NUR201 | NUR201 Medical Surgical Exam 1
Version 3 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A nurse is assessing a patient with a localized inflammatory response. Which clinical
manifestation is primarily caused by increased capillary permeability?
A. Redness (Erythema)
B. Loss of function
C. Heat (Warmth)
D. Swelling (Edema)
Correct Answer: D
Expert Explanation: The inflammatory response involves a vascular phase where
chemical mediators are released. These mediators cause capillaries to become more
porous, allowing fluid and protein to leak into the interstitial space. This shift of
fluid results in localized swelling or edema at the site of injury. While redness and
heat are caused by vasodilation, swelling is specifically linked to permeability. The
nurse must monitor for these changes to assess the severity of the inflammatory
process.
,2. Which type of cellular adaptation occurs when there is an increase in the number of
cells in an organ or tissue?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Expert Explanation: Hyperplasia is defined as an increase in the total number of
cells resulting from increased cellular division. This is different from hypertrophy,
which refers to an increase in the size of existing cells. Hyperplasia can be a normal
compensatory mechanism or a pathological response to excessive hormonal
stimulation. Understanding these adaptations helps nurses identify potential risks
for tissue dysfunction or malignancy. Monitoring the size and function of the
affected organ is a critical nursing intervention.
3. A patient is recovering from a surgical incision that is being allowed to heal through
the formation of granulation tissue. This is known as healing by:
A. Secondary intention
B. Primary intention
C. Tertiary intention
,D. Delayed primary closure
Correct Answer: A
Expert Explanation: Healing by secondary intention occurs when wound edges
cannot be approximated and the wound fills with granulation tissue. This process is
common in large wounds or those with significant tissue loss and infection. Because
the wound remains open, the risk of infection is higher and the resulting scar is
usually larger. The nurse must focus on meticulous wound care and monitoring for
signs of systemic infection. Proper nutrition is also vital to support the extensive
tissue repair required in this stage.
4. The nurse identifies that a patient is in the proliferative phase of wound healing.
Which biological process is dominant during this stage?
A. Collagen synthesis and epithelialization
B. Phagocytosis by macrophages
C. Vasoconstriction to control bleeding
D. Scar tissue remodeling and strengthening
Correct Answer: A
Expert Explanation: The proliferative phase of healing begins a few days after
injury and lasts for several weeks. During this time, fibroblasts synthesize collagen
to provide structure to the new tissue. Granulation tissue forms, and epithelial cells
, migrate across the wound surface to close the gap. This phase is crucial for restoring
the physical integrity of the skin and underlying structures. Nurses should observe
for healthy pink granulation tissue as a sign of progress.
5. A patient exhibits a ‘shift to the left’ on a White Blood Cell (WBC) differential. How
should the nurse interpret this finding?
A. The patient has a chronic viral infection.
B. The patient has a depleted bone marrow reserve.
C. The patient is experiencing an allergic reaction.
D. The patient has an increased number of immature neutrophils.
Correct Answer: D
Expert Explanation: A shift to the left indicates that the bone marrow is releasing
immature neutrophils, known as bands, into the bloodstream. This typically occurs
in response to an acute bacterial infection where the demand for white cells exceeds
the supply of mature ones. It serves as a significant clinical indicator of the severity
of the inflammatory or infectious process. The nurse should correlate this finding
with the patient’s temperature and physical symptoms. Prompt communication
with the healthcare provider is necessary to adjust the treatment plan.
Version 3 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A nurse is assessing a patient with a localized inflammatory response. Which clinical
manifestation is primarily caused by increased capillary permeability?
A. Redness (Erythema)
B. Loss of function
C. Heat (Warmth)
D. Swelling (Edema)
Correct Answer: D
Expert Explanation: The inflammatory response involves a vascular phase where
chemical mediators are released. These mediators cause capillaries to become more
porous, allowing fluid and protein to leak into the interstitial space. This shift of
fluid results in localized swelling or edema at the site of injury. While redness and
heat are caused by vasodilation, swelling is specifically linked to permeability. The
nurse must monitor for these changes to assess the severity of the inflammatory
process.
,2. Which type of cellular adaptation occurs when there is an increase in the number of
cells in an organ or tissue?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Correct Answer: B
Expert Explanation: Hyperplasia is defined as an increase in the total number of
cells resulting from increased cellular division. This is different from hypertrophy,
which refers to an increase in the size of existing cells. Hyperplasia can be a normal
compensatory mechanism or a pathological response to excessive hormonal
stimulation. Understanding these adaptations helps nurses identify potential risks
for tissue dysfunction or malignancy. Monitoring the size and function of the
affected organ is a critical nursing intervention.
3. A patient is recovering from a surgical incision that is being allowed to heal through
the formation of granulation tissue. This is known as healing by:
A. Secondary intention
B. Primary intention
C. Tertiary intention
,D. Delayed primary closure
Correct Answer: A
Expert Explanation: Healing by secondary intention occurs when wound edges
cannot be approximated and the wound fills with granulation tissue. This process is
common in large wounds or those with significant tissue loss and infection. Because
the wound remains open, the risk of infection is higher and the resulting scar is
usually larger. The nurse must focus on meticulous wound care and monitoring for
signs of systemic infection. Proper nutrition is also vital to support the extensive
tissue repair required in this stage.
4. The nurse identifies that a patient is in the proliferative phase of wound healing.
Which biological process is dominant during this stage?
A. Collagen synthesis and epithelialization
B. Phagocytosis by macrophages
C. Vasoconstriction to control bleeding
D. Scar tissue remodeling and strengthening
Correct Answer: A
Expert Explanation: The proliferative phase of healing begins a few days after
injury and lasts for several weeks. During this time, fibroblasts synthesize collagen
to provide structure to the new tissue. Granulation tissue forms, and epithelial cells
, migrate across the wound surface to close the gap. This phase is crucial for restoring
the physical integrity of the skin and underlying structures. Nurses should observe
for healthy pink granulation tissue as a sign of progress.
5. A patient exhibits a ‘shift to the left’ on a White Blood Cell (WBC) differential. How
should the nurse interpret this finding?
A. The patient has a chronic viral infection.
B. The patient has a depleted bone marrow reserve.
C. The patient is experiencing an allergic reaction.
D. The patient has an increased number of immature neutrophils.
Correct Answer: D
Expert Explanation: A shift to the left indicates that the bone marrow is releasing
immature neutrophils, known as bands, into the bloodstream. This typically occurs
in response to an acute bacterial infection where the demand for white cells exceeds
the supply of mature ones. It serves as a significant clinical indicator of the severity
of the inflammatory or infectious process. The nurse should correlate this finding
with the patient’s temperature and physical symptoms. Prompt communication
with the healthcare provider is necessary to adjust the treatment plan.
