Med-Surg 1 Final Exam questions and
answers 2026\2027 A+ Grade
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
- correct 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
- correct 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
Swelling of ankles
- correct answer Irregular heartbeat
RATIONALE: Arrhythmias can be triggered by hyperkalemia.
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
- correct 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
- correct 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
- correct answer Hyperkalemia
RATIONALE: When the renal system cannot rid the body of enough K+, this electrolyte builds up and a
condition called hyperkalemia develops.
A nurse understands that fluid balance is mainly monitored in the body by which two systems?
Respiratory and circulatory
Renal and gastrointestinal
Circulatory and renal
Hepatic and lymphatic
- correct 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
- correct 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
- correct 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
Potassium chloride, 80 mEq in 1000 mL D5W in 12 hours
Potassium chloride, 50 mEq in 500 mL D5W in 4 hours
- correct answer 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.
answers 2026\2027 A+ Grade
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
- correct 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
- correct 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
Swelling of ankles
- correct answer Irregular heartbeat
RATIONALE: Arrhythmias can be triggered by hyperkalemia.
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
- correct 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
- correct 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
- correct answer Hyperkalemia
RATIONALE: When the renal system cannot rid the body of enough K+, this electrolyte builds up and a
condition called hyperkalemia develops.
A nurse understands that fluid balance is mainly monitored in the body by which two systems?
Respiratory and circulatory
Renal and gastrointestinal
Circulatory and renal
Hepatic and lymphatic
- correct 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
- correct 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
- correct 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
Potassium chloride, 80 mEq in 1000 mL D5W in 12 hours
Potassium chloride, 50 mEq in 500 mL D5W in 4 hours
- correct answer 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.
