Medical-Surgical Nursing Exam 2026practice set with answers and
rationales
1.
A patient with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss, increasing risk of
hypokalemia and dysrhythmias.
2.
Which sign is most indicative of hypoxia?
A. Bradycardia
B. Restlessness
C. Hypertension
D. Hypothermia
Answer: B. Restlessness
Rationale: Early hypoxia causes CNS irritability leading to restlessness and anxiety.
3.
A postoperative patient suddenly develops chest pain and dyspnea. The nurse suspects:
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Pneumothorax
Answer: C. Pulmonary embolism
,Rationale: Sudden chest pain, dyspnea, and tachycardia are classic signs of PE.
4.
Which intervention is priority for a patient experiencing active seizure?
A. Restrain the patient
B. Insert oral airway
C. Protect airway and prevent injury
D. Give oral anticonvulsants
Answer: C. Protect airway and prevent injury
Rationale: Safety and airway protection are the first priorities during seizures.
5.
Which electrolyte imbalance is most associated with tetany?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B. Hypocalcemia
Rationale: Low calcium increases neuromuscular excitability causing tetany.
6.
A patient with COPD should receive oxygen at what level initially?
A. 10 L/min
B. 8 L/min
C. 1–2 L/min
D. 6 L/min
Answer: C. 1–2 L/min
Rationale: COPD patients are oxygen-sensitive; low-flow oxygen prevents CO₂ retention.
7.
Which assessment finding indicates fluid overload?
A. Dry mucous membranes
, B. Sunken eyes
C. Crackles in lungs
D. Decreased blood pressure
Answer: C. Crackles in lungs
Rationale: Fluid overload leads to pulmonary congestion and crackles.
8.
A patient with diabetes shows shakiness and sweating. The nurse should first:
A. Give insulin
B. Check blood glucose
C. Give orange juice
D. Call the physician
Answer: B. Check blood glucose
Rationale: Always confirm hypoglycemia before treatment.
9.
Which condition requires airborne precautions?
A. Influenza
B. Tuberculosis
C. MRSA
D. Hepatitis B
Answer: B. Tuberculosis
Rationale: TB spreads via airborne droplet nuclei.
10.
Normal urine output in adults is:
A. 10 mL/hr
B. 20 mL/hr
C. 30 mL/hr
D. 50 mL/hr
Answer: C. 30 mL/hr
rationales
1.
A patient with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss, increasing risk of
hypokalemia and dysrhythmias.
2.
Which sign is most indicative of hypoxia?
A. Bradycardia
B. Restlessness
C. Hypertension
D. Hypothermia
Answer: B. Restlessness
Rationale: Early hypoxia causes CNS irritability leading to restlessness and anxiety.
3.
A postoperative patient suddenly develops chest pain and dyspnea. The nurse suspects:
A. Atelectasis
B. Pneumonia
C. Pulmonary embolism
D. Pneumothorax
Answer: C. Pulmonary embolism
,Rationale: Sudden chest pain, dyspnea, and tachycardia are classic signs of PE.
4.
Which intervention is priority for a patient experiencing active seizure?
A. Restrain the patient
B. Insert oral airway
C. Protect airway and prevent injury
D. Give oral anticonvulsants
Answer: C. Protect airway and prevent injury
Rationale: Safety and airway protection are the first priorities during seizures.
5.
Which electrolyte imbalance is most associated with tetany?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B. Hypocalcemia
Rationale: Low calcium increases neuromuscular excitability causing tetany.
6.
A patient with COPD should receive oxygen at what level initially?
A. 10 L/min
B. 8 L/min
C. 1–2 L/min
D. 6 L/min
Answer: C. 1–2 L/min
Rationale: COPD patients are oxygen-sensitive; low-flow oxygen prevents CO₂ retention.
7.
Which assessment finding indicates fluid overload?
A. Dry mucous membranes
, B. Sunken eyes
C. Crackles in lungs
D. Decreased blood pressure
Answer: C. Crackles in lungs
Rationale: Fluid overload leads to pulmonary congestion and crackles.
8.
A patient with diabetes shows shakiness and sweating. The nurse should first:
A. Give insulin
B. Check blood glucose
C. Give orange juice
D. Call the physician
Answer: B. Check blood glucose
Rationale: Always confirm hypoglycemia before treatment.
9.
Which condition requires airborne precautions?
A. Influenza
B. Tuberculosis
C. MRSA
D. Hepatitis B
Answer: B. Tuberculosis
Rationale: TB spreads via airborne droplet nuclei.
10.
Normal urine output in adults is:
A. 10 mL/hr
B. 20 mL/hr
C. 30 mL/hr
D. 50 mL/hr
Answer: C. 30 mL/hr
