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Exam 4: NUR170 / NUR 170 | Concepts of Medical-
Surgical Nursing Study Guide (Latest 2026–2027) |
Verified Questions & Answers | Grade A – Galen
Subject: Medical-Surgical Nursing (NUR170) Exam 4 Study Guide
Source: Galen College
Format: Multiple-Choice & Select-All-That-Apply Questions & Answers
1. The nurse is admitting an older adult with decompensated CHF.
The nursing assessment reveals adventitious lung sounds, dyspnea,
and orthopnea. Which physician order should the nurse question?
A. Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
Correct Answer: A. Intravenous (IV) 500 mL of 0.9% NaCl at 125
mL/hr
Rationale:
1. The patient's symptoms (adventitious lung sounds, dyspnea,
orthopnea) indicate pulmonary edema and fluid overload due to
heart failure.
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2. Administering 0.9% NaCl (normal saline), an isotonic solution, would
increase intravascular volume, worsening the heart failure and
pulmonary congestion.
3. The nurse should question this order and anticipate a diuretic or fluid
restriction instead.
2. The nurse is assessing a patient before hanging an IV solution
of 0.9% NaCl with KCl in it. Which assessment finding should cause the
nurse to hold the IV solution and contact the provider?
A. Urine output 8 mL/hr
Correct Answer: A. Urine output 8 mL/hr
Rationale:
1. Potassium (KCl) is primarily excreted by the kidneys.
2. A urine output of 8 mL/hr indicates severe oliguria and acute kidney
injury.
3. Administering potassium to a patient with impaired renal function
can lead to life-threatening hyperkalemia. The IV must be held and
the provider notified.
3. The patient has recent bilateral, above the knee amputations
and has developed C. difficile diarrhea. What assessments should the
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nurse use to detect fluid volume deficit in this patient? (Select all that
apply.)
A. Observe for flatness of neck veins when supine
B. Measure rate and character of pulse
C. Test for skin turgor
Correct Answers: A, B, C
Rationale:
1. Flat neck veins: In hypovolemia, decreased intravascular volume
leads to low central venous pressure, causing neck veins to appear
flat even when supine.
2. Pulse rate/character: Hypovolemia triggers tachycardia; the pulse
may become weak and thready.
3. Skin turgor: Dehydration reduces skin elasticity; poor skin turgor is
a sign of fluid deficit.
4. The patient is receiving tube feedings due to a jaw surgery.
What change in assessment findings should prompt the nurse to
request an order for serum sodium concentration?
A. Decreased level of consciousness
Correct Answer: A. Decreased level of consciousness
Rationale:
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1. Tube feedings can cause fluid and electrolyte imbalances, including
hypernatremia (high sodium) or hyponatremia (low sodium).
2. Both conditions can cause neurological symptoms. A sudden decrease
in level of consciousness is a critical sign of severe sodium imbalance.
3. The nurse should immediately assess sodium levels to guide
treatment.
5. A nurse is caring for a patient prescribed peripheral
intravenous therapy. Which task will the nurse assign to the nursing
assistant (NA)?
A. Recording intake and output
Correct Answer: A. Recording intake and output
Rationale:
1. Recording intake and output (I&O) is a routine, data-collection task
within the scope of practice for a nursing assistant.
2. It does not require nursing judgment or sterile technique.
3. The RN retains responsibility for interpreting the I&O data and
adjusting the plan of care.
6. A patient is experiencing dehydration. While planning care, the
nurse considers that the majority of the patient's total water volume
Exam 4: NUR170 / NUR 170 | Concepts of Medical-
Surgical Nursing Study Guide (Latest 2026–2027) |
Verified Questions & Answers | Grade A – Galen
Subject: Medical-Surgical Nursing (NUR170) Exam 4 Study Guide
Source: Galen College
Format: Multiple-Choice & Select-All-That-Apply Questions & Answers
1. The nurse is admitting an older adult with decompensated CHF.
The nursing assessment reveals adventitious lung sounds, dyspnea,
and orthopnea. Which physician order should the nurse question?
A. Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
Correct Answer: A. Intravenous (IV) 500 mL of 0.9% NaCl at 125
mL/hr
Rationale:
1. The patient's symptoms (adventitious lung sounds, dyspnea,
orthopnea) indicate pulmonary edema and fluid overload due to
heart failure.
, 2|Page
2. Administering 0.9% NaCl (normal saline), an isotonic solution, would
increase intravascular volume, worsening the heart failure and
pulmonary congestion.
3. The nurse should question this order and anticipate a diuretic or fluid
restriction instead.
2. The nurse is assessing a patient before hanging an IV solution
of 0.9% NaCl with KCl in it. Which assessment finding should cause the
nurse to hold the IV solution and contact the provider?
A. Urine output 8 mL/hr
Correct Answer: A. Urine output 8 mL/hr
Rationale:
1. Potassium (KCl) is primarily excreted by the kidneys.
2. A urine output of 8 mL/hr indicates severe oliguria and acute kidney
injury.
3. Administering potassium to a patient with impaired renal function
can lead to life-threatening hyperkalemia. The IV must be held and
the provider notified.
3. The patient has recent bilateral, above the knee amputations
and has developed C. difficile diarrhea. What assessments should the
, 3|Page
nurse use to detect fluid volume deficit in this patient? (Select all that
apply.)
A. Observe for flatness of neck veins when supine
B. Measure rate and character of pulse
C. Test for skin turgor
Correct Answers: A, B, C
Rationale:
1. Flat neck veins: In hypovolemia, decreased intravascular volume
leads to low central venous pressure, causing neck veins to appear
flat even when supine.
2. Pulse rate/character: Hypovolemia triggers tachycardia; the pulse
may become weak and thready.
3. Skin turgor: Dehydration reduces skin elasticity; poor skin turgor is
a sign of fluid deficit.
4. The patient is receiving tube feedings due to a jaw surgery.
What change in assessment findings should prompt the nurse to
request an order for serum sodium concentration?
A. Decreased level of consciousness
Correct Answer: A. Decreased level of consciousness
Rationale:
, 4|Page
1. Tube feedings can cause fluid and electrolyte imbalances, including
hypernatremia (high sodium) or hyponatremia (low sodium).
2. Both conditions can cause neurological symptoms. A sudden decrease
in level of consciousness is a critical sign of severe sodium imbalance.
3. The nurse should immediately assess sodium levels to guide
treatment.
5. A nurse is caring for a patient prescribed peripheral
intravenous therapy. Which task will the nurse assign to the nursing
assistant (NA)?
A. Recording intake and output
Correct Answer: A. Recording intake and output
Rationale:
1. Recording intake and output (I&O) is a routine, data-collection task
within the scope of practice for a nursing assistant.
2. It does not require nursing judgment or sterile technique.
3. The RN retains responsibility for interpreting the I&O data and
adjusting the plan of care.
6. A patient is experiencing dehydration. While planning care, the
nurse considers that the majority of the patient's total water volume
