NURS 201 | Medical-Surgical Nursing – Promoting Wellness | Final
Exam 2026 |WCU
1. A patient with chronic obstructive pulmonary disease (COPD) is being
discharged. Which instruction should the nurse prioritize to help promote
wellness and prevent exacerbations?
A. Increase dietary intake of simple carbohydrates for energy.
B. Receive an annual influenza vaccination and a pneumococcal vaccine as recommended.
C. Maintain oxygen flow at 6L/min via nasal cannula at all times.
D. Limit fluid intake to less than 1 liter per day to prevent pulmonary edema.
Answer: B
Rationale: Vaccinations are critical in COPD patients to prevent respiratory infections,
which are a leading cause of exacerbations. High carb diets increase CO2 production,
oxygen should be titrated carefully, and fluids should generally be increased to thin
secretions.
2. Which clinical manifestation should the nurse expect to find in a patient
diagnosed with right-sided heart failure?
A. Peripheral edema and jugular venous distention
B. Frothy, pink-tinged sputum
C. Crackles in the lungs and dyspnea
D. Orthopnea and paroxysmal nocturnal dyspnea
Answer: A
Rationale: Right-sided heart failure results in systemic venous congestion, leading to
peripheral edema, JVD, and hepatomegaly. Left-sided failure causes pulmonary symptoms
like crackles and orthopnea.
,3. A patient is 24 hours post-operative following an abdominal hysterectomy.
Which assessment finding requires immediate intervention by the nurse?
A. Absent bowel sounds in all four quadrants
B. Serosanguinous drainage on the abdominal dressing
C. Pain level of 5 on a scale of 0-10
D. Unilateral calf swelling and tenderness
Answer: D
Rationale: Unilateral calf swelling and tenderness are signs of deep vein thrombosis
(DVT), a major post-op complication that can lead to pulmonary embolism. Absent bowel
sounds are expected shortly after surgery, and pain/serosanguinous drainage are common.
4. When caring for a patient with a potassium level of 6.2 mEq/L, which
intervention is the nurse’s priority?
A. Obtain an immediate electrocardiogram (ECG).
B. Administer a potassium-sparing diuretic.
C. Monitor the patient for muscle weakness.
D. Encourage the intake of bananas and orange juice.
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) can cause lethal cardiac dysrhythmias. Obtaining an
ECG is the priority to assess for peaked T-waves or widened QRS complexes. Potassium-
sparing diuretics and high-K foods would worsen the condition.
, 5. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations,
a blood glucose of 560 mg/dL, and ketonuria. Which acid-base imbalance is
occurring?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Metabolic Acidosis
Answer: D
Rationale: Diabetic Ketoacidosis (DKA) leads to a buildup of ketones (acids), resulting in
metabolic acidosis. Kussmaul respirations are a compensatory mechanism to blow off CO2
(acid).
6. A patient is receiving a blood transfusion and reports sudden chills, lower
back pain, and itching. What is the nurse’s first action?
A. Stop the transfusion immediately.
B. Administer diphenhydramine as ordered.
C. Slow the infusion rate and notify the physician.
D. Check the patient’s temperature and blood pressure.
Answer: A
Rationale: These are signs of a hemolytic or allergic transfusion reaction. The nurse must
stop the infusion immediately to prevent further exposure to the incompatible blood
product.
Exam 2026 |WCU
1. A patient with chronic obstructive pulmonary disease (COPD) is being
discharged. Which instruction should the nurse prioritize to help promote
wellness and prevent exacerbations?
A. Increase dietary intake of simple carbohydrates for energy.
B. Receive an annual influenza vaccination and a pneumococcal vaccine as recommended.
C. Maintain oxygen flow at 6L/min via nasal cannula at all times.
D. Limit fluid intake to less than 1 liter per day to prevent pulmonary edema.
Answer: B
Rationale: Vaccinations are critical in COPD patients to prevent respiratory infections,
which are a leading cause of exacerbations. High carb diets increase CO2 production,
oxygen should be titrated carefully, and fluids should generally be increased to thin
secretions.
2. Which clinical manifestation should the nurse expect to find in a patient
diagnosed with right-sided heart failure?
A. Peripheral edema and jugular venous distention
B. Frothy, pink-tinged sputum
C. Crackles in the lungs and dyspnea
D. Orthopnea and paroxysmal nocturnal dyspnea
Answer: A
Rationale: Right-sided heart failure results in systemic venous congestion, leading to
peripheral edema, JVD, and hepatomegaly. Left-sided failure causes pulmonary symptoms
like crackles and orthopnea.
,3. A patient is 24 hours post-operative following an abdominal hysterectomy.
Which assessment finding requires immediate intervention by the nurse?
A. Absent bowel sounds in all four quadrants
B. Serosanguinous drainage on the abdominal dressing
C. Pain level of 5 on a scale of 0-10
D. Unilateral calf swelling and tenderness
Answer: D
Rationale: Unilateral calf swelling and tenderness are signs of deep vein thrombosis
(DVT), a major post-op complication that can lead to pulmonary embolism. Absent bowel
sounds are expected shortly after surgery, and pain/serosanguinous drainage are common.
4. When caring for a patient with a potassium level of 6.2 mEq/L, which
intervention is the nurse’s priority?
A. Obtain an immediate electrocardiogram (ECG).
B. Administer a potassium-sparing diuretic.
C. Monitor the patient for muscle weakness.
D. Encourage the intake of bananas and orange juice.
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) can cause lethal cardiac dysrhythmias. Obtaining an
ECG is the priority to assess for peaked T-waves or widened QRS complexes. Potassium-
sparing diuretics and high-K foods would worsen the condition.
, 5. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations,
a blood glucose of 560 mg/dL, and ketonuria. Which acid-base imbalance is
occurring?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Metabolic Acidosis
Answer: D
Rationale: Diabetic Ketoacidosis (DKA) leads to a buildup of ketones (acids), resulting in
metabolic acidosis. Kussmaul respirations are a compensatory mechanism to blow off CO2
(acid).
6. A patient is receiving a blood transfusion and reports sudden chills, lower
back pain, and itching. What is the nurse’s first action?
A. Stop the transfusion immediately.
B. Administer diphenhydramine as ordered.
C. Slow the infusion rate and notify the physician.
D. Check the patient’s temperature and blood pressure.
Answer: A
Rationale: These are signs of a hemolytic or allergic transfusion reaction. The nurse must
stop the infusion immediately to prevent further exposure to the incompatible blood
product.
