RN Medical–Surgical Comprehensive Practice Exam
RN Medical–Surgical Comprehensive Practice
Exam | Adult Health Nursing – Actual Exam with
Detailed Rationales For Grade A+
1. A client with heart failure reports weight gain of 2 kg in 2 days. What is the
priority action?
A. Document the finding
B. Restrict fluids
C. Notify the provider
D. Encourage ambulation
Answer: C
Rationale: Rapid weight gain indicates fluid retention and worsening heart failure.
2. A client with COPD should receive oxygen at which flow rate?
A. 1–2 L/min
B. 6 L/min
C. 10 L/min
D. 15 L/min
Answer: A
Rationale: Low-flow oxygen prevents suppression of hypoxic drive.
3. Which lab confirms myocardial infarction?
A. BNP
B. Troponin
C. CK
D. Myoglobin
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, RN Medical–Surgical Comprehensive Practice Exam
Answer: B
Rationale: Troponin is the most specific marker for myocardial injury.
4. A client with DKA will have which finding?
A. Low glucose
B. Metabolic alkalosis
C. Kussmaul respirations
D. Bradycardia
Answer: C
Rationale: Deep, rapid respirations compensate for metabolic acidosis.
5. Which symptom indicates hypocalcemia?
A. Constipation
B. Positive Trousseau sign
C. Lethargy
D. Decreased reflexes
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability.
6. A client with stroke symptoms should first receive:
A. Aspirin
B. CT scan
C. MRI
D. Heparin
Answer: B
Rationale: CT rules out hemorrhage before thrombolytics.
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, RN Medical–Surgical Comprehensive Practice Exam
7. Which indicates left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Crackles
D. JVD
Answer: C
Rationale: Pulmonary congestion occurs in left HF.
8. A potassium of 6.5 requires monitoring for:
A. Seizures
B. Arrhythmias
C. Bleeding
D. Hypotension
Answer: B
Rationale: Hyperkalemia causes life-threatening cardiac dysrhythmias.
9. A client on warfarin has INR 5.8. Priority?
A. Hold dose
B. Vitamin K
C. Heparin
D. Increase dose
Answer: B
Rationale: High INR increases bleeding risk.
10. Sudden dyspnea in DVT patient suggests:
A. Asthma
B. MI
3|Page
RN Medical–Surgical Comprehensive Practice
Exam | Adult Health Nursing – Actual Exam with
Detailed Rationales For Grade A+
1. A client with heart failure reports weight gain of 2 kg in 2 days. What is the
priority action?
A. Document the finding
B. Restrict fluids
C. Notify the provider
D. Encourage ambulation
Answer: C
Rationale: Rapid weight gain indicates fluid retention and worsening heart failure.
2. A client with COPD should receive oxygen at which flow rate?
A. 1–2 L/min
B. 6 L/min
C. 10 L/min
D. 15 L/min
Answer: A
Rationale: Low-flow oxygen prevents suppression of hypoxic drive.
3. Which lab confirms myocardial infarction?
A. BNP
B. Troponin
C. CK
D. Myoglobin
1|Page
, RN Medical–Surgical Comprehensive Practice Exam
Answer: B
Rationale: Troponin is the most specific marker for myocardial injury.
4. A client with DKA will have which finding?
A. Low glucose
B. Metabolic alkalosis
C. Kussmaul respirations
D. Bradycardia
Answer: C
Rationale: Deep, rapid respirations compensate for metabolic acidosis.
5. Which symptom indicates hypocalcemia?
A. Constipation
B. Positive Trousseau sign
C. Lethargy
D. Decreased reflexes
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability.
6. A client with stroke symptoms should first receive:
A. Aspirin
B. CT scan
C. MRI
D. Heparin
Answer: B
Rationale: CT rules out hemorrhage before thrombolytics.
2|Page
, RN Medical–Surgical Comprehensive Practice Exam
7. Which indicates left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Crackles
D. JVD
Answer: C
Rationale: Pulmonary congestion occurs in left HF.
8. A potassium of 6.5 requires monitoring for:
A. Seizures
B. Arrhythmias
C. Bleeding
D. Hypotension
Answer: B
Rationale: Hyperkalemia causes life-threatening cardiac dysrhythmias.
9. A client on warfarin has INR 5.8. Priority?
A. Hold dose
B. Vitamin K
C. Heparin
D. Increase dose
Answer: B
Rationale: High INR increases bleeding risk.
10. Sudden dyspnea in DVT patient suggests:
A. Asthma
B. MI
3|Page
