• NUR 6001 09/15/2026
NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse expect to find
when reviewing laboratory values of an 80-year-old male?
a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity. - Correct Answer :C
Rationale
P 1
, • NUR 6001 09/15/2026
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the serum glucose
increases slightly, also due to changes in the kidney. The specific gravity declines by age 80 from 1.032 to 1.024.
5. In preparing to administer intravenous albumin to a client following surgery, what is the priority nursing
intervention? (Select all that apply.)
a. Set the infusion pump to infuse the albumin within four hours.
b. Compare the client's blood type with the label on the albumin.
c. Assign a UAP to monitor blood pressure q15 minutes.
d. Administer through a large gauge catheter.
e. Monitor hemoglobin and hematocrit levels.
f. Assess for increased bleeding after administration. - Correct Answer :A, C, D, E, F
Rationale
Albumin should be infused within four hours because it does not contain any preservatives. Any fluid remaining
after four hours should be discarded. Albumin administration does not require blood typing. Vital signs should be
monitored periodically to assess for fluid volume overload. A large gauge catheter allows for fast infusion rate,
which may be necessary. Hemodilution may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the
HgB and HCT levels should be monitored. While monitoring for bleeding because of the increased blood volume
and blood pressure.
6. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO PRN, for a
client with chronic kidney disease (CKD) who is complaining of indigestion. What intervention should the nurse
implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription. - Correct Answer :D
Rationale
P 2
, • NUR 6001 09/15/2026
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
prescription should be questioned by the nurse.
7. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping. - Correct Answer :A
Rationale
Among the findings characteristic of a small bowel obstruction is the presence of severe fluid and electrolyte
imbalances.
8. The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment. Which
subjective information is most important for the nurse to note?
a. A history of obesity.
b. An allergy to sulfa drugs.
c. Cessation of smoking three years ago.
d. Numbness in the soles of the feet. - Correct Answer :B
Rationale
An allergy to sulfa drugs may make the client unable to use some of the most common antihyperglycemic agents
(sulfonylureas). The nurse needs to highlight this allergy for the healthcare provider.
9. The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure without
specific instruction from the healthcare provider if the client's
P 3
, • NUR 6001 09/15/2026
a. serum digoxin level is 1.5.
b. blood pressure is 104/68.
c. serum potassium level is 3.
d. apical pulse is 68/min. - Correct Answer :C
Rationale
Hypokalemia can precipitate digitalis toxicity in persons receiving digoxin which will increase the chance of
dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
10. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated
two years ago. The client reports that he has a history of "heart trouble," but has no problems at present.
Hospital protocol requires that those over 50 years of age have a recent ECG prior to surgery. What nursing
action is best for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately. - Correct Answer :B
Rationale
According to the hospital policy, clients over the age of 50 and/or with a history of cardiovascular disease, should
receive ECG evaluation prior to surgery, generally 24 hours to two weeks before. The nurse needs to first arrange
for an ECG to be performed immediately prior to surgery.
11. The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which
assessment should the nurse identify before beginning the teaching session?
a. Present knowledge related to the skill of injection.
b. Intelligence and developmental level of the client.
P 4
NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse expect to find
when reviewing laboratory values of an 80-year-old male?
a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity. - Correct Answer :C
Rationale
P 1
, • NUR 6001 09/15/2026
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the serum glucose
increases slightly, also due to changes in the kidney. The specific gravity declines by age 80 from 1.032 to 1.024.
5. In preparing to administer intravenous albumin to a client following surgery, what is the priority nursing
intervention? (Select all that apply.)
a. Set the infusion pump to infuse the albumin within four hours.
b. Compare the client's blood type with the label on the albumin.
c. Assign a UAP to monitor blood pressure q15 minutes.
d. Administer through a large gauge catheter.
e. Monitor hemoglobin and hematocrit levels.
f. Assess for increased bleeding after administration. - Correct Answer :A, C, D, E, F
Rationale
Albumin should be infused within four hours because it does not contain any preservatives. Any fluid remaining
after four hours should be discarded. Albumin administration does not require blood typing. Vital signs should be
monitored periodically to assess for fluid volume overload. A large gauge catheter allows for fast infusion rate,
which may be necessary. Hemodilution may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the
HgB and HCT levels should be monitored. While monitoring for bleeding because of the increased blood volume
and blood pressure.
6. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO PRN, for a
client with chronic kidney disease (CKD) who is complaining of indigestion. What intervention should the nurse
implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription. - Correct Answer :D
Rationale
P 2
, • NUR 6001 09/15/2026
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
prescription should be questioned by the nurse.
7. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping. - Correct Answer :A
Rationale
Among the findings characteristic of a small bowel obstruction is the presence of severe fluid and electrolyte
imbalances.
8. The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment. Which
subjective information is most important for the nurse to note?
a. A history of obesity.
b. An allergy to sulfa drugs.
c. Cessation of smoking three years ago.
d. Numbness in the soles of the feet. - Correct Answer :B
Rationale
An allergy to sulfa drugs may make the client unable to use some of the most common antihyperglycemic agents
(sulfonylureas). The nurse needs to highlight this allergy for the healthcare provider.
9. The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure without
specific instruction from the healthcare provider if the client's
P 3
, • NUR 6001 09/15/2026
a. serum digoxin level is 1.5.
b. blood pressure is 104/68.
c. serum potassium level is 3.
d. apical pulse is 68/min. - Correct Answer :C
Rationale
Hypokalemia can precipitate digitalis toxicity in persons receiving digoxin which will increase the chance of
dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
10. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated
two years ago. The client reports that he has a history of "heart trouble," but has no problems at present.
Hospital protocol requires that those over 50 years of age have a recent ECG prior to surgery. What nursing
action is best for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately. - Correct Answer :B
Rationale
According to the hospital policy, clients over the age of 50 and/or with a history of cardiovascular disease, should
receive ECG evaluation prior to surgery, generally 24 hours to two weeks before. The nurse needs to first arrange
for an ECG to be performed immediately prior to surgery.
11. The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin. Which
assessment should the nurse identify before beginning the teaching session?
a. Present knowledge related to the skill of injection.
b. Intelligence and developmental level of the client.
P 4
