NUR 201 MEDICAL-SURGICAL NURSING EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
This comprehensive collection of 200 unique questions is specifically designed
to mirror the content and complexity of the NUR 201 Medical-Surgical
Nursing exam. The questions systematically cover all core domains, including
the nursing process, pathophysiology, pharmacology, and evidence-based
interventions for common medical-surgical conditions such as respiratory,
cardiovascular, renal, endocrine, gastrointestinal, and neurological disorders.
The set thoroughly tests your knowledge of fluid and electrolyte imbalances,
infectious diseases, wound care, perioperative nursing, and emergency
management. Each question is accompanied by a correct answer and a
detailed rationale to reinforce foundational concepts, ensuring you are well-
prepared for the exam's focus on clinical reasoning, patient safety, and holistic
care.
1. A registered nurse is observing a student nurse assessing a patient. Which
action by the student nurse requires immediate intervention?
A. The student nurse presses on the skin over the tibia for 10 seconds to check
for edema.
B. The student nurse palpates both carotid arteries simultaneously to compare
pulse quality.
C. The student nurse auscultates the lungs while the patient takes deep breaths.
D. The student nurse checks capillary refill on the patient's finger.
Answer: B
Rationale: Palpating both carotid arteries simultaneously can cause a significant
decrease in cerebral blood flow, leading to syncope, bradycardia, or even cardiac
arrest. The carotid pulse should be assessed on one side at a time. Pressing over the
tibia for 10 seconds is the correct technique for assessing pitting edema .
2. A patient with acute shortness of breath is admitted to the hospital. What is the
nurse's priority action during the initial assessment?
A. Ask the patient to lie down to complete a full physical assessment.
B. Briefly ask specific questions about this episode of respiratory distress.
C. Complete the admission database to check for allergies before treatment.
D. Delay the physical assessment to first complete pulmonary function tests.
, Answer: B
Rationale: During an acute respiratory event, the initial assessment should be
focused and brief to quickly identify the cause and severity of the distress and
initiate life-saving interventions. A full head-to-toe assessment or completing the
entire database should be deferred until the patient is stable .
3. The nurse observes that a patient with respiratory disease experiences a
decrease in SpO2 from 93% to 88% while the patient is ambulating. What is the
priority action of the nurse?
A. Notify the health care provider.
B. Administer PRN supplemental O2.
C. Document the response to exercise.
D. Encourage the patient to pace activity.
Answer: B
Rationale: A drop in SpO2 to 88% indicates significant desaturation. The
immediate priority is to administer supplemental oxygen as ordered to correct the
hypoxemia. The other actions can be taken after stabilizing the patient's oxygen
saturation .
4. The nurse prepares a patient with a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
A. High-Fowler's position with the left arm extended
B. Supine with the head of the bed elevated 30 degrees
C. On the right side with the left arm extended above the head
D. Sitting upright with the arms supported on an overbed table
Answer: D
Rationale: For a thoracentesis, the patient should be positioned sitting upright
and leaning forward with the arms supported on an overbed table. This position
widens the intercostal spaces and allows for easier access and fluid removal from
the pleural space .
5. A patient has the following arterial blood gas (ABG) results: pH 7.28, PaCO2
34 mm Hg, PaO2 85 mm Hg, HCO3- 18 mEq/L. The nurse would expect which
finding?
A. Intercostal retractions
B. Kussmaul respirations
C. Low oxygen saturation (SpO2)
D. Decreased venous O2 pressure
Answer: B
, Rationale: The ABG results indicate metabolic acidosis (low pH and low HCO3-
). The respiratory compensation for metabolic acidosis is hyperventilation to blow
off CO2, which presents clinically as Kussmaul respirations (deep, rapid
breathing). This is a classic finding in diabetic ketoacidosis .
6. On auscultation of a patient's lungs, the nurse hears low-pitched, bubbling
sounds during inhalation in the lower third of both lungs. How should the nurse
document this finding?
A. Inspiratory crackles at the bases
B. Expiratory wheezes in both lungs
C. Abnormal lung sounds in the apices of both lungs
D. Pleural friction rub in the right and left lower lobes
Answer: A
Rationale: Crackles (rales) are low-pitched, discontinuous, bubbling sounds
heard on inspiration. They are often associated with fluid in the alveoli, commonly
heard at the lung bases in conditions like heart failure or pneumonia .
7. The nurse teaches a patient about pulmonary spirometry testing. Which
statement, if made by the patient, indicates teaching was effective?
A. "I will need to avoid eating for at least 12 hours before the test."
B. "I will be asked to inhale deeply and then exhale as forcefully and completely
as possible."
C. "The test will require me to be NPO and have an IV started."
D. "The test will measure how well oxygen moves from my lungs into my
blood."
Answer: B
Rationale: Spirometry measures lung function by assessing the volume and flow
of air during forced inhalation and exhalation. The patient will be asked to take a
deep breath and then exhale as hard and as fast as possible into the mouthpiece .
8. Which nursing intervention is important when providing care for a patient with
sickle cell crisis?
A. Limiting the patient's intake of oral and IV fluids
B. Evaluating the effectiveness of opioid analgesics
C. Encouraging the patient to ambulate as much as tolerated
D. Teaching the patient about high-protein, high-calorie foods
Answer: B
Rationale: Pain is the most common clinical manifestation of a sickle cell crisis
and usually requires large doses of continuous opioids for control. The nurse's
, priority is to assess and manage this severe pain. Fluids should be increased, not
limited, to reduce blood viscosity .
9. Which statement by a patient indicates good understanding of the nurse's
teaching about preventing a sickle cell crisis?
A. "Home oxygen therapy is frequently used to decrease sickling."
B. "There are no effective medications that can help prevent sickling."
C. "Routine continuous dosage opioids are prescribed to prevent a crisis."
D. "Risk for a crisis is decreased by having an annual influenza vaccination."
Answer: D
Rationale: Infection is the most common trigger for a sickle cell crisis.
Receiving annual influenza and other recommended immunizations (e.g.,
pneumococcal) is a key preventive measure to reduce infection risk and thereby
prevent a crisis .
10. Which instruction will the nurse plan to include in discharge teaching for a
patient admitted with a sickle cell crisis?
A. Limit fluids to 2 to 3 quarts per day.
B. Avoid exposure to crowds when possible.
C. Take a daily multivitamin supplement with iron.
D. Drink no more than two caffeinated beverages daily.
Answer: B
Rationale: Avoiding crowds minimizes exposure to infections, which are the
most common cause of sickle cell crises. Maintaining good hydration (not
restricting fluids) and avoiding iron supplements (which can lead to iron overload)
are also important teaching points .
11. The nurse observes scleral jaundice in a patient being admitted with hemolytic
anemia. Which laboratory result should the nurse check?
A. Schilling test
B. Bilirubin level
C. Stool occult blood
D. Gastric acid analysis
Answer: B
Rationale: Jaundice (icterus) is caused by the elevation of bilirubin level
associated with red blood cell hemolysis. The breakdown of RBCs releases
hemoglobin, which is converted to bilirubin, leading to the yellow discoloration of
the skin and sclera .
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
This comprehensive collection of 200 unique questions is specifically designed
to mirror the content and complexity of the NUR 201 Medical-Surgical
Nursing exam. The questions systematically cover all core domains, including
the nursing process, pathophysiology, pharmacology, and evidence-based
interventions for common medical-surgical conditions such as respiratory,
cardiovascular, renal, endocrine, gastrointestinal, and neurological disorders.
The set thoroughly tests your knowledge of fluid and electrolyte imbalances,
infectious diseases, wound care, perioperative nursing, and emergency
management. Each question is accompanied by a correct answer and a
detailed rationale to reinforce foundational concepts, ensuring you are well-
prepared for the exam's focus on clinical reasoning, patient safety, and holistic
care.
1. A registered nurse is observing a student nurse assessing a patient. Which
action by the student nurse requires immediate intervention?
A. The student nurse presses on the skin over the tibia for 10 seconds to check
for edema.
B. The student nurse palpates both carotid arteries simultaneously to compare
pulse quality.
C. The student nurse auscultates the lungs while the patient takes deep breaths.
D. The student nurse checks capillary refill on the patient's finger.
Answer: B
Rationale: Palpating both carotid arteries simultaneously can cause a significant
decrease in cerebral blood flow, leading to syncope, bradycardia, or even cardiac
arrest. The carotid pulse should be assessed on one side at a time. Pressing over the
tibia for 10 seconds is the correct technique for assessing pitting edema .
2. A patient with acute shortness of breath is admitted to the hospital. What is the
nurse's priority action during the initial assessment?
A. Ask the patient to lie down to complete a full physical assessment.
B. Briefly ask specific questions about this episode of respiratory distress.
C. Complete the admission database to check for allergies before treatment.
D. Delay the physical assessment to first complete pulmonary function tests.
, Answer: B
Rationale: During an acute respiratory event, the initial assessment should be
focused and brief to quickly identify the cause and severity of the distress and
initiate life-saving interventions. A full head-to-toe assessment or completing the
entire database should be deferred until the patient is stable .
3. The nurse observes that a patient with respiratory disease experiences a
decrease in SpO2 from 93% to 88% while the patient is ambulating. What is the
priority action of the nurse?
A. Notify the health care provider.
B. Administer PRN supplemental O2.
C. Document the response to exercise.
D. Encourage the patient to pace activity.
Answer: B
Rationale: A drop in SpO2 to 88% indicates significant desaturation. The
immediate priority is to administer supplemental oxygen as ordered to correct the
hypoxemia. The other actions can be taken after stabilizing the patient's oxygen
saturation .
4. The nurse prepares a patient with a left-sided pleural effusion for a
thoracentesis. How should the nurse position the patient?
A. High-Fowler's position with the left arm extended
B. Supine with the head of the bed elevated 30 degrees
C. On the right side with the left arm extended above the head
D. Sitting upright with the arms supported on an overbed table
Answer: D
Rationale: For a thoracentesis, the patient should be positioned sitting upright
and leaning forward with the arms supported on an overbed table. This position
widens the intercostal spaces and allows for easier access and fluid removal from
the pleural space .
5. A patient has the following arterial blood gas (ABG) results: pH 7.28, PaCO2
34 mm Hg, PaO2 85 mm Hg, HCO3- 18 mEq/L. The nurse would expect which
finding?
A. Intercostal retractions
B. Kussmaul respirations
C. Low oxygen saturation (SpO2)
D. Decreased venous O2 pressure
Answer: B
, Rationale: The ABG results indicate metabolic acidosis (low pH and low HCO3-
). The respiratory compensation for metabolic acidosis is hyperventilation to blow
off CO2, which presents clinically as Kussmaul respirations (deep, rapid
breathing). This is a classic finding in diabetic ketoacidosis .
6. On auscultation of a patient's lungs, the nurse hears low-pitched, bubbling
sounds during inhalation in the lower third of both lungs. How should the nurse
document this finding?
A. Inspiratory crackles at the bases
B. Expiratory wheezes in both lungs
C. Abnormal lung sounds in the apices of both lungs
D. Pleural friction rub in the right and left lower lobes
Answer: A
Rationale: Crackles (rales) are low-pitched, discontinuous, bubbling sounds
heard on inspiration. They are often associated with fluid in the alveoli, commonly
heard at the lung bases in conditions like heart failure or pneumonia .
7. The nurse teaches a patient about pulmonary spirometry testing. Which
statement, if made by the patient, indicates teaching was effective?
A. "I will need to avoid eating for at least 12 hours before the test."
B. "I will be asked to inhale deeply and then exhale as forcefully and completely
as possible."
C. "The test will require me to be NPO and have an IV started."
D. "The test will measure how well oxygen moves from my lungs into my
blood."
Answer: B
Rationale: Spirometry measures lung function by assessing the volume and flow
of air during forced inhalation and exhalation. The patient will be asked to take a
deep breath and then exhale as hard and as fast as possible into the mouthpiece .
8. Which nursing intervention is important when providing care for a patient with
sickle cell crisis?
A. Limiting the patient's intake of oral and IV fluids
B. Evaluating the effectiveness of opioid analgesics
C. Encouraging the patient to ambulate as much as tolerated
D. Teaching the patient about high-protein, high-calorie foods
Answer: B
Rationale: Pain is the most common clinical manifestation of a sickle cell crisis
and usually requires large doses of continuous opioids for control. The nurse's
, priority is to assess and manage this severe pain. Fluids should be increased, not
limited, to reduce blood viscosity .
9. Which statement by a patient indicates good understanding of the nurse's
teaching about preventing a sickle cell crisis?
A. "Home oxygen therapy is frequently used to decrease sickling."
B. "There are no effective medications that can help prevent sickling."
C. "Routine continuous dosage opioids are prescribed to prevent a crisis."
D. "Risk for a crisis is decreased by having an annual influenza vaccination."
Answer: D
Rationale: Infection is the most common trigger for a sickle cell crisis.
Receiving annual influenza and other recommended immunizations (e.g.,
pneumococcal) is a key preventive measure to reduce infection risk and thereby
prevent a crisis .
10. Which instruction will the nurse plan to include in discharge teaching for a
patient admitted with a sickle cell crisis?
A. Limit fluids to 2 to 3 quarts per day.
B. Avoid exposure to crowds when possible.
C. Take a daily multivitamin supplement with iron.
D. Drink no more than two caffeinated beverages daily.
Answer: B
Rationale: Avoiding crowds minimizes exposure to infections, which are the
most common cause of sickle cell crises. Maintaining good hydration (not
restricting fluids) and avoiding iron supplements (which can lead to iron overload)
are also important teaching points .
11. The nurse observes scleral jaundice in a patient being admitted with hemolytic
anemia. Which laboratory result should the nurse check?
A. Schilling test
B. Bilirubin level
C. Stool occult blood
D. Gastric acid analysis
Answer: B
Rationale: Jaundice (icterus) is caused by the elevation of bilirubin level
associated with red blood cell hemolysis. The breakdown of RBCs releases
hemoglobin, which is converted to bilirubin, leading to the yellow discoloration of
the skin and sclera .
