NURS 201: Medical-Surgical Nursing - Promoting Wellness
(Comprehensive Exam) 2026 |WCU
1. A patient who underwent a total hip arthroplasty 24 hours ago becomes
suddenly short of breath and anxious. Their oxygen saturation drops to 88% on
room air. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Fat embolism syndrome
C. Pneumonia
D. Atelectasis
Answer: A
Rationale: Sudden onset of dyspnea, anxiety, and hypoxia post-orthopedic surgery is a
classic presentation of a pulmonary embolism, which is a life-threatening emergency.
2. A nurse is caring for a patient with Chronic Kidney Disease (CKD) whose
potassium level is 6.4 mEq/L. Which of the following provider orders should the
nurse implement first?
A. Administer Sodium Polystyrene Sulfonate orally
B. Administer a dose of IV Furosemide
C. Prepare the patient for hemodialysis
D. Initiate continuous cardiac monitoring
Answer: D
Rationale: Hyperkalemia (6.4 mEq/L) can cause life-threatening cardiac arrhythmias.
Assessing cardiac rhythm via monitoring is the priority before administering treatments.
,3. A patient with Type 1 Diabetes Mellitus is found unconscious and diaphoretic.
What is the nurse’s immediate priority action?
A. Administer 15g of simple carbohydrates orally
B. Check the patient’s blood glucose level
C. Administer Glucagon IM or Subcutaneously
D. Call the healthcare provider immediately
Answer: C
Rationale: In an unconscious patient with suspected hypoglycemia, providing glucose via
Glucagon or IV Dextrose is the priority. Oral intake is contraindicated due to aspiration risk.
4. Which assessment finding in a patient with a chest tube requires immediate
intervention by the nurse?
A. Tidaling in the water-seal chamber with respirations
B. Intermittent bubbling in the suction control chamber
C. Continuous bubbling in the water-seal chamber
D. 50 mL of serosanguinous drainage in the last hour
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system, which requires immediate troubleshooting. Tidaling is normal, and suction
bubbling is expected.
5. A patient with heart failure is prescribed Digoxin. Which laboratory result
should the nurse report to the provider before administering the medication?
A. Sodium 138 mEq/L
B. Calcium 9.2 mg/dL
C. Creatinine 1.0 mg/dL
D. Potassium 3.1 mEq/L
Answer: D
, Rationale: Hypokalemia (Potassium < 3.5 mEq/L) significantly increases the risk of
Digoxin toxicity, even if the Digoxin level is within the therapeutic range.
6. A nurse is teaching a patient with COPD about ‘pursed-lip breathing.’ What is
the primary purpose of this technique?
A. To prevent airway collapse during expiration
B. To increase the rate of respirations
C. To strengthen the intercostal muscles
D. To increase the amount of inspired oxygen
Answer: A
Rationale: Pursed-lip breathing creates positive pressure in the airways, preventing them
from collapsing on exhalation and allowing for better CO2 elimination.
7. A patient is admitted with suspected Cushing’s Syndrome. Which of the
following clinical manifestations would the nurse expect to observe?
A. Weight loss and hypotension
B. Truncal obesity and moon face
C. Hyperpigmentation and hyperkalemia
D. Polyuria and polydipsia
Answer: B
Rationale: Cushing’s Syndrome, caused by excess cortisol, results in fat redistribution
(truncal obesity, moon face, buffalo hump) and hyperglycemia.
(Comprehensive Exam) 2026 |WCU
1. A patient who underwent a total hip arthroplasty 24 hours ago becomes
suddenly short of breath and anxious. Their oxygen saturation drops to 88% on
room air. Which complication should the nurse suspect first?
A. Pulmonary embolism
B. Fat embolism syndrome
C. Pneumonia
D. Atelectasis
Answer: A
Rationale: Sudden onset of dyspnea, anxiety, and hypoxia post-orthopedic surgery is a
classic presentation of a pulmonary embolism, which is a life-threatening emergency.
2. A nurse is caring for a patient with Chronic Kidney Disease (CKD) whose
potassium level is 6.4 mEq/L. Which of the following provider orders should the
nurse implement first?
A. Administer Sodium Polystyrene Sulfonate orally
B. Administer a dose of IV Furosemide
C. Prepare the patient for hemodialysis
D. Initiate continuous cardiac monitoring
Answer: D
Rationale: Hyperkalemia (6.4 mEq/L) can cause life-threatening cardiac arrhythmias.
Assessing cardiac rhythm via monitoring is the priority before administering treatments.
,3. A patient with Type 1 Diabetes Mellitus is found unconscious and diaphoretic.
What is the nurse’s immediate priority action?
A. Administer 15g of simple carbohydrates orally
B. Check the patient’s blood glucose level
C. Administer Glucagon IM or Subcutaneously
D. Call the healthcare provider immediately
Answer: C
Rationale: In an unconscious patient with suspected hypoglycemia, providing glucose via
Glucagon or IV Dextrose is the priority. Oral intake is contraindicated due to aspiration risk.
4. Which assessment finding in a patient with a chest tube requires immediate
intervention by the nurse?
A. Tidaling in the water-seal chamber with respirations
B. Intermittent bubbling in the suction control chamber
C. Continuous bubbling in the water-seal chamber
D. 50 mL of serosanguinous drainage in the last hour
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system, which requires immediate troubleshooting. Tidaling is normal, and suction
bubbling is expected.
5. A patient with heart failure is prescribed Digoxin. Which laboratory result
should the nurse report to the provider before administering the medication?
A. Sodium 138 mEq/L
B. Calcium 9.2 mg/dL
C. Creatinine 1.0 mg/dL
D. Potassium 3.1 mEq/L
Answer: D
, Rationale: Hypokalemia (Potassium < 3.5 mEq/L) significantly increases the risk of
Digoxin toxicity, even if the Digoxin level is within the therapeutic range.
6. A nurse is teaching a patient with COPD about ‘pursed-lip breathing.’ What is
the primary purpose of this technique?
A. To prevent airway collapse during expiration
B. To increase the rate of respirations
C. To strengthen the intercostal muscles
D. To increase the amount of inspired oxygen
Answer: A
Rationale: Pursed-lip breathing creates positive pressure in the airways, preventing them
from collapsing on exhalation and allowing for better CO2 elimination.
7. A patient is admitted with suspected Cushing’s Syndrome. Which of the
following clinical manifestations would the nurse expect to observe?
A. Weight loss and hypotension
B. Truncal obesity and moon face
C. Hyperpigmentation and hyperkalemia
D. Polyuria and polydipsia
Answer: B
Rationale: Cushing’s Syndrome, caused by excess cortisol, results in fat redistribution
(truncal obesity, moon face, buffalo hump) and hyperglycemia.
