NUR 417 MED-SURG EXAM 2 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
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CORE DOMAINS
Cardiovascular System Disorders
Respiratory System Disorders
Neurological System Disorders
Endocrine System Disorders
Renal and Genitourinary System Disorders
Gastrointestinal System Disorders
Musculoskeletal System Disorders
Hematologic and Oncologic Disorders
Perioperative Nursing and Emergency Management
Ethics, Legal Compliance, and Professional Standards
INTRODUCTION
This comprehensive examination is designed to evaluate the advanced knowledge and
clinical decision-making skills of nursing students in the medical-surgical setting. The
assessment focuses on applying foundational theory to complex, real-world patient
scenarios across multiple body systems. It challenges the candidate to demonstrate
competence in critical thinking, prioritization, and safe clinical practice. The structure,
comprising multiple-choice and scenario-based questions, ensures a rigorous
evaluation of the nurse's ability to synthesize information, adhere to legal and ethical
standards, and deliver high-quality, patient-centered care in diverse healthcare
environments.
SECTION ONE: QUESTIONS 1–300
,A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes into
the transfusion, the client reports chills, a low backache, and has a temperature of
38.9°C (102°F). What is the nurse's priority action?
A. Slow the transfusion rate and administer an antipyretic.
B. Stop the transfusion immediately and maintain IV access with normal saline.
C. Recheck the client's temperature in 15 minutes.
D. Continue the transfusion and notify the provider.
Correct Answer
B. Stop the transfusion immediately and maintain IV access with normal saline.
RATIONALE: These manifestations suggest an acute hemolytic transfusion reaction, a
life-threatening complication. The priority is to stop the transfusion immediately to
prevent further infusion of incompatible blood and maintain venous access for
emergency medications and fluids.
A client with chronic kidney disease (CKD) has a potassium level of 6.8 mEq/L. Which of
the following medications should the nurse anticipate administering first?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Insulin and glucose
D. Furosemide
Correct Answer
B. Calcium gluconate
RATIONALE: The client is at risk for fatal cardiac dysrhythmias due to hyperkalemia.
Calcium gluconate is administered first to stabilize the myocardial cell membranes and
protect the heart, without lowering the serum potassium level. Other medications are
given to lower the potassium level but are secondary to cardiac protection.
,A nurse is assessing a client who has a new diagnosis of acute respiratory distress
syndrome (ARDS). Which of the following findings should the nurse expect?
A. Increased pulmonary compliance
B. Metabolic alkalosis
C. Hypoxemia refractory to supplemental oxygen
D. Bradypnea
Correct Answer
C. Hypoxemia refractory to supplemental oxygen
RATIONALE: A hallmark of ARDS is severe hypoxemia that does not improve with
supplemental oxygen due to ventilation-perfusion mismatch and intrapulmonary
shunting. Pulmonary compliance is decreased, and clients typically experience
tachypnea and respiratory alkalosis initially.
A client is admitted with a suspected cervical spine injury following a motor vehicle
crash. Which action is most important for the nurse to take?
A. Perform a thorough neurological assessment.
B. Apply a hard cervical collar and maintain manual in-line stabilization.
C. Prepare for an emergency CT scan.
D. Administer a prescribed analgesic.
Correct Answer
B. Apply a hard cervical collar and maintain manual in-line stabilization.
RATIONALE: The priority in a suspected spinal cord injury is to prevent further damage.
Immobilizing the cervical spine with a collar and maintaining manual in-line stabilization
is the most critical initial nursing action to protect the spinal cord from secondary
injury.
A nurse is teaching a client with diabetes mellitus about self-administration of insulin.
Which statement by the client indicates a need for further teaching?
A. "I will rotate injection sites to prevent tissue damage."
, B. "I should aspirate before injecting the insulin."
C. "I will store unopened vials of insulin in the refrigerator."
D. "I should check my blood glucose level before meals."
Correct Answer
B. "I should aspirate before injecting the insulin."
RATIONALE: Aspiration is not recommended for insulin administration. It is
unnecessary and can cause trauma. The other statements demonstrate correct
understanding of insulin administration and management.
A client is receiving furosemide for heart failure. Which laboratory value requires the
most immediate intervention by the nurse?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. Hemoglobin 13 g/dL
D. BUN 18 mg/dL
Correct Answer
A. Potassium 3.1 mEq/L
RATIONALE: Furosemide is a loop diuretic that causes potassium loss. A potassium
level of 3.1 mEq/L indicates hypokalemia, which can lead to life-threatening cardiac
dysrhythmias. This is the priority finding.
A nurse is caring for a client who is one day postoperative following abdominal surgery.
The client reports sudden, severe pain at the surgical site, and the nurse notes
dehiscence of the wound. What should the nurse do first?
A. Irrigate the wound with sterile saline.
B. Place the client in a low Fowler's position and cover the wound with a sterile dressing
soaked in sterile normal saline.
C. Push the tissue back into place.
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Cardiovascular System Disorders
Respiratory System Disorders
Neurological System Disorders
Endocrine System Disorders
Renal and Genitourinary System Disorders
Gastrointestinal System Disorders
Musculoskeletal System Disorders
Hematologic and Oncologic Disorders
Perioperative Nursing and Emergency Management
Ethics, Legal Compliance, and Professional Standards
INTRODUCTION
This comprehensive examination is designed to evaluate the advanced knowledge and
clinical decision-making skills of nursing students in the medical-surgical setting. The
assessment focuses on applying foundational theory to complex, real-world patient
scenarios across multiple body systems. It challenges the candidate to demonstrate
competence in critical thinking, prioritization, and safe clinical practice. The structure,
comprising multiple-choice and scenario-based questions, ensures a rigorous
evaluation of the nurse's ability to synthesize information, adhere to legal and ethical
standards, and deliver high-quality, patient-centered care in diverse healthcare
environments.
SECTION ONE: QUESTIONS 1–300
,A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes into
the transfusion, the client reports chills, a low backache, and has a temperature of
38.9°C (102°F). What is the nurse's priority action?
A. Slow the transfusion rate and administer an antipyretic.
B. Stop the transfusion immediately and maintain IV access with normal saline.
C. Recheck the client's temperature in 15 minutes.
D. Continue the transfusion and notify the provider.
Correct Answer
B. Stop the transfusion immediately and maintain IV access with normal saline.
RATIONALE: These manifestations suggest an acute hemolytic transfusion reaction, a
life-threatening complication. The priority is to stop the transfusion immediately to
prevent further infusion of incompatible blood and maintain venous access for
emergency medications and fluids.
A client with chronic kidney disease (CKD) has a potassium level of 6.8 mEq/L. Which of
the following medications should the nurse anticipate administering first?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Insulin and glucose
D. Furosemide
Correct Answer
B. Calcium gluconate
RATIONALE: The client is at risk for fatal cardiac dysrhythmias due to hyperkalemia.
Calcium gluconate is administered first to stabilize the myocardial cell membranes and
protect the heart, without lowering the serum potassium level. Other medications are
given to lower the potassium level but are secondary to cardiac protection.
,A nurse is assessing a client who has a new diagnosis of acute respiratory distress
syndrome (ARDS). Which of the following findings should the nurse expect?
A. Increased pulmonary compliance
B. Metabolic alkalosis
C. Hypoxemia refractory to supplemental oxygen
D. Bradypnea
Correct Answer
C. Hypoxemia refractory to supplemental oxygen
RATIONALE: A hallmark of ARDS is severe hypoxemia that does not improve with
supplemental oxygen due to ventilation-perfusion mismatch and intrapulmonary
shunting. Pulmonary compliance is decreased, and clients typically experience
tachypnea and respiratory alkalosis initially.
A client is admitted with a suspected cervical spine injury following a motor vehicle
crash. Which action is most important for the nurse to take?
A. Perform a thorough neurological assessment.
B. Apply a hard cervical collar and maintain manual in-line stabilization.
C. Prepare for an emergency CT scan.
D. Administer a prescribed analgesic.
Correct Answer
B. Apply a hard cervical collar and maintain manual in-line stabilization.
RATIONALE: The priority in a suspected spinal cord injury is to prevent further damage.
Immobilizing the cervical spine with a collar and maintaining manual in-line stabilization
is the most critical initial nursing action to protect the spinal cord from secondary
injury.
A nurse is teaching a client with diabetes mellitus about self-administration of insulin.
Which statement by the client indicates a need for further teaching?
A. "I will rotate injection sites to prevent tissue damage."
, B. "I should aspirate before injecting the insulin."
C. "I will store unopened vials of insulin in the refrigerator."
D. "I should check my blood glucose level before meals."
Correct Answer
B. "I should aspirate before injecting the insulin."
RATIONALE: Aspiration is not recommended for insulin administration. It is
unnecessary and can cause trauma. The other statements demonstrate correct
understanding of insulin administration and management.
A client is receiving furosemide for heart failure. Which laboratory value requires the
most immediate intervention by the nurse?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. Hemoglobin 13 g/dL
D. BUN 18 mg/dL
Correct Answer
A. Potassium 3.1 mEq/L
RATIONALE: Furosemide is a loop diuretic that causes potassium loss. A potassium
level of 3.1 mEq/L indicates hypokalemia, which can lead to life-threatening cardiac
dysrhythmias. This is the priority finding.
A nurse is caring for a client who is one day postoperative following abdominal surgery.
The client reports sudden, severe pain at the surgical site, and the nurse notes
dehiscence of the wound. What should the nurse do first?
A. Irrigate the wound with sterile saline.
B. Place the client in a low Fowler's position and cover the wound with a sterile dressing
soaked in sterile normal saline.
C. Push the tissue back into place.
