Advanced Med-Surg Principles Jersey
College Mid-Term Questions with Correct
Answers
Course
Advanced Med-Surg Principles Jersey College
1. A patient with a history of heart failure is admitted with worsening dyspnea
and peripheral edema. Which assessment finding requires immediate
intervention?
A) 2+ pitting edema in the lower extremities
B) Crackles auscultated in both lung bases
C) Blood pressure of 142/88 mmHg
D) Oxygen saturation of 88% on room air
✅ Correct Answer: D) Oxygen saturation of 88% on room air
➡ Rationale: Hypoxia requires immediate intervention to prevent respiratory failure.
2. A patient with type 2 diabetes is admitted for pneumonia. Which blood glucose
finding requires the nurse to notify the provider?
A) 110 mg/dL
B) 145 mg/dL
C) 220 mg/dL
D) 55 mg/dL
✅ Correct Answer: D) 55 mg/dL
➡ Rationale: Blood glucose below 70 mg/dL is hypoglycemia, requiring urgent intervention.
3. A nurse is caring for a patient with a newly placed tracheostomy. What is the
priority nursing intervention?
A) Suction the tracheostomy every hour
B) Keep a replacement tracheostomy tube at the bedside
C) Provide humidified oxygen at all times
D) Monitor for infection at the tracheostomy site
✅ Correct Answer: B) Keep a replacement tracheostomy tube at the bedside
➡ Rationale: In case of accidental decannulation, immediate reinsertion is necessary.
,4. A patient with chronic kidney disease has a potassium level of 6.5 mEq/L.
What is the priority intervention?
A) Administer sodium polystyrene sulfonate (Kayexalate)
B) Place the patient on a cardiac monitor
C) Restrict dietary potassium intake
D) Monitor urine output
✅ Correct Answer: B) Place the patient on a cardiac monitor
➡ Rationale: Hyperkalemia increases the risk of lethal cardiac arrhythmias.
5. A nurse is caring for a post-op patient who suddenly develops chest pain,
dyspnea, and tachycardia. What is the nurse’s immediate action?
A) Administer morphine for pain relief
B) Lower the head of the bed
C) Apply oxygen and notify the provider
D) Encourage deep breathing and coughing
✅ Correct Answer: C) Apply oxygen and notify the provider
➡ Rationale: These symptoms suggest a pulmonary embolism, which requires immediate
oxygen and emergency intervention.
6. A patient with cirrhosis is experiencing confusion and asterixis. Which
medication should the nurse anticipate administering?
A) Lactulose
B) Furosemide
C) Metronidazole
D) Vitamin K
✅ Correct Answer: A) Lactulose
➡ Rationale: Lactulose helps remove ammonia, reducing hepatic encephalopathy.
7. A patient with a chest tube for a pneumothorax has continuous bubbling in the
water seal chamber. What should the nurse do?
,A) Continue monitoring; this is an expected finding
B) Clamp the chest tube and notify the provider
C) Check for air leaks and reinforce tubing connections
D) Immediately remove the chest tube
✅ Correct Answer: C) Check for air leaks and reinforce tubing connections
➡ Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
8. Which lab finding is expected in a patient with acute pancreatitis?
A) Elevated lipase and amylase
B) Decreased bilirubin
C) Hypokalemia
D) Low blood glucose
✅ Correct Answer: A) Elevated lipase and amylase
➡ Rationale: These are key markers of pancreatic inflammation.
9. A patient with myasthenia gravis is receiving pyridostigmine. What is the
primary purpose of this medication?
A) Reduce inflammation
B) Improve nerve signal transmission
C) Prevent muscle spasms
D) Lower blood pressure
✅ Correct Answer: B) Improve nerve signal transmission
➡ Rationale: Pyridostigmine is a cholinesterase inhibitor, improving neuromuscular
transmission.
10. A patient with a spinal cord injury at T4 is experiencing severe hypertension,
bradycardia, and a pounding headache. What is the priority intervention?
A) Administer IV labetalol
B) Elevate the head of the bed
C) Apply compression stockings
D) Increase IV fluids
, ✅ Correct Answer: B) Elevate the head of the bed
➡ Rationale: These are signs of autonomic dysreflexia, requiring HOB elevation and removal
of triggering stimuli (e.g., bladder distention).
11. A patient with COPD is receiving oxygen therapy at 4 L/min via nasal cannula. The
patient becomes drowsy and confused. What should the nurse do first?
A) Increase oxygen to 6 L/min
B) Decrease oxygen to 2 L/min
C) Call the provider immediately
D) Place the patient in Trendelenburg position
✅ Correct Answer: B) Decrease oxygen to 2 L/min
➡ Rationale: In COPD patients, excessive oxygen can reduce the drive to breathe, leading to
CO2 retention and respiratory depression.
12. A nurse is caring for a patient with septic shock. Which finding requires immediate
intervention?
A) Blood pressure of 90/58 mmHg
B) Warm, flushed skin
C) Urine output of 10 mL/hr
D) White blood cell count of 14,000/mm³
✅ Correct Answer: C) Urine output of 10 mL/hr
➡ Rationale: Oliguria (<30 mL/hr) signals poor perfusion and potential multi-organ failure.
13. A patient with a deep vein thrombosis (DVT) is receiving IV heparin. Which lab value
should the nurse monitor?
A) INR
B) Platelet count
C) aPTT
D) Hematocrit
✅ Correct Answer: C) aPTT
➡ Rationale: aPTT monitors heparin therapy and should be 1.5–2 times the normal range.
14. A patient with a gastric ulcer is prescribed omeprazole. What is the primary purpose of
this medication?
College Mid-Term Questions with Correct
Answers
Course
Advanced Med-Surg Principles Jersey College
1. A patient with a history of heart failure is admitted with worsening dyspnea
and peripheral edema. Which assessment finding requires immediate
intervention?
A) 2+ pitting edema in the lower extremities
B) Crackles auscultated in both lung bases
C) Blood pressure of 142/88 mmHg
D) Oxygen saturation of 88% on room air
✅ Correct Answer: D) Oxygen saturation of 88% on room air
➡ Rationale: Hypoxia requires immediate intervention to prevent respiratory failure.
2. A patient with type 2 diabetes is admitted for pneumonia. Which blood glucose
finding requires the nurse to notify the provider?
A) 110 mg/dL
B) 145 mg/dL
C) 220 mg/dL
D) 55 mg/dL
✅ Correct Answer: D) 55 mg/dL
➡ Rationale: Blood glucose below 70 mg/dL is hypoglycemia, requiring urgent intervention.
3. A nurse is caring for a patient with a newly placed tracheostomy. What is the
priority nursing intervention?
A) Suction the tracheostomy every hour
B) Keep a replacement tracheostomy tube at the bedside
C) Provide humidified oxygen at all times
D) Monitor for infection at the tracheostomy site
✅ Correct Answer: B) Keep a replacement tracheostomy tube at the bedside
➡ Rationale: In case of accidental decannulation, immediate reinsertion is necessary.
,4. A patient with chronic kidney disease has a potassium level of 6.5 mEq/L.
What is the priority intervention?
A) Administer sodium polystyrene sulfonate (Kayexalate)
B) Place the patient on a cardiac monitor
C) Restrict dietary potassium intake
D) Monitor urine output
✅ Correct Answer: B) Place the patient on a cardiac monitor
➡ Rationale: Hyperkalemia increases the risk of lethal cardiac arrhythmias.
5. A nurse is caring for a post-op patient who suddenly develops chest pain,
dyspnea, and tachycardia. What is the nurse’s immediate action?
A) Administer morphine for pain relief
B) Lower the head of the bed
C) Apply oxygen and notify the provider
D) Encourage deep breathing and coughing
✅ Correct Answer: C) Apply oxygen and notify the provider
➡ Rationale: These symptoms suggest a pulmonary embolism, which requires immediate
oxygen and emergency intervention.
6. A patient with cirrhosis is experiencing confusion and asterixis. Which
medication should the nurse anticipate administering?
A) Lactulose
B) Furosemide
C) Metronidazole
D) Vitamin K
✅ Correct Answer: A) Lactulose
➡ Rationale: Lactulose helps remove ammonia, reducing hepatic encephalopathy.
7. A patient with a chest tube for a pneumothorax has continuous bubbling in the
water seal chamber. What should the nurse do?
,A) Continue monitoring; this is an expected finding
B) Clamp the chest tube and notify the provider
C) Check for air leaks and reinforce tubing connections
D) Immediately remove the chest tube
✅ Correct Answer: C) Check for air leaks and reinforce tubing connections
➡ Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
8. Which lab finding is expected in a patient with acute pancreatitis?
A) Elevated lipase and amylase
B) Decreased bilirubin
C) Hypokalemia
D) Low blood glucose
✅ Correct Answer: A) Elevated lipase and amylase
➡ Rationale: These are key markers of pancreatic inflammation.
9. A patient with myasthenia gravis is receiving pyridostigmine. What is the
primary purpose of this medication?
A) Reduce inflammation
B) Improve nerve signal transmission
C) Prevent muscle spasms
D) Lower blood pressure
✅ Correct Answer: B) Improve nerve signal transmission
➡ Rationale: Pyridostigmine is a cholinesterase inhibitor, improving neuromuscular
transmission.
10. A patient with a spinal cord injury at T4 is experiencing severe hypertension,
bradycardia, and a pounding headache. What is the priority intervention?
A) Administer IV labetalol
B) Elevate the head of the bed
C) Apply compression stockings
D) Increase IV fluids
, ✅ Correct Answer: B) Elevate the head of the bed
➡ Rationale: These are signs of autonomic dysreflexia, requiring HOB elevation and removal
of triggering stimuli (e.g., bladder distention).
11. A patient with COPD is receiving oxygen therapy at 4 L/min via nasal cannula. The
patient becomes drowsy and confused. What should the nurse do first?
A) Increase oxygen to 6 L/min
B) Decrease oxygen to 2 L/min
C) Call the provider immediately
D) Place the patient in Trendelenburg position
✅ Correct Answer: B) Decrease oxygen to 2 L/min
➡ Rationale: In COPD patients, excessive oxygen can reduce the drive to breathe, leading to
CO2 retention and respiratory depression.
12. A nurse is caring for a patient with septic shock. Which finding requires immediate
intervention?
A) Blood pressure of 90/58 mmHg
B) Warm, flushed skin
C) Urine output of 10 mL/hr
D) White blood cell count of 14,000/mm³
✅ Correct Answer: C) Urine output of 10 mL/hr
➡ Rationale: Oliguria (<30 mL/hr) signals poor perfusion and potential multi-organ failure.
13. A patient with a deep vein thrombosis (DVT) is receiving IV heparin. Which lab value
should the nurse monitor?
A) INR
B) Platelet count
C) aPTT
D) Hematocrit
✅ Correct Answer: C) aPTT
➡ Rationale: aPTT monitors heparin therapy and should be 1.5–2 times the normal range.
14. A patient with a gastric ulcer is prescribed omeprazole. What is the primary purpose of
this medication?
