N108 MED SURG FINAL MOCK EXAM |
QUESTIONS AND ANSWERS WITH RATIONALES
| 2026/2027 UPDATED | EASTWICK COLLEGE.
99 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
N108 MED SURG FINAL MOCK EXAM | QUESTIONS AND ANSWERS WITH RATIONALES | 2026/2027
UPDATED | EASTWICK COLLEGE.. It contains 99 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 99 Questions
Foundations - Application - N108 MED SURG AND WITH Rationales 2026/2027 Updated Eastwick College
Medical-surgical Nursing Undergraduate YEAR 3 Adn/baccalaureate Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Perioperative CARE 1-17 Finding, Acute, Arterial, Intervention, Injury
Cardiovascular Disorders 18-34 Finding, Acute, Syndrome, Respiratory, Indicates
Respiratory Disorders 35-51 Finding, Rather, Arterial, Intervention, Blood
Neurological Disorders 52-68 Finding, Intervention, Acute, Indicates, Immediate
Endocrine Disorders 69-85 Finding, Indicates, Rather, Injury, Arterial
Renal AND Urinary Disorders 86-99 Acute, Finding, Indicates, Kidney, Injury
TOTAL 99 All questions include answers and detailed rationales
,Section A - Perioperative CARE
Q1.
Which finding most urgently requires intervention in a client one hour after total
thyroidectomy?
A. Serum calcium 8.2 mg/dL with positive B. Hoarse voice and frequent throat clearing
Trousseau sign
C. Incisional pain rated 6/10 with swelling at D. Heart rate 110/min and blood pressure
site 150/90 mm Hg
Correct: A - Serum calcium 8.2 mg/dL with positive Trousseau sign
Rationale:Positive Trousseau sign with hypocalcemia indicates impending tetany and
laryngospasm, a life-threatening complication after thyroidectomy. Hoarseness may be
transient nerve irritation; pain and swelling are expected; tachycardia and hypertension are
concerning but not immediately lethal compared to airway risk.
Q2.
A client with acute decompensated heart failure has crackles and S3. Which prescription
should the nurse question?
A. Furosemide 40 mg IV push B. 0.9% sodium chloride at 125 mL/hr
C. Bumetanide 1 mg IV now D. Morphine 2 mg IV for anxiety
Correct: B - 0.9% sodium chloride at 125 mL/hr
Rationale:Rapid isotonic fluid administration worsens pulmonary congestion in acute
decompensated heart failure. Loop diuretics (furosemide, bumetanide) and cautious morphine
are appropriate for preload reduction and anxiety. The nurse should question the saline bolus.
Q3.
Which assessment finding best differentiates autonomic dysreflexia from sepsis in a client
with T6 spinal cord injury?
A. Temperature 38.9°C (102°F) with B. Sudden severe hypertension with
tachycardia bradycardia and flushing above the lesion
C. Hypotension with warm, dry skin D. Confusion and tachypnea
Correct: B - Sudden severe hypertension with bradycardia and flushing above the lesion
Page 3
, Section A - Perioperative CARE
Rationale: Autonomic dysreflexia presents with paroxysmal hypertension, bradycardia, and
flushing above the level of injury due to sympathetic overactivity. Sepsis typically causes
fever, tachycardia, and hypotension. The other options are nonspecific or suggest sepsis.
Q4.
A client with diabetic ketoacidosis has a potassium level of 3.2 mEq/L. Which action is
priority?
A. Administer regular insulin IV bolus B. Begin potassium replacement before
insulin
C. Give sodium bicarbonate IV D. Start 0.45% sodium chloride infusion
Correct: B - Begin potassium replacement before insulin
Rationale:Insulin drives potassium intracellularly, worsening hypokalemia and risking fatal
dysrhythmias. Potassium must be replaced first when K+ <3.3 mEq/L. Bicarbonate is not
indicated; hypotonic fluids are contraindicated initially.
Q5.
Which arterial blood gas value indicates the need for immediate intubation in a client with
myasthenia gravis?
A. pH 7.32, PaCO2 48 mm Hg, HCO3 24 B. pH 7.48, PaCO2 30 mm Hg, HCO3 24
mEq/L mEq/L
C. pH 7.30, PaCO2 56 mm Hg, HCO3 26 D. pH 7.35, PaCO2 40 mm Hg, HCO3 22
mEq/L mEq/L
Correct: C - pH 7.30, PaCO2 56 mm Hg, HCO3 26 mEq/L
Rationale:Rising PaCO2 with respiratory acidosis indicates ventilatory failure and impending
respiratory arrest in myasthenic crisis. Options A and B show mild disturbances; D is normal.
Intubation is indicated for hypercapnia with acidosis.
Q6.
A client with acute pancreatitis has a calcium level of 7.8 mg/dL. Which intervention is
most appropriate?
A. Administer IV calcium gluconate B. Encourage high-fat diet
C. Prepare for parathyroidectomy D. Restrict oral fluids
Correct: A - Administer IV calcium gluconate
Page 4
QUESTIONS AND ANSWERS WITH RATIONALES
| 2026/2027 UPDATED | EASTWICK COLLEGE.
99 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
N108 MED SURG FINAL MOCK EXAM | QUESTIONS AND ANSWERS WITH RATIONALES | 2026/2027
UPDATED | EASTWICK COLLEGE.. It contains 99 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 99 Questions
Foundations - Application - N108 MED SURG AND WITH Rationales 2026/2027 Updated Eastwick College
Medical-surgical Nursing Undergraduate YEAR 3 Adn/baccalaureate Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Perioperative CARE 1-17 Finding, Acute, Arterial, Intervention, Injury
Cardiovascular Disorders 18-34 Finding, Acute, Syndrome, Respiratory, Indicates
Respiratory Disorders 35-51 Finding, Rather, Arterial, Intervention, Blood
Neurological Disorders 52-68 Finding, Intervention, Acute, Indicates, Immediate
Endocrine Disorders 69-85 Finding, Indicates, Rather, Injury, Arterial
Renal AND Urinary Disorders 86-99 Acute, Finding, Indicates, Kidney, Injury
TOTAL 99 All questions include answers and detailed rationales
,Section A - Perioperative CARE
Q1.
Which finding most urgently requires intervention in a client one hour after total
thyroidectomy?
A. Serum calcium 8.2 mg/dL with positive B. Hoarse voice and frequent throat clearing
Trousseau sign
C. Incisional pain rated 6/10 with swelling at D. Heart rate 110/min and blood pressure
site 150/90 mm Hg
Correct: A - Serum calcium 8.2 mg/dL with positive Trousseau sign
Rationale:Positive Trousseau sign with hypocalcemia indicates impending tetany and
laryngospasm, a life-threatening complication after thyroidectomy. Hoarseness may be
transient nerve irritation; pain and swelling are expected; tachycardia and hypertension are
concerning but not immediately lethal compared to airway risk.
Q2.
A client with acute decompensated heart failure has crackles and S3. Which prescription
should the nurse question?
A. Furosemide 40 mg IV push B. 0.9% sodium chloride at 125 mL/hr
C. Bumetanide 1 mg IV now D. Morphine 2 mg IV for anxiety
Correct: B - 0.9% sodium chloride at 125 mL/hr
Rationale:Rapid isotonic fluid administration worsens pulmonary congestion in acute
decompensated heart failure. Loop diuretics (furosemide, bumetanide) and cautious morphine
are appropriate for preload reduction and anxiety. The nurse should question the saline bolus.
Q3.
Which assessment finding best differentiates autonomic dysreflexia from sepsis in a client
with T6 spinal cord injury?
A. Temperature 38.9°C (102°F) with B. Sudden severe hypertension with
tachycardia bradycardia and flushing above the lesion
C. Hypotension with warm, dry skin D. Confusion and tachypnea
Correct: B - Sudden severe hypertension with bradycardia and flushing above the lesion
Page 3
, Section A - Perioperative CARE
Rationale: Autonomic dysreflexia presents with paroxysmal hypertension, bradycardia, and
flushing above the level of injury due to sympathetic overactivity. Sepsis typically causes
fever, tachycardia, and hypotension. The other options are nonspecific or suggest sepsis.
Q4.
A client with diabetic ketoacidosis has a potassium level of 3.2 mEq/L. Which action is
priority?
A. Administer regular insulin IV bolus B. Begin potassium replacement before
insulin
C. Give sodium bicarbonate IV D. Start 0.45% sodium chloride infusion
Correct: B - Begin potassium replacement before insulin
Rationale:Insulin drives potassium intracellularly, worsening hypokalemia and risking fatal
dysrhythmias. Potassium must be replaced first when K+ <3.3 mEq/L. Bicarbonate is not
indicated; hypotonic fluids are contraindicated initially.
Q5.
Which arterial blood gas value indicates the need for immediate intubation in a client with
myasthenia gravis?
A. pH 7.32, PaCO2 48 mm Hg, HCO3 24 B. pH 7.48, PaCO2 30 mm Hg, HCO3 24
mEq/L mEq/L
C. pH 7.30, PaCO2 56 mm Hg, HCO3 26 D. pH 7.35, PaCO2 40 mm Hg, HCO3 22
mEq/L mEq/L
Correct: C - pH 7.30, PaCO2 56 mm Hg, HCO3 26 mEq/L
Rationale:Rising PaCO2 with respiratory acidosis indicates ventilatory failure and impending
respiratory arrest in myasthenic crisis. Options A and B show mild disturbances; D is normal.
Intubation is indicated for hypercapnia with acidosis.
Q6.
A client with acute pancreatitis has a calcium level of 7.8 mg/dL. Which intervention is
most appropriate?
A. Administer IV calcium gluconate B. Encourage high-fat diet
C. Prepare for parathyroidectomy D. Restrict oral fluids
Correct: A - Administer IV calcium gluconate
Page 4
