1
NURS201 / NURS 201 Midterm Exam Medical
Surgical Nursing Promoting Wellness Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed Rationales –
Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Foundations of Medical-Surgical Nursing | Q1 – Q15
Section 2 | Cardiovascular and Respiratory Disorders | Q16 – Q30
Section 3 | Gastrointestinal and Renal Disorders | Q31 – Q45
Section 4 | Neurological and Musculoskeletal Disorders | Q46 – Q60
Section 5 | Endocrine, Immunologic, and Multisystem Disorders | Q61 – Q75
SECTION 1: FOUNDATIONS OF MEDICAL-SURGICAL NURSING
Question 1 of 75
A 62-year-old male is admitted to the medical-surgical unit for preoperative bowel preparation
before colon surgery. His vital signs are temperature 37.0°C, heart rate 82 bpm, respiratory rate
16/min, blood pressure 138/84 mmHg, and oxygen saturation 97% on room air. Laboratory
values reveal potassium 3.4 mEq/L, sodium 138 mEq/L, creatinine 1.0 mg/dL, and glucose 102
mg/dL. The nurse notes the patient has been NPO for 8 hours and has received four liters of
polyethylene glycol bowel preparation solution over the past 6 hours. The patient reports
dizziness when standing and has had six liquid bowel movements.
A. Administer intravenous metoclopramide to reduce nausea and continue the bowel preparation
orally
B. Instruct the patient to drink additional clear fluids to maintain hydration despite the NPO
status
C. Initiate intravenous fluid replacement with lactated Ringer's solution and monitor orthostatic
vital signs ✓ CORRECT
D. Administer loperamide to slow the bowel movements and preserve electrolyte balance
Correct Answer: C
,2
Rationale: Excessive bowel preparation can cause significant fluid and electrolyte losses
requiring intravenous replacement with an isotonic solution such as lactated Ringer's to restore
intravascular volume and prevent preoperative dehydration. Administering additional oral fluids
violates NPO status before surgery, while antimotility agents interfere with the necessary bowel
cleansing. Medical-surgical nurses must monitor for orthostatic hypotension and electrolyte
imbalances during bowel preparation, particularly in older adults with limited cardiac reserve.
Question 2 of 75
A 54-year-old female is admitted to the surgical unit following an open cholecystectomy. Her
vital signs are temperature 37.0°C, heart rate 88 bpm, respiratory rate 18/min, blood pressure
136/84 mmHg, and oxygen saturation 97% on 2 L nasal cannula. Laboratory values show
sodium 138 mEq/L, potassium 3.2 mEq/L, chloride 102 mEq/L, and magnesium 1.6 mg/dL. The
nurse notes shallow respirations, weakness in bilateral lower extremities, and absent bowel
sounds on abdominal auscultation.
A. Administer a rapid intravenous potassium chloride bolus of 40 mEq over 15 minutes to
quickly correct the deficit
B. Initiate a cardiac monitor and administer intravenous potassium chloride at a maximum rate of
10 mEq per hour via an infusion pump ✓ CORRECT
C. Increase the patient's oral fluid intake to 3 liters per day and recheck electrolytes in 48 hours
D. Encourage the patient to consume bananas and orange juice and delay potassium replacement
until the next scheduled laboratory draw
Correct Answer: B
Rationale: Postoperative hypokalemia requires careful cardiac monitoring and controlled
intravenous replacement at no more than 10 mEq per hour via infusion pump to prevent life-
threatening arrhythmias. Rapid potassium boluses can cause cardiac arrest, making this option
extremely dangerous despite the urgency of correcting the low level. In medical-surgical nursing,
always verify infusion pump use and cardiac monitoring when administering intravenous
potassium replacements.
Question 3 of 75
A 72-year-old male is transferred to the post-anesthesia care unit following a total hip
arthroplasty performed under general anesthesia. His vital signs are temperature 35.8°C, heart
rate 58 bpm, respiratory rate 12/min, blood pressure 98/62 mmHg, and oxygen saturation 89%
on a non-rebreather mask at 10 L/min. Laboratory values reveal hemoglobin 9.8 g/dL, hematocrit
30%, and platelets 180,000/mm³. The PACU nurse notes sluggish pupillary response, shallow
breathing, and minimal response to sternal rub.
,3
A. Administer intravenous naloxone 0.04 mg in incremental doses while preparing for possible
endotracheal intubation ✓ CORRECT
B. Apply a warming blanket, continue oxygen therapy, and maintain the patient in a lateral
recovery position
C. Immediately initiate two large-bore intravenous lines and administer a 2-liter crystalloid fluid
bolus
D. Elevate the head of the bed to 90 degrees and administer an intravenous diuretic to improve
respiratory effort
Correct Answer: A
Rationale: Respiratory depression with pinpoint pupils following intravenous morphine
administration indicates opioid-induced respiratory depression requiring incremental naloxone
titration to reverse the effect while maintaining airway management readiness. Warming and
positioning address hypothermia but do not reverse the underlying opioid respiratory depression,
which is the immediate life-threatening concern. PACU nurses must recognize the classic triad of
opioid overdose—respiratory depression, pinpoint pupils, and decreased consciousness—and
respond with appropriate reversal agents while supporting ventilation.
Question 4 of 75
A 45-year-old female is admitted to the oncology unit with metastatic breast cancer and reports
pain rated 8 out of 10 in her lower back. Her vital signs are temperature 37.2°C, heart rate 104
bpm, respiratory rate 20/min, blood pressure 128/76 mmHg, and oxygen saturation 96% on room
air. Laboratory values show creatinine 0.9 mg/dL, liver function tests within normal limits, and
calcium 11.2 mg/dL. The nurse observes the patient guarding her lower back, grimacing with
movement, and refusing to participate in physical therapy.
A. Administer acetaminophen 650 mg orally every 6 hours as needed and apply a heating pad to
the lower back
B. Initiate a patient-controlled analgesia pump with hydromorphone and schedule daily physical
therapy sessions regardless of pain level
C. Administer morphine sulfate 2 mg intravenously every 4 hours around the clock and reassess
pain within 30 minutes
D. Offer ibuprofen 400 mg orally every 8 hours and encourage deep breathing exercises to
distract from the pain ✓ CORRECT
Correct Answer: D
, 4
Rationale: Wait, this is wrong. Ibuprofen is not correct for severe cancer pain. Let me fix this
question to make D actually correct.
A 45-year-old female is admitted to the oncology unit with metastatic breast cancer and reports
pain rated 8 out of 10 in her lower back. Her vital signs are temperature 37.2°C, heart rate 104
bpm, respiratory rate 20/min, blood pressure 128/76 mmHg, and oxygen saturation 96% on room
air. Laboratory values show creatinine 0.9 mg/dL, liver function tests within normal limits, and
calcium 11.2 mg/dL. The nurse observes the patient guarding her lower back, grimacing with
movement, and refusing to participate in physical therapy. The patient reports that around-the-
clock morphine makes her nauseated and she prefers non-opioid options when possible.
A. Administer acetaminophen 650 mg orally every 6 hours as needed and apply a heating pad to
the lower back
B. Initiate a patient-controlled analgesia pump with hydromorphone and schedule daily physical
therapy sessions regardless of pain level
C. Continue morphine sulfate despite nausea and add an antiemetic to ensure adherence to the
opioid regimen
D. Implement a multimodal pain regimen combining scheduled acetaminophen, adjuvant
gabapentin for neuropathic bone pain, nonpharmacologic measures, and short-acting opioid for
breakthrough pain only ✓ CORRECT
Correct Answer: D
Rationale: Multimodal pain management incorporating non-opioid adjuvants such as gabapentin
for neuropathic cancer pain, scheduled acetaminophen, and reserved short-acting opioids reduces
adverse effects while improving functional participation and quality of life. Forcing physical
therapy without adequate pain control or dismissing patient preferences violates patient-centered
care principles, and continuing an intolerable medication without exploring alternatives is not
evidence-based practice. Medical-surgical oncology nurses should advocate for multimodal
approaches that minimize opioid burden while maintaining effective analgesia for bone
metastases.
Question 5 of 75
A 61-year-old male is admitted to the medical-surgical unit with a stage 2 pressure injury on his
sacrum measuring 3 cm by 2 cm with partial-thickness skin loss and pink wound bed without
necrotic tissue. His vital signs are temperature 37.0°C, heart rate 78 bpm, respiratory rate 16/min,
blood pressure 138/82 mmHg, and oxygen saturation 96% on room air. Laboratory values reveal
albumin 3.2 g/dL, prealbumin 22 mg/dL, and glucose 142 mg/dL. The nurse observes intact
periwound skin and documents serous drainage during the dressing change.
NURS201 / NURS 201 Midterm Exam Medical
Surgical Nursing Promoting Wellness Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed Rationales –
Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Foundations of Medical-Surgical Nursing | Q1 – Q15
Section 2 | Cardiovascular and Respiratory Disorders | Q16 – Q30
Section 3 | Gastrointestinal and Renal Disorders | Q31 – Q45
Section 4 | Neurological and Musculoskeletal Disorders | Q46 – Q60
Section 5 | Endocrine, Immunologic, and Multisystem Disorders | Q61 – Q75
SECTION 1: FOUNDATIONS OF MEDICAL-SURGICAL NURSING
Question 1 of 75
A 62-year-old male is admitted to the medical-surgical unit for preoperative bowel preparation
before colon surgery. His vital signs are temperature 37.0°C, heart rate 82 bpm, respiratory rate
16/min, blood pressure 138/84 mmHg, and oxygen saturation 97% on room air. Laboratory
values reveal potassium 3.4 mEq/L, sodium 138 mEq/L, creatinine 1.0 mg/dL, and glucose 102
mg/dL. The nurse notes the patient has been NPO for 8 hours and has received four liters of
polyethylene glycol bowel preparation solution over the past 6 hours. The patient reports
dizziness when standing and has had six liquid bowel movements.
A. Administer intravenous metoclopramide to reduce nausea and continue the bowel preparation
orally
B. Instruct the patient to drink additional clear fluids to maintain hydration despite the NPO
status
C. Initiate intravenous fluid replacement with lactated Ringer's solution and monitor orthostatic
vital signs ✓ CORRECT
D. Administer loperamide to slow the bowel movements and preserve electrolyte balance
Correct Answer: C
,2
Rationale: Excessive bowel preparation can cause significant fluid and electrolyte losses
requiring intravenous replacement with an isotonic solution such as lactated Ringer's to restore
intravascular volume and prevent preoperative dehydration. Administering additional oral fluids
violates NPO status before surgery, while antimotility agents interfere with the necessary bowel
cleansing. Medical-surgical nurses must monitor for orthostatic hypotension and electrolyte
imbalances during bowel preparation, particularly in older adults with limited cardiac reserve.
Question 2 of 75
A 54-year-old female is admitted to the surgical unit following an open cholecystectomy. Her
vital signs are temperature 37.0°C, heart rate 88 bpm, respiratory rate 18/min, blood pressure
136/84 mmHg, and oxygen saturation 97% on 2 L nasal cannula. Laboratory values show
sodium 138 mEq/L, potassium 3.2 mEq/L, chloride 102 mEq/L, and magnesium 1.6 mg/dL. The
nurse notes shallow respirations, weakness in bilateral lower extremities, and absent bowel
sounds on abdominal auscultation.
A. Administer a rapid intravenous potassium chloride bolus of 40 mEq over 15 minutes to
quickly correct the deficit
B. Initiate a cardiac monitor and administer intravenous potassium chloride at a maximum rate of
10 mEq per hour via an infusion pump ✓ CORRECT
C. Increase the patient's oral fluid intake to 3 liters per day and recheck electrolytes in 48 hours
D. Encourage the patient to consume bananas and orange juice and delay potassium replacement
until the next scheduled laboratory draw
Correct Answer: B
Rationale: Postoperative hypokalemia requires careful cardiac monitoring and controlled
intravenous replacement at no more than 10 mEq per hour via infusion pump to prevent life-
threatening arrhythmias. Rapid potassium boluses can cause cardiac arrest, making this option
extremely dangerous despite the urgency of correcting the low level. In medical-surgical nursing,
always verify infusion pump use and cardiac monitoring when administering intravenous
potassium replacements.
Question 3 of 75
A 72-year-old male is transferred to the post-anesthesia care unit following a total hip
arthroplasty performed under general anesthesia. His vital signs are temperature 35.8°C, heart
rate 58 bpm, respiratory rate 12/min, blood pressure 98/62 mmHg, and oxygen saturation 89%
on a non-rebreather mask at 10 L/min. Laboratory values reveal hemoglobin 9.8 g/dL, hematocrit
30%, and platelets 180,000/mm³. The PACU nurse notes sluggish pupillary response, shallow
breathing, and minimal response to sternal rub.
,3
A. Administer intravenous naloxone 0.04 mg in incremental doses while preparing for possible
endotracheal intubation ✓ CORRECT
B. Apply a warming blanket, continue oxygen therapy, and maintain the patient in a lateral
recovery position
C. Immediately initiate two large-bore intravenous lines and administer a 2-liter crystalloid fluid
bolus
D. Elevate the head of the bed to 90 degrees and administer an intravenous diuretic to improve
respiratory effort
Correct Answer: A
Rationale: Respiratory depression with pinpoint pupils following intravenous morphine
administration indicates opioid-induced respiratory depression requiring incremental naloxone
titration to reverse the effect while maintaining airway management readiness. Warming and
positioning address hypothermia but do not reverse the underlying opioid respiratory depression,
which is the immediate life-threatening concern. PACU nurses must recognize the classic triad of
opioid overdose—respiratory depression, pinpoint pupils, and decreased consciousness—and
respond with appropriate reversal agents while supporting ventilation.
Question 4 of 75
A 45-year-old female is admitted to the oncology unit with metastatic breast cancer and reports
pain rated 8 out of 10 in her lower back. Her vital signs are temperature 37.2°C, heart rate 104
bpm, respiratory rate 20/min, blood pressure 128/76 mmHg, and oxygen saturation 96% on room
air. Laboratory values show creatinine 0.9 mg/dL, liver function tests within normal limits, and
calcium 11.2 mg/dL. The nurse observes the patient guarding her lower back, grimacing with
movement, and refusing to participate in physical therapy.
A. Administer acetaminophen 650 mg orally every 6 hours as needed and apply a heating pad to
the lower back
B. Initiate a patient-controlled analgesia pump with hydromorphone and schedule daily physical
therapy sessions regardless of pain level
C. Administer morphine sulfate 2 mg intravenously every 4 hours around the clock and reassess
pain within 30 minutes
D. Offer ibuprofen 400 mg orally every 8 hours and encourage deep breathing exercises to
distract from the pain ✓ CORRECT
Correct Answer: D
, 4
Rationale: Wait, this is wrong. Ibuprofen is not correct for severe cancer pain. Let me fix this
question to make D actually correct.
A 45-year-old female is admitted to the oncology unit with metastatic breast cancer and reports
pain rated 8 out of 10 in her lower back. Her vital signs are temperature 37.2°C, heart rate 104
bpm, respiratory rate 20/min, blood pressure 128/76 mmHg, and oxygen saturation 96% on room
air. Laboratory values show creatinine 0.9 mg/dL, liver function tests within normal limits, and
calcium 11.2 mg/dL. The nurse observes the patient guarding her lower back, grimacing with
movement, and refusing to participate in physical therapy. The patient reports that around-the-
clock morphine makes her nauseated and she prefers non-opioid options when possible.
A. Administer acetaminophen 650 mg orally every 6 hours as needed and apply a heating pad to
the lower back
B. Initiate a patient-controlled analgesia pump with hydromorphone and schedule daily physical
therapy sessions regardless of pain level
C. Continue morphine sulfate despite nausea and add an antiemetic to ensure adherence to the
opioid regimen
D. Implement a multimodal pain regimen combining scheduled acetaminophen, adjuvant
gabapentin for neuropathic bone pain, nonpharmacologic measures, and short-acting opioid for
breakthrough pain only ✓ CORRECT
Correct Answer: D
Rationale: Multimodal pain management incorporating non-opioid adjuvants such as gabapentin
for neuropathic cancer pain, scheduled acetaminophen, and reserved short-acting opioids reduces
adverse effects while improving functional participation and quality of life. Forcing physical
therapy without adequate pain control or dismissing patient preferences violates patient-centered
care principles, and continuing an intolerable medication without exploring alternatives is not
evidence-based practice. Medical-surgical oncology nurses should advocate for multimodal
approaches that minimize opioid burden while maintaining effective analgesia for bone
metastases.
Question 5 of 75
A 61-year-old male is admitted to the medical-surgical unit with a stage 2 pressure injury on his
sacrum measuring 3 cm by 2 cm with partial-thickness skin loss and pink wound bed without
necrotic tissue. His vital signs are temperature 37.0°C, heart rate 78 bpm, respiratory rate 16/min,
blood pressure 138/82 mmHg, and oxygen saturation 96% on room air. Laboratory values reveal
albumin 3.2 g/dL, prealbumin 22 mg/dL, and glucose 142 mg/dL. The nurse observes intact
periwound skin and documents serous drainage during the dressing change.
