremia and
concentrated urine. Option C indicates hypernatremia from overcorrection. Option D still
shows hyponatremia and elevated urine osmolality.
Why Wrong:
A - Persistent hyponatremia and high urine osmolality indicate ongoing SIADH.
C - Hypernatremia suggests overcorrection, not effective balanced treatment.
D - Serum sodium remains low and urine osmolality high, showing inadequate
response.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 52.
Q2. Which finding most reliably indicates adequate tissue perfusion in a patient with
septic shock who has received a 30 mL/kg fluid bolus and is on norepinephrine?
A. Mean arterial pressure (MAP) 65 mm Hg
B. Central venous oxygen saturation (ScvO2) 70%
C. Urine output 0.5 mL/kg/hr
D. Serum lactate < 2 mmol/L
Correct Answer: B. Central venous oxygen saturation (ScvO2) 70%
Rationale: ScvO2 "e 70% reflects adequate oxygen delivery relative to consumption, a
direct marker of tissue perfusion. MAP, urine output, and lactate are indirect indicators
and can be normal despite ongoing tissue hypoxia. In early septic shock, ScvO2 is the most
reliable guide for resuscitation.
Why Wrong:
A - MAP is a pressure target, not direct evidence of tissue perfusion.
C - Urine output reflects renal perfusion but can be maintained in early shock.
D - Lactate may lag behind perfusion status and is affected by clearance.
Reference: Surviving Sepsis Campaign (2021). Critical Care Medicine, 49(11).
Page 3
, Q3. A patient with chronic kidney disease (CKD) stage 4 is prescribed sevelamer.
Which laboratory value is the best indicator of therapeutic effectiveness?
A. Serum calcium 8.2 mg/dL
B. Serum phosphorus 4.8 mg/dL
C. Serum PTH 120 pg/mL
D. Serum vitamin D 25-hydroxy 30 ng/mL
Correct Answer: B. Serum phosphorus 4.8 mg/dL
Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus in CKD.
Target phosphorus is 3.5-5.5 mg/dL for CKD stages 3-5. Option B is within that range.
Calcium, PTH, and vitamin D are secondary indicators but not direct measures of binder
efficacy.
Why Wrong:
A - Calcium is not the primary target of phosphate binders.
C - PTH reflects bone disease, not immediate phosphate binding.
D - Vitamin D levels are unrelated to sevelamer's mechanism.
Reference: KDIGO 2017 Clinical Practice Guideline Update for CKD-MBD.
Q4. A patient is receiving a continuous infusion of heparin for deep vein thrombosis.
The aPTT is 95 seconds (therapeutic range 60-80). The nurse notes a new onset of
flank pain and hematuria. What is the priority action?
A. Administer protamine sulfate
B. Stop the heparin infusion
C. Increase the heparin infusion rate
D. Obtain a CT scan of the abdomen
Correct Answer: B. Stop the heparin infusion
Rationale: Flank pain and hematuria in a patient on heparin suggest retroperitoneal
bleeding or renal hemorrhage. The priority is to stop the heparin infusion to prevent
further bleeding. Protamine sulfate may be given after stopping, but the immediate action
is cessation. Increasing the infusion would worsen bleeding. CT is diagnostic but not the
first action.
Why Wrong:
A - Protamine is an antidote but should be given after stopping the infusion and
confirming bleeding.
C - Increasing heparin would exacerbate hemorrhage.
D - Imaging is important but not the priority over stopping the drug.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 33.
Page 4
