MED SURG 201 Final Exam – West
Coast University – Complete
Questions and Answers
Multiple-Choice Questions
1. A patient with newly diagnosed diabetes mellitus is scheduled for discharge. What is the
priority teaching action for the nurse?
a) Instruct about cardiovascular risk
b) Provide detailed dietary information
c) Teach glucose self-monitoring and medication administration
d) Discuss exercise effects on glucose
Answer: c) Teach glucose self-monitoring and medication administration
Rationale: Teaching glucose self-monitoring and medication administration is critical for
immediate self-management and safety at discharge.
2. A 75-year-old patient is admitted for pancreatitis. Which assessment tool is most
appropriate?
a) Drug Abuse Screening Test (DAST-10)
b) Clinical Institute Withdrawal Assessment (CIWA-Ar)
c) Screening Test-Geriatric Version (SMAST-G)
d) Mini-Mental State Examination
Answer: c) Screening Test-Geriatric Version (SMAST-G)
Rationale: Pancreatitis is often associated with alcohol abuse, and SMAST-G is
appropriate for assessing alcohol use in older adults.
3. A patient with atrial fibrillation is shown a 6-second ECG strip. What is the nurse’s
priority action?
a) Administer defibrillation
b) Prepare for cardioversion
c) Assess for pulse deficit
d) Initiate CPR
Answer: c) Assess for pulse deficit
Rationale: Atrial fibrillation can cause a pulse deficit, requiring assessment to evaluate
perfusion.
4. A patient with ventricular fibrillation is on a monitor. Which action is the priority?
a) Administer oxygen
b) Initiate defibrillation and CPR
c) Prepare for cardioversion
d) Administer amiodarone
Answer: b) Initiate defibrillation and CPR
, Rationale: Ventricular fibrillation is a life-threatening arrhythmia requiring immediate
defibrillation and CPR.
5. A patient with a GI bleed and continuous nasogastric suctioning has an arterial blood gas
(ABG) result. What is the expected finding?
a) Respiratory acidosis
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
Answer: b) Metabolic alkalosis
Rationale: Loss of gastric acid from suctioning causes metabolic alkalosis due to
decreased hydrogen ions.
6. A nurse is assessing a client post-thyroidectomy. What is the priority assessment?
a) Pain level
b) Respiratory rate and effort
c) Blood pressure
d) Wound drainage
Answer: b) Respiratory rate and effort
Rationale: Airway compromise from swelling or hematoma is a priority post-
thyroidectomy.
7. A patient with pneumonia is admitted. Which nursing intervention is most appropriate?
a) Administer antibiotics as prescribed
b) Encourage bed rest without activity
c) Restrict fluid intake
d) Administer a diuretic
Answer: a) Administer antibiotics as prescribed
Rationale: Antibiotics treat the underlying infection in pneumonia, improving outcomes.
8. A patient with tuberculosis reports night sweats and weight loss. What is the nurse’s
priority action?
a) Initiate airborne precautions
b) Administer oxygen
c) Encourage high-calorie meals
d) Monitor blood pressure
Answer: a) Initiate airborne precautions
Rationale: Tuberculosis is highly contagious, requiring airborne precautions to prevent
spread.
9. A patient with a history of epilepsy is admitted. Which precaution should the nurse
implement?
a) Restrict all visitors
b) Initiate seizure precautions
c) Administer a PRN sedative
d) Encourage high-stimulus activities
Answer: b) Initiate seizure precautions
Rationale: Seizure precautions (e.g., padded bed rails) ensure safety during potential
seizures.
10. A patient with gastroesophageal reflux disease (GERD) is prescribed ranitidine. What is
the medication’s mechanism of action?
, a) Neutralizes stomach acid
b) Blocks histamine receptors in the stomach
c) Inhibits proton pump activity
d) Increases gastric motility
Answer: b) Blocks histamine receptors in the stomach
Rationale: Ranitidine, an H2 receptor antagonist, reduces acid production by blocking
histamine receptors.
11. A patient with breast cancer asks about BRCA gene testing. What is the nurse’s best
response?
a) “Breast cancer is rarely caused by the BRCA gene.”
b) “It depends on how you’ll feel if the test is positive.”
c) “There are many factors to consider before testing.”
d) “You should decide about mastectomy first.”
Answer: c) “There are many factors to consider before testing.”
Rationale: Genetic testing involves complex considerations, including counseling and
risk assessment.
12. A nurse is assessing an older adult for malnutrition. Which finding is most concerning?
a) High cholesterol
b) Low albumin
c) Normal weight
d) Stable blood pressure
Answer: b) Low albumin
Rationale: Low albumin indicates malnutrition and is a critical finding in older adults.
13. A patient with lung cancer states, “I want to travel abroad.” What should the nurse do?
a) Discourage travel due to prognosis
b) Discuss travel plans and medical needs
c) Refer the patient to a travel agency
d) Administer oxygen immediately
Answer: b) Discuss travel plans and medical needs
Rationale: Supporting the patient’s goals while addressing medical needs promotes
autonomy.
14. A patient with thrombocytopenia is admitted. Which assessment finding is expected?
a) Fever and chills
b) Petechiae and ecchymoses
c) Hypertension
d) Chest pain
Answer: b) Petechiae and ecchymoses
Rationale: Thrombocytopenia causes bleeding tendencies, leading to petechiae and
ecchymoses.
15. A nurse is preparing to administer ampicillin 50 mg/kg/day PO to a child weighing 88 lb.
What is the daily dose?
a) 1000 mg
b) 2000 mg
c) 3000 mg
d) 4000 mg
Coast University – Complete
Questions and Answers
Multiple-Choice Questions
1. A patient with newly diagnosed diabetes mellitus is scheduled for discharge. What is the
priority teaching action for the nurse?
a) Instruct about cardiovascular risk
b) Provide detailed dietary information
c) Teach glucose self-monitoring and medication administration
d) Discuss exercise effects on glucose
Answer: c) Teach glucose self-monitoring and medication administration
Rationale: Teaching glucose self-monitoring and medication administration is critical for
immediate self-management and safety at discharge.
2. A 75-year-old patient is admitted for pancreatitis. Which assessment tool is most
appropriate?
a) Drug Abuse Screening Test (DAST-10)
b) Clinical Institute Withdrawal Assessment (CIWA-Ar)
c) Screening Test-Geriatric Version (SMAST-G)
d) Mini-Mental State Examination
Answer: c) Screening Test-Geriatric Version (SMAST-G)
Rationale: Pancreatitis is often associated with alcohol abuse, and SMAST-G is
appropriate for assessing alcohol use in older adults.
3. A patient with atrial fibrillation is shown a 6-second ECG strip. What is the nurse’s
priority action?
a) Administer defibrillation
b) Prepare for cardioversion
c) Assess for pulse deficit
d) Initiate CPR
Answer: c) Assess for pulse deficit
Rationale: Atrial fibrillation can cause a pulse deficit, requiring assessment to evaluate
perfusion.
4. A patient with ventricular fibrillation is on a monitor. Which action is the priority?
a) Administer oxygen
b) Initiate defibrillation and CPR
c) Prepare for cardioversion
d) Administer amiodarone
Answer: b) Initiate defibrillation and CPR
, Rationale: Ventricular fibrillation is a life-threatening arrhythmia requiring immediate
defibrillation and CPR.
5. A patient with a GI bleed and continuous nasogastric suctioning has an arterial blood gas
(ABG) result. What is the expected finding?
a) Respiratory acidosis
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
Answer: b) Metabolic alkalosis
Rationale: Loss of gastric acid from suctioning causes metabolic alkalosis due to
decreased hydrogen ions.
6. A nurse is assessing a client post-thyroidectomy. What is the priority assessment?
a) Pain level
b) Respiratory rate and effort
c) Blood pressure
d) Wound drainage
Answer: b) Respiratory rate and effort
Rationale: Airway compromise from swelling or hematoma is a priority post-
thyroidectomy.
7. A patient with pneumonia is admitted. Which nursing intervention is most appropriate?
a) Administer antibiotics as prescribed
b) Encourage bed rest without activity
c) Restrict fluid intake
d) Administer a diuretic
Answer: a) Administer antibiotics as prescribed
Rationale: Antibiotics treat the underlying infection in pneumonia, improving outcomes.
8. A patient with tuberculosis reports night sweats and weight loss. What is the nurse’s
priority action?
a) Initiate airborne precautions
b) Administer oxygen
c) Encourage high-calorie meals
d) Monitor blood pressure
Answer: a) Initiate airborne precautions
Rationale: Tuberculosis is highly contagious, requiring airborne precautions to prevent
spread.
9. A patient with a history of epilepsy is admitted. Which precaution should the nurse
implement?
a) Restrict all visitors
b) Initiate seizure precautions
c) Administer a PRN sedative
d) Encourage high-stimulus activities
Answer: b) Initiate seizure precautions
Rationale: Seizure precautions (e.g., padded bed rails) ensure safety during potential
seizures.
10. A patient with gastroesophageal reflux disease (GERD) is prescribed ranitidine. What is
the medication’s mechanism of action?
, a) Neutralizes stomach acid
b) Blocks histamine receptors in the stomach
c) Inhibits proton pump activity
d) Increases gastric motility
Answer: b) Blocks histamine receptors in the stomach
Rationale: Ranitidine, an H2 receptor antagonist, reduces acid production by blocking
histamine receptors.
11. A patient with breast cancer asks about BRCA gene testing. What is the nurse’s best
response?
a) “Breast cancer is rarely caused by the BRCA gene.”
b) “It depends on how you’ll feel if the test is positive.”
c) “There are many factors to consider before testing.”
d) “You should decide about mastectomy first.”
Answer: c) “There are many factors to consider before testing.”
Rationale: Genetic testing involves complex considerations, including counseling and
risk assessment.
12. A nurse is assessing an older adult for malnutrition. Which finding is most concerning?
a) High cholesterol
b) Low albumin
c) Normal weight
d) Stable blood pressure
Answer: b) Low albumin
Rationale: Low albumin indicates malnutrition and is a critical finding in older adults.
13. A patient with lung cancer states, “I want to travel abroad.” What should the nurse do?
a) Discourage travel due to prognosis
b) Discuss travel plans and medical needs
c) Refer the patient to a travel agency
d) Administer oxygen immediately
Answer: b) Discuss travel plans and medical needs
Rationale: Supporting the patient’s goals while addressing medical needs promotes
autonomy.
14. A patient with thrombocytopenia is admitted. Which assessment finding is expected?
a) Fever and chills
b) Petechiae and ecchymoses
c) Hypertension
d) Chest pain
Answer: b) Petechiae and ecchymoses
Rationale: Thrombocytopenia causes bleeding tendencies, leading to petechiae and
ecchymoses.
15. A nurse is preparing to administer ampicillin 50 mg/kg/day PO to a child weighing 88 lb.
What is the daily dose?
a) 1000 mg
b) 2000 mg
c) 3000 mg
d) 4000 mg
