JERSEY COLLEGE MED SURG 1 RN FINAL EXAM ACTUAL
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE QUESTIONS AND CORRECT VERIFIED
SOLUTIONS WITH DETAILED RATIONALES (A NEW UPDATED
VERSION 2026 EDITION) |GUARANTEED SUCCESS A+ (BRAND
NEW!) FULL REVISED MED SURG 1 RN FINAL EXAM |JERSEY
COLLEGE
1. A nurse is assessing a client with chronic obstructive pulmonary
disease (COPD). Which finding requires immediate intervention?
A. Pursed-lip breathing
B. Clubbing of the fingers
C. Productive cough with green sputum
D. Sudden onset of pleuritic chest pain and confusion
Correct Answer: D
Rationale: Sudden pleuritic chest pain and confusion suggest a
possible pneumothorax or pulmonary embolism, which are life-
threatening complications in COPD. Pursed-lip breathing and
clubbing are chronic findings; green sputum indicates infection but is
not immediately life-threatening.
2. A client with heart failure has jugular vein distension, crackles in lung
bases, and 3+ pitting edema. Which medication should the nurse
anticipate administering?
A. Metoprolol
B. Furosemide
,Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces preload by
promoting excretion of fluid, directly addressing jugular distension,
crackles, and edema. Metoprolol is a beta-blocker for chronic
management, not acute decompensation.
3. A nurse is caring for a client post-myocardial infarction. Which
laboratory value is most concerning?
A. Troponin I 0.04 ng/mL
B. Troponin I 4.2 ng/mL
Correct Answer: B
Rationale: Normal troponin I is <0.04 ng/mL; a value of 4.2 ng/mL
indicates significant myocardial necrosis. The other values are within
normal limits.
4. A client with diabetes mellitus type 2 is admitted with hyperglycemia.
Which insulin can be administered intravenously?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
Correct Answer: C
Rationale: Regular insulin (short-acting) is the only insulin
compatible for IV bolus or continuous infusion due to rapid onset and
no risk of precipitation. NPH and glargine are for subcutaneous use
only.
,5. A nurse assesses a client with cirrhosis who has asterixis. What is the
priority nursing action?
A. Administer a laxative
B. Prepare to administer lactulose
Correct Answer: B
Rationale: Asterixis (liver flap) indicates hepatic encephalopathy.
Lactulose reduces serum ammonia levels by acidifying the colon and
promoting excretion. Laxatives may be used but lactulose is first-line.
6. A client with chronic kidney disease (CKD) has a potassium level of
6.8 mEq/L. Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
Correct Answer: B
Rationale: Hyperkalemia (>6.5 mEq/L) risks fatal dysrhythmias;
cardiac monitoring is the priority to detect peaked T waves or QRS
widening. Calcium gluconate may follow to stabilize membranes.
7. A postoperative client reports sudden shortness of breath and chest
pain. The nurse notes oxygen saturation of 88% on room air. What is the
most likely cause?
A. Atelectasis
B. Pulmonary embolism
Correct Answer: B
, Rationale: Sudden dyspnea, chest pain, and hypoxemia
postoperatively are classic for pulmonary embolism due to venous
stasis and hypercoagulability. Atelectasis develops more gradually.
8. A nurse is teaching a client with gout about dietary modifications.
Which food should the client avoid?
A. Cherries
B. Sardines
Correct Answer: B
Rationale: Sardines are high in purines, which increase uric acid
production and exacerbate gout. Cherries may lower uric acid and
are encouraged.
9. A client with pneumonia has a prescription for ceftriaxone. Which
assessment finding requires withholding the medication and contacting
the provider?
A. Temperature 100.4°F
B. History of anaphylaxis to penicillin
Correct Answer: B
Rationale: Ceftriaxone (cephalosporin) has cross-sensitivity risk (up to
10%) with penicillin allergies; anaphylaxis history is a
contraindication. Mild fever is expected with pneumonia.
10. A nurse is caring for a client with acute pancreatitis. Which finding
indicates a complication?
A. Epigastric pain radiating to the back
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE QUESTIONS AND CORRECT VERIFIED
SOLUTIONS WITH DETAILED RATIONALES (A NEW UPDATED
VERSION 2026 EDITION) |GUARANTEED SUCCESS A+ (BRAND
NEW!) FULL REVISED MED SURG 1 RN FINAL EXAM |JERSEY
COLLEGE
1. A nurse is assessing a client with chronic obstructive pulmonary
disease (COPD). Which finding requires immediate intervention?
A. Pursed-lip breathing
B. Clubbing of the fingers
C. Productive cough with green sputum
D. Sudden onset of pleuritic chest pain and confusion
Correct Answer: D
Rationale: Sudden pleuritic chest pain and confusion suggest a
possible pneumothorax or pulmonary embolism, which are life-
threatening complications in COPD. Pursed-lip breathing and
clubbing are chronic findings; green sputum indicates infection but is
not immediately life-threatening.
2. A client with heart failure has jugular vein distension, crackles in lung
bases, and 3+ pitting edema. Which medication should the nurse
anticipate administering?
A. Metoprolol
B. Furosemide
,Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces preload by
promoting excretion of fluid, directly addressing jugular distension,
crackles, and edema. Metoprolol is a beta-blocker for chronic
management, not acute decompensation.
3. A nurse is caring for a client post-myocardial infarction. Which
laboratory value is most concerning?
A. Troponin I 0.04 ng/mL
B. Troponin I 4.2 ng/mL
Correct Answer: B
Rationale: Normal troponin I is <0.04 ng/mL; a value of 4.2 ng/mL
indicates significant myocardial necrosis. The other values are within
normal limits.
4. A client with diabetes mellitus type 2 is admitted with hyperglycemia.
Which insulin can be administered intravenously?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
Correct Answer: C
Rationale: Regular insulin (short-acting) is the only insulin
compatible for IV bolus or continuous infusion due to rapid onset and
no risk of precipitation. NPH and glargine are for subcutaneous use
only.
,5. A nurse assesses a client with cirrhosis who has asterixis. What is the
priority nursing action?
A. Administer a laxative
B. Prepare to administer lactulose
Correct Answer: B
Rationale: Asterixis (liver flap) indicates hepatic encephalopathy.
Lactulose reduces serum ammonia levels by acidifying the colon and
promoting excretion. Laxatives may be used but lactulose is first-line.
6. A client with chronic kidney disease (CKD) has a potassium level of
6.8 mEq/L. Which intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate
B. Place the client on a cardiac monitor
Correct Answer: B
Rationale: Hyperkalemia (>6.5 mEq/L) risks fatal dysrhythmias;
cardiac monitoring is the priority to detect peaked T waves or QRS
widening. Calcium gluconate may follow to stabilize membranes.
7. A postoperative client reports sudden shortness of breath and chest
pain. The nurse notes oxygen saturation of 88% on room air. What is the
most likely cause?
A. Atelectasis
B. Pulmonary embolism
Correct Answer: B
, Rationale: Sudden dyspnea, chest pain, and hypoxemia
postoperatively are classic for pulmonary embolism due to venous
stasis and hypercoagulability. Atelectasis develops more gradually.
8. A nurse is teaching a client with gout about dietary modifications.
Which food should the client avoid?
A. Cherries
B. Sardines
Correct Answer: B
Rationale: Sardines are high in purines, which increase uric acid
production and exacerbate gout. Cherries may lower uric acid and
are encouraged.
9. A client with pneumonia has a prescription for ceftriaxone. Which
assessment finding requires withholding the medication and contacting
the provider?
A. Temperature 100.4°F
B. History of anaphylaxis to penicillin
Correct Answer: B
Rationale: Ceftriaxone (cephalosporin) has cross-sensitivity risk (up to
10%) with penicillin allergies; anaphylaxis history is a
contraindication. Mild fever is expected with pneumonia.
10. A nurse is caring for a client with acute pancreatitis. Which finding
indicates a complication?
A. Epigastric pain radiating to the back
