Med Surg 201 Final Exam Practice Exam
Actual Exam 2026/2027 | Complete
Exam-Style Questions | 100% Verified –
Detailed Rationales – Pass Guaranteed –
A+ Graded
Question 1
A 68-year-old male with heart failure presents with weight gain, jugular
venous distension, and bilateral lower extremity edema. Which dietary
instruction is most important?
A. Increase fluid intake to 3 L/day
B. Restrict sodium to <2 g/day
C. Increase potassium-rich foods
D. Restrict protein intake
Correct ,,answer,,,: B
Rationale: Sodium restriction reduces fluid retention (B). Increased
fluid (A) worsens edema. Potassium (C) is not primary. Protein
restriction (D) not indicated in heart failure.
Question 2
,A patient with COPD has an SpO₂ of 88% on room air and a PaCO₂ of
58 mmHg. Which oxygen delivery method is safest?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 2 L/min (24% FiO₂)
C. Nasal cannula at 6 L/min
D. Simple face mask at 10 L/min
Correct ,,answer,,,: B
Rationale: COPD with hypercapnia needs controlled O₂ (Venturi) to
avoid suppressing respiratory drive (B). High flow (A, C, D) can worsen
hypercapnia.
Question 3
A 55-year-old post-op day 1 from total knee replacement reports
sudden-onset chest pain and dyspnea. Heart rate 110, BP 100/70, SpO₂
89%. Which priority intervention?
A. Administer sublingual nitroglycerin
B. Obtain stat ECG and troponin
C. Administer oxygen and prepare for CT pulmonary angiography
D. Give aspirin 325 mg chewed
Correct ,,answer,,,: C
Rationale: Post-op sudden dyspnea + hypoxia → PE until proven
otherwise. Oxygen and CTPA (C) are next. Nitroglycerin (A) is for
angina. ECG/troponin (B) for MI but less likely post-op. Aspirin (D)
helpful but not priority over oxygen/imaging.
,Question 4
A patient with cirrhosis presents with hematemesis. Which finding
indicates the most severe blood loss?
A. Heart rate 90, BP 120/80
B. Heart rate 120, BP 90/60
C. Hemoglobin 10 g/dL
D. Melena
Correct ,,answer,,,: B
Rationale: Tachycardia + hypotension (B) suggests ≥30% blood loss
(hypovolemic shock). HR 90 (A) is normal. Hgb 10 (C) is mild anemia.
Melena (D) indicates upper GI bleed but not severity.
Question 5
A patient with type 1 diabetes has blood glucose of 450 mg/dL, nausea,
vomiting, and Kussmaul respirations. Which ABG finding is expected?
A. pH 7.38, PaCO₂ 40, HCO₃ 24
B. pH 7.28, PaCO₂ 30, HCO₃ 14
C. pH 7.48, PaCO₂ 45, HCO₃ 30
D. pH 7.50, PaCO₂ 25, HCO₃ 20
Correct ,,answer,,,: B
Rationale: DKA → metabolic acidosis with compensatory respiratory
alkalosis (low pH, low HCO₃, low PaCO₂) (B). A is normal. C is
metabolic alkalosis. D is respiratory alkalosis with metabolic acidosis
(mixed).
, Question 6
A patient post-MI develops a new harsh holosystolic murmur at the left
lower sternal border. Which complication is most likely?
A. Papillary muscle rupture
B. Ventricular septal rupture
C. Free wall rupture
D. Pericarditis
Correct ,,answer,,,: B
Rationale: VSD murmur is holosystolic at LLSB (B). Papillary muscle
rupture (A) causes mitral regurgitation murmur at apex. Free wall
rupture (C) causes tamponade. Pericarditis (D) causes friction rub.
Question 7
A patient with chronic kidney disease (stage 4) has a potassium of 6.2
mEq/L. Which ECG finding is most concerning?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged PR interval
Correct ,,answer,,,: C
Rationale: Hyperkalemia causes peaked T waves (C), then wide QRS,
then sine wave. Flattened T waves (A) and U waves (B) are
hypokalemia. Prolonged PR (D) can occur but peaked T waves are
earliest.
Actual Exam 2026/2027 | Complete
Exam-Style Questions | 100% Verified –
Detailed Rationales – Pass Guaranteed –
A+ Graded
Question 1
A 68-year-old male with heart failure presents with weight gain, jugular
venous distension, and bilateral lower extremity edema. Which dietary
instruction is most important?
A. Increase fluid intake to 3 L/day
B. Restrict sodium to <2 g/day
C. Increase potassium-rich foods
D. Restrict protein intake
Correct ,,answer,,,: B
Rationale: Sodium restriction reduces fluid retention (B). Increased
fluid (A) worsens edema. Potassium (C) is not primary. Protein
restriction (D) not indicated in heart failure.
Question 2
,A patient with COPD has an SpO₂ of 88% on room air and a PaCO₂ of
58 mmHg. Which oxygen delivery method is safest?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 2 L/min (24% FiO₂)
C. Nasal cannula at 6 L/min
D. Simple face mask at 10 L/min
Correct ,,answer,,,: B
Rationale: COPD with hypercapnia needs controlled O₂ (Venturi) to
avoid suppressing respiratory drive (B). High flow (A, C, D) can worsen
hypercapnia.
Question 3
A 55-year-old post-op day 1 from total knee replacement reports
sudden-onset chest pain and dyspnea. Heart rate 110, BP 100/70, SpO₂
89%. Which priority intervention?
A. Administer sublingual nitroglycerin
B. Obtain stat ECG and troponin
C. Administer oxygen and prepare for CT pulmonary angiography
D. Give aspirin 325 mg chewed
Correct ,,answer,,,: C
Rationale: Post-op sudden dyspnea + hypoxia → PE until proven
otherwise. Oxygen and CTPA (C) are next. Nitroglycerin (A) is for
angina. ECG/troponin (B) for MI but less likely post-op. Aspirin (D)
helpful but not priority over oxygen/imaging.
,Question 4
A patient with cirrhosis presents with hematemesis. Which finding
indicates the most severe blood loss?
A. Heart rate 90, BP 120/80
B. Heart rate 120, BP 90/60
C. Hemoglobin 10 g/dL
D. Melena
Correct ,,answer,,,: B
Rationale: Tachycardia + hypotension (B) suggests ≥30% blood loss
(hypovolemic shock). HR 90 (A) is normal. Hgb 10 (C) is mild anemia.
Melena (D) indicates upper GI bleed but not severity.
Question 5
A patient with type 1 diabetes has blood glucose of 450 mg/dL, nausea,
vomiting, and Kussmaul respirations. Which ABG finding is expected?
A. pH 7.38, PaCO₂ 40, HCO₃ 24
B. pH 7.28, PaCO₂ 30, HCO₃ 14
C. pH 7.48, PaCO₂ 45, HCO₃ 30
D. pH 7.50, PaCO₂ 25, HCO₃ 20
Correct ,,answer,,,: B
Rationale: DKA → metabolic acidosis with compensatory respiratory
alkalosis (low pH, low HCO₃, low PaCO₂) (B). A is normal. C is
metabolic alkalosis. D is respiratory alkalosis with metabolic acidosis
(mixed).
, Question 6
A patient post-MI develops a new harsh holosystolic murmur at the left
lower sternal border. Which complication is most likely?
A. Papillary muscle rupture
B. Ventricular septal rupture
C. Free wall rupture
D. Pericarditis
Correct ,,answer,,,: B
Rationale: VSD murmur is holosystolic at LLSB (B). Papillary muscle
rupture (A) causes mitral regurgitation murmur at apex. Free wall
rupture (C) causes tamponade. Pericarditis (D) causes friction rub.
Question 7
A patient with chronic kidney disease (stage 4) has a potassium of 6.2
mEq/L. Which ECG finding is most concerning?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged PR interval
Correct ,,answer,,,: C
Rationale: Hyperkalemia causes peaked T waves (C), then wide QRS,
then sine wave. Flattened T waves (A) and U waves (B) are
hypokalemia. Prolonged PR (D) can occur but peaked T waves are
earliest.
