NURS 201 Medical-Surgical Nursing – Promoting Wellness Final
Review 2026 |WCU
1. A patient with heart failure is prescribed digoxin. Which of the following
assessment findings would most strongly suggest digoxin toxicity?
A. Increased urinary output
B. Serum potassium level of 4.8 mEq/L
C. Heart rate of 72 beats per minute
D. Frequent premature ventricular contractions
Answer: D
Rationale: Digoxin toxicity often manifests as cardiac dysrhythmias, including PVCs,
bradycardia, or heart blocks, along with visual changes and gastrointestinal distress.
2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following
is the priority nursing intervention?
A. Administering subcutaneous long-acting insulin
B. Starting an intravenous infusion of 0.9% normal saline
C. Providing a carbohydrate-rich snack
D. Assessing the patient’s deep tendon reflexes
Answer: B
Rationale: The priority in DKA is fluid resuscitation to restore circulatory volume and
address dehydration before or concurrent with insulin therapy.
,3. When caring for a patient after a thyroidectomy, the nurse notes the patient
is experiencing muscle spasms and tingling in the fingers. Which medication
should the nurse expect to administer?
A. Levothyroxine
B. Calcium gluconate
C. Potassium chloride
D. Propylthiouracil
Answer: B
Rationale: Spasms and tingling (Trousseau’s or Chvostek’s signs) indicate hypocalcemia,
often due to accidental parathyroid gland removal during thyroidectomy.
4. A nurse is assessing a patient with a chest tube. Which finding should be
reported to the provider immediately?
A. Occasional bubbling in the water seal chamber during expiration
B. Continuous bubbling in the water seal chamber
C. Fluctuation of the water level with respiration (tidaling)
D. Drainage of 50 mL of serosanguinous fluid over 4 hours
Answer: B
Rationale: Continuous bubbling in the water seal chamber suggests an air leak in the
system or the patient’s pleural space, requiring urgent intervention.
5. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS).
Which oxygenation strategy is most commonly utilized in the ICU for this
condition?
A. Mechanical ventilation with Positive End-Expiratory Pressure (PEEP)
B. Simple face mask at 10 L/min
C. Incentive spirometry every hour
D. Low-flow nasal cannula at 2 L/min
Answer: A
, Rationale: PEEP is essential in ARDS to keep alveoli open and improve gas exchange in
stiff, non-compliant lungs.
6. Which laboratory value is most indicative of chronic kidney disease (CKD)
progression?
A. Decreased Glomerular Filtration Rate (GFR)
B. Increased Glomerular Filtration Rate (GFR)
C. Decreased Serum Creatinine
D. Decreased Blood Urea Nitrogen (BUN)
Answer: A
Rationale: GFR is the gold standard for determining kidney function and staging the
progression of chronic kidney disease.
7. A client with a history of atrial fibrillation is taking warfarin. Which INR range
is typically targeted for this patient?
A. 0.5 - 1.0
B. 2.0 - 3.0
C. 4.5 - 5.5
D. 1.1 - 1.5
Answer: B
Rationale: For atrial fibrillation, a therapeutic INR is usually maintained between 2.0 and
3.0 to prevent thromboembolic events while minimizing bleeding risk.
8. What is the primary goal of palliative care for a patient with end-stage heart
failure?
A. Curing the underlying myocardial damage
B. Providing aggressive surgical intervention
C. Restricting all forms of physical activity
D. Enhancing quality of life and symptom management
Answer: D
Review 2026 |WCU
1. A patient with heart failure is prescribed digoxin. Which of the following
assessment findings would most strongly suggest digoxin toxicity?
A. Increased urinary output
B. Serum potassium level of 4.8 mEq/L
C. Heart rate of 72 beats per minute
D. Frequent premature ventricular contractions
Answer: D
Rationale: Digoxin toxicity often manifests as cardiac dysrhythmias, including PVCs,
bradycardia, or heart blocks, along with visual changes and gastrointestinal distress.
2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following
is the priority nursing intervention?
A. Administering subcutaneous long-acting insulin
B. Starting an intravenous infusion of 0.9% normal saline
C. Providing a carbohydrate-rich snack
D. Assessing the patient’s deep tendon reflexes
Answer: B
Rationale: The priority in DKA is fluid resuscitation to restore circulatory volume and
address dehydration before or concurrent with insulin therapy.
,3. When caring for a patient after a thyroidectomy, the nurse notes the patient
is experiencing muscle spasms and tingling in the fingers. Which medication
should the nurse expect to administer?
A. Levothyroxine
B. Calcium gluconate
C. Potassium chloride
D. Propylthiouracil
Answer: B
Rationale: Spasms and tingling (Trousseau’s or Chvostek’s signs) indicate hypocalcemia,
often due to accidental parathyroid gland removal during thyroidectomy.
4. A nurse is assessing a patient with a chest tube. Which finding should be
reported to the provider immediately?
A. Occasional bubbling in the water seal chamber during expiration
B. Continuous bubbling in the water seal chamber
C. Fluctuation of the water level with respiration (tidaling)
D. Drainage of 50 mL of serosanguinous fluid over 4 hours
Answer: B
Rationale: Continuous bubbling in the water seal chamber suggests an air leak in the
system or the patient’s pleural space, requiring urgent intervention.
5. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS).
Which oxygenation strategy is most commonly utilized in the ICU for this
condition?
A. Mechanical ventilation with Positive End-Expiratory Pressure (PEEP)
B. Simple face mask at 10 L/min
C. Incentive spirometry every hour
D. Low-flow nasal cannula at 2 L/min
Answer: A
, Rationale: PEEP is essential in ARDS to keep alveoli open and improve gas exchange in
stiff, non-compliant lungs.
6. Which laboratory value is most indicative of chronic kidney disease (CKD)
progression?
A. Decreased Glomerular Filtration Rate (GFR)
B. Increased Glomerular Filtration Rate (GFR)
C. Decreased Serum Creatinine
D. Decreased Blood Urea Nitrogen (BUN)
Answer: A
Rationale: GFR is the gold standard for determining kidney function and staging the
progression of chronic kidney disease.
7. A client with a history of atrial fibrillation is taking warfarin. Which INR range
is typically targeted for this patient?
A. 0.5 - 1.0
B. 2.0 - 3.0
C. 4.5 - 5.5
D. 1.1 - 1.5
Answer: B
Rationale: For atrial fibrillation, a therapeutic INR is usually maintained between 2.0 and
3.0 to prevent thromboembolic events while minimizing bleeding risk.
8. What is the primary goal of palliative care for a patient with end-stage heart
failure?
A. Curing the underlying myocardial damage
B. Providing aggressive surgical intervention
C. Restricting all forms of physical activity
D. Enhancing quality of life and symptom management
Answer: D
