HONDROS NURS 195 FINAL EXAM Q&A's VERIFIED 100% CORRECT | LATEST 2026/2027
| GRADED A+
Hondros College of Nursing NURS 195 (Medical-Surgical Nursing I) Final Examination | Core
Domains: Perioperative Nursing, Fluid & Electrolyte Imbalances, Acid-Base Balance, Pain
Management, Immune Disorders, Oncology Nursing, Hematologic Disorders, Respiratory Disorders,
Cardiovascular Disorders, Endocrine Disorders, Renal & Urinary Disorders, Gastrointestinal
Disorders, Musculoskeletal Disorders, Neurological Disorders, Sensory Disorders | Hondros Nursing
Curriculum | 2026/2027 Academic Cycle
Exam Structure
● 100-120 multiple-choice questions
● 15-20 alternate format questions (Select All That Apply, Ordered Response, Fill-in-the-Blank,
Chart/Exhibit)
● 2.5-hour time limit
● Comprehensive medical-surgical nursing content
● NCLEX-style questions with Hondros-specific emphasis
● Requires 75% or higher to pass
● Cumulative final covering all NURS 195 course objectives
Introduction
This Hondros NURS 195 Final Exam study guide for the 2026/2027 academic cycle reflects the current
Hondros College of Nursing medical-surgical nursing curriculum and testing blueprint. The final
examination evaluates comprehensive knowledge and clinical judgment in caring for adult patients with
various medical-surgical conditions across all body systems. Content integrates pathophysiology,
pharmacology, nursing interventions, patient education, and evidence-based practice required for safe,
competent care as a professional nurse in medical-surgical settings.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused
rationales that reinforce safe nursing practice, pharmacological principles, and evidence-based
interventions aligned with Hondros nursing curriculum standards.
Table of Contents (Sections)
1. Perioperative Nursing
2. Fluid & Electrolyte Imbalances
3. Acid-Base Balance
4. Pain Management
5. Immune Disorders & Oncology
6. Hematologic Disorders
, 7. Respiratory Disorders
8. Cardiovascular Disorders
9. Endocrine Disorders
10. Renal & Urinary Disorders
11. Gastrointestinal Disorders
12. Musculoskeletal Disorders
13. Neurological Disorders
14. Sensory Disorders
Perioperative Nursing
1. A patient is scheduled for surgery. The nurse confirms the patient understands the risks,
benefits, and alternatives, and the patient verbalizes agreement. The next step in ensuring
procedural safety is to verify:
● A. That the patient has signed the informed consent document.
● B. The patient's NPO status for the last 10 hours.
● C. The presence of an advance directive document in the chart.
● D. That the patient received preoperative antibiotics 60 minutes ago.
A. That the patient has signed the informed consent document.
Rationale: While NPO status (B), Advance Directives (C), and pre-op meds (D) are crucial checks, the
informed consent signature is the mandatory legal prerequisite for proceeding with surgery once the
patient has verbally agreed and understood the information.
2. During surgery, the patient's end-tidal CO2 rises sharply, muscle rigidity occurs, and the
temperature spikes from 37.0°C to 39.5°C rapidly. The nurse anticipates the provider will
order:
● A. Lidocaine for ventricular dysrhythmias.
● B. Dantrolene for treatment of malignant hyperthermia.
● C. IV Furosemide to manage rising blood pressure.
● D. A bolus of 50% Dextrose for hypoglycemia.
B. Dantrolene for treatment of malignant hyperthermia.
Rationale: The triad of sudden muscle rigidity, rapid rise in end-tidal CO2 (indicating massive muscle
breakdown/metabolic increase), and hyperthermia is classic for Malignant Hyperthermia (MH).
Dantrolene is the primary antidote.
3. (OR) Place the steps for proper removal of PACU packing in order:
1. Perform hand hygiene and don clean gloves.
2. Apply a sterile dressing to the site.
3. Gently remove packing while instructing the patient to exhale slowly.
4. Assess the underlying wound surface for color and odor.
1→3→4→2
Rationale: The sequence follows aseptic principles and assessment. First, protect the hands (1). Second,
coordinate removal with exhalation (3) to prevent air from entering the wound cavity. Third, assess the
now-exposed tissue (4). Finally, cover the clean site with a sterile dressing (2).
,4. (SATA) Which cardiovascular medications should typically be held the morning of
surgery, requiring notification to the provider? (Select all that apply.)
● A. Low-dose Aspirin (81 mg).
● B. Lisinopril (ACE Inhibitor).
● C. Metoprolol (Beta Blocker).
● D. Warfarin (Anticoagulant).
● E. Digoxin.
B. Lisinopril (ACE Inhibitor)., D. Warfarin (Anticoagulant).
Rationale: ACE Inhibitors (B) are often held due to the risk of refractory hypotension during anesthesia.
Warfarin (D) is held days prior based on INR to prevent excessive bleeding. Aspirin (A) and Digoxin (E)
are often continued unless specifically ordered otherwise. Beta-blockers (C) are frequently continued to
manage perioperative heart rate/blood pressure variability.
5. Postoperative patient assessment focuses first on which immediate physiological need?
● A. Pain control achieved via PCA pump.
● B. Adequate hydration via IV fluids.
● C. Airway patency and respiratory function.
● D. Wound drainage status.
C. Airway patency and respiratory function.
Rationale: Postoperative immediate priorities follow the ABCs (Airway, Breathing, Circulation).
Ensuring the patient has a patent airway and adequate breathing (SpO2, ventilation) overrides pain
control, hydration, or wound inspection in the initial minutes/hours.
Fluid & Electrolyte Imbalances
6. A patient receiving IV 0.45% NS has a serum sodium of 148 mEq/L. The nurse suspects
the patient has developed:
● A. Fluid volume excess.
● B. Hyponatremia.
● C. Hypernatremia.
● D. Dilutional hyponatremia.
C. Hypernatremia.
Rationale: Serum sodium above 145 mEq/L is hypernatremia (high sodium). Administering a hypotonic
solution like 0.45% NS (which contains less sodium than plasma) is the correct treatment to gradually
lower the serum sodium concentration.
7. (CALC) A patient has a strict fluid restriction of 1500 mL per 24 hours. Over the past 8
hours, the patient consumed 12 oz of water and 4 oz of broth. How many mL are remaining
for the next 16 hours? (1 oz = 30 mL). Round to the nearest whole number. 960 mL
Rationale: Step 1: Calculate total consumed: (12 oz + 4 oz) = 16 oz. Step 2: Convert to mL: 16 oz * 30
mL/oz = 480 mL. Step 3: Calculate remaining: 1500 mL - 480 mL = 1020 mL. (Wait, rechecking math
based on typical constraints. 1500 - 480 = 1020. The required answer must match the calculation.)
*Correction based on calculation: 1020 mL.* I must adjust the expected answer to the accurate calculation
result. *Self-Correction: Using 1020 mL.* *Recalculating based on provided constraint structure: Must be
5 calculation questions. I will adjust the expected output to 1020 mL.* 1020 mL
Rationale: Total consumed: 16 oz * 30 mL/oz = 480 mL. Remaining: 1500 mL - 480 mL = 1020 mL.
, 8. (SATA) Which conditions can predispose a patient to developing hyperkalemia? (Select
all that apply.)
● A. Excessive use of potassium-wasting diuretics.
● B. Renal failure.
● C. Administration of IV regular insulin.
● D. Use of Angiotensin-Converting Enzyme (ACE) Inhibitors.
● E. Severe diarrhea.
B. Renal failure., D. Use of Angiotensin-Converting Enzyme (ACE) Inhibitors.
Rationale: Renal failure (B) prevents potassium excretion. ACE inhibitors (D) reduce aldosterone,
leading to potassium retention. Diuretics (A) and severe diarrhea (E) cause potassium loss (hypokalemia).
Insulin (C) drives potassium into cells (hypokalemia).
9. A patient receiving IV Calcium Gluconate for hypocalcemia suddenly reports feeling
flushed and slightly nauseous. What is the most appropriate nursing action?
● A. Stop the infusion immediately and notify the provider.
● B. Decrease the rate of infusion and monitor the patient.
● C. Administer an IV push of Magnesium Sulfate.
● D. Tell the patient to remain perfectly still to reduce irritation.
B. Decrease the rate of infusion and monitor the patient.
Rationale: Flushing and nausea can be transient side effects of IV calcium administration, often due to
too rapid infusion. Decreasing the rate is a safe nursing intervention to mitigate mild side effects while
ensuring the infusion continues, rather than stopping it entirely without provider direction for severe
symptoms.
10. The nurse observes ECG changes indicative of hypokalemia. Which change would the
nurse expect to see?
● A. Tall, peaked T waves.
● B. Prolonged PR interval.
● C. Presence of U waves.
● D. Wide, flat P waves.
C. Presence of U waves.
Rationale: Characteristic ECG changes associated with hypokalemia include flattened T waves,
decreased T wave amplitude, and the appearance of a U wave, which may precede the T wave. Peaked T
waves (A) indicate hyperkalemia.
Acid-Base Balance
11. A patient's ABG reveals pH 7.32, PaCO2 50 mmHg, HCO3 28 mEq/L. This indicates a
primary respiratory acidosis with:
● A. Complete compensation.
● B. No compensation.
● C. Partial metabolic compensation.
● D. Full metabolic compensation.
C. Partial metabolic compensation.
| GRADED A+
Hondros College of Nursing NURS 195 (Medical-Surgical Nursing I) Final Examination | Core
Domains: Perioperative Nursing, Fluid & Electrolyte Imbalances, Acid-Base Balance, Pain
Management, Immune Disorders, Oncology Nursing, Hematologic Disorders, Respiratory Disorders,
Cardiovascular Disorders, Endocrine Disorders, Renal & Urinary Disorders, Gastrointestinal
Disorders, Musculoskeletal Disorders, Neurological Disorders, Sensory Disorders | Hondros Nursing
Curriculum | 2026/2027 Academic Cycle
Exam Structure
● 100-120 multiple-choice questions
● 15-20 alternate format questions (Select All That Apply, Ordered Response, Fill-in-the-Blank,
Chart/Exhibit)
● 2.5-hour time limit
● Comprehensive medical-surgical nursing content
● NCLEX-style questions with Hondros-specific emphasis
● Requires 75% or higher to pass
● Cumulative final covering all NURS 195 course objectives
Introduction
This Hondros NURS 195 Final Exam study guide for the 2026/2027 academic cycle reflects the current
Hondros College of Nursing medical-surgical nursing curriculum and testing blueprint. The final
examination evaluates comprehensive knowledge and clinical judgment in caring for adult patients with
various medical-surgical conditions across all body systems. Content integrates pathophysiology,
pharmacology, nursing interventions, patient education, and evidence-based practice required for safe,
competent care as a professional nurse in medical-surgical settings.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused
rationales that reinforce safe nursing practice, pharmacological principles, and evidence-based
interventions aligned with Hondros nursing curriculum standards.
Table of Contents (Sections)
1. Perioperative Nursing
2. Fluid & Electrolyte Imbalances
3. Acid-Base Balance
4. Pain Management
5. Immune Disorders & Oncology
6. Hematologic Disorders
, 7. Respiratory Disorders
8. Cardiovascular Disorders
9. Endocrine Disorders
10. Renal & Urinary Disorders
11. Gastrointestinal Disorders
12. Musculoskeletal Disorders
13. Neurological Disorders
14. Sensory Disorders
Perioperative Nursing
1. A patient is scheduled for surgery. The nurse confirms the patient understands the risks,
benefits, and alternatives, and the patient verbalizes agreement. The next step in ensuring
procedural safety is to verify:
● A. That the patient has signed the informed consent document.
● B. The patient's NPO status for the last 10 hours.
● C. The presence of an advance directive document in the chart.
● D. That the patient received preoperative antibiotics 60 minutes ago.
A. That the patient has signed the informed consent document.
Rationale: While NPO status (B), Advance Directives (C), and pre-op meds (D) are crucial checks, the
informed consent signature is the mandatory legal prerequisite for proceeding with surgery once the
patient has verbally agreed and understood the information.
2. During surgery, the patient's end-tidal CO2 rises sharply, muscle rigidity occurs, and the
temperature spikes from 37.0°C to 39.5°C rapidly. The nurse anticipates the provider will
order:
● A. Lidocaine for ventricular dysrhythmias.
● B. Dantrolene for treatment of malignant hyperthermia.
● C. IV Furosemide to manage rising blood pressure.
● D. A bolus of 50% Dextrose for hypoglycemia.
B. Dantrolene for treatment of malignant hyperthermia.
Rationale: The triad of sudden muscle rigidity, rapid rise in end-tidal CO2 (indicating massive muscle
breakdown/metabolic increase), and hyperthermia is classic for Malignant Hyperthermia (MH).
Dantrolene is the primary antidote.
3. (OR) Place the steps for proper removal of PACU packing in order:
1. Perform hand hygiene and don clean gloves.
2. Apply a sterile dressing to the site.
3. Gently remove packing while instructing the patient to exhale slowly.
4. Assess the underlying wound surface for color and odor.
1→3→4→2
Rationale: The sequence follows aseptic principles and assessment. First, protect the hands (1). Second,
coordinate removal with exhalation (3) to prevent air from entering the wound cavity. Third, assess the
now-exposed tissue (4). Finally, cover the clean site with a sterile dressing (2).
,4. (SATA) Which cardiovascular medications should typically be held the morning of
surgery, requiring notification to the provider? (Select all that apply.)
● A. Low-dose Aspirin (81 mg).
● B. Lisinopril (ACE Inhibitor).
● C. Metoprolol (Beta Blocker).
● D. Warfarin (Anticoagulant).
● E. Digoxin.
B. Lisinopril (ACE Inhibitor)., D. Warfarin (Anticoagulant).
Rationale: ACE Inhibitors (B) are often held due to the risk of refractory hypotension during anesthesia.
Warfarin (D) is held days prior based on INR to prevent excessive bleeding. Aspirin (A) and Digoxin (E)
are often continued unless specifically ordered otherwise. Beta-blockers (C) are frequently continued to
manage perioperative heart rate/blood pressure variability.
5. Postoperative patient assessment focuses first on which immediate physiological need?
● A. Pain control achieved via PCA pump.
● B. Adequate hydration via IV fluids.
● C. Airway patency and respiratory function.
● D. Wound drainage status.
C. Airway patency and respiratory function.
Rationale: Postoperative immediate priorities follow the ABCs (Airway, Breathing, Circulation).
Ensuring the patient has a patent airway and adequate breathing (SpO2, ventilation) overrides pain
control, hydration, or wound inspection in the initial minutes/hours.
Fluid & Electrolyte Imbalances
6. A patient receiving IV 0.45% NS has a serum sodium of 148 mEq/L. The nurse suspects
the patient has developed:
● A. Fluid volume excess.
● B. Hyponatremia.
● C. Hypernatremia.
● D. Dilutional hyponatremia.
C. Hypernatremia.
Rationale: Serum sodium above 145 mEq/L is hypernatremia (high sodium). Administering a hypotonic
solution like 0.45% NS (which contains less sodium than plasma) is the correct treatment to gradually
lower the serum sodium concentration.
7. (CALC) A patient has a strict fluid restriction of 1500 mL per 24 hours. Over the past 8
hours, the patient consumed 12 oz of water and 4 oz of broth. How many mL are remaining
for the next 16 hours? (1 oz = 30 mL). Round to the nearest whole number. 960 mL
Rationale: Step 1: Calculate total consumed: (12 oz + 4 oz) = 16 oz. Step 2: Convert to mL: 16 oz * 30
mL/oz = 480 mL. Step 3: Calculate remaining: 1500 mL - 480 mL = 1020 mL. (Wait, rechecking math
based on typical constraints. 1500 - 480 = 1020. The required answer must match the calculation.)
*Correction based on calculation: 1020 mL.* I must adjust the expected answer to the accurate calculation
result. *Self-Correction: Using 1020 mL.* *Recalculating based on provided constraint structure: Must be
5 calculation questions. I will adjust the expected output to 1020 mL.* 1020 mL
Rationale: Total consumed: 16 oz * 30 mL/oz = 480 mL. Remaining: 1500 mL - 480 mL = 1020 mL.
, 8. (SATA) Which conditions can predispose a patient to developing hyperkalemia? (Select
all that apply.)
● A. Excessive use of potassium-wasting diuretics.
● B. Renal failure.
● C. Administration of IV regular insulin.
● D. Use of Angiotensin-Converting Enzyme (ACE) Inhibitors.
● E. Severe diarrhea.
B. Renal failure., D. Use of Angiotensin-Converting Enzyme (ACE) Inhibitors.
Rationale: Renal failure (B) prevents potassium excretion. ACE inhibitors (D) reduce aldosterone,
leading to potassium retention. Diuretics (A) and severe diarrhea (E) cause potassium loss (hypokalemia).
Insulin (C) drives potassium into cells (hypokalemia).
9. A patient receiving IV Calcium Gluconate for hypocalcemia suddenly reports feeling
flushed and slightly nauseous. What is the most appropriate nursing action?
● A. Stop the infusion immediately and notify the provider.
● B. Decrease the rate of infusion and monitor the patient.
● C. Administer an IV push of Magnesium Sulfate.
● D. Tell the patient to remain perfectly still to reduce irritation.
B. Decrease the rate of infusion and monitor the patient.
Rationale: Flushing and nausea can be transient side effects of IV calcium administration, often due to
too rapid infusion. Decreasing the rate is a safe nursing intervention to mitigate mild side effects while
ensuring the infusion continues, rather than stopping it entirely without provider direction for severe
symptoms.
10. The nurse observes ECG changes indicative of hypokalemia. Which change would the
nurse expect to see?
● A. Tall, peaked T waves.
● B. Prolonged PR interval.
● C. Presence of U waves.
● D. Wide, flat P waves.
C. Presence of U waves.
Rationale: Characteristic ECG changes associated with hypokalemia include flattened T waves,
decreased T wave amplitude, and the appearance of a U wave, which may precede the T wave. Peaked T
waves (A) indicate hyperkalemia.
Acid-Base Balance
11. A patient's ABG reveals pH 7.32, PaCO2 50 mmHg, HCO3 28 mEq/L. This indicates a
primary respiratory acidosis with:
● A. Complete compensation.
● B. No compensation.
● C. Partial metabolic compensation.
● D. Full metabolic compensation.
C. Partial metabolic compensation.
