Exam 1: NUR 201 /NUR201 Medical-Surgical Nursing I
2026/2027 |Newly Released| Fortis College
50 Questions & Answers |Grade A+ |100% Correct Rationales
Guaranteed Pass
Q1: A 62-year-old female is admitted with muscle weakness, fatigue, and palpitations. Her ECG
shows flattened T-waves and prominent U-waves. She has been taking hydrochlorothiazide for
hypertension. Which electrolyte imbalance is most likely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Correct because hydrochlorothiazide is a potassium-wasting diuretic that promotes
renal excretion of potassium, placing this patient at high risk for hypokalemia (potassium <3.5
mEq/L). The ECG findings of flattened T-waves and prominent U-waves are pathognomonic for
hypokalemia and reflect delayed ventricular repolarization. The nurse must obtain a serum
potassium level, initiate cardiac monitoring, and administer oral or IV potassium replacement per
provider orders while encouraging potassium-rich foods such as bananas, oranges, and potatoes.
Q2: A nurse in the PACU notes a postoperative patient has a respiratory rate of 8 breaths/minute,
oxygen saturation of 88%, and is difficult to arouse following morphine administration. Which is
the priority nursing action?
A. Stimulate the patient and encourage deep breathing exercises
B. Apply supplemental oxygen and prepare to administer naloxone
C. Increase the IV fluid rate to enhance drug metabolism
D. Document the findings and continue routine monitoring
Correct Answer: D
Rationale: Correct because this patient is exhibiting classic signs of opioid-induced respiratory
depression (shallow respirations, hypoxemia, decreased level of consciousness) following
,morphine administration, which is a life-threatening emergency requiring immediate
intervention. The nurse must first apply supplemental oxygen to correct hypoxemia while
preparing to administer naloxone, an opioid antagonist that reverses respiratory depression by
displacing morphine from opioid receptors. Continuous monitoring of respiratory rate, oxygen
saturation, and level of consciousness is essential after naloxone administration because its
duration of action is shorter than morphine, creating risk for recurrent respiratory depression.
Q3: A 55-year-old male is scheduled for an elective inguinal hernia repair. The surgeon has
explained the procedure, risks, and alternatives. Which action by the nurse demonstrates proper
verification of informed consent?
A. The nurse explains the surgical risks to the patient when the surgeon is unavailable
B. The nurse witnesses the patient's signature and asks the patient to describe the procedure in
his own words
C. The nurse obtains the patient's signature on the consent form before the surgeon arrives
D. The nurse assumes consent is valid because the patient is scheduled for surgery
Correct Answer: A
Rationale: Correct because informed consent is a legal and ethical requirement that must be
obtained by the physician who will perform the procedure; the nurse's role is to witness the
signature and verify patient understanding through teach-back, ensuring the patient can explain
the procedure, risks, benefits, and alternatives in his own words without coercion. The nurse
must never obtain consent or explain surgical risks independently, as this exceeds the nursing
scope of practice and invalidates the consent process. Verifying understanding protects patient
autonomy and ensures the patient possesses the decision-making capacity required for legally
valid informed consent.
Q4: A patient with chronic pancreatitis presents with perioral numbness, muscle cramps, and a
positive Trousseau's sign. Which electrolyte imbalance should the nurse suspect?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypomagnesemia
Correct Answer: C
Rationale: Correct because chronic pancreatitis causes fat malabsorption and subsequent vitamin
D deficiency, leading to hypocalcemia (calcium <8.5 mg/dL), which manifests with
neuromuscular irritability including perioral numbness, muscle cramps, and positive Trousseau's
, sign (carpal spasm with BP cuff inflation). The nurse must implement seizure precautions,
monitor for laryngospasm and tetany, and prepare for IV calcium gluconate administration if the
patient develops severe symptoms or cardiac dysrhythmias. Continuous ECG monitoring is
essential to detect prolonged QT interval, which increases the risk of torsades de pointes.
Q5: A postoperative patient on POD #1 has a temperature of 100.6°F, decreased breath sounds at
the lung bases, and refuses to use the incentive spirometer due to incisional pain. Which
complication is most likely developing?
A. Pneumonia
B. Atelectasis
C. Pulmonary embolism
D. Surgical site infection
Correct Answer: D
Rationale: Correct because a low-grade fever (100-101°F) within the first 24-48 hours
postoperatively, combined with decreased breath sounds and the patient's refusal to perform deep
breathing exercises, is the classic presentation of atelectasis caused by collapsed alveoli from
shallow breathing, anesthesia effects, and inadequate lung expansion. Atelectasis is the most
common cause of postoperative fever in the immediate postoperative period and is preventable
with incentive spirometry, early ambulation, cough and deep breathing exercises, and adequate
pain control. The priority nursing interventions include optimizing pain management to facilitate
deep breathing, encouraging incentive spirometry (10-15 breaths per hour while awake), and
mobilizing the patient to prevent progression to pneumonia.
Q6: A patient with heart failure and cirrhosis has a serum sodium of 130 mEq/L. The patient is
alert, oriented, and reports mild headache. Which nursing intervention is most appropriate?
A. Administer 3% hypertonic saline immediately
B. Implement fluid restriction and monitor neurological status
C. Encourage oral fluid intake to correct the dilutional state
D. Initiate seizure precautions and prepare for rapid correction
Correct Answer: A
Rationale: Correct because this patient has mild hyponatremia (sodium 130 mEq/L) with
neurological symptoms in the context of hypervolemic states (heart failure and cirrhosis),
making fluid restriction the most appropriate initial intervention to reduce total body water and
gradually increase serum sodium concentration. The nurse must monitor neurological status
closely for progression to severe symptoms including confusion, seizures, or coma, which would
2026/2027 |Newly Released| Fortis College
50 Questions & Answers |Grade A+ |100% Correct Rationales
Guaranteed Pass
Q1: A 62-year-old female is admitted with muscle weakness, fatigue, and palpitations. Her ECG
shows flattened T-waves and prominent U-waves. She has been taking hydrochlorothiazide for
hypertension. Which electrolyte imbalance is most likely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Correct because hydrochlorothiazide is a potassium-wasting diuretic that promotes
renal excretion of potassium, placing this patient at high risk for hypokalemia (potassium <3.5
mEq/L). The ECG findings of flattened T-waves and prominent U-waves are pathognomonic for
hypokalemia and reflect delayed ventricular repolarization. The nurse must obtain a serum
potassium level, initiate cardiac monitoring, and administer oral or IV potassium replacement per
provider orders while encouraging potassium-rich foods such as bananas, oranges, and potatoes.
Q2: A nurse in the PACU notes a postoperative patient has a respiratory rate of 8 breaths/minute,
oxygen saturation of 88%, and is difficult to arouse following morphine administration. Which is
the priority nursing action?
A. Stimulate the patient and encourage deep breathing exercises
B. Apply supplemental oxygen and prepare to administer naloxone
C. Increase the IV fluid rate to enhance drug metabolism
D. Document the findings and continue routine monitoring
Correct Answer: D
Rationale: Correct because this patient is exhibiting classic signs of opioid-induced respiratory
depression (shallow respirations, hypoxemia, decreased level of consciousness) following
,morphine administration, which is a life-threatening emergency requiring immediate
intervention. The nurse must first apply supplemental oxygen to correct hypoxemia while
preparing to administer naloxone, an opioid antagonist that reverses respiratory depression by
displacing morphine from opioid receptors. Continuous monitoring of respiratory rate, oxygen
saturation, and level of consciousness is essential after naloxone administration because its
duration of action is shorter than morphine, creating risk for recurrent respiratory depression.
Q3: A 55-year-old male is scheduled for an elective inguinal hernia repair. The surgeon has
explained the procedure, risks, and alternatives. Which action by the nurse demonstrates proper
verification of informed consent?
A. The nurse explains the surgical risks to the patient when the surgeon is unavailable
B. The nurse witnesses the patient's signature and asks the patient to describe the procedure in
his own words
C. The nurse obtains the patient's signature on the consent form before the surgeon arrives
D. The nurse assumes consent is valid because the patient is scheduled for surgery
Correct Answer: A
Rationale: Correct because informed consent is a legal and ethical requirement that must be
obtained by the physician who will perform the procedure; the nurse's role is to witness the
signature and verify patient understanding through teach-back, ensuring the patient can explain
the procedure, risks, benefits, and alternatives in his own words without coercion. The nurse
must never obtain consent or explain surgical risks independently, as this exceeds the nursing
scope of practice and invalidates the consent process. Verifying understanding protects patient
autonomy and ensures the patient possesses the decision-making capacity required for legally
valid informed consent.
Q4: A patient with chronic pancreatitis presents with perioral numbness, muscle cramps, and a
positive Trousseau's sign. Which electrolyte imbalance should the nurse suspect?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypomagnesemia
Correct Answer: C
Rationale: Correct because chronic pancreatitis causes fat malabsorption and subsequent vitamin
D deficiency, leading to hypocalcemia (calcium <8.5 mg/dL), which manifests with
neuromuscular irritability including perioral numbness, muscle cramps, and positive Trousseau's
, sign (carpal spasm with BP cuff inflation). The nurse must implement seizure precautions,
monitor for laryngospasm and tetany, and prepare for IV calcium gluconate administration if the
patient develops severe symptoms or cardiac dysrhythmias. Continuous ECG monitoring is
essential to detect prolonged QT interval, which increases the risk of torsades de pointes.
Q5: A postoperative patient on POD #1 has a temperature of 100.6°F, decreased breath sounds at
the lung bases, and refuses to use the incentive spirometer due to incisional pain. Which
complication is most likely developing?
A. Pneumonia
B. Atelectasis
C. Pulmonary embolism
D. Surgical site infection
Correct Answer: D
Rationale: Correct because a low-grade fever (100-101°F) within the first 24-48 hours
postoperatively, combined with decreased breath sounds and the patient's refusal to perform deep
breathing exercises, is the classic presentation of atelectasis caused by collapsed alveoli from
shallow breathing, anesthesia effects, and inadequate lung expansion. Atelectasis is the most
common cause of postoperative fever in the immediate postoperative period and is preventable
with incentive spirometry, early ambulation, cough and deep breathing exercises, and adequate
pain control. The priority nursing interventions include optimizing pain management to facilitate
deep breathing, encouraging incentive spirometry (10-15 breaths per hour while awake), and
mobilizing the patient to prevent progression to pneumonia.
Q6: A patient with heart failure and cirrhosis has a serum sodium of 130 mEq/L. The patient is
alert, oriented, and reports mild headache. Which nursing intervention is most appropriate?
A. Administer 3% hypertonic saline immediately
B. Implement fluid restriction and monitor neurological status
C. Encourage oral fluid intake to correct the dilutional state
D. Initiate seizure precautions and prepare for rapid correction
Correct Answer: A
Rationale: Correct because this patient has mild hyponatremia (sodium 130 mEq/L) with
neurological symptoms in the context of hypervolemic states (heart failure and cirrhosis),
making fluid restriction the most appropriate initial intervention to reduce total body water and
gradually increase serum sodium concentration. The nurse must monitor neurological status
closely for progression to severe symptoms including confusion, seizures, or coma, which would
