Page 1 of 52
NUR 201 MEDICAL-SURGICAL NURSING I EXAM COMPREHENSIVE
QUESTIONS AND CORRECT ANSWERS LATEST EDITION 2026
NUR 201 MEDICAL-SURGICAL NURSING I | QUESTIONS
10-POINT EXAM COVERAGE SUMMARY
1. Fluid, Electrolyte & Acid-Base Balance – Imbalances, IV therapy, monitoring, nursing
interventions
2. Perioperative Nursing Care – Preoperative, intraoperative, postoperative phases,
complications
3. Wound Care & Infection Control – Wound healing, dressings, asepsis, surgical site
infections
4. Respiratory System Disorders – COPD, pneumonia, asthma, oxygenation, suctioning
5. Cardiovascular System Disorders – Hypertension, heart failure, MI, dysrhythmias,
anticoagulation
6. Endocrine System Disorders – Diabetes, thyroid, adrenal disorders, hormone
replacement
7. Gastrointestinal & Renal Disorders – GI bleeding, ostomies, renal failure, dialysis,
urinary care
8. Musculoskeletal & Neurological Disorders – Fractures, traction, stroke, seizures, spinal
cord injury
9. Oncology & Hematologic Disorders – Cancer care, chemotherapy, anemia, clotting
disorders
10. Emergency, Critical Care & Disaster Nursing – Triage, shock, codes, disaster response,
burn care
1|Page
,Page 2 of 52
SECTION 1: FLUID, ELECTROLYTE & ACID-BASE BALANCE (20 QUESTIONS)
1. A nurse is assessing a client with fluid volume deficit who has been vomiting for three days.
Which clinical finding should the nurse expect to observe during the assessment?
A) Decreased urine output and dry mucous membranes
B) Bounding pulse and hypertension
C) Crackles in the lung bases
D) Weight gain and peripheral edema
Rationale: Fluid volume deficit causes decreased urine output, dry mucous membranes,
tachycardia, and hypotension. Bounding pulse, crackles, and edema indicate fluid overload.
2. A nurse is caring for a client receiving intravenous potassium chloride. Which action is most
important for the nurse to take during administration?
A) Administer the medication by IV push over five minutes
B) Ensure adequate urine output before administration
C) Administer the medication rapidly to correct the deficit
D) Withhold the medication if the client reports nausea
Rationale: Potassium should never be given IV push and requires adequate urine output to
prevent hyperkalemia. Rapid administration can cause cardiac arrest.
3. A nurse is reviewing laboratory results for a client with metabolic alkalosis. Which finding
should the nurse anticipate based on this acid-base imbalance?
A) Increased serum bicarbonate and decreased potassium
B) Decreased serum bicarbonate and increased potassium
C) Increased serum carbon dioxide and decreased pH
D) Decreased serum pH and increased hydrogen ions
Rationale: Metabolic alkalosis is characterized by elevated bicarbonate, often with hypokalemia
from vomiting or diuretic use.
2|Page
,Page 3 of 52
4. A nurse is assessing a client with hyperkalemia. Which electrocardiogram finding should the
nurse report immediately to the provider?
A) Tall, peaked T waves
B) Prolonged QT interval
C) ST segment depression
D) Prominent U waves
Rationale: Hyperkalemia causes tall, peaked T waves, widened QRS, and risk of cardiac arrest. U
waves and prolonged QT suggest hypokalemia.
5. A nurse is teaching a client about a low-sodium diet for hypertension management. Which
food selection by the client indicates correct understanding of the teaching?
A) Fresh fruit and steamed vegetables
B) Canned soup and processed deli meats
C) Frozen pizza and salted crackers
D) Pickles and soy sauce
Rationale: Fresh fruits and vegetables are low in sodium; canned soups, processed meats, and
pickled foods are high in sodium.
6. A nurse is monitoring a client receiving a blood transfusion. Which finding indicates a possible
transfusion reaction requiring immediate intervention?
A) Fever, chills, and lower back pain
B) Mild fatigue and drowsiness
C) Increased urine output and thirst
D) Gradual improvement in hemoglobin
Rationale: Fever, chills, and back pain indicate a hemolytic transfusion reaction requiring
immediate cessation of the transfusion.
7. A nurse is assessing a client with hypocalcemia. Which clinical manifestation should the nurse
expect to find during the assessment?
A) Positive Trousseau's sign and tingling in fingers
B) Hypertension and bounding pulse
3|Page
, Page 4 of 52
C) Decreased deep tendon reflexes
D) Muscle weakness and constipation
Rationale: Hypocalcemia causes neuromuscular irritability, positive Trousseau's and Chvostek's
signs, and paresthesias. Hypercalcemia causes weakness and constipation.
8. A nurse is calculating the intake and output for a client over a 24-hour period. Which output
measurement should the nurse include in the total?
A) Urine, vomitus, and wound drainage
B) Urine only
C) Urine and insensible losses
D) Urine, emesis, and diarrhea
Rationale: Intake and output records include measurable outputs such as urine, vomitus,
diarrhea, and wound drainage. Insensible losses are not measured.
9. A nurse is caring for a client with respiratory acidosis. Which intervention should the nurse
implement first to address the underlying cause?
A) Encourage deep breathing and coughing exercises
B) Administer sodium bicarbonate intravenously
C) Restrict fluid intake to prevent overload
D) Place the client in a supine position
Rationale: Respiratory acidosis is caused by hypoventilation; improving ventilation through
deep breathing and coughing addresses the cause.
10. A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone (SIADH).
Which finding should the nurse expect?
A) Concentrated urine and decreased serum sodium
B) Dilute urine and increased serum sodium
C) Polyuria and polydipsia
D) Hypernatremia and dehydration
Rationale: SIADH causes excessive ADH release, leading to water retention, concentrated urine,
and dilutional hyponatremia.
4|Page
NUR 201 MEDICAL-SURGICAL NURSING I EXAM COMPREHENSIVE
QUESTIONS AND CORRECT ANSWERS LATEST EDITION 2026
NUR 201 MEDICAL-SURGICAL NURSING I | QUESTIONS
10-POINT EXAM COVERAGE SUMMARY
1. Fluid, Electrolyte & Acid-Base Balance – Imbalances, IV therapy, monitoring, nursing
interventions
2. Perioperative Nursing Care – Preoperative, intraoperative, postoperative phases,
complications
3. Wound Care & Infection Control – Wound healing, dressings, asepsis, surgical site
infections
4. Respiratory System Disorders – COPD, pneumonia, asthma, oxygenation, suctioning
5. Cardiovascular System Disorders – Hypertension, heart failure, MI, dysrhythmias,
anticoagulation
6. Endocrine System Disorders – Diabetes, thyroid, adrenal disorders, hormone
replacement
7. Gastrointestinal & Renal Disorders – GI bleeding, ostomies, renal failure, dialysis,
urinary care
8. Musculoskeletal & Neurological Disorders – Fractures, traction, stroke, seizures, spinal
cord injury
9. Oncology & Hematologic Disorders – Cancer care, chemotherapy, anemia, clotting
disorders
10. Emergency, Critical Care & Disaster Nursing – Triage, shock, codes, disaster response,
burn care
1|Page
,Page 2 of 52
SECTION 1: FLUID, ELECTROLYTE & ACID-BASE BALANCE (20 QUESTIONS)
1. A nurse is assessing a client with fluid volume deficit who has been vomiting for three days.
Which clinical finding should the nurse expect to observe during the assessment?
A) Decreased urine output and dry mucous membranes
B) Bounding pulse and hypertension
C) Crackles in the lung bases
D) Weight gain and peripheral edema
Rationale: Fluid volume deficit causes decreased urine output, dry mucous membranes,
tachycardia, and hypotension. Bounding pulse, crackles, and edema indicate fluid overload.
2. A nurse is caring for a client receiving intravenous potassium chloride. Which action is most
important for the nurse to take during administration?
A) Administer the medication by IV push over five minutes
B) Ensure adequate urine output before administration
C) Administer the medication rapidly to correct the deficit
D) Withhold the medication if the client reports nausea
Rationale: Potassium should never be given IV push and requires adequate urine output to
prevent hyperkalemia. Rapid administration can cause cardiac arrest.
3. A nurse is reviewing laboratory results for a client with metabolic alkalosis. Which finding
should the nurse anticipate based on this acid-base imbalance?
A) Increased serum bicarbonate and decreased potassium
B) Decreased serum bicarbonate and increased potassium
C) Increased serum carbon dioxide and decreased pH
D) Decreased serum pH and increased hydrogen ions
Rationale: Metabolic alkalosis is characterized by elevated bicarbonate, often with hypokalemia
from vomiting or diuretic use.
2|Page
,Page 3 of 52
4. A nurse is assessing a client with hyperkalemia. Which electrocardiogram finding should the
nurse report immediately to the provider?
A) Tall, peaked T waves
B) Prolonged QT interval
C) ST segment depression
D) Prominent U waves
Rationale: Hyperkalemia causes tall, peaked T waves, widened QRS, and risk of cardiac arrest. U
waves and prolonged QT suggest hypokalemia.
5. A nurse is teaching a client about a low-sodium diet for hypertension management. Which
food selection by the client indicates correct understanding of the teaching?
A) Fresh fruit and steamed vegetables
B) Canned soup and processed deli meats
C) Frozen pizza and salted crackers
D) Pickles and soy sauce
Rationale: Fresh fruits and vegetables are low in sodium; canned soups, processed meats, and
pickled foods are high in sodium.
6. A nurse is monitoring a client receiving a blood transfusion. Which finding indicates a possible
transfusion reaction requiring immediate intervention?
A) Fever, chills, and lower back pain
B) Mild fatigue and drowsiness
C) Increased urine output and thirst
D) Gradual improvement in hemoglobin
Rationale: Fever, chills, and back pain indicate a hemolytic transfusion reaction requiring
immediate cessation of the transfusion.
7. A nurse is assessing a client with hypocalcemia. Which clinical manifestation should the nurse
expect to find during the assessment?
A) Positive Trousseau's sign and tingling in fingers
B) Hypertension and bounding pulse
3|Page
, Page 4 of 52
C) Decreased deep tendon reflexes
D) Muscle weakness and constipation
Rationale: Hypocalcemia causes neuromuscular irritability, positive Trousseau's and Chvostek's
signs, and paresthesias. Hypercalcemia causes weakness and constipation.
8. A nurse is calculating the intake and output for a client over a 24-hour period. Which output
measurement should the nurse include in the total?
A) Urine, vomitus, and wound drainage
B) Urine only
C) Urine and insensible losses
D) Urine, emesis, and diarrhea
Rationale: Intake and output records include measurable outputs such as urine, vomitus,
diarrhea, and wound drainage. Insensible losses are not measured.
9. A nurse is caring for a client with respiratory acidosis. Which intervention should the nurse
implement first to address the underlying cause?
A) Encourage deep breathing and coughing exercises
B) Administer sodium bicarbonate intravenously
C) Restrict fluid intake to prevent overload
D) Place the client in a supine position
Rationale: Respiratory acidosis is caused by hypoventilation; improving ventilation through
deep breathing and coughing addresses the cause.
10. A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone (SIADH).
Which finding should the nurse expect?
A) Concentrated urine and decreased serum sodium
B) Dilute urine and increased serum sodium
C) Polyuria and polydipsia
D) Hypernatremia and dehydration
Rationale: SIADH causes excessive ADH release, leading to water retention, concentrated urine,
and dilutional hyponatremia.
4|Page
