RN Adult Medical-Surgical Nursing 12th Edition
(2027/2028) – Complete 150 Verified Q&A with
Answers & Rationales for Exam Prep
Q1
A patient with chronic heart failure has an ejection fraction (EF) of 35%. Which statement
best explains this finding?
A. The heart pumps normally and EF is within normal range
B. The heart pumps less blood than normal, indicating systolic dysfunction
C. EF measures the heart rate, not cardiac function
D. EF above 30% indicates diastolic dysfunction
Answer: ✅ B
Rationale: Normal EF is 50–70%. EF of 35% indicates systolic dysfunction and reduced
cardiac output.
Q2
A patient with type 2 diabetes mellitus reports dizziness and sweating. Which is the priority
nursing action?
A. Administer insulin
B. Check blood glucose immediately
C. Encourage exercise
D. Provide high-fiber diet
,Answer: ✅ B
Rationale: Hypoglycemia is a medical emergency. Blood glucose must be checked
immediately to guide treatment.
Q3
Which lab value indicates renal impairment in an older adult?
A. Serum creatinine 0.8 mg/dL
B. Blood urea nitrogen (BUN) 45 mg/dL
C. Sodium 138 mEq/L
D. Potassium 4.2 mEq/L
Answer: ✅ B
Rationale: BUN normally ranges from 7–20 mg/dL. Elevated BUN with normal creatinine
can indicate pre-renal or early renal impairment.
Q4
A patient with COPD uses accessory muscles to breathe. What does this indicate?
A. Mild respiratory distress
B. Severe hypoxemia
C. Ineffective breathing pattern
D. Normal compensation
Answer: ✅ C
Rationale: Use of accessory muscles indicates labored breathing and ineffective
ventilation.
Q5
Which electrolyte imbalance is most likely in a patient taking loop diuretics?
,A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: ✅ B
Rationale: Loop diuretics increase potassium excretion, leading to hypokalemia.
Q6
A post-operative patient develops sudden shortness of breath, chest pain, and tachycardia.
What is the priority nursing action?
A. Encourage deep breathing
B. Administer analgesics
C. Notify provider immediately; suspect pulmonary embolism
D. Apply sequential compression devices
Answer: ✅ C
Rationale: Sudden dyspnea, chest pain, and tachycardia post-op may indicate PE, a life-
threatening emergency.
Q7
Which intervention helps prevent pressure ulcers in an immobile patient?
A. Keep patient in one position to maintain stability
B. Reposition patient every 2 hours
C. Use a donut-shaped pillow under the sacrum
D. Apply lotion every 12 hours
Answer: ✅ B
Rationale: Frequent repositioning relieves pressure on bony prominences, preventing skin
breakdown.
, Q8
A patient with cirrhosis has ascites. Which assessment finding is most concerning?
A. Weight gain of 1 lb in 1 week
B. Shifting dullness on percussion
C. Tense abdomen with shortness of breath
D. Mild ankle edema
Answer: ✅ C
Rationale: Tense ascites with respiratory compromise is potentially life-threatening and
requires prompt intervention.
Q9
Which symptom is classic for left-sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary congestion and dyspnea
D. Hepatomegaly
Answer: ✅ C
Rationale: Left-sided HF causes pulmonary symptoms due to fluid backing up into the
lungs.
Q10
A patient is on warfarin therapy. Which lab value is used to monitor therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. PT
(2027/2028) – Complete 150 Verified Q&A with
Answers & Rationales for Exam Prep
Q1
A patient with chronic heart failure has an ejection fraction (EF) of 35%. Which statement
best explains this finding?
A. The heart pumps normally and EF is within normal range
B. The heart pumps less blood than normal, indicating systolic dysfunction
C. EF measures the heart rate, not cardiac function
D. EF above 30% indicates diastolic dysfunction
Answer: ✅ B
Rationale: Normal EF is 50–70%. EF of 35% indicates systolic dysfunction and reduced
cardiac output.
Q2
A patient with type 2 diabetes mellitus reports dizziness and sweating. Which is the priority
nursing action?
A. Administer insulin
B. Check blood glucose immediately
C. Encourage exercise
D. Provide high-fiber diet
,Answer: ✅ B
Rationale: Hypoglycemia is a medical emergency. Blood glucose must be checked
immediately to guide treatment.
Q3
Which lab value indicates renal impairment in an older adult?
A. Serum creatinine 0.8 mg/dL
B. Blood urea nitrogen (BUN) 45 mg/dL
C. Sodium 138 mEq/L
D. Potassium 4.2 mEq/L
Answer: ✅ B
Rationale: BUN normally ranges from 7–20 mg/dL. Elevated BUN with normal creatinine
can indicate pre-renal or early renal impairment.
Q4
A patient with COPD uses accessory muscles to breathe. What does this indicate?
A. Mild respiratory distress
B. Severe hypoxemia
C. Ineffective breathing pattern
D. Normal compensation
Answer: ✅ C
Rationale: Use of accessory muscles indicates labored breathing and ineffective
ventilation.
Q5
Which electrolyte imbalance is most likely in a patient taking loop diuretics?
,A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: ✅ B
Rationale: Loop diuretics increase potassium excretion, leading to hypokalemia.
Q6
A post-operative patient develops sudden shortness of breath, chest pain, and tachycardia.
What is the priority nursing action?
A. Encourage deep breathing
B. Administer analgesics
C. Notify provider immediately; suspect pulmonary embolism
D. Apply sequential compression devices
Answer: ✅ C
Rationale: Sudden dyspnea, chest pain, and tachycardia post-op may indicate PE, a life-
threatening emergency.
Q7
Which intervention helps prevent pressure ulcers in an immobile patient?
A. Keep patient in one position to maintain stability
B. Reposition patient every 2 hours
C. Use a donut-shaped pillow under the sacrum
D. Apply lotion every 12 hours
Answer: ✅ B
Rationale: Frequent repositioning relieves pressure on bony prominences, preventing skin
breakdown.
, Q8
A patient with cirrhosis has ascites. Which assessment finding is most concerning?
A. Weight gain of 1 lb in 1 week
B. Shifting dullness on percussion
C. Tense abdomen with shortness of breath
D. Mild ankle edema
Answer: ✅ C
Rationale: Tense ascites with respiratory compromise is potentially life-threatening and
requires prompt intervention.
Q9
Which symptom is classic for left-sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary congestion and dyspnea
D. Hepatomegaly
Answer: ✅ C
Rationale: Left-sided HF causes pulmonary symptoms due to fluid backing up into the
lungs.
Q10
A patient is on warfarin therapy. Which lab value is used to monitor therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. PT
