Purdue Global Medical Surg Midterm 2026

Question 1

Purdue Global Medical Surg Midterm 2026. An elderly client who is in good health is being assessed by a nurse. What should the nurse understand about expected age-related changes in hepatic function in this client?

• A) The liver’s ability to metabolize medications decreases with age.
• B) The liver’s capacity to produce digestive enzymes increases with age.
• C) The liver’s ability to store and release glucose remains constant in old age.
• D) The liver’s production of clotting factors becomes more efficient with age.

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Question 2

A nurse is assessing a new middle-aged woman in the presurgical unit. The patient shares that she is currently taking oral contraceptives. What should the nurse include in the post-operative plan of care based on this information?

• A) Encouraging early ambulation to prevent blood clots
• B) Administering additional doses of oral contraceptives
• C) Monitoring for signs of pregnancy
• D) Recommending the discontinuation of oral contraceptives

Question 54

A client’s family asks the nurse why their loved one cannot return directly to their hospital room after surgery but must go to the PACU first. What is the nurse’s best response?

• A) “The PACU is where your loved one will be prepared for discharge once they wake up.”
• B) “PACU is a standard protocol to monitor clients after surgery for dietary complications.”
• C) “The operating room team needs time to clean and prepare the patient’s room.”
• D) “The PACU allows us to monitor and stabilize your loved one after surgery and ensure their safety.”

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Question 55

A nurse is caring for a client who has returned to the unit after having a permanent pacemaker implanted. What should the nurse monitor for as a potential complication following this procedure?

• A) Increased blood pressure
• B) Bradycardia and heart block
• C) Increased oxygen saturation
• D) Shortness of breath, hematoma, decreased pulse/bp, hiccoughs

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Question 57

A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus bradycardia with 6 to 8 premature ventricular contractions (PVCs) per minute. The pattern that the nurse recognizes as the most characteristic of PVCs is?

• A) An irregular rhythm.
• B) An inverted T wave.
• C) A wide, distorted QRS complex. Purdue Global Medical Surg Midterm 2026
• D) An increasingly long P-R interval.

Question 58

During the admission assessment of several clients, the nurse is prioritizing cancer screening. Among the following clients, who is most likely to face the highest immediate risk of oral cancer?

• A) A 30-year-old male who is a social drinker.
• B) A 60-year-old female who has a long history of tobacco use.
• C) A 45-year-old male with a family history of cancer.
• D) A 25-year-old female who recently quit smoking.

Question 62

A client with a known history of heart disease is being assessed by a nurse for decreased cardiac output. Which assessment finding would indicate a decreased cardiac output in this client? Purdue Global Medical Surg Midterm 2026

• A) Increased blood pressure
• B) A heart rate of 75
• C) Strong, palpable peripheral pulses
• D) Decreased level of consciousness and low pulse

Question 63

During the care of a preoperative client, the nurse has given the client a preoperative IV benzodiazepine. The client is now requesting to void. What action should the nurse take?

• A) Assist the client to the bathroom
• B) Offer the client a bedpan or urinal
• C) Wait until the client gets to the operating room and is catharized
• D) Have the client walk to the bathroom alone

Question 64

The patient with chronic stable angina asks the nurse why his chest pain often occurs with or right after activity. The nurse’s best response is?

• A) “The amount of oxygen being delivered to your heart with activity is not meeting the demand”
• B) “Let’s talk with the doctor about getting supplemental oxygen for you to use at home.”
• C) “Have you been taking your diltiazem?”
• D) “You should not be exerting yourself!”

Question 65

A client has been admitted to the PACU following surgery. The nurse is concerned about the possibility of hypovolemic shock based on what assessment findings?

• A) Elevated blood pressure and increased heart rate.
• B) Rapid, shallow breathing and low body temperature.
• C) Decreased blood pressure and weak, rapid pulse.
• D) Confusion and restlessness. Purdue Global Medical Surg Midterm 2026

Question 66

A nurse is creating an education plan for a client with venous insufficiency. What measure should the nurse include in the plan?

• A) Wear TED stockings properly during the day and off at night
• B) Limit activity whenever possible
• C) Sleep with legs in a dependent position
• D) Avoid the use of TED stockings

Question 67

A new nurse is performing an abdominal assessment on a patient. The experienced nurse emphasizes the importance of following the correct sequence to avoid altering bowel sounds and patient comfort. Which sequence should the nurse follow to ensure accurate assessment findings?

• A) Inspection, palpation, auscultation, percussion
• B) Palpation, inspection, auscultation
• C) Auscultation, inspection, palpation
• D) Inspection, auscultation, palpation

Question 69

A client with cholelithiasis is scheduled for a laparoscopic cholecystectomy. Why is a laparoscopic cholecystectomy preferred by surgeons over an open procedure?

• A) A laparoscopic cholecystectomy poses fewer surgical risks than an open procedure
• B) A laparoscopic cholecystectomy can be performed in a clinic setting where an open procedure requires an operating room
• C) A laparoscopic cholecystectomy allows for removal of the entire gallbladder
• D) A laparoscopic cholecystectomy can be performed under conscious sedation

Question 70

A nurse is caring for a client with Raynaud’s phenomenon, a condition characterized by discolorations in the extremities during times of stress and cold weather. What is the most appropriate nursing problem this client?

• A) Impaired Physical Mobility
• B) Ineffective Peripheral Tissue Perfusion
• C) Risk for Imbalanced Nutrition: Less Than Body Requirements
• D) Risk for Injury

Question 71

An occupational health nurse is providing education at an event, and an office worker asks about the risk for developing varicose veins. What is the nurse’s best advice to help prevent varicose veins in this population?

• A) Elevate the legs whenever possible during the workday.
• B) Avoid standing or sitting for prolonged periods without movement.
• C) Wear high-heeled shoes to improve blood flow in the legs.
• D) Apply heat to the legs to relax the blood vessels.

Question 72

A client is 2 hours postoperative with a foley catheter in place. The last hourly urine output recorded for this client was 10 mL. The tubing of the Foley is confirmed to be patent. What should the nurse do?

• A) Irrigate the Foley with 30 mL of normal saline
• B) Notify the physician, chart the findings, and continue to monitor the hourly urine output closely
• C) Decrease the IV fluid rate and massage the client’s abdomen
• D) Have the client sit in a high-Fowler’s position.

Question 74

A client is scheduled for an extended surgery and may require a blood transfusion during the procedure. What is the nursing action that is essential to ensure the client’s safety?

• A) Ensure the client is fasting for several hours before surgery.
• B) Double-check the client’s allergy history and administer a standard preoperative dose of antihistamines.
• C) Verify the client’s blood type and confirm the availability of compatible blood products.
• D) Administer prophylactic antibiotics to prevent potential postoperative infections.

Question 75

The nurse is caring for a 65-year-old male patient on telemetry. The nurse notes the following rhythm on the telemetry monitor and knows the rhythm is ventricular tachycardia. What is the first thing the nurse should do? Medical Surg Midterm 2026.

• A) Obtain an ECG
• B) Call the patient’s provider
• C) Assess the patient’s pulse and prepare for cardioversion
• D) Assess the patient’s level of consciousness

Question 76

The nurse is educating a group of senior citizens regarding modifiable risk factors for coronary artery disease. The nurse knows there is a need for further education when one participant answers the following?

• A) hypertension and smoking
• B) diabetes mellitus and age
• C) inactivity and high sodium diet
• D) age and gender

Question 77

A nurse is teaching a CPR class to a community group, and a participant asks about the difference between cardioversion and defibrillation. What is the nurse’s best response?

• A) “Cardioversion and defibrillation are the same thing, just different names for it.”
• B) “The difference between the two is the timing of the electrical current.”
• C) “Cardioversion is a more aggressive procedure than defibrillation and is used in critical cases.”
• D) “The only difference is the type of electrical shock used, but the purpose is the same.”

Question 78

A nurse is explaining to a client’s family why a B-type natriuretic peptide (BNP) sample was drawn from the client. What possible diagnosis might an elevated BNP level indicate, as discussed by the nurse?

• A) Hyperthyroidism
• B) Acute kidney injury
• C) Heart failure
• D) Pneumonia

Question 79

A primary health care provider prescribes 1 unit of packed red blood cells to infuse over 4 hours for a client with anemia. The unit of blood contains 250 mL. The drop factor is 10 drops (gtt)/1 mL. The nurse prepares to set the flow rate at how many drops per minute? Fill in the blank. Record your answer to the nearest whole number. Do not add labels or abbreviations to the answer.

• Answer: 10

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Question 80

A client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent nausea during labor. The medication is available in 2 mg/ml. How many mL should the nurse administer? Record your answer to the nearest whole number. Do not add labels or abbreviations to the answer.

• Answer: 2

Question 86

The physician orders 3000 ml of Normal Saline to run for 24 hours. Drip factor is 10 gtt/ml. What is the drop rate for this infusion? Round to the nearest tenth. Medical Surg Midterm 2026.

• A) 21 gtt/min
• B) 23 gtt/min
• C) 25 gtt/min
• D) 30 gtt/min

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Question 87

What volume is required for an injection if 500mg are ordered and stock ampules contain 250mg/ml?

• A) 0.2 mL
• B) 1 mL
• C) 2 mL
• D) 2.2 mL

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Question 88

The patient has an infusion of 25,000 units of heparin in 500 mL D5W infusing at 32 mL/hr. The physician leaves an order to adjust the IV flow rate to deliver 1400 units of heparin/hour. How should the flow rate of the current infusion be adjusted?

• A) Increase to 35 mL/hr
• B) Decrease to 28 mL/hr
• C) Increase to 34 mL/hr
• D) Decrease to 26 mL/hr

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Question 89

Calculate the infusion rate to administer 50 mg of an antibiotic in 100 mL of NS. To infuse over 20 minutes. The tubing has a drop factor of 20 gtt/mL

• A) 32 gtt/min
• B) 33 gtt/min
• C) 50 gtt/min
• D) 100 gtt/min

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Question 90

Your client is to receive 600 mL of 0.9% NS in four hours. At what rate will the nurse set the IV pump?

• A) 100 mL/hr
• B) 125 mL/hr
• C) 150 mL/hr
• D) 175 mL/hr

Question 93

An adult client with a history of dyspepsia has been diagnosed with chronic gastritis. The nurse’s health education should include which guidelines? Select all that apply.

• A) Avoid drinking alcohol
• B) Adopt a low-residue diet
• C) Avoid non-steroidal anti-inflammatory medications
• D) Take calcium as prescribed
• E) Prepare for the possibility for surgery
• F) Take iron as prescribed

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Question 94

The nurse is providing care for an adult client who has sought care for the treatment of obesity. When performing an assessment of this client, the nurse should address what potential contributing factors? Select all that apply.

• A) Activity level Purdue Global Medical Surg Midterm 2026
• B) Genitourinary issues
• C) Family history and genetics
• D) Endocrine factors
• E) Microbiota
• F) Coping strategies

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Question 95

What are the nurse’s priority actions in the PACU? (Select 2).

• A) Monitor Blood pressure
• B) Monitor Vital Signs – ABC’s
• C) Assess pain and administer ordered analgesics
• D) Give an aspirin
• E) Assess surgical sites
• F) Encourage ambulation now

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Question 96

Based on the information above, Which interventions should the nurse implement first, after obtaining vital signs, ABC’s? (Select 2)

• A) administer antiemetic
• B) Urine output – bladder scan
• C) ABC’s/ VS
• D) Incisions/assess for bleeding/hematoma
• E) skin integrity

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Question 97

Which problem is the priority concern at this time? (Select 1)

• A) Post operative nausea
• B) Hypotension with possible internal bleeding
• C) Room temperature
• D) Diaphoresis

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Question 98

Which nursing actions are appropriate? (Select all that apply)

• A) Encourage PO fluids
• B) Let the patient rest and do not go back in the room for at least an hour
• C) Administer IVF as ordred
• D) Monitor VS and report changes ASAP
• E) Prepare for possible blood transfusion Medical Surg Midterm 2026.

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Question 99

Which action should the nurse take first? (Select one)

• A) Assist in changing out of the patient gown
• B) Discontinue IV Site
• C) Assess the patient’s readiness for discharge
• D) Go over discharge instructions