2025-2026 Med-Surg 1 Final Exam
Questions with Correct Answers
Graded A+.
Where is the best place to begin to select a vein for an initial intravenous (IV) site in a left-
handed patient?
Right forearm
Antecubital vein of the left arm
Left forearm
Antecubital vein of the right arm - Answer Right Forearm
RATIONALE: Unless other reasons are identified, IV sites should be started in the most distal
portion of the nondominant arm or hand.
A nurse assesses an area where an intravenous (IV) line had been recently removed. The area
has redness, swelling, and warmth. What should the nurse suspect as the cause?
Blood loss and hemorrhage
Embolus from the former catheter
Inflammation and possible phlebitis
Infiltration and air embolus - Answer Inflammation and possible phlebitis
RATIONALE: IV sites may show signs of inflammation or infection or both after an IV line has
been removed.
The K+ laboratory report shows a level of 5.2 mEq/L. What is the most important assessment for
the nurse to make?
Excessive thirst
Frightening hallucinations
Irregular heartbeat
,A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of baby
aspirin approximately 8 hours earlier. In addition to providing reassurance to the patient, which
nursing action is the most appropriate?
Inducing vomiting
Frequently assessing the mental and neurologic status
Taking daily weights and vital signs - Answer Frequently assessing the mental and neurologic
status
RATIONALE: The baby aspirin was ingested too long ago to have vomiting or stomach aspiration
be of any use. The child requires frequent assessment of neurologic function because the child
may need mechanical ventilation.
When the water absorption in the renal tubules becomes greater than normal, what
assessment finding should a nurse anticipate?
Less concentrated urine
More concentrated urine
Less alkaline urine
More alkaline urine - Answer More concentrated urine
RATIONALE: When more water is kept back in the body, the water left to form urine is less;
therefore, the urine is more concentrated.
A patient has renal damage because of diabetes. What is the highest risk for this patient?
Hypokalemia
Hypercalcemia
Hyperkalemia
Hypocalcemia - Answer Hyperkalemia
RATIONALE: When the renal system cannot rid the body of enough K+, this electrolyte builds up
and a condition called hyperkalemia develops.
,Renal and gastrointestinal
Circulatory and renal
Hepatic and lymphatic - Answer Circulatory and renal
RATIONALE: The monitoring of basic fluid balance in the body is performed by the renal and
circulatory systems.
What is usually associated with hyperchloremia?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis - Answer Metabolic acidosis
RATIONALE: Chlorides bind with positively charged ions such as K+ in the patient with metabolic
acidosis.
Each compartment of the body has a water-fluid distribution movement of its own. What is the
process allowing these fluids to move and distribute themselves among compartments?
Active transport
Osmosis
Filtration
Diffusion - Answer Osmosis
RATIONALE: The intracellular and extracellular compartments contain water and dissolved
substances. The water filters back and forth as needed to maintain homeostasis via osmolarity.
Which order should be clarified by a nurse when transcribing orders?
Potassium chloride, 80 mEq in 1000 mL D5W in 24 hours
Potassium chloride, 40 mEq IV in 10 mL D5W IV push
, RATIONALE: Potassium chloride is never given by intravenous push in such a small amount of
diluent. Potassium chloride is always dissolved in D5W and should be infused at no more than
10 mEq/hr.
What is the source of calories in IV solutions?
Dextrose
Water
Vitamins
Electrolytes - Answer Dextrose
RATIONALE: Dextrose is sugar and the source of calories.
An older adult patient is quite ill and confused and begins to cry pitifully when a nurse
approaches the bed to start an intravenous (IV) line. What is the best action for the nurse at this
time?
Give an analgesic as ordered, wait a few minutes, and then proceed.
Inform the patient that the physician has ordered the IV and calmly continue to prepare the site
and start the IV.
Restrain the patient's arm to a padded arm board and proceed as directed.
Keep the infusion equipment out of sight as much as possible, talk slowly, and divert the
attention of the patient. - Answer Keep the infusion equipment out of sight as much as
possible, talk slowly, and divert the attention of the patient.
RATIONALE: Confusion during a bout of illness in older adults is common. Distraction and
reassurance usually gain compliance. Medication and restraints are not indicated.
A nurse assesses that a patient's urine has become much more concentrated. What is the most
likely cause for the change?
Antidiuretic hormone (ADH)
Adrenaline
Insulin
Questions with Correct Answers
Graded A+.
Where is the best place to begin to select a vein for an initial intravenous (IV) site in a left-
handed patient?
Right forearm
Antecubital vein of the left arm
Left forearm
Antecubital vein of the right arm - Answer Right Forearm
RATIONALE: Unless other reasons are identified, IV sites should be started in the most distal
portion of the nondominant arm or hand.
A nurse assesses an area where an intravenous (IV) line had been recently removed. The area
has redness, swelling, and warmth. What should the nurse suspect as the cause?
Blood loss and hemorrhage
Embolus from the former catheter
Inflammation and possible phlebitis
Infiltration and air embolus - Answer Inflammation and possible phlebitis
RATIONALE: IV sites may show signs of inflammation or infection or both after an IV line has
been removed.
The K+ laboratory report shows a level of 5.2 mEq/L. What is the most important assessment for
the nurse to make?
Excessive thirst
Frightening hallucinations
Irregular heartbeat
,A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of baby
aspirin approximately 8 hours earlier. In addition to providing reassurance to the patient, which
nursing action is the most appropriate?
Inducing vomiting
Frequently assessing the mental and neurologic status
Taking daily weights and vital signs - Answer Frequently assessing the mental and neurologic
status
RATIONALE: The baby aspirin was ingested too long ago to have vomiting or stomach aspiration
be of any use. The child requires frequent assessment of neurologic function because the child
may need mechanical ventilation.
When the water absorption in the renal tubules becomes greater than normal, what
assessment finding should a nurse anticipate?
Less concentrated urine
More concentrated urine
Less alkaline urine
More alkaline urine - Answer More concentrated urine
RATIONALE: When more water is kept back in the body, the water left to form urine is less;
therefore, the urine is more concentrated.
A patient has renal damage because of diabetes. What is the highest risk for this patient?
Hypokalemia
Hypercalcemia
Hyperkalemia
Hypocalcemia - Answer Hyperkalemia
RATIONALE: When the renal system cannot rid the body of enough K+, this electrolyte builds up
and a condition called hyperkalemia develops.
,Renal and gastrointestinal
Circulatory and renal
Hepatic and lymphatic - Answer Circulatory and renal
RATIONALE: The monitoring of basic fluid balance in the body is performed by the renal and
circulatory systems.
What is usually associated with hyperchloremia?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis - Answer Metabolic acidosis
RATIONALE: Chlorides bind with positively charged ions such as K+ in the patient with metabolic
acidosis.
Each compartment of the body has a water-fluid distribution movement of its own. What is the
process allowing these fluids to move and distribute themselves among compartments?
Active transport
Osmosis
Filtration
Diffusion - Answer Osmosis
RATIONALE: The intracellular and extracellular compartments contain water and dissolved
substances. The water filters back and forth as needed to maintain homeostasis via osmolarity.
Which order should be clarified by a nurse when transcribing orders?
Potassium chloride, 80 mEq in 1000 mL D5W in 24 hours
Potassium chloride, 40 mEq IV in 10 mL D5W IV push
, RATIONALE: Potassium chloride is never given by intravenous push in such a small amount of
diluent. Potassium chloride is always dissolved in D5W and should be infused at no more than
10 mEq/hr.
What is the source of calories in IV solutions?
Dextrose
Water
Vitamins
Electrolytes - Answer Dextrose
RATIONALE: Dextrose is sugar and the source of calories.
An older adult patient is quite ill and confused and begins to cry pitifully when a nurse
approaches the bed to start an intravenous (IV) line. What is the best action for the nurse at this
time?
Give an analgesic as ordered, wait a few minutes, and then proceed.
Inform the patient that the physician has ordered the IV and calmly continue to prepare the site
and start the IV.
Restrain the patient's arm to a padded arm board and proceed as directed.
Keep the infusion equipment out of sight as much as possible, talk slowly, and divert the
attention of the patient. - Answer Keep the infusion equipment out of sight as much as
possible, talk slowly, and divert the attention of the patient.
RATIONALE: Confusion during a bout of illness in older adults is common. Distraction and
reassurance usually gain compliance. Medication and restraints are not indicated.
A nurse assesses that a patient's urine has become much more concentrated. What is the most
likely cause for the change?
Antidiuretic hormone (ADH)
Adrenaline
Insulin
