MED SURG 201 Final
Exam
1. A patient with pneumonia has RR 32/min, O₂ sat 88% on room air, and crackles in
both lower lobes. What is the nurse’s priority?
A. Encourage fluids
B. Obtain sputum culture
C. Apply oxygen
D. Administer ordered azithromycin
Correct Answer: C. Apply oxygen
Hypoxemia is the immediate risk; oxygenation always comes before diagnostics or
medications.
2. A patient with COPD is receiving 2 L/min O₂ via nasal cannula. Which finding
requires immediate action?
A. O₂ sat 91%
B. Pursed-lip breathing
C. Respiratory rate 10/min
D. Barrel-shaped chest
Correct Answer: C. Respiratory rate 10/min
Indicates respiratory depression—dangerous in CO₂ retainers.
,3. The nurse is caring for a patient after a thyroidectomy. Which assessment is the
priority?
A. Nausea
B. Hoarse voice
C. Chvostek’s sign
D. Difficulty breathing
Correct Answer: D. Difficulty breathing
Can indicate laryngeal swelling or airway obstruction—life-threatening.
4. A patient with DKA is receiving IV insulin. Which lab requires immediate
intervention?
A. K⁺ 3.0
B. Glucose 240
C. CO₂ 18
D. Na⁺ 132
Correct Answer: A. K⁺ 3.0
Insulin pushes K⁺ into cells → severe hypokalemia → dysrhythmias.
5. A patient in heart failure has gained 4 lbs in 24 hrs. Which action is best?
A. Restrict potassium
B. Increase IV fluids
C. Give PRN furosemide
D. Give PRN nitroglycerin
Correct Answer: C. Give PRN furosemide
Rapid weight gain = fluid overload.
,6. A patient with cirrhosis has confusion and a hand-flapping tremor. What
medication is expected?
A. Pantoprazole
B. Lactulose
C. Furosemide
D. Ondansetron
Correct Answer: B. Lactulose
Treats hepatic encephalopathy by reducing ammonia.
7. A patient with acute kidney injury shows peaked T-waves. What electrolyte
abnormality is expected?
A. Hypocalcemia
B. Hyperkalemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: B. Hyperkalemia
Peaked T waves = hallmark of high potassium.
8. The nurse suspects a PE. What is the first action?
A. Start IV
B. Apply high-flow O₂
C. Draw D-dimer
D. Prepare for CT angiography
Correct Answer: B. Apply high-flow O₂
Airway and oxygenation are always first.
, 9. A patient with myasthenia gravis is drooling and weak. What does the nurse
suspect?
A. Myasthenic crisis
B. Cholinergic crisis
C. Thyroid storm
D. Adrenal crisis
Correct Answer: A. Myasthenic crisis
Undermedication → respiratory muscle weakness.
10. A patient with Cushing’s has purple striae, bruising, and hyperglycemia. What lab
result is expected?
A. Low cortisol
B. High cortisol
C. Low sodium
D. High potassium
Correct Answer: B. High cortisol
11. A patient is 1 hour postoperative after abdominal surgery. Which finding requires
immediate intervention?
A. RR 10/min
B. Pain 7/10
C. BP 140/90
D. Urine output 40 mL/hr
Correct Answer: A. RR 10/min
Indicates opioid-induced respiratory depression.
Exam
1. A patient with pneumonia has RR 32/min, O₂ sat 88% on room air, and crackles in
both lower lobes. What is the nurse’s priority?
A. Encourage fluids
B. Obtain sputum culture
C. Apply oxygen
D. Administer ordered azithromycin
Correct Answer: C. Apply oxygen
Hypoxemia is the immediate risk; oxygenation always comes before diagnostics or
medications.
2. A patient with COPD is receiving 2 L/min O₂ via nasal cannula. Which finding
requires immediate action?
A. O₂ sat 91%
B. Pursed-lip breathing
C. Respiratory rate 10/min
D. Barrel-shaped chest
Correct Answer: C. Respiratory rate 10/min
Indicates respiratory depression—dangerous in CO₂ retainers.
,3. The nurse is caring for a patient after a thyroidectomy. Which assessment is the
priority?
A. Nausea
B. Hoarse voice
C. Chvostek’s sign
D. Difficulty breathing
Correct Answer: D. Difficulty breathing
Can indicate laryngeal swelling or airway obstruction—life-threatening.
4. A patient with DKA is receiving IV insulin. Which lab requires immediate
intervention?
A. K⁺ 3.0
B. Glucose 240
C. CO₂ 18
D. Na⁺ 132
Correct Answer: A. K⁺ 3.0
Insulin pushes K⁺ into cells → severe hypokalemia → dysrhythmias.
5. A patient in heart failure has gained 4 lbs in 24 hrs. Which action is best?
A. Restrict potassium
B. Increase IV fluids
C. Give PRN furosemide
D. Give PRN nitroglycerin
Correct Answer: C. Give PRN furosemide
Rapid weight gain = fluid overload.
,6. A patient with cirrhosis has confusion and a hand-flapping tremor. What
medication is expected?
A. Pantoprazole
B. Lactulose
C. Furosemide
D. Ondansetron
Correct Answer: B. Lactulose
Treats hepatic encephalopathy by reducing ammonia.
7. A patient with acute kidney injury shows peaked T-waves. What electrolyte
abnormality is expected?
A. Hypocalcemia
B. Hyperkalemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: B. Hyperkalemia
Peaked T waves = hallmark of high potassium.
8. The nurse suspects a PE. What is the first action?
A. Start IV
B. Apply high-flow O₂
C. Draw D-dimer
D. Prepare for CT angiography
Correct Answer: B. Apply high-flow O₂
Airway and oxygenation are always first.
, 9. A patient with myasthenia gravis is drooling and weak. What does the nurse
suspect?
A. Myasthenic crisis
B. Cholinergic crisis
C. Thyroid storm
D. Adrenal crisis
Correct Answer: A. Myasthenic crisis
Undermedication → respiratory muscle weakness.
10. A patient with Cushing’s has purple striae, bruising, and hyperglycemia. What lab
result is expected?
A. Low cortisol
B. High cortisol
C. Low sodium
D. High potassium
Correct Answer: B. High cortisol
11. A patient is 1 hour postoperative after abdominal surgery. Which finding requires
immediate intervention?
A. RR 10/min
B. Pain 7/10
C. BP 140/90
D. Urine output 40 mL/hr
Correct Answer: A. RR 10/min
Indicates opioid-induced respiratory depression.
