WEST COAST UNIVERSITY
MED SURG 201 Final Exam
Questions and Answers (West Coast University)
Official Practice Exam · 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
50 90 80% Annual
TABLE OF CONTENTS
Section 1: Cardiovascular Disorders ........................... Questions 1 - 10
Section 2: Respiratory Disorders ................................. Questions 11 - 20
Section 3: Neurological Disorders .............................. Questions 21 - 30
Section 4: GI and Genitourinary Disorders ........... Questions 31 - 40
Section 5: Musculoskeletal and Integumentary ...... Questions 41 - 50
Answer Key ............................................................... Last Page
INSTRUCTIONS
This practice exam contains 50 multiple-choice questions divided across five clinical sections. Each question has
four answer choices (A through D). Select the one best answer for each question. You have 90 minutes to
complete the entire exam. A passing score of 80% (40 out of 50 correct) is required. Read each scenario carefully
before selecting your answer. The correct answer and rationale are provided immediately after each question for
self-assessment purposes. Review the rationales for both correct and incorrect options to maximize your learning.
Good luck!
EXAM DETAILS
Exam: MED SURG 201 Final Exam
Institution: West Coast University
Edition: 2026/2027
Total Questions: 50
Time Allowed: 90 minutes
Passing Score: 80% (40 correct answers required)
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 1 of 27
,SECTION 1: CARDIOVASCULAR DISORDERS — 2026/2027
Q1 Question 1 of 50
Q1. A 67-year-old male presents to the emergency department with crushing substernal
chest pain radiating to the left arm, diaphoresis, and nausea that began 45 minutes ago.
His ECG shows ST-segment elevation in leads V1 through V4. The nurse anticipates
which immediate collaborative intervention?
A. Administration of thrombolytic therapy within 30 minutes of arrival
B. Initiation of beta-blocker therapy to reduce myocardial oxygen demand
C. Immediate insertion of a pulmonary artery catheter for hemodynamic monitoring
D. Administration of intravenous antibiotics to prevent post-MI infection
Correct Answer: A
Rationale:
ST-elevation myocardial infarction (STEMI) requires rapid reperfusion, and thrombolytic therapy administered
within 30 minutes of hospital arrival is a gold-standard collaborative intervention. While beta-blockers are
eventually indicated, they are not the immediate life-saving priority. Pulmonary artery catheterization is not
routinely indicated, and antibiotics are unrelated to MI management.
Q2 Question 2 of 50
Q2. A 54-year-old female with a history of atrial fibrillation is admitted with sudden onset
left-sided weakness, facial droop, and slurred speech. Her INR is 1.2. The nurse
recognizes that this clinical presentation most likely indicates which complication?
A. Hemorrhagic stroke due to anticoagulant therapy
B. Ischemic stroke secondary to thromboembolism from atrial fibrillation
C. Transient ischemic attack that will resolve within 24 hours
D. Subdural hematoma from recent minor head trauma
Correct Answer: B
Rationale:
Atrial fibrillation promotes stasis of blood in the atria, forming thrombi that can embolize to the brain and cause
ischemic stroke. The subtherapeutic INR of 1.2 indicates inadequate anticoagulation, supporting
thromboembolic stroke. Hemorrhagic stroke is less likely with a low INR, and the deficits exceed typical TIA
resolution.
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 2 of 27
, Q3 Question 3 of 50
Q3. A 72-year-old male with chronic heart failure returns for a follow-up visit reporting
progressive dyspnea on exertion, 3+ pitting edema in both ankles, and a 5-pound weight
gain over three days. His current medications include lisinopril and metoprolol. The nurse
anticipates which medication adjustment?
A. Discontinuation of metoprolol to improve cardiac output
B. Increasing the dose of lisinopril to reduce afterload further
C. Addition of furosemide to manage fluid volume excess
D. Initiation of digoxin to strengthen myocardial contraction
Correct Answer: C
Rationale:
The patient is exhibiting signs of fluid volume overload (weight gain, edema, dyspnea), and furosemide is the
standard diuretic added to heart failure regimens to promote diuresis. Discontinuing metoprolol would be
harmful as beta-blockers improve outcomes in HF. While lisinopril dose may eventually increase, the acute
priority is fluid removal.
Q4 Question 4 of 50
Q4. A 59-year-old female is admitted with severe chest pain, and her cardiac biomarkers
show elevated troponin I. She asks the nurse why blood is being drawn multiple times a
day. The nurse explains that serial troponin levels are measured primarily to accomplish
which goal?
A. To evaluate the effectiveness of anticoagulant therapy in dissolving coronary thrombi
B. To determine the exact location of the coronary artery that is occluded
C. To confirm the diagnosis by observing the rise and fall pattern characteristic of
myocardial injury
D. To assess the degree of atherosclerotic plaque narrowing in the coronary arteries
Correct Answer: C
Rationale:
Serial troponin measurements are the gold standard for diagnosing myocardial infarction because troponin
rises and falls in a characteristic pattern over 12 to 24 hours. Troponin does not assess thrombus dissolution,
pinpoint the exact coronary artery, or measure plaque burden -- those require imaging or angiography.
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 3 of 27
MED SURG 201 Final Exam
Questions and Answers (West Coast University)
Official Practice Exam · 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
50 90 80% Annual
TABLE OF CONTENTS
Section 1: Cardiovascular Disorders ........................... Questions 1 - 10
Section 2: Respiratory Disorders ................................. Questions 11 - 20
Section 3: Neurological Disorders .............................. Questions 21 - 30
Section 4: GI and Genitourinary Disorders ........... Questions 31 - 40
Section 5: Musculoskeletal and Integumentary ...... Questions 41 - 50
Answer Key ............................................................... Last Page
INSTRUCTIONS
This practice exam contains 50 multiple-choice questions divided across five clinical sections. Each question has
four answer choices (A through D). Select the one best answer for each question. You have 90 minutes to
complete the entire exam. A passing score of 80% (40 out of 50 correct) is required. Read each scenario carefully
before selecting your answer. The correct answer and rationale are provided immediately after each question for
self-assessment purposes. Review the rationales for both correct and incorrect options to maximize your learning.
Good luck!
EXAM DETAILS
Exam: MED SURG 201 Final Exam
Institution: West Coast University
Edition: 2026/2027
Total Questions: 50
Time Allowed: 90 minutes
Passing Score: 80% (40 correct answers required)
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 1 of 27
,SECTION 1: CARDIOVASCULAR DISORDERS — 2026/2027
Q1 Question 1 of 50
Q1. A 67-year-old male presents to the emergency department with crushing substernal
chest pain radiating to the left arm, diaphoresis, and nausea that began 45 minutes ago.
His ECG shows ST-segment elevation in leads V1 through V4. The nurse anticipates
which immediate collaborative intervention?
A. Administration of thrombolytic therapy within 30 minutes of arrival
B. Initiation of beta-blocker therapy to reduce myocardial oxygen demand
C. Immediate insertion of a pulmonary artery catheter for hemodynamic monitoring
D. Administration of intravenous antibiotics to prevent post-MI infection
Correct Answer: A
Rationale:
ST-elevation myocardial infarction (STEMI) requires rapid reperfusion, and thrombolytic therapy administered
within 30 minutes of hospital arrival is a gold-standard collaborative intervention. While beta-blockers are
eventually indicated, they are not the immediate life-saving priority. Pulmonary artery catheterization is not
routinely indicated, and antibiotics are unrelated to MI management.
Q2 Question 2 of 50
Q2. A 54-year-old female with a history of atrial fibrillation is admitted with sudden onset
left-sided weakness, facial droop, and slurred speech. Her INR is 1.2. The nurse
recognizes that this clinical presentation most likely indicates which complication?
A. Hemorrhagic stroke due to anticoagulant therapy
B. Ischemic stroke secondary to thromboembolism from atrial fibrillation
C. Transient ischemic attack that will resolve within 24 hours
D. Subdural hematoma from recent minor head trauma
Correct Answer: B
Rationale:
Atrial fibrillation promotes stasis of blood in the atria, forming thrombi that can embolize to the brain and cause
ischemic stroke. The subtherapeutic INR of 1.2 indicates inadequate anticoagulation, supporting
thromboembolic stroke. Hemorrhagic stroke is less likely with a low INR, and the deficits exceed typical TIA
resolution.
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 2 of 27
, Q3 Question 3 of 50
Q3. A 72-year-old male with chronic heart failure returns for a follow-up visit reporting
progressive dyspnea on exertion, 3+ pitting edema in both ankles, and a 5-pound weight
gain over three days. His current medications include lisinopril and metoprolol. The nurse
anticipates which medication adjustment?
A. Discontinuation of metoprolol to improve cardiac output
B. Increasing the dose of lisinopril to reduce afterload further
C. Addition of furosemide to manage fluid volume excess
D. Initiation of digoxin to strengthen myocardial contraction
Correct Answer: C
Rationale:
The patient is exhibiting signs of fluid volume overload (weight gain, edema, dyspnea), and furosemide is the
standard diuretic added to heart failure regimens to promote diuresis. Discontinuing metoprolol would be
harmful as beta-blockers improve outcomes in HF. While lisinopril dose may eventually increase, the acute
priority is fluid removal.
Q4 Question 4 of 50
Q4. A 59-year-old female is admitted with severe chest pain, and her cardiac biomarkers
show elevated troponin I. She asks the nurse why blood is being drawn multiple times a
day. The nurse explains that serial troponin levels are measured primarily to accomplish
which goal?
A. To evaluate the effectiveness of anticoagulant therapy in dissolving coronary thrombi
B. To determine the exact location of the coronary artery that is occluded
C. To confirm the diagnosis by observing the rise and fall pattern characteristic of
myocardial injury
D. To assess the degree of atherosclerotic plaque narrowing in the coronary arteries
Correct Answer: C
Rationale:
Serial troponin measurements are the gold standard for diagnosing myocardial infarction because troponin
rises and falls in a characteristic pattern over 12 to 24 hours. Troponin does not assess thrombus dissolution,
pinpoint the exact coronary artery, or measure plaque burden -- those require imaging or angiography.
MED SURG 201 Final Exam — 2026/2027 | Passing Score: 80% | Page 3 of 27
