Page 1 of 144
NURS 201 Intermediate Med Surg Midterm Exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR-JUST RELEASED
NURS 201 Intermediate Med Surg Midterm Exam – Summarized Topics
• Cardiovascular Disorders – Heart failure (HF), hypertension, coronary artery disease (CAD),
acute coronary syndrome (ACS), myocardial infarction (MI), stable/unstable angina, atrial
fibrillation, peripheral artery disease (PAD), dysrhythmias (ECG interpretation)
• Respiratory Disorders – COPD, asthma, pneumonia, pulmonary embolism (PE), tuberculosis
(TB), chest tubes, mechanical ventilation, oxygen therapy, ABG interpretation
• Hematologic Disorders – Thrombocytopenia (ITP, TTP, HIT), anemia, blood transfusions (types,
administration, reactions), autologous vs. designated donor
• Neurologic Disorders – Bell's palsy, Guillain-Barré syndrome (GBS), multiple sclerosis (MS),
myasthenia gravis, Parkinson's disease, amyotrophic lateral sclerosis (ALS)
• Oncology – Cancer diagnosis/staging, chemotherapy, brachytherapy, hospice care, tumor
markers (BRCA gene)
• Pain Management – Pain assessment (self-report), pharmacological/non-pharmacological
interventions, PCA pump, ATC administration
• Fluid & Electrolytes – Diuretics (furosemide), potassium balance, fluid restrictions
• Genitourinary/Gastrointestinal – Urolithiasis, pancreatitis, BPH, ED, incontinence
• Pharmacology – ACE inhibitors (lisinopril, angioedema), beta-blockers (carvedilol), nitrates,
warfarin (INR monitoring), anticholinergics (Cogentin, benztropine)
• Nursing Process & Priority Setting – Maslow's hierarchy, three-tier priority
(high/intermediate/low), QSEN, care plans, case management
1. A patient with heart failure has crackles in lung bases, 2+ pitting edema, and weight gain of 2 kg in 24
hours. Furosemide is administered. Which finding best indicates the medication is effective?
A) Blood pressure increases from 100/60 to 130/85 mmHg
B) Weight loss of 2 kg
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C) Urine output decreases
D) Crackles become more widespread
Answer: B – Furosemide is a loop diuretic that reduces fluid volume. Weight loss indicates effective
diuresis and reduced fluid overload.
2. A patient with COPD has oxygen ordered at 2 L/min via nasal cannula. The nurse understands that
high oxygen concentrations can be dangerous because:
A) High oxygen causes oxygen toxicity affecting lung tissue
B) High oxygen dries mucous membranes leading to infection
C) High oxygen can suppress the hypoxic respiratory drive
D) High oxygen causes bronchospasm and wheezing
Answer: C – COPD patients with chronic hypercapnia rely on hypoxic drive (low O2) to stimulate
breathing. High O2 removes this drive, leading to respiratory depression and CO2 retention.
3. A patient with thrombocytopenia asks why they must use an electric razor. Which explanation is most
accurate?
, Page 3 of 144
A) Electric razors provide a closer shave with less irritation
B) Straight razors can cause nicks that lead to prolonged bleeding
C) Electric razors are cheaper and more sanitary
D) Straight razors require shaving cream which irritates skin
Answer: B – Thrombocytopenia causes decreased platelets and prolonged bleeding even from minor
cuts. Electric razors minimize the risk of nicks and bleeding.
4. A patient with Bell's palsy asks how long the condition typically lasts. The nurse's best response is:
A) "Most patients recover completely within 3–6 months without treatment"
B) "Symptoms are permanent in about 50% of cases"
C) "Most patients begin to get better within 2 weeks after onset"
D) "Full recovery takes at least one year of therapy"
Answer: C – Most patients with Bell's palsy begin to show improvement within 2 weeks of symptom
onset, with many recovering fully.
5. A patient receiving chemotherapy has a WBC count of 1,500/mm³. Which visitor should the nurse
restrict from entering the patient's room?
, Page 4 of 144
A) A family member with a healing surgical wound
B) A friend who reports seasonal allergies with sneezing
C) A child recently exposed to chickenpox at school
D) A spouse who smokes cigarettes outdoors
Answer: C – The patient is severely neutropenic (normal WBC 5,000–10,000; <2,000 increases risk).
Exposure to chickenpox (varicella) could cause life-threatening disseminated infection.
6. A patient with myasthenia gravis is prescribed pyridostigmine (cholinesterase inhibitor). What
adverse reaction requires immediate emergency intervention?
A) Dry mouth and blurred vision
B) Increased muscle weakness
C) Mild nausea and diarrhea
D) Headache and drowsiness
Answer: B – Increased muscle weakness may indicate cholinergic crisis (overmedication) or myasthenic
crisis (undermedication); both can lead to respiratory failure requiring emergency care.
NURS 201 Intermediate Med Surg Midterm Exam COMPLETE
QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR-JUST RELEASED
NURS 201 Intermediate Med Surg Midterm Exam – Summarized Topics
• Cardiovascular Disorders – Heart failure (HF), hypertension, coronary artery disease (CAD),
acute coronary syndrome (ACS), myocardial infarction (MI), stable/unstable angina, atrial
fibrillation, peripheral artery disease (PAD), dysrhythmias (ECG interpretation)
• Respiratory Disorders – COPD, asthma, pneumonia, pulmonary embolism (PE), tuberculosis
(TB), chest tubes, mechanical ventilation, oxygen therapy, ABG interpretation
• Hematologic Disorders – Thrombocytopenia (ITP, TTP, HIT), anemia, blood transfusions (types,
administration, reactions), autologous vs. designated donor
• Neurologic Disorders – Bell's palsy, Guillain-Barré syndrome (GBS), multiple sclerosis (MS),
myasthenia gravis, Parkinson's disease, amyotrophic lateral sclerosis (ALS)
• Oncology – Cancer diagnosis/staging, chemotherapy, brachytherapy, hospice care, tumor
markers (BRCA gene)
• Pain Management – Pain assessment (self-report), pharmacological/non-pharmacological
interventions, PCA pump, ATC administration
• Fluid & Electrolytes – Diuretics (furosemide), potassium balance, fluid restrictions
• Genitourinary/Gastrointestinal – Urolithiasis, pancreatitis, BPH, ED, incontinence
• Pharmacology – ACE inhibitors (lisinopril, angioedema), beta-blockers (carvedilol), nitrates,
warfarin (INR monitoring), anticholinergics (Cogentin, benztropine)
• Nursing Process & Priority Setting – Maslow's hierarchy, three-tier priority
(high/intermediate/low), QSEN, care plans, case management
1. A patient with heart failure has crackles in lung bases, 2+ pitting edema, and weight gain of 2 kg in 24
hours. Furosemide is administered. Which finding best indicates the medication is effective?
A) Blood pressure increases from 100/60 to 130/85 mmHg
B) Weight loss of 2 kg
, Page 2 of 144
C) Urine output decreases
D) Crackles become more widespread
Answer: B – Furosemide is a loop diuretic that reduces fluid volume. Weight loss indicates effective
diuresis and reduced fluid overload.
2. A patient with COPD has oxygen ordered at 2 L/min via nasal cannula. The nurse understands that
high oxygen concentrations can be dangerous because:
A) High oxygen causes oxygen toxicity affecting lung tissue
B) High oxygen dries mucous membranes leading to infection
C) High oxygen can suppress the hypoxic respiratory drive
D) High oxygen causes bronchospasm and wheezing
Answer: C – COPD patients with chronic hypercapnia rely on hypoxic drive (low O2) to stimulate
breathing. High O2 removes this drive, leading to respiratory depression and CO2 retention.
3. A patient with thrombocytopenia asks why they must use an electric razor. Which explanation is most
accurate?
, Page 3 of 144
A) Electric razors provide a closer shave with less irritation
B) Straight razors can cause nicks that lead to prolonged bleeding
C) Electric razors are cheaper and more sanitary
D) Straight razors require shaving cream which irritates skin
Answer: B – Thrombocytopenia causes decreased platelets and prolonged bleeding even from minor
cuts. Electric razors minimize the risk of nicks and bleeding.
4. A patient with Bell's palsy asks how long the condition typically lasts. The nurse's best response is:
A) "Most patients recover completely within 3–6 months without treatment"
B) "Symptoms are permanent in about 50% of cases"
C) "Most patients begin to get better within 2 weeks after onset"
D) "Full recovery takes at least one year of therapy"
Answer: C – Most patients with Bell's palsy begin to show improvement within 2 weeks of symptom
onset, with many recovering fully.
5. A patient receiving chemotherapy has a WBC count of 1,500/mm³. Which visitor should the nurse
restrict from entering the patient's room?
, Page 4 of 144
A) A family member with a healing surgical wound
B) A friend who reports seasonal allergies with sneezing
C) A child recently exposed to chickenpox at school
D) A spouse who smokes cigarettes outdoors
Answer: C – The patient is severely neutropenic (normal WBC 5,000–10,000; <2,000 increases risk).
Exposure to chickenpox (varicella) could cause life-threatening disseminated infection.
6. A patient with myasthenia gravis is prescribed pyridostigmine (cholinesterase inhibitor). What
adverse reaction requires immediate emergency intervention?
A) Dry mouth and blurred vision
B) Increased muscle weakness
C) Mild nausea and diarrhea
D) Headache and drowsiness
Answer: B – Increased muscle weakness may indicate cholinergic crisis (overmedication) or myasthenic
crisis (undermedication); both can lead to respiratory failure requiring emergency care.
