Latest 2026/2027 NUR 201 — Medical-Surgical Nursing Final Exam verified with
correct answers/instant pdf
1. A client with heart failure reports increasing shortness of breath and has
bilateral crackles. Which assessment finding requires the nurse's immediate
attention?
A. Mild fatigue
B. Oxygen saturation of 88%
C. Heart rate of 82/min
D. Blood pressure of 128/76 mmHg
Answer: B
Rationale: An oxygen saturation of 88% indicates significant hypoxemia. The nurse should
immediately assess airway and breathing and provide oxygen and other interventions as
indicated.
2. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Pulmonary crackles
D. Enlarged liver
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion, crackles, dyspnea, and orthopnea.
3. A client taking furosemide should be monitored closely for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B
,Rationale: Furosemide is a loop diuretic that increases urinary potassium loss and can cause
hypokalemia.
4. A client with acute myocardial infarction suddenly develops severe dyspnea
and pink, frothy sputum. What complication should the nurse suspect?
A. Pulmonary edema
B. Constipation
C. Deep vein thrombosis
D. Hypoglycemia
Answer: A
Rationale: Severe dyspnea accompanied by pink, frothy sputum is highly suggestive of acute
pulmonary edema, which requires immediate intervention.
5. Which symptom is most concerning for an acute myocardial infarction?
A. Mild headache
B. Substernal pressure radiating to the arm or jaw
C. Increased appetite
D. Mild ankle itching
Answer: B
Rationale: Cardiac ischemia commonly causes pressure, squeezing, or discomfort in the chest
that may radiate to the arm, shoulder, neck, jaw, or back.
6. A client with COPD is receiving oxygen. Which nursing action is appropriate?
A. Administer oxygen as prescribed and monitor respiratory status
B. Automatically discontinue oxygen if the client has COPD
C. Encourage prolonged breath-holding
D. Place the client flat in bed
Answer: A
Rationale: Clients with COPD may require carefully titrated oxygen therapy. The nurse should
follow the prescribed oxygen target and monitor respiratory status rather than withholding
oxygen.
,7. Which position generally promotes easier breathing in a client experiencing
dyspnea?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Answer: B
Rationale: High-Fowler's positioning promotes lung expansion and can decrease the work of
breathing.
8. A client with asthma develops severe wheezing and difficulty speaking. Which
medication is generally used for rapid relief of acute bronchospasm?
A. Albuterol
B. Warfarin
C. Furosemide
D. Levothyroxine
Answer: A
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that produces rapid
bronchodilation and is commonly used as a rescue medication.
9. Which finding in a client with asthma suggests severe respiratory
compromise?
A. Ability to speak in full sentences
B. Mild occasional cough
C. Silent chest with markedly decreased breath sounds
D. Respiratory rate of 16/min
Answer: C
Rationale: A previously wheezing client who develops a silent chest may have critically reduced
airflow and impending respiratory failure.
, 10. Which finding is commonly associated with pneumonia?
A. Crackles and productive cough
B. Bradycardia only
C. Increased urine output
D. Clear lungs in every case
Answer: A
Rationale: Pneumonia commonly produces cough, fever, abnormal breath sounds such as
crackles, dyspnea, and sometimes purulent sputum.
11. A client with suspected bacterial pneumonia has a temperature of 39°C
(102.2°F), heart rate of 118/min, and respiratory rate of 28/min. What should the
nurse assess for most urgently?
A. Signs of sepsis and respiratory deterioration
B. Hair loss
C. Chronic constipation
D. Visual acuity
Answer: A
Rationale: Fever, tachycardia, and tachypnea can indicate systemic infection and possible
sepsis. The nurse should assess perfusion, mental status, oxygenation, blood pressure, urine
output, and other indicators of deterioration.
12. Which assessment finding is typical of hypokalemia?
A. Muscle weakness
B. Hyperactive bowel sounds only
C. Severe hypertension in every case
D. Increased deep tendon reflexes
Answer: A
Rationale: Hypokalemia can cause muscle weakness, fatigue, cardiac dysrhythmias, and
decreased gastrointestinal motility.
correct answers/instant pdf
1. A client with heart failure reports increasing shortness of breath and has
bilateral crackles. Which assessment finding requires the nurse's immediate
attention?
A. Mild fatigue
B. Oxygen saturation of 88%
C. Heart rate of 82/min
D. Blood pressure of 128/76 mmHg
Answer: B
Rationale: An oxygen saturation of 88% indicates significant hypoxemia. The nurse should
immediately assess airway and breathing and provide oxygen and other interventions as
indicated.
2. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Pulmonary crackles
D. Enlarged liver
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion, crackles, dyspnea, and orthopnea.
3. A client taking furosemide should be monitored closely for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B
,Rationale: Furosemide is a loop diuretic that increases urinary potassium loss and can cause
hypokalemia.
4. A client with acute myocardial infarction suddenly develops severe dyspnea
and pink, frothy sputum. What complication should the nurse suspect?
A. Pulmonary edema
B. Constipation
C. Deep vein thrombosis
D. Hypoglycemia
Answer: A
Rationale: Severe dyspnea accompanied by pink, frothy sputum is highly suggestive of acute
pulmonary edema, which requires immediate intervention.
5. Which symptom is most concerning for an acute myocardial infarction?
A. Mild headache
B. Substernal pressure radiating to the arm or jaw
C. Increased appetite
D. Mild ankle itching
Answer: B
Rationale: Cardiac ischemia commonly causes pressure, squeezing, or discomfort in the chest
that may radiate to the arm, shoulder, neck, jaw, or back.
6. A client with COPD is receiving oxygen. Which nursing action is appropriate?
A. Administer oxygen as prescribed and monitor respiratory status
B. Automatically discontinue oxygen if the client has COPD
C. Encourage prolonged breath-holding
D. Place the client flat in bed
Answer: A
Rationale: Clients with COPD may require carefully titrated oxygen therapy. The nurse should
follow the prescribed oxygen target and monitor respiratory status rather than withholding
oxygen.
,7. Which position generally promotes easier breathing in a client experiencing
dyspnea?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone with the head flat
Answer: B
Rationale: High-Fowler's positioning promotes lung expansion and can decrease the work of
breathing.
8. A client with asthma develops severe wheezing and difficulty speaking. Which
medication is generally used for rapid relief of acute bronchospasm?
A. Albuterol
B. Warfarin
C. Furosemide
D. Levothyroxine
Answer: A
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that produces rapid
bronchodilation and is commonly used as a rescue medication.
9. Which finding in a client with asthma suggests severe respiratory
compromise?
A. Ability to speak in full sentences
B. Mild occasional cough
C. Silent chest with markedly decreased breath sounds
D. Respiratory rate of 16/min
Answer: C
Rationale: A previously wheezing client who develops a silent chest may have critically reduced
airflow and impending respiratory failure.
, 10. Which finding is commonly associated with pneumonia?
A. Crackles and productive cough
B. Bradycardia only
C. Increased urine output
D. Clear lungs in every case
Answer: A
Rationale: Pneumonia commonly produces cough, fever, abnormal breath sounds such as
crackles, dyspnea, and sometimes purulent sputum.
11. A client with suspected bacterial pneumonia has a temperature of 39°C
(102.2°F), heart rate of 118/min, and respiratory rate of 28/min. What should the
nurse assess for most urgently?
A. Signs of sepsis and respiratory deterioration
B. Hair loss
C. Chronic constipation
D. Visual acuity
Answer: A
Rationale: Fever, tachycardia, and tachypnea can indicate systemic infection and possible
sepsis. The nurse should assess perfusion, mental status, oxygenation, blood pressure, urine
output, and other indicators of deterioration.
12. Which assessment finding is typical of hypokalemia?
A. Muscle weakness
B. Hyperactive bowel sounds only
C. Severe hypertension in every case
D. Increased deep tendon reflexes
Answer: A
Rationale: Hypokalemia can cause muscle weakness, fatigue, cardiac dysrhythmias, and
decreased gastrointestinal motility.
