Medical-Surgical Nursing Final Exam
Course Introduction
Medical-Surgical Nursing is a comprehensive course that focuses on the care of adult patients with a variety of acute and chronic health conditions commonly encountered in medical and surgical settings. The course emphasizes the nursing process, critical thinking, and clinical decision-making skills necessary for effective patient assessment, planning, intervention, and evaluation. Students will learn about pathophysiology, pharmacology, diagnostic procedures, nursing interventions, and multidisciplinary collaboration in the management of common medical and surgical disorders. The course also addresses patient safety, health promotion, patient education, and ethical and legal considerations, preparing students to deliver holistic and evidence-based care in diverse healthcare environments.
Recommended Textbook
Calculate with Confidence 7th Edition by Morris
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Chapter 1: Roman Numerals
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Sample Questions
Q1) Perform the indicated operation and record the result in lowercase Roman numerals.
12 ÷ 2 = _____
Answer: vi
Q2) Perform the indicated operation and record the result in lowercase Roman numerals.
10 + 2 = _____
Answer: xii
Q3) Perform the indicated operation and record the result in lowercase Roman numerals.
3 * 10 = _____
Answer: xxx
Q4) Perform the indicated operation and record the result in lowercase Roman numerals.
29 - 1 = _____
Answer: xxviii
Q5) Write the following Arabic number as a lowercase Roman numeral. \(11 ^ { 1 } / _2\) = _____ Answer: xiss
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Chapter 2: Fractions
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Sample Questions
Q1) Change the following improper fraction to a whole or mixed number. 1,500/100 = _____
Answer: 15
Q2) The nurse is instructed to give a client 2/3 of a cup of solution. If 1 cup = 240 milliliters (mL), how many mL should the nurse administer? _____ Answer: 160 mL
Q3) Perform the indicated operation with fractions. Reduce to lowest terms as indicated. 16 5/6 - 14 3/8 = ____ Answer: 2 11/24
Q4) Perform the indicated operation with fractions. Reduce to lowest terms as indicated. 14 - 5/9 = _____ Answer: 13 4/9
Q5) Perform the indicated operation with fractions. Reduce to lowest terms as indicated. 6 5/16 + 5 3/16 = _____ Answer: 11 1/2
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Chapter 3: Decimals
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Sample Questions
Q1) Perform the indicated operation with decimals.
60 ÷ 0.012 = _____
Answer: 5,000
Q2) A client weighed 165.4 pounds (lb) before getting ill. After a lengthy recovery the client weighed 148.6 lb. How much weight did the client lose? _____
Answer: 16.8 lb
Q3) Indicate the largest number in the following set.
0.75, 0.749: _____
Answer: 0.75
Q4) Round off the following decimal to the nearest tenth.
0.52 = _____
Answer: 0.5
Q5) A client is brought into the emergency department with a body temperature of 95.2S1U1P1\(\circ\)S1S1P0F. If the normal body temperature is 98.6S1U1P1\(\circ\)S1S1P0 F, how far below normal was the client's temperature? _____
Answer: 3.4S1U1P1\(\circ\)S1S1P0 F
Q6) Identify the decimal with the largest value in the following set.
0.7, 0.67, 0.86: _____
Answer: 0.86
Page 5
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Chapter 4: Ratio and Proportion
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Sample Questions
Q1) Solve for x. \(1^1 /_ 2\) :2 = x:3
x = _____
Q2) If three tablets (tabs) contain 60 mg, how many tabs would need to be given for 80 mg? ______
Q3) If one glass of milk contains 300 milligrams (mg) of calcium, how many mg of calcium are in \(3 ^ { 1 } / _2\) glasses of milk? ______
Q4) Solve for x in the following.
0.5/0.125 = x/4
x = _____
Q5) Solve for x in the following.
500:3 = 350:x
x = _____
Q6) Solve for x. Round to the nearest tenth.
1:3.6 = x:170
x = _____
Q7) Solve for x.
1/0.05 = x/0.1
x = _____
Q8) Express the following dosage as a ratio. A capsule contains 450 mg of medication; _____
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Chapter 5: Percentages
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Sample Questions
Q1) Change the following percentage to a ratio. 0.4% = _____
Q2) A client who weighed 210 pounds (lb) lost 30 lb. What was the percent of decrease in the client's weight? (State answer to the nearest whole percent.) _____
Q3) Find the following percentage. 16% of 79 = _____
Q4) Change the following percentage to a ratio and its decimal equivalent. 45% = _____; _____
Q5) Change the following percentage to a fraction. Reduce to lowest terms. 37.5% = _____
Q6) Convert 42.5% to decimal form. _____
Q7) Convert 84.75% to decimal form. _____
Q8) A client has received 45% of a 500 mL bag of intravenous (IV) solution. How many mL of IV solution has the client received? _____
Q9) A client has a 2,500 mL bag of irrigation solution hanging. 750 mL of the solution have infused. What percent of the irrigation solution has infused? _____
Q10) Find the following percentage. 8% of 32 = _____
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Chapter 6: Metric System
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Sample Questions
Q1) Directions: Write the equivalent indicated.
54.6 g = _____ kg
Q2) Directions: Write the equivalent indicated.
6,724 g = _______ kg
Q3) Six-tenths of a liter:
A) 0.6 L
B) 6/10 L
C) 0.60 L
D) 0.60 l
Q4) The liter is (Select all that apply.)
A) a unit of volume in the metric system.
B) smaller than a milliliter.
C) equivalent to 1,000 milliliters.
D) abbreviated using a small case l.
E) abbreviated with a capital L.
F) the basic unit for weight.
Q5) Directions: Write the equivalent indicated.
1.57 kg = _____ g
Q6) Directions: Write the equivalent indicated.
8.3 L = _____ mL
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Chapter 7: Apothecary and Household Systems
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Sample Questions
Q1) Directions: Write the equivalent indicated.
30 mL = _____ oz
Q2) Use of the apothecary system has been identified as a source of error in medication administration.
A)True
B)False
Q3) Directions: Write the abbreviation for the term. ounce: _____
Q4) The drop is a standardized unit of measure. A)True B)False
Q5) The household system (Select all that apply.)
A) is more accurate than the metric system.
B) expresses quantities using Arabic numbers and decimals.
C) is primarily used for dosages at home.
D) expresses quantities in fractions and Arabic numbers.
E) is preferred for medication administration.
F) has measures such as tbs and tsp.
Q6) Directions: Express the following value correctly.
2.75 OZ
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Chapter 8: Converting Within and Between Systems
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Sample Questions
Q1) Directions: Write the equivalent indicated. 0.3 mg = _____ g
Q2) A client reports drinking 48 oz of water on a visit to the clinic. How many mL did the client drink? _________ mL
Q3) Directions: Write the equivalent indicated. 4,176 g = _____ kg
Q4) A client had a physical a year ago and weighed 85 kg. The client tells you he lost 11 lb. What is the client's current weight in kg? _______ kg
Q5) Directions: Write the equivalent indicated. 2,575 mL = _______ L
Q6) A client needs to drink \(1^1 / _2\) oz of an elixir per day. How many tsp would this be equivalent to? ________ tsp
Q7) Directions: Write the equivalent indicated. 56 in. = ______ cm
Q8) A client has an order for Maalox 30 mL p.o. at bedtime. How many tsb will the nurse instruct the client to take? _____ tsb
Q9) A client received 5.4 liters of IV fluid during a surgical procedure. How many mL of IV fluid did the client receive? _____ mL
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Chapter 9: Additional Conversions Useful in the Health Care Setting
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Sample Questions
Q1) Directions: Write the equivalent indicated.
1 cm = _____ mm
Q2) Directions: Convert the following weight as indicated. Round weight to the nearest tenth.
14 lb, 4 oz = _____ kg
Q3) Directions: Convert the following temperature as indicated.
39° C = _____° F
Q4) Directions: Convert the following weight as indicated. Round weight to the nearest tenth.
41 lb, 2 oz = _____ kg
Q5) Directions: Convert the following weight as indicated. Round weight to the nearest tenth.
20.8 kg = _____ lb
Q6) Directions: Convert as indicated. 34 mm = _____ cm
Q7) Directions: Convert the following weight as indicated. Round weight to the nearest tenth. \(39^3 / _4\) lb = _____ kg
12.8° C = _____° F Page 11
Q8) Directions: Convert the following temperature as indicated.
Q9) A wound measures 4.2 cm in length. How many mm is this? _____ mm
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Page 12
Chapter 10: Medication Administration
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Sample Questions
Q1) Directions: Complete the following sentence with the correct word or number. Administration of medications within 30 minutes of the scheduled time is referred to as the _____________.
Q2) The "six rights" of medication administration are
A) medication, dosage, route, time, client, documentation.
B) medication, solution, doctor, shift, time, documentation.
C) medication, order, signature, time, route, documentation.
D) medication, client, signature, time, hospital, documentation
Q3) After administering a medication, the nurse should
A) pour the medications for the next administration time.
B) document medication given prior to administering.
C) order the next dosage needed from the pharmacy.
D) document the time of administration.
Q4) A dropper is safe to use when administering medications when it is used for the specific medication it is calibrated to.
A)True
B)False
Q5) A nurse who administers a medication that is unsafe is liable for the error.
A)True
B)False
Page 13
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Chapter 11: Understanding and Interpreting Medication
Orders
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Sample Questions
Q1) Directions: Correct the following medication order using the ISMP list of Error-Prone Abbreviations, Symbols, and Dose Designations. Doxycycline 100 mg po bid pc
Q2) Directions: Give the abbreviation for the following. Every hour: _____
Q3) Complete the following sentence with the correct word or number. A medication order is written without a frequency. The nurse should
Q4) Directions: Correct the following medication order using the ISMP list of Error-Prone Abbreviations, Symbols, and Dose Designations. Heparin 5,000 units subcut daily
Q5) Trailing zeros are necessary to avoid misinterpretation of a value. A)True B)False
Q6) Directions: Give the abbreviation for the following. Immediately: _____
Q7) Directions: For the following medication order indicate what component of the order is missing.
Solu-Medrol 50 mg.
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Chapter 12: Medication Administration Records and Medication
Distribution
Systems
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Sample Questions
Q1) By what route will the heparin be administered? _______________
Q2) A client refuses a p.o. medication and provides the nurse with a reason for refusing the medication. What should the nurse's action be?
A) Inform the client they cannot refuse a medication.
B) Report it to the nurse manager.
C) Administer the medication by an injectable route.
D) Document the refusal and inform the prescriber.
Q3) A client has a gastrostomy tube (GT) in place. The health care provider ordered the medication p.o. What action would be appropriate for the nurse to take?
A) Dilute the p.o. medication with water and administer by GT.
B) Administer the medication p.o. as ordered.
C) Clarify the order with the health care provider who wrote the order.
D) Clarify the order with the charge nurse.
Q4) What are the client's medication allergies? ______________
Q5) K-Dur 10 mEq is ordered. What does mEq mean? _______________
Q6) How many hours are between the scheduled times for K-Dur? _______________
Page 15
Q7) The prescriber orders a medication q8h. The nurse enters the following times on the medication administration record (MAR): 12 AM-6 AM-12 PM-6 PM. What error has occurred?
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Chapter 13: Reading Medication Labels
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Sample Questions
Q1) If a medication label reads "Ambien (zolpidem tartrate) 5 mg tablets, Searle," the medication's generic name is A) Ambien.
B) Searle.
C) zolpidem tartrate.
D) tablets.
Q2) A medication label reads "Calan SR (verapamil hydrochloride) 240 mg sustained release caplets." The form is A) caplets.
B) sustained-release caplets.
C) 240 mg.
D) verapamil hydrochloride.
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16
Chapter 14: Dosage Calculation Using the Ratio and Proportion Method
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Sample Questions
Q1) Directions: Calculate the following dosage using the ratio and proportion method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Amoxil 0.5 g p.o. q6h
Available: Amoxil capsules labeled 250 mg per capsule
Q2) Directions: Calculate the following dosage using the ratio and proportion method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Raloxifene HCl 60 mg p.o.b.i.d.
Available: Raloxifene HCl tablets labeled 60 mg per tablet
Q3) Directions: Calculate the following dosage using the ratio and proportion method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Thorazine 25 mg p.o. t.i.d.
Available: Thorazine syrup labeled 10 mg per 5 mL
Q4) Directions: Calculate the following dosage using the ratio and proportion method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Zofran 7 mg p.o.b.i.d.
Available: Zofran oral solution labeled 4 mg per 5 Ml
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Page 17
Chapter 15: Dosage Calculation Using the Formula Method
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Sample Questions
Q1) Directions: Calculate the following dosage using the formula method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Raloxifene HCl 60 mg p.o.b.i.d.
Available: Raloxifene HCl tablets labeled 60 mg per tablet
Q2) Directions: Calculate the following dosage using the formula method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Compazine 8 mg p.o. stat
Available: Compazine syrup labeled 5 mg per 5 mL
Q3) Directions: Calculate the following dosage using the formula method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Zofran 7 mg p.o.b.i.d.
Available: Zofran oral solution labeled 4 mg per 5 mL
Q4) Directions: Calculate the following dosage using the formula method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Thorazine 25 mg p.o. t.i.d.
Available: Thorazine syrup labeled 10 mg per 5 mL
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Chapter 16: Dosage Calculation Using the Dimensional Analysis Method
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Sample Questions
Q1) Directions: Calculate the following dosage using the dimensional analysis method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Thorazine 25 mg p.o. t.i.d.
Available: Thorazine syrup labeled 10 mg per 5 mL
Q2) Directions: Calculate the following dosage using the dimensional analysis method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Amoxil 0.5 g p.o. q6h
Available: Amoxil capsules labeled 250 mg per capsule
Q3) Directions: Calculate the following dosage using the dimensional analysis method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Zofran 7 mg p.o.b.i.d.
Available: Zofran oral solution labeled 4 mg per 5 mL
Q4) Directions: Calculate the following dosage using the dimensional analysis method. Round mL answers to the nearest tenth unless otherwise indicated.
Order: Raloxifene HCl 60 mg p.o.b.i.d.
Available: Raloxifene HCl tablets labeled 60 mg per tablet
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Chapter 17: Oral Medications
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Sample Questions
Q1) Directions: Complete with the correct word(s) or number. The most common form of oral medication is the __________.
Q2) Directions: Complete with the correct word(s) or number.
Sublingual tablets must never be _______________ but placed _______________ the tongue.
Q3) Directions: Complete with the correct word(s) or number. The solid form of medication that contains granules that delays the release of the medication is referred to as a _______________.
Q4) Directions: Complete with the correct word(s) or number. The nurse should question and check any calculation that indicates you should administer more than ________ tablets or capsules to achieve a single dose.
Q5) Directions: Complete with the correct word(s) or number. Enteric-coated tablets and time-release tablets should never be _______________.
Q6) Directions: Complete with the correct word(s) or number. An elongated tablet for easy swallowing is referred to as a _______________.
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Chapter 18: Parenteral Medications
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Sample Questions
Q1) Directions: Complete the following statements with the correct word(s) or number(s). The term used for injectable medications is _______________.
Q2) Directions: Complete the following statements with the correct word(s) or number(s).
If a nurse calculates a dosage of 3.39 mL of medication, which size syringe should the nurse select? _____ What would be the nearest measurable dose on the syringe?
Q3) Directions: Complete the following statements with the correct word(s) or number(s).
The route that is used for diagnostic purposes is called _______________.
Q4) Directions: Complete the following statements with the correct word(s) or number(s).
The calibrations on a syringe that indicate the capacity can be found on the _______________.
Q5) A 3-mL syringe is calibrated in which of the following increments?
A) 0.01 mL
B) 0.1 mL
C) 0.2 mL
D) 1 mL
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Chapter 19: Reconstitution of Solutions
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Sample Questions
Q1) Directions: Prepare the following strength solutions. Describe your calculations. 1/4 strength Ensure 8 oz p.o. q4h for 24 hours
Q2) Directions: Prepare the following strength solutions. Describe your calculations. Prepare irrigant 250 mL 1/2 strength solution: ______________________________
Q3) Directions: Prepare the following strength solutions. Describe your calculations. 800 mL of 3/4 strength Sustacal via gastrostomy over 6 hours
Q4) Directions: Indicate how you would prepare each of the following using full-strength hydrogen peroxide (solute) and normal saline (solvent).
0.24 L of 1/3 strength for wound care
Q5) Directions: Indicate how you would prepare each of the following using full-strength hydrogen peroxide (solute) and normal saline (solvent).
300 mL of 3/4 strength for skeletal pin care
Q6) Directions: Indicate how you would prepare each of the following using full-strength hydrogen peroxide (solute) and normal saline (solvent).
8 oz of 1/2 strength for wound care
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Chapter 20: Insulin
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Sample Questions
Q1) What is the difference between the calibration of units on the 1-mL insulin syringe and on the Lo-Dose syringe? ______________________________
Q2) U-100 on the label of an insulin vial me ______________________________.
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Chapter 21: Intravenous Solutions and Equipment
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Sample Questions
Q1) 500 mL \(^1 /_ 2\) NS sodium chloride (NaCl): _____
Q2) The IV line that can be used to administer medications and solutions and can be connected to a port on the main infusion is called _______________.
Q3) _______________ devices allow a client to self-administer pain medication.
Q4) An IV pump is an example of an ___________ infusion device.
Q5) In IV fluid abbreviations, D5NS identifies what IV fluid? _______________
Q6) Directions: Interpret the following IV orders.
1,000 mL (1 L) of L/R q8h
Q7) 250 mL D5NS _______ g dextrose ________ g NaCl
Q8) 0.5 L D \(5^1 / _4\) NS ________ g dextrose ________ g NaCl
Q9) The name for the main infusion administration set is _______________.
Q10) Directions: Interpret the following IV orders.
1,000 mL (1 L) D5W to infuse at a rate of 100 mL per hour
Q11) 5 L D10W dextrose: _______________
Q12) List the components and percentage strengths of the following IV solutions.
a. D5
\(^1 / _4\) S
b. D5NS 10 mEq KCl
c. D5RL Page 24
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Chapter 22: Intravenous Calculations
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Sample Questions
Q1) Directions: Determine the flow rate for the following IV being administered by infusion pump.
Ampicillin 1.5 g in 100 mL 0.9% NS over 45 min: _____
Q2) 100 units of regular Humulin insulin in 250 mL 0.9% NS were to infuse at 4 mL/hr. How many units per hour will be delivered? _____
Q3) 250 mL were to infuse in 8 hr at 31 microgtt/min. The drop factor is 60 gtt/mL. After 4 hr, you notice that 100 mL have infused.
a. Recalculated rate: _____
b. Percentage of change: _____
c. Course of action: _____
Q4) Order: Regular Humulin Insulin 8 units/hr IV
Available: 50 units of insulin in 150 mL 0.9% NS
What rate in mL/hr will infuse 8 units/hr? _____
Q5) Order: regular Humulin insulin 10 units/hr IV
Available: 40 units of insulin in 100 mL 0.9% NS
What rate in mL/hr will infuse 10 units/hr? _____
Q6) Total parenteral nutrition (TPN) solution of 1,000 mL at 30 mL/hr
Determine the infusion time: _____
Q7) The type of administration set that delivers the smallest drops is called _______________.
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Chapter 23: Heparin Calculations
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Sample Questions
Q1) Which solution of heparin is more concentrated: 1,000 units per mL or 10,000 units per mL? _____
Q2) Order: Infuse heparin at 2,000 units/hr IV from a solution containing 20,000 units of heparin in 500 mL D5W. How many milliliters will infuse per hour? _____ mL
Q3) Order: 25,000 units heparin IV in 250 mL 0.9% NS to infuse at 20 units/kg/hr. The client weighs 165 lb.
a. Weight in kilograms: _____
b. How many units will the client receive per hour? _____
Q4) A client weighs 81 kg. Determine the bolus dose of heparin, the initial infusion rate, and then adjust the hourly infusion rate up or down on the basis of the APTT results. APTT is reported as 43. The IV pump is calibrated in tenths of a milliliter.
Q5) A client weighs 158.4 lb. Determine the bolus dose of heparin, the initial infusion rate, and then adjust the hourly infusion rate based on the APTT results. APTT is reported as 88. The IV pump is calibrated to deliver in tenths of an mL/hr.
Q6) Order: 10,000 units of heparin in 500 mL 0.9% NS to infuse at 120 mL/hr units/hr = _____
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Page 27
Chapter 24: Critical Care Calculations
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Sample Questions
Q1) A client is receiving procainamide 1 g in 500 mL D5W at 120 mL/hr.
a. mg/hr: _____
b. mg/min: _____
Q2) Esmolol is ordered for a client. The solution available is 2.5 g in 250 mL D5W. The order is to infuse 32 mL/hr.
a. mg/hr: _____
b. mg/min: _____
Q3) A client is receiving dopamine 800 mg in 500 mL D5W infusing at a rate of 30 mL/hr.
a. mg/hr: _____
b. mcg/min: _____
Q4) Order: Dobutamine 2.5 mcg/kg/min for a client who weighs 193 lb
Available: Dobutamine 250 mg in 250 mL D5W
a. What is the client's weight in kilograms? _____ (to the nearest tenth)
b. Calculate the rate in mL/hr required to infuse 2 mcg/kg/min: _____
Q5) Lidocaine to infuse at 3 mg/min. The solution available is 2 g of lidocaine in 500 mL D5W. Determine the IV flow rate. ____
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28
Chapter 25: Pediatric and Adult Dosage Calculation Based on Weight
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Sample Questions
Q1) Directions: Using the West nomogram or formula when indicated, calculate the following dosages. Express answer to the nearest tenth. The recommended dosage of Paraplatin for ovarian cancer is 360 mg/m<sup>2</sup>. The client's BSA is 1.67 m<sup>2</sup>. What dosage should the client receive? _____
Q2) Child weighing 24 kg
a. Daily fluid maintenance _____________________ mL/day
b. IV rate __________________ mL/hr
Q3) 170 cm and 50 kg: _____ m<sup>2</sup>
Q4) Child weighing 77 lb
Convert weight
Equivalent 2.2 lb= 1 kg
77 lb ÷ 2.2 = 35 kg
Q5) An adolescent who measures 157.5 cm and weighs 59.1 kg: _____ m<sup>2</sup>
Q6) 32 inches and 25 lb: _____ m<sup>2</sup>
Q7) A child who measures 26 inches and weighs 36 lb: _____ m<sup>2</sup>
Q8) Order: Epinephrine 0.25 mg IV stat
Available: Epinephrine 0.1 mg/mL
How many milliliters will you prepare to administer? _____ mL
Q9) 22 inches and 10 lb: _____ m<sup>2</sup> Page 29
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Page 30