MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
MED SURG 201 MEDICAL
SURGICAL FINAL EXAM-
QUESTIONS & ANSWERS.
FINAL EXAM PASADO.
Page 1 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
,MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
FINAL EXAM PASADO
4. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes
mellitus is scheduled for discharge the second day after admission. When implementing patient
teaching, what is the priority action forthe nurse?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANS: C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the
patient should know how to test blood glucose and administer medications to control glucose
levels. The patient will need further teaching about the role of diet, exercise, various
medications, and the many potential complications of diabetes, but these topics can be addressed
through planning for appropriate referrals.
14. A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate
for the nurse to use during the admission assessment?
a. Drug Abuse Screening Test (DAST-10)
b. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
c. Screening Test-Geriatric Version (SMAST-G)
d. Mini-Mental State Examination
ANS: C
Because the abuse of alcohol is a common factor associated with the development of
pancreatitis, the first assessment step is to screen for alcohol use using a validated screening
questionnaire. The SMAST-G is a short-form alcoholism screening instrument tailored
specifically to the needs of the older adult. If the patient scores positively on the SMAST-G, then
the CIWA-Ar would be a useful tool for determining treatment. The DAST-10 provides more
general information regarding substance use. The Mini-Mental State Examination is used to
screen for cognitive impairment.
1. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do
you think I should be tested for the gene?” Which response by the nurse is most appropriate?
a. “In most cases, breast cancer is not caused by the BRCA gene.”
b. “It depends on how you will feel if the test is positive for the BRCA gene.”
c. “There are many things to consider before deciding to have genetic testing.”
d. “You should decide first whether you are willing to have a bilateral mastectomy.”
ANS: C
Although presymptomatic testing for genetic disorders allows patients to take action (such as
mastectomy) to prevent the development of some genetically caused disorders, patients also need
to consider that test results in their medical record may affect insurance, employability, etc.
Telling a patient that a decision about mastectomy should be made before testing implies that the
nurse has made a judgment about what the patient should do if the test is positive. Although the
patient may need to think about her reaction if the test is positive, other issues (e.g., insurance)
also should be considered. Although most breast cancers are not related to BRCA gene mutations,
the patient with a BRCA gene mutation has a markedly increased risk for breast cancer.
Page 2 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
,MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
7. The nurse in the outpatient clinic has obtained health histories for these new patients. Which
patient may need referral for genetic testing?
a. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
b. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
c. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
d. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
ANS: C
The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is
asymptomatic until the patient is older. Presymptomatic testing will give the patient information that
will be useful in guiding lifestyle and childbearing choices. The other patients do not have any
indication of genetic disorders or need for genetic testing.
14. An adolescent patient seeks care in the emergency department after sharing needles forheroin
injection with a friend who has hepatitis B. To provide immediate protection from infection, what
medication will the nurse administer?
a. Corticosteroids
b. Gamma globulin
c. Hepatitis B vaccine
d. Fresh frozen plasma
ANS: B
The patient should first receive antibodies for hepatitis B from injection of gamma globulin. The
hepatitis B vaccination series should be started to provide active immunity. Fresh frozen plasma
and corticosteroids will not be effective in preventing hepatitis B in the patient.
6. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse
what the letters and numbers mean. Which response by the nurse is most appropriate?
a. “The cancer involves only the cervix.”
b. “The cancer cells look almost like normal cells.”
c. “Further testing is needed to determine the spread of the cancer.”
d. “It is difficult to determine the original site of the cervical cancer.”
ANS: A
Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time.
Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is
the cervix. Further testing is not indicated given that the cancer has not spread.
10. External-beam radiation is planned for a patient with cervical cancer. What instructions should the
nurse give to the patient to prevent complications from the effects of the radiation?
a. Test all stools for the presence of blood.
b. Maintain a high-residue, high-fiber diet.
c. Clean the perianal area carefully after every bowel movement.
d. Inspect the mouth and throat daily for the appearance of thrush.
ANS: C
Page 3 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
, MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent
diarrhea. Careful cleaning of this area will help decrease the risk for skin breakdown and infection.
Stools are likely to have occult blood from the inflammation associated with radiation, so routine testing
of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue
diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.
11. The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep
respirations. Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery.
ANS: C
The rapid, deep (Kussmaul) respirations indicate a metabolic acidosis and the need for correction of the
acidosis with a saline bolus to prevent hypovolemia followed by insulin administration to allow glucose to
reenter the cells. Oxygen therapy is not indicated because there is no indication that the increased
respiratory rate is related to hypoxemia. The respiratory pattern is compensatory, and the patient will not
be able to slow the respiratory rate. Lorazepam administration will slow the respiratory rate and increase
the level of acidosis.
17. The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which nursing
action should the nurse include on the care plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau’s and Chvostek’s signs.
d. Encourage fluid intake up to 4000 mL every day.
ANS: D
To decrease the risk for renal calculi, the patient should have a fluid intake of 3000 to 4000 mL daily.
Ambulation helps decrease the loss of calcium from bone and is encouraged in patients with
hypercalcemia. Trousseau’s and Chvostek’s signs are monitored when there is a possibility of
hypocalcemia. There is no indication that the patient needs frequent assessment of lung sounds, although
these would be assessed every shift.
26. A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction and
is complaining of anxiety and incisional pain. The patient’s respiratory rate is 32 breaths/minute and the
arterial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first?
a. Discontinue the nasogastric suction.
b. Give the patient the PRN IV morphine sulfate 4 mg.
c. Notify the health care provider about the ABG results.
d. Teach the patient how to take slow, deep breaths when anxious.
ANS: B
The patient’s respiratory alkalosis is caused by the increased respiratory rate associated with pain and
anxiety. The nurse’s first action should be to medicate the patient for pain. Although the nasogastric
suction may contribute to the alkalosis, it is not appropriate to discontinue the tube when the patient needs
gastric suction. The health care provider may be notified about the ABGs but is likely to instruct the nurse
to medicate for pain. The patient will not be able to take slow, deep breaths when experiencing pain.
Page 4 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
MED SURG 201 MEDICAL
SURGICAL FINAL EXAM-
QUESTIONS & ANSWERS.
FINAL EXAM PASADO.
Page 1 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
,MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
FINAL EXAM PASADO
4. A patient who was admitted to the hospital with hyperglycemia and newly diagnosed diabetes
mellitus is scheduled for discharge the second day after admission. When implementing patient
teaching, what is the priority action forthe nurse?
a. Instruct about the increased risk for cardiovascular disease.
b. Provide detailed information about dietary control of glucose.
c. Teach glucose self-monitoring and medication administration.
d. Give information about the effects of exercise on glucose control.
ANS: C
When time is limited, the nurse should focus on the priorities of teaching. In this situation, the
patient should know how to test blood glucose and administer medications to control glucose
levels. The patient will need further teaching about the role of diet, exercise, various
medications, and the many potential complications of diabetes, but these topics can be addressed
through planning for appropriate referrals.
14. A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate
for the nurse to use during the admission assessment?
a. Drug Abuse Screening Test (DAST-10)
b. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
c. Screening Test-Geriatric Version (SMAST-G)
d. Mini-Mental State Examination
ANS: C
Because the abuse of alcohol is a common factor associated with the development of
pancreatitis, the first assessment step is to screen for alcohol use using a validated screening
questionnaire. The SMAST-G is a short-form alcoholism screening instrument tailored
specifically to the needs of the older adult. If the patient scores positively on the SMAST-G, then
the CIWA-Ar would be a useful tool for determining treatment. The DAST-10 provides more
general information regarding substance use. The Mini-Mental State Examination is used to
screen for cognitive impairment.
1. The sister of a patient diagnosed with BRCA gene–related breast cancer asks the nurse, “Do
you think I should be tested for the gene?” Which response by the nurse is most appropriate?
a. “In most cases, breast cancer is not caused by the BRCA gene.”
b. “It depends on how you will feel if the test is positive for the BRCA gene.”
c. “There are many things to consider before deciding to have genetic testing.”
d. “You should decide first whether you are willing to have a bilateral mastectomy.”
ANS: C
Although presymptomatic testing for genetic disorders allows patients to take action (such as
mastectomy) to prevent the development of some genetically caused disorders, patients also need
to consider that test results in their medical record may affect insurance, employability, etc.
Telling a patient that a decision about mastectomy should be made before testing implies that the
nurse has made a judgment about what the patient should do if the test is positive. Although the
patient may need to think about her reaction if the test is positive, other issues (e.g., insurance)
also should be considered. Although most breast cancers are not related to BRCA gene mutations,
the patient with a BRCA gene mutation has a markedly increased risk for breast cancer.
Page 2 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
,MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
7. The nurse in the outpatient clinic has obtained health histories for these new patients. Which
patient may need referral for genetic testing?
a. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
b. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
c. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
d. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
ANS: C
The adult form of polycystic kidney disease is an autosomal dominant disorder and frequently it is
asymptomatic until the patient is older. Presymptomatic testing will give the patient information that
will be useful in guiding lifestyle and childbearing choices. The other patients do not have any
indication of genetic disorders or need for genetic testing.
14. An adolescent patient seeks care in the emergency department after sharing needles forheroin
injection with a friend who has hepatitis B. To provide immediate protection from infection, what
medication will the nurse administer?
a. Corticosteroids
b. Gamma globulin
c. Hepatitis B vaccine
d. Fresh frozen plasma
ANS: B
The patient should first receive antibodies for hepatitis B from injection of gamma globulin. The
hepatitis B vaccination series should be started to provide active immunity. Fresh frozen plasma
and corticosteroids will not be effective in preventing hepatitis B in the patient.
6. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse
what the letters and numbers mean. Which response by the nurse is most appropriate?
a. “The cancer involves only the cervix.”
b. “The cancer cells look almost like normal cells.”
c. “Further testing is needed to determine the spread of the cancer.”
d. “It is difficult to determine the original site of the cervical cancer.”
ANS: A
Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time.
Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is
the cervix. Further testing is not indicated given that the cancer has not spread.
10. External-beam radiation is planned for a patient with cervical cancer. What instructions should the
nurse give to the patient to prevent complications from the effects of the radiation?
a. Test all stools for the presence of blood.
b. Maintain a high-residue, high-fiber diet.
c. Clean the perianal area carefully after every bowel movement.
d. Inspect the mouth and throat daily for the appearance of thrush.
ANS: C
Page 3 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
, MED SURG 201 MEDICAL SURGICAL FINAL EXAM
MED SURG 201 MEDICAL SURGICAL FINAL EXAM 2/18/2026
Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent
diarrhea. Careful cleaning of this area will help decrease the risk for skin breakdown and infection.
Stools are likely to have occult blood from the inflammation associated with radiation, so routine testing
of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue
diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.
11. The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep
respirations. Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery.
ANS: C
The rapid, deep (Kussmaul) respirations indicate a metabolic acidosis and the need for correction of the
acidosis with a saline bolus to prevent hypovolemia followed by insulin administration to allow glucose to
reenter the cells. Oxygen therapy is not indicated because there is no indication that the increased
respiratory rate is related to hypoxemia. The respiratory pattern is compensatory, and the patient will not
be able to slow the respiratory rate. Lorazepam administration will slow the respiratory rate and increase
the level of acidosis.
17. The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which nursing
action should the nurse include on the care plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau’s and Chvostek’s signs.
d. Encourage fluid intake up to 4000 mL every day.
ANS: D
To decrease the risk for renal calculi, the patient should have a fluid intake of 3000 to 4000 mL daily.
Ambulation helps decrease the loss of calcium from bone and is encouraged in patients with
hypercalcemia. Trousseau’s and Chvostek’s signs are monitored when there is a possibility of
hypocalcemia. There is no indication that the patient needs frequent assessment of lung sounds, although
these would be assessed every shift.
26. A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction and
is complaining of anxiety and incisional pain. The patient’s respiratory rate is 32 breaths/minute and the
arterial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first?
a. Discontinue the nasogastric suction.
b. Give the patient the PRN IV morphine sulfate 4 mg.
c. Notify the health care provider about the ABG results.
d. Teach the patient how to take slow, deep breaths when anxious.
ANS: B
The patient’s respiratory alkalosis is caused by the increased respiratory rate associated with pain and
anxiety. The nurse’s first action should be to medicate the patient for pain. Although the nasogastric
suction may contribute to the alkalosis, it is not appropriate to discontinue the tube when the patient needs
gastric suction. The health care provider may be notified about the ABGs but is likely to instruct the nurse
to medicate for pain. The patient will not be able to take slow, deep breaths when experiencing pain.
Page 4 MED SURG 201 MEDICAL SURGICAL FINAL EXAM.pdf
