Midterm Practice Questions for Med Surge II (NURS 221)
Question: 1 of 80
A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of
the following should the nurse include as a modifiable risk factor for this disorder? (Select all that
apply.)
A. Genetic predisposition
a. Genetic predisposition is incorrect. Although it is a risk factor for heart disease, clients
cannot change their genetic predisposition. They should focus on the risk factors they can
change.
B. Hypercholesterolemia
a. Hypercholesterolemia is correct. Cholesterol levels outside the healthful range
increase clients’ risk for heart disease, and they can change these levels
B. Hypertension
a. Hypertension is correct. Although it may not always be possible to eliminate
hypertension, clients can change their blood pressure levels and thus reduce their risk for
atherosclerosis.
B. Obesity
a. Obesity is correct. Clients who are overweight or obese can reduce their risk for heart
disease by losing weight.
B. Smoking
a. Smoking is correct. Clients who smoke can reduce their risk for heart disease by
quitting smoking.
Question: 2 of 80
A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse
should explain that the purpose of this medication is which of the following?
A. To convert atrial fibrillation to sinus rhythm
a. Antidysrhythmic medications such as diltiazem are used to slow the ventricular rate for
clients who have atrial fibrillation.
B. To dissolve clots in the bloodstream
a. Thrombolytic medications, such as alteplase, are used to remove thrombi that have
already formed.
B. To slow the response of the ventricles to the fast atrial impulses
a. Beta-blockers such as carvedilol slow the heart rate.
B. To reduce the risk of stroke in clients who have atrial fibrillation
a. Clients who have atrial fibrillation are at an increased risk for thrombus formation and
subsequent embolization to the brain. Anticoagulants, such as dabigatran, help prevent
thrombus formation.
Question: 3 of 80
A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation
therapy for the treatment of lung cancer. Which of the following should the nurse plan to include
in the teaching?
A. Bottled water is an appropriate choice to increase fluid intake.
a. Clients who have neutropenia are at risk for foodborne illness. Bottled water prevents
client exposure to pathogens that may be found in other water sources.
B. The salad bar is a healthy choice when dining out.
a. Clients who have neutropenia should avoid salad bars due to a higher risk of exposure to
pathogens from raw foods, as well as from other individuals.
B. Soft-boiled eggs are an appropriate source of protein.
a. Clients who have neutropenia should avoid foods that are not fully cooked due to a
higher risk of foodborne illness.
B. Eating at a buffet is a good choice to increase caloric intake.
a. Clients who have neutropenia should avoid buffets due to a higher risk of foodborne
illness and pathogen exposure.
Question: 4 of 80
Midterm Practice Questions for Med Surge II (NURS 221)
,Midterm Practice Questions for Med Surge II (NURS 221)
A nurse is providing teaching to a client about preventing skin cancer. Which of the following
client statements indicates a need for further teaching?
A. "Eating a high fiber diet will reduce my risk for developing skin cancer."
a. A high-fiber diet is recommended to reduce the risk for colon cancer.
B. "I should check my skin monthly for any changes."
a. The client should examine his skin monthly to increase the opportunity for early detection
of new lesions or skin changes that can develop into skin cancer.
B. "I should avoid the use of tanning booths."
a. The client should avoid tanning booths because they can increase the risk of skin cancer
due to ultraviolet light exposure.
B. "I should use sunscreen even on cloudy days."
a. The client should apply sunscreen on a daily basis to reduce the risk of skin cancer.
Question: 5 of 80
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for
cromolyn and albuterol, both by nebulizer. Which of the following statements by the client
indicates an understanding of the teaching?
A. "If my breathing begins to feel tight, I will use the cromolyn immediately."
a. Cromolyn, a leukotriene modifier, is used for prophylaxis treatment of asthma, not acute
attacks. Albuterol, a short acting bronchodilator, should be used for the treatment of acute
bronchospasms.
B. "I will be sure to take the albuterol before taking the cromolyn."
a. The client should always use the bronchodilator (albuterol) prior to using the leukotriene
modifier (cromolyn). Using the bronchodilator first allows the airways to be opened,
ensuring that the maximum dose of medication will get to the client's lungs.
B. "I will use both medications immediately after exercising."
a. Both albuterol and cromolyn are used to prevent exercise-induced bronchospasm, but
administration should be made prior, not after, exercising.
B. "I will administer the medications 10 minutes apart."
a. Inhalations of different medications should be administered 2 to 5 minutes apart.
Question: 7 of 80
A female middle adult client tells a nurse that she tested positive for a mutant BRCA1 gene. The
nurse should recognize that the client is at an increased risk for which of the following situations?
A. Delivering a child who has Down syndrome
a. The BRCA1 gene is not used to determine the probability of having a child who has
Down syndrome.
B. Developing Alzheimer's disease
a. The BRCA1 gene is not used to determine the probability of developing Alzheimer's
disease.
B. Developing breast cancer
a. The BRCA1 gene is used to determine the probability of a client developing breast
cancer. BRCA1 genetic testing is used for women who have a strong family history of
breast cancer.
B. Developing thyroid cancer
a. The BRCA1 gene is not used to determine the probability of developing thyroid cancer.
Question: 8 of 80
A nurse is teaching a client who taking benztropine to treat Parkinson's disease. The nurse should
instruct the client to report which of the following adverse effects?
A. Excess salivation
a. Dry mouth is an adverse effect of benztropine, due to the anticholinergic response of the
medication.
B. Difficulty voiding
Midterm Practice Questions for Med Surge II (NURS 221)
, Midterm Practice Questions for Med Surge II (NURS 221)
a. The nurse should instruct the client to report difficulty voiding, which may indicate urinary
retention, as an adverse effect of benztropine. Benztropine is an anticholinergic
medication that helps decrease the rigidity and tremors of Parkinson’s disease.
B. Diarrhea
a. Constipation is an adverse effect of benztropine, which is due to the anticholinergic
response of the medication that slows peristalsis.
B. Slow pulse
a. Tachycardia is an adverse effect of benztropine, which is due to the anticholinergic
response of the medication.
Question: 9 of 80
A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which
of the following interventions should the nurse take?
A. Prepare the client for mechanical ventilation.
a. The client who is experiencing a myasthenic crisis is at risk for loss of adequate
respiratory function. The nurse should closely monitor the client's respiratory status and
prepare for possible mechanical ventilation.
B. Administer an anticholinesterase medication.
a. The client who is experiencing a myasthenic crisis should not receive anticholinesterase
medications during a myasthenic crisis. These medications are often ineffective during a
crisis and may increase respiratory secretions.
B. Instruct the client to perform the pursed lip breathing.
a. Myasthenia gravis is an autoimmune illness that results in progressive muscular
weakness. A client who is experiencing myasthenic crisis is at risk for respiratory failure
and will not benefit from pursed lip breathing.
B. Prepare to administer a vasoconstrictor.
a. A client who is experiencing myasthenic crisis will be hypertensive rather than
hypotensive.
Question: 10 of 80
A client's intravenous infusion needs to be taken off the pump for a procedure, and the nurse
needs to calculate the drops per minute that the infusion should flow. The infusion rate is ordered
at 60mL per hour. The intravenous tubing delivers 15 drops per mL. The nurse should set the flow
rate at drops per minute.
gtt/min – 15
Question: 11 of 80
A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the
following findings should the nurse expect?
A. Decreased brain natriuretic peptide (BNP).
a. The BNP is a neurohormone that aids in the regulation of fluid balance by detecting
increased stretch of the myocardium and triggering diuresis through sodium excretion via
the kidneys. The BNP level is elevated in the client who has acute heart failure.
B. Elevated central venous pressure (CVP).
a. CVP is a measurement of the pressure in the right atria or ventricle at the end of diastole.
An elevated CVP is indicative of heart failure.
B. Increased pulmonary artery wedge pressure (PAWP).
a. Pulmonary pressure increases in left-sided heart failure because of the increased
pressure and volume of blood in the left ventricle.
B. Decreased specific gravity
a. Urinary specific gravity is increased in the client who has heart failure as a result of fluid
retention by the body.
Midterm Practice Questions for Med Surge II (NURS 221)
Question: 1 of 80
A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of
the following should the nurse include as a modifiable risk factor for this disorder? (Select all that
apply.)
A. Genetic predisposition
a. Genetic predisposition is incorrect. Although it is a risk factor for heart disease, clients
cannot change their genetic predisposition. They should focus on the risk factors they can
change.
B. Hypercholesterolemia
a. Hypercholesterolemia is correct. Cholesterol levels outside the healthful range
increase clients’ risk for heart disease, and they can change these levels
B. Hypertension
a. Hypertension is correct. Although it may not always be possible to eliminate
hypertension, clients can change their blood pressure levels and thus reduce their risk for
atherosclerosis.
B. Obesity
a. Obesity is correct. Clients who are overweight or obese can reduce their risk for heart
disease by losing weight.
B. Smoking
a. Smoking is correct. Clients who smoke can reduce their risk for heart disease by
quitting smoking.
Question: 2 of 80
A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse
should explain that the purpose of this medication is which of the following?
A. To convert atrial fibrillation to sinus rhythm
a. Antidysrhythmic medications such as diltiazem are used to slow the ventricular rate for
clients who have atrial fibrillation.
B. To dissolve clots in the bloodstream
a. Thrombolytic medications, such as alteplase, are used to remove thrombi that have
already formed.
B. To slow the response of the ventricles to the fast atrial impulses
a. Beta-blockers such as carvedilol slow the heart rate.
B. To reduce the risk of stroke in clients who have atrial fibrillation
a. Clients who have atrial fibrillation are at an increased risk for thrombus formation and
subsequent embolization to the brain. Anticoagulants, such as dabigatran, help prevent
thrombus formation.
Question: 3 of 80
A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation
therapy for the treatment of lung cancer. Which of the following should the nurse plan to include
in the teaching?
A. Bottled water is an appropriate choice to increase fluid intake.
a. Clients who have neutropenia are at risk for foodborne illness. Bottled water prevents
client exposure to pathogens that may be found in other water sources.
B. The salad bar is a healthy choice when dining out.
a. Clients who have neutropenia should avoid salad bars due to a higher risk of exposure to
pathogens from raw foods, as well as from other individuals.
B. Soft-boiled eggs are an appropriate source of protein.
a. Clients who have neutropenia should avoid foods that are not fully cooked due to a
higher risk of foodborne illness.
B. Eating at a buffet is a good choice to increase caloric intake.
a. Clients who have neutropenia should avoid buffets due to a higher risk of foodborne
illness and pathogen exposure.
Question: 4 of 80
Midterm Practice Questions for Med Surge II (NURS 221)
,Midterm Practice Questions for Med Surge II (NURS 221)
A nurse is providing teaching to a client about preventing skin cancer. Which of the following
client statements indicates a need for further teaching?
A. "Eating a high fiber diet will reduce my risk for developing skin cancer."
a. A high-fiber diet is recommended to reduce the risk for colon cancer.
B. "I should check my skin monthly for any changes."
a. The client should examine his skin monthly to increase the opportunity for early detection
of new lesions or skin changes that can develop into skin cancer.
B. "I should avoid the use of tanning booths."
a. The client should avoid tanning booths because they can increase the risk of skin cancer
due to ultraviolet light exposure.
B. "I should use sunscreen even on cloudy days."
a. The client should apply sunscreen on a daily basis to reduce the risk of skin cancer.
Question: 5 of 80
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for
cromolyn and albuterol, both by nebulizer. Which of the following statements by the client
indicates an understanding of the teaching?
A. "If my breathing begins to feel tight, I will use the cromolyn immediately."
a. Cromolyn, a leukotriene modifier, is used for prophylaxis treatment of asthma, not acute
attacks. Albuterol, a short acting bronchodilator, should be used for the treatment of acute
bronchospasms.
B. "I will be sure to take the albuterol before taking the cromolyn."
a. The client should always use the bronchodilator (albuterol) prior to using the leukotriene
modifier (cromolyn). Using the bronchodilator first allows the airways to be opened,
ensuring that the maximum dose of medication will get to the client's lungs.
B. "I will use both medications immediately after exercising."
a. Both albuterol and cromolyn are used to prevent exercise-induced bronchospasm, but
administration should be made prior, not after, exercising.
B. "I will administer the medications 10 minutes apart."
a. Inhalations of different medications should be administered 2 to 5 minutes apart.
Question: 7 of 80
A female middle adult client tells a nurse that she tested positive for a mutant BRCA1 gene. The
nurse should recognize that the client is at an increased risk for which of the following situations?
A. Delivering a child who has Down syndrome
a. The BRCA1 gene is not used to determine the probability of having a child who has
Down syndrome.
B. Developing Alzheimer's disease
a. The BRCA1 gene is not used to determine the probability of developing Alzheimer's
disease.
B. Developing breast cancer
a. The BRCA1 gene is used to determine the probability of a client developing breast
cancer. BRCA1 genetic testing is used for women who have a strong family history of
breast cancer.
B. Developing thyroid cancer
a. The BRCA1 gene is not used to determine the probability of developing thyroid cancer.
Question: 8 of 80
A nurse is teaching a client who taking benztropine to treat Parkinson's disease. The nurse should
instruct the client to report which of the following adverse effects?
A. Excess salivation
a. Dry mouth is an adverse effect of benztropine, due to the anticholinergic response of the
medication.
B. Difficulty voiding
Midterm Practice Questions for Med Surge II (NURS 221)
, Midterm Practice Questions for Med Surge II (NURS 221)
a. The nurse should instruct the client to report difficulty voiding, which may indicate urinary
retention, as an adverse effect of benztropine. Benztropine is an anticholinergic
medication that helps decrease the rigidity and tremors of Parkinson’s disease.
B. Diarrhea
a. Constipation is an adverse effect of benztropine, which is due to the anticholinergic
response of the medication that slows peristalsis.
B. Slow pulse
a. Tachycardia is an adverse effect of benztropine, which is due to the anticholinergic
response of the medication.
Question: 9 of 80
A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which
of the following interventions should the nurse take?
A. Prepare the client for mechanical ventilation.
a. The client who is experiencing a myasthenic crisis is at risk for loss of adequate
respiratory function. The nurse should closely monitor the client's respiratory status and
prepare for possible mechanical ventilation.
B. Administer an anticholinesterase medication.
a. The client who is experiencing a myasthenic crisis should not receive anticholinesterase
medications during a myasthenic crisis. These medications are often ineffective during a
crisis and may increase respiratory secretions.
B. Instruct the client to perform the pursed lip breathing.
a. Myasthenia gravis is an autoimmune illness that results in progressive muscular
weakness. A client who is experiencing myasthenic crisis is at risk for respiratory failure
and will not benefit from pursed lip breathing.
B. Prepare to administer a vasoconstrictor.
a. A client who is experiencing myasthenic crisis will be hypertensive rather than
hypotensive.
Question: 10 of 80
A client's intravenous infusion needs to be taken off the pump for a procedure, and the nurse
needs to calculate the drops per minute that the infusion should flow. The infusion rate is ordered
at 60mL per hour. The intravenous tubing delivers 15 drops per mL. The nurse should set the flow
rate at drops per minute.
gtt/min – 15
Question: 11 of 80
A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the
following findings should the nurse expect?
A. Decreased brain natriuretic peptide (BNP).
a. The BNP is a neurohormone that aids in the regulation of fluid balance by detecting
increased stretch of the myocardium and triggering diuresis through sodium excretion via
the kidneys. The BNP level is elevated in the client who has acute heart failure.
B. Elevated central venous pressure (CVP).
a. CVP is a measurement of the pressure in the right atria or ventricle at the end of diastole.
An elevated CVP is indicative of heart failure.
B. Increased pulmonary artery wedge pressure (PAWP).
a. Pulmonary pressure increases in left-sided heart failure because of the increased
pressure and volume of blood in the left ventricle.
B. Decreased specific gravity
a. Urinary specific gravity is increased in the client who has heart failure as a result of fluid
retention by the body.
Midterm Practice Questions for Med Surge II (NURS 221)
