1|Page
NURS 201 INTERMEDIATE MED SURG MIDTERM EXAM
2026/2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a patient with fluid volume deficit. Which finding
should the nurse expect?
A. Bounding peripheral pulses
B. Jugular venous distention
C. Postural hypotension
D. Crackles in the lung bases
Answer: C. Postural hypotension occurs due to decreased circulating
blood volume, which reduces venous return and cardiac output,
causing a drop in blood pressure with position changes. Bounding
pulses, JVD, and crackles are indicators of fluid volume excess.
2. A patient with heart failure is receiving furosemide. Which laboratory
value is most important for the nurse to monitor?
A. Serum calcium
B. Serum potassium
C. Serum albumin
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D. Serum magnesium
Answer: B. Furosemide is a loop diuretic that promotes potassium
excretion, placing the patient at high risk for hypokalemia. Hypokalemia
can precipitate cardiac arrhythmias, making serum potassium
monitoring essential.
3. A nurse is teaching a patient about nitroglycerin therapy for angina.
Which statement indicates a need for further teaching?
A. "I can take a tablet every 5 minutes for up to 3 doses."
B. "I should store the tablets in a dark, tightly closed bottle."
C. "If the pain is not relieved after one dose, I should immediately call
911."
D. "I will sit or lie down before taking the medication."
Answer: C. The correct protocol is to take one dose, wait 5 minutes, and
if unrelieved, call 911 before taking additional doses. Calling 911 after
one unrelieved dose without trying a second dose misinterprets the
standard guideline, which recommends calling 911 if pain persists after
the first dose while continuing the regimen. The statement incorrectly
suggests delaying emergency services beyond the appropriate window.
4. The nurse is evaluating the understanding of a patient with a new
diagnosis of hypertension. Which patient statement demonstrates a
correct understanding of lifestyle modifications?
A. "I will limit my alcohol intake to three beers per day."
B. "I should aim for at least 150 minutes of moderate-intensity aerobic
activity per week."
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C. "I can continue to add salt to my food as long as I take my
medication."
D. "I only need to follow this diet until my blood pressure is normal."
Answer: B. Current hypertension guidelines recommend at least 150
minutes of moderate-intensity aerobic activity weekly to help lower
blood pressure. Alcohol intake should be limited to no more than two
drinks per day for men. Sodium restriction is critical, and lifestyle
modifications are lifelong.
5. A patient with chronic kidney disease is experiencing a potassium
level of 6.8 mEq/L. Which electrocardiogram change should the nurse
anticipate?
A. Prominent U wave
B. Flattened T wave
C. Peaked T wave
D. ST segment depression
Answer: C. Hyperkalemia causes tall, peaked T waves on the ECG.
Flattened T waves and prominent U waves are associated with
hypokalemia. ST segment depression may indicate myocardial ischemia
or digoxin effect.
6. A nurse is caring for a patient receiving a blood transfusion who
develops chills, flank pain, and reddish-brown urine. What type of
transfusion reaction is most likely occurring?
A. Febrile nonhemolytic reaction
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B. Allergic reaction
C. Hemolytic reaction
D. Circulatory overload
Answer: C. Hemolytic reactions result from ABO incompatibility and
cause destruction of donor red blood cells, releasing hemoglobin into
the plasma and urine (hemoglobinuria). Signs include chills, flank pain,
and reddish-brown urine. Febrile reactions cause fever; allergic
reactions cause hives and itching; circulatory overload causes dyspnea
and crackles.
7. A patient with cirrhosis is at highest risk for bleeding due to which
pathophysiological process?
A. Increased platelet production
B. Decreased synthesis of clotting factors
C. Enhanced vitamin K absorption
D. Hyperactive fibrinolytic inhibition
Answer: B. The liver synthesizes most clotting factors (I, II, V, VII, IX, X).
In cirrhosis, hepatocyte damage impairs this synthesis, leading to
coagulopathy and bleeding risk. Vitamin K absorption is decreased, not
enhanced. Platelet production is often decreased due to splenic
sequestration.
8. A nurse is assessing a patient with hypocalcemia. Which clinical
manifestation should the nurse expect?
A. Decreased deep tendon reflexes
NURS 201 INTERMEDIATE MED SURG MIDTERM EXAM
2026/2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a patient with fluid volume deficit. Which finding
should the nurse expect?
A. Bounding peripheral pulses
B. Jugular venous distention
C. Postural hypotension
D. Crackles in the lung bases
Answer: C. Postural hypotension occurs due to decreased circulating
blood volume, which reduces venous return and cardiac output,
causing a drop in blood pressure with position changes. Bounding
pulses, JVD, and crackles are indicators of fluid volume excess.
2. A patient with heart failure is receiving furosemide. Which laboratory
value is most important for the nurse to monitor?
A. Serum calcium
B. Serum potassium
C. Serum albumin
,2|Page
D. Serum magnesium
Answer: B. Furosemide is a loop diuretic that promotes potassium
excretion, placing the patient at high risk for hypokalemia. Hypokalemia
can precipitate cardiac arrhythmias, making serum potassium
monitoring essential.
3. A nurse is teaching a patient about nitroglycerin therapy for angina.
Which statement indicates a need for further teaching?
A. "I can take a tablet every 5 minutes for up to 3 doses."
B. "I should store the tablets in a dark, tightly closed bottle."
C. "If the pain is not relieved after one dose, I should immediately call
911."
D. "I will sit or lie down before taking the medication."
Answer: C. The correct protocol is to take one dose, wait 5 minutes, and
if unrelieved, call 911 before taking additional doses. Calling 911 after
one unrelieved dose without trying a second dose misinterprets the
standard guideline, which recommends calling 911 if pain persists after
the first dose while continuing the regimen. The statement incorrectly
suggests delaying emergency services beyond the appropriate window.
4. The nurse is evaluating the understanding of a patient with a new
diagnosis of hypertension. Which patient statement demonstrates a
correct understanding of lifestyle modifications?
A. "I will limit my alcohol intake to three beers per day."
B. "I should aim for at least 150 minutes of moderate-intensity aerobic
activity per week."
,3|Page
C. "I can continue to add salt to my food as long as I take my
medication."
D. "I only need to follow this diet until my blood pressure is normal."
Answer: B. Current hypertension guidelines recommend at least 150
minutes of moderate-intensity aerobic activity weekly to help lower
blood pressure. Alcohol intake should be limited to no more than two
drinks per day for men. Sodium restriction is critical, and lifestyle
modifications are lifelong.
5. A patient with chronic kidney disease is experiencing a potassium
level of 6.8 mEq/L. Which electrocardiogram change should the nurse
anticipate?
A. Prominent U wave
B. Flattened T wave
C. Peaked T wave
D. ST segment depression
Answer: C. Hyperkalemia causes tall, peaked T waves on the ECG.
Flattened T waves and prominent U waves are associated with
hypokalemia. ST segment depression may indicate myocardial ischemia
or digoxin effect.
6. A nurse is caring for a patient receiving a blood transfusion who
develops chills, flank pain, and reddish-brown urine. What type of
transfusion reaction is most likely occurring?
A. Febrile nonhemolytic reaction
, 4|Page
B. Allergic reaction
C. Hemolytic reaction
D. Circulatory overload
Answer: C. Hemolytic reactions result from ABO incompatibility and
cause destruction of donor red blood cells, releasing hemoglobin into
the plasma and urine (hemoglobinuria). Signs include chills, flank pain,
and reddish-brown urine. Febrile reactions cause fever; allergic
reactions cause hives and itching; circulatory overload causes dyspnea
and crackles.
7. A patient with cirrhosis is at highest risk for bleeding due to which
pathophysiological process?
A. Increased platelet production
B. Decreased synthesis of clotting factors
C. Enhanced vitamin K absorption
D. Hyperactive fibrinolytic inhibition
Answer: B. The liver synthesizes most clotting factors (I, II, V, VII, IX, X).
In cirrhosis, hepatocyte damage impairs this synthesis, leading to
coagulopathy and bleeding risk. Vitamin K absorption is decreased, not
enhanced. Platelet production is often decreased due to splenic
sequestration.
8. A nurse is assessing a patient with hypocalcemia. Which clinical
manifestation should the nurse expect?
A. Decreased deep tendon reflexes
