NUR 1211 Medical Surgical Final Cumulative Exam
NUR 1211 MEDICAL SURGICAL FINAL CUMULATIVE EXAM NEWEST 2026/2027
ACTUAL EXAM COMPLETE 400 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH DETAILED RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
You are an emergency-room nurse caring for a trauma patient. Your patient has
the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How
would you interpret these results?
A). Respiratory acidosis with no compensation
B). Metabolic alkalosis with a compensatory alkalosis
C). Metabolic acidosis with no compensation
D). Metabolic acidosis with a compensatory respiratory alkalosis
D). Metabolic acidosis with a compensatory respiratory alkalosis
Rationale:
A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO3 is also low,
which causes alkalosis. The bicarbonate is low, which causes acidosis. The pH
bicarbonate more closely corresponds with a decrease in pH, making the
metabolic component the primary problem.
You are making initial shift assessments on your patients. While assessing one
patient's peripheral IV site, you note edema around the insertion site. How should
you document this complication related to IV therapy?
A). Air emboli
B). Phlebitis
C). Infiltration
D). Fluid overload
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, NUR 1211 Medical Surgical Final Cumulative Exam
C). Infiltration
Rationale:
Infiltration is the administration of non-vesicant solution or medication into the
surrounding tissue. This can occur when the IV cannula dislodges or perforates the
wall of the vein. Infiltration is characterized by edema around the insertion site,
leakage of IV fluid from the insertion site, discomfort and coolness in the area of
infiltration, and a significant decrease in the flow rate. Air emboli, phlebitis, and
fluid overload are not indications of infiltration.
You are performing an admission assessment on an older adult patient newly
admitted for end-stage liver disease. What principle should guide your assessment
of the patient's skin turgor?
A). Overhydration is common among healthy older adults.
B). Dehydration causes the skin to appear spongy.
C). Inelastic skin turgor is a normal part of aging.
D). Skin turgor cannot be assessed in patients over 70.
C). Inelastic skin turgor is a normal part of aging.
Rationale:
Inelastic skin is a normal change of aging. However, this does not mean that skin
turgor cannot be assessed in older patients. Dehydration, not overhydration,
causes inelastic skin with tenting. Overhydration, not dehydration, causes the skin
to appear edematous and spongy.
The physician has ordered a peripheral IV to be inserted before the patient goes
for computed tomography. What should the nurse do when selecting a site on the
hand or arm for insertion of an IV catheter?
A). Choose a hairless site if available.
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, NUR 1211 Medical Surgical Final Cumulative Exam
B). Consider potential effects on the patient's mobility when selecting a site.
C). Have the patient briefly hold his arm over his head before insertion.
D). Leave the tourniquet on for at least 3 minutes.
B). Consider potential effects on the patient's mobility when selecting a site.
Rationale:
Ideally, both arms and hands are carefully inspected before choosing a specific
venipuncture site that does not interfere with mobility. Instruct the patient to hold
his arm in a dependent position to increase blood flow. Never leave a tourniquet in
place longer than 2 minutes. The site does not necessarily need to be devoid of
hair.
A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a
patient with increased intracranial pressure. This solution will increase the
number of dissolved particles in the patient's blood, creating pressure for fluids in
the tissues to shift into the capillaries and increase the blood volume. This process
is best described as which of the following?
A). Hydrostatic pressure
B). Osmosis and osmolality
C). Diffusion
D). Active transport
B). Osmosis and osmolality
Rationale:
Osmosis is the movement of fluid from a region of low solute concentration to a
region of high solute concentration across a semipermeable membrane.
Hydrostatic pressure refers to changes in water or volume related to water
pressure. Diffusion is the movement of solutes from an area of greater
concentration to lesser concentration; the solutes in an intact vascular system are
unable to move so diffusion normally should not be taking place. Active transport
3|Page
, NUR 1211 Medical Surgical Final Cumulative Exam
is the movement of molecules against the concentration gradient and requires
adenosine triphosphate (ATP) as an energy source; this process typically takes
place at the cellular level and is not involved in vascular volume changes.
You are the surgical nurse caring for a 65-year-old female patient who is
postoperative day 1 following a thyroidectomy. During your shift assessment, the
patient complains of tingling in her lips and fingers. She tells you that she has an
intermittent spasm in her wrist and hand and she exhibits increased muscle tone.
What electrolyte imbalance should you first suspect?
A). Hypophosphatemia
B). Hypocalcemia
C). Hypermagnesemia
D). Hyperkalemia
B). Hypocalcemia
Rationale:
Tetany is the most characteristic manifestation of hypocalcemia and
hypomagnesemia. Sensations of tingling may occur in the tips of the fingers,
around the mouth, and, less commonly, in the feet. Hypophosphatemia creates
central nervous dysfunction, resulting in seizures and coma. Hypermagnesemia
creates hypoactive reflexes and somnolence. Signs of hyperkalemia include
paresthesias and anxiety.
A nurse is planning care for a nephrology patient with a new nursing graduate. The
nurse states, "A patient in renal failure partially loses the ability to regulate
changes in pH." What is the cause of this partial inability?
A). The kidneys regulate and reabsorb carbonic acid to change and maintain pH.
B). The kidneys buffer acids through electrolyte changes.
4|Page
NUR 1211 MEDICAL SURGICAL FINAL CUMULATIVE EXAM NEWEST 2026/2027
ACTUAL EXAM COMPLETE 400 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH DETAILED RATIONALES |ALREADY GRADED
A+||BRAND NEW VERSION!!
You are an emergency-room nurse caring for a trauma patient. Your patient has
the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How
would you interpret these results?
A). Respiratory acidosis with no compensation
B). Metabolic alkalosis with a compensatory alkalosis
C). Metabolic acidosis with no compensation
D). Metabolic acidosis with a compensatory respiratory alkalosis
D). Metabolic acidosis with a compensatory respiratory alkalosis
Rationale:
A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO3 is also low,
which causes alkalosis. The bicarbonate is low, which causes acidosis. The pH
bicarbonate more closely corresponds with a decrease in pH, making the
metabolic component the primary problem.
You are making initial shift assessments on your patients. While assessing one
patient's peripheral IV site, you note edema around the insertion site. How should
you document this complication related to IV therapy?
A). Air emboli
B). Phlebitis
C). Infiltration
D). Fluid overload
1|Page
, NUR 1211 Medical Surgical Final Cumulative Exam
C). Infiltration
Rationale:
Infiltration is the administration of non-vesicant solution or medication into the
surrounding tissue. This can occur when the IV cannula dislodges or perforates the
wall of the vein. Infiltration is characterized by edema around the insertion site,
leakage of IV fluid from the insertion site, discomfort and coolness in the area of
infiltration, and a significant decrease in the flow rate. Air emboli, phlebitis, and
fluid overload are not indications of infiltration.
You are performing an admission assessment on an older adult patient newly
admitted for end-stage liver disease. What principle should guide your assessment
of the patient's skin turgor?
A). Overhydration is common among healthy older adults.
B). Dehydration causes the skin to appear spongy.
C). Inelastic skin turgor is a normal part of aging.
D). Skin turgor cannot be assessed in patients over 70.
C). Inelastic skin turgor is a normal part of aging.
Rationale:
Inelastic skin is a normal change of aging. However, this does not mean that skin
turgor cannot be assessed in older patients. Dehydration, not overhydration,
causes inelastic skin with tenting. Overhydration, not dehydration, causes the skin
to appear edematous and spongy.
The physician has ordered a peripheral IV to be inserted before the patient goes
for computed tomography. What should the nurse do when selecting a site on the
hand or arm for insertion of an IV catheter?
A). Choose a hairless site if available.
2|Page
, NUR 1211 Medical Surgical Final Cumulative Exam
B). Consider potential effects on the patient's mobility when selecting a site.
C). Have the patient briefly hold his arm over his head before insertion.
D). Leave the tourniquet on for at least 3 minutes.
B). Consider potential effects on the patient's mobility when selecting a site.
Rationale:
Ideally, both arms and hands are carefully inspected before choosing a specific
venipuncture site that does not interfere with mobility. Instruct the patient to hold
his arm in a dependent position to increase blood flow. Never leave a tourniquet in
place longer than 2 minutes. The site does not necessarily need to be devoid of
hair.
A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a
patient with increased intracranial pressure. This solution will increase the
number of dissolved particles in the patient's blood, creating pressure for fluids in
the tissues to shift into the capillaries and increase the blood volume. This process
is best described as which of the following?
A). Hydrostatic pressure
B). Osmosis and osmolality
C). Diffusion
D). Active transport
B). Osmosis and osmolality
Rationale:
Osmosis is the movement of fluid from a region of low solute concentration to a
region of high solute concentration across a semipermeable membrane.
Hydrostatic pressure refers to changes in water or volume related to water
pressure. Diffusion is the movement of solutes from an area of greater
concentration to lesser concentration; the solutes in an intact vascular system are
unable to move so diffusion normally should not be taking place. Active transport
3|Page
, NUR 1211 Medical Surgical Final Cumulative Exam
is the movement of molecules against the concentration gradient and requires
adenosine triphosphate (ATP) as an energy source; this process typically takes
place at the cellular level and is not involved in vascular volume changes.
You are the surgical nurse caring for a 65-year-old female patient who is
postoperative day 1 following a thyroidectomy. During your shift assessment, the
patient complains of tingling in her lips and fingers. She tells you that she has an
intermittent spasm in her wrist and hand and she exhibits increased muscle tone.
What electrolyte imbalance should you first suspect?
A). Hypophosphatemia
B). Hypocalcemia
C). Hypermagnesemia
D). Hyperkalemia
B). Hypocalcemia
Rationale:
Tetany is the most characteristic manifestation of hypocalcemia and
hypomagnesemia. Sensations of tingling may occur in the tips of the fingers,
around the mouth, and, less commonly, in the feet. Hypophosphatemia creates
central nervous dysfunction, resulting in seizures and coma. Hypermagnesemia
creates hypoactive reflexes and somnolence. Signs of hyperkalemia include
paresthesias and anxiety.
A nurse is planning care for a nephrology patient with a new nursing graduate. The
nurse states, "A patient in renal failure partially loses the ability to regulate
changes in pH." What is the cause of this partial inability?
A). The kidneys regulate and reabsorb carbonic acid to change and maintain pH.
B). The kidneys buffer acids through electrolyte changes.
4|Page
