NURS 201 Intermediate Med Surg Midterm
Exam Questions and Answers | 2026 Update |
100% Correct - WCU.
Complete Practice Examination – 2026 Update
150 Questions with Answers & Rationales
SECTION 1: ONCOLOGY &
HEMATOLOGY (Questions 1-30)
Q1. A nurse is caring for a client receiving external beam radiation
therapy for lung cancer. Which finding requires immediate
intervention?
● A) Dry, peeling skin in the treatment area
● B) Fatigue after several treatments
● C) White blood cell count of 2,500/µL
● D) Sore throat and fever
Answer: D) Sore throat and fever
,Rationale: Fever with sore throat in a radiation patient may indicate
neutropenia and infection, a medical emergency. Neutropenic fever
requires immediate evaluation and antibiotics. Dry skin and fatigue are
expected side effects. Mild leukopenia is common but fever changes
the priority.
Q2. A client with breast cancer is receiving tamoxifen. Which adverse
effect should the nurse emphasize as a priority to report?
● A) Hot flashes
● B) Vaginal discharge
● C) Leg pain or swelling
● D) Nausea
Answer: C) Leg pain or swelling
Rationale: Tamoxifen increases risk of deep vein thrombosis and
pulmonary embolism. Leg pain, swelling, warmth, or redness could
indicate DVT and requires immediate evaluation. Hot flashes and
vaginal discharge are common but not emergent.
Q3. A client is undergoing brachytherapy for cervical cancer with a
sealed radioactive implant. Which action by the nurse is correct?
● A) Assign the client to a semi-private room
● B) Limit each visitor to 30 minutes per day
● C) Keep a lead-lined container in the room
● D) Wear a dosimeter badge only when providing direct care
Answer: C) Keep a lead-lined container in the room
,Rationale: If the implant becomes dislodged, it must be picked up with
long-handled forceps and placed in a lead-lined container. Visitors
should be limited to 15-30 minutes and stay at least 6 feet away.
Pregnant women and children are prohibited. The nurse wears a
dosimeter at all times while in the room.
Q4. A client with acute lymphocytic leukemia has a platelet count of
18,000/µL. Which precaution is most important?
● A) Private room with positive airflow
● B) No fresh fruits or flowers
● C) Soft-bristled toothbrush and electric razor
● D) Strict handwashing before entering
Answer: C) Soft-bristled toothbrush and electric razor
Rationale: Severe thrombocytopenia (platelets <20,000) increases
bleeding risk. Soft toothbrush and electric razor prevent mucosal and
skin trauma. Neutropenic precautions (private room, no fresh produce)
apply for low WBC, not low platelets.
Q5. A client receiving chemotherapy reports severe nausea 3 days
after treatment. Which intervention is most appropriate?
● A) Administer ondansetron 30 minutes before chemotherapy
only
● B) Instruct the client to eat a large, fatty meal before treatment
● C) Prescribe a combination of antiemetics (e.g., 5-HT3
antagonist plus dexamethasone)
● D) Advise the client to skip meals on chemotherapy days
, Answer: C) Prescribe a combination of antiemetics
Rationale: Delayed nausea is treated with a combination of
antiemetics including dexamethasone, metoclopramide, or aprepitant.
Ondansetron is more effective for acute nausea. Small, bland meals
are recommended.
Q6. A client undergoing chemotherapy reports mouth pain and white
patches on the tongue. Which intervention is appropriate?
● A) Use a firm-bristled toothbrush to remove debris
● B) Rinse with alcohol-based mouthwash twice daily
● C) Apply nystatin suspension as prescribed
● D) Eat citrus fruits to increase vitamin C
Answer: C) Apply nystatin suspension as prescribed
Rationale: White patches suggest oral candidiasis (thrush) from
immunosuppression. Antifungal nystatin or fluconazole is treatment.
Alcohol-based mouthwash and firm brushing worsen irritation.
Q7. A nurse is preparing to administer packed red blood cells to a
client with chemotherapy-induced anemia. Which IV solution is
compatible?
● A) 5% dextrose in water (D5W)
● B) Lactated Ringer's
● C) 0.9% normal saline
● D) 0.45% normal saline
Answer: C) 0.9% normal saline
Exam Questions and Answers | 2026 Update |
100% Correct - WCU.
Complete Practice Examination – 2026 Update
150 Questions with Answers & Rationales
SECTION 1: ONCOLOGY &
HEMATOLOGY (Questions 1-30)
Q1. A nurse is caring for a client receiving external beam radiation
therapy for lung cancer. Which finding requires immediate
intervention?
● A) Dry, peeling skin in the treatment area
● B) Fatigue after several treatments
● C) White blood cell count of 2,500/µL
● D) Sore throat and fever
Answer: D) Sore throat and fever
,Rationale: Fever with sore throat in a radiation patient may indicate
neutropenia and infection, a medical emergency. Neutropenic fever
requires immediate evaluation and antibiotics. Dry skin and fatigue are
expected side effects. Mild leukopenia is common but fever changes
the priority.
Q2. A client with breast cancer is receiving tamoxifen. Which adverse
effect should the nurse emphasize as a priority to report?
● A) Hot flashes
● B) Vaginal discharge
● C) Leg pain or swelling
● D) Nausea
Answer: C) Leg pain or swelling
Rationale: Tamoxifen increases risk of deep vein thrombosis and
pulmonary embolism. Leg pain, swelling, warmth, or redness could
indicate DVT and requires immediate evaluation. Hot flashes and
vaginal discharge are common but not emergent.
Q3. A client is undergoing brachytherapy for cervical cancer with a
sealed radioactive implant. Which action by the nurse is correct?
● A) Assign the client to a semi-private room
● B) Limit each visitor to 30 minutes per day
● C) Keep a lead-lined container in the room
● D) Wear a dosimeter badge only when providing direct care
Answer: C) Keep a lead-lined container in the room
,Rationale: If the implant becomes dislodged, it must be picked up with
long-handled forceps and placed in a lead-lined container. Visitors
should be limited to 15-30 minutes and stay at least 6 feet away.
Pregnant women and children are prohibited. The nurse wears a
dosimeter at all times while in the room.
Q4. A client with acute lymphocytic leukemia has a platelet count of
18,000/µL. Which precaution is most important?
● A) Private room with positive airflow
● B) No fresh fruits or flowers
● C) Soft-bristled toothbrush and electric razor
● D) Strict handwashing before entering
Answer: C) Soft-bristled toothbrush and electric razor
Rationale: Severe thrombocytopenia (platelets <20,000) increases
bleeding risk. Soft toothbrush and electric razor prevent mucosal and
skin trauma. Neutropenic precautions (private room, no fresh produce)
apply for low WBC, not low platelets.
Q5. A client receiving chemotherapy reports severe nausea 3 days
after treatment. Which intervention is most appropriate?
● A) Administer ondansetron 30 minutes before chemotherapy
only
● B) Instruct the client to eat a large, fatty meal before treatment
● C) Prescribe a combination of antiemetics (e.g., 5-HT3
antagonist plus dexamethasone)
● D) Advise the client to skip meals on chemotherapy days
, Answer: C) Prescribe a combination of antiemetics
Rationale: Delayed nausea is treated with a combination of
antiemetics including dexamethasone, metoclopramide, or aprepitant.
Ondansetron is more effective for acute nausea. Small, bland meals
are recommended.
Q6. A client undergoing chemotherapy reports mouth pain and white
patches on the tongue. Which intervention is appropriate?
● A) Use a firm-bristled toothbrush to remove debris
● B) Rinse with alcohol-based mouthwash twice daily
● C) Apply nystatin suspension as prescribed
● D) Eat citrus fruits to increase vitamin C
Answer: C) Apply nystatin suspension as prescribed
Rationale: White patches suggest oral candidiasis (thrush) from
immunosuppression. Antifungal nystatin or fluconazole is treatment.
Alcohol-based mouthwash and firm brushing worsen irritation.
Q7. A nurse is preparing to administer packed red blood cells to a
client with chemotherapy-induced anemia. Which IV solution is
compatible?
● A) 5% dextrose in water (D5W)
● B) Lactated Ringer's
● C) 0.9% normal saline
● D) 0.45% normal saline
Answer: C) 0.9% normal saline
