KAPLAN ADULT MEDICAL-SURGICAL NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
* Cardiovascular System Management
* Respiratory System and Critical Care
* Endocrine Disorders and Diabetes Management
* Gastrointestinal and Hepatobiliary Care
* Renal and Urinary System Management
* Neurological and Musculoskeletal Care
* Perioperative Nursing and Postoperative Care
* Fluid, Electrolyte, and Acid-Base Balance
* Infectious Disease and Immune Response
* Ethics, Legal Compliance, and Professional Standards*
This comprehensive assessment is designed to evaluate nursing competency in adult medical-surgical practice. The exam measures critical
knowledge areas including clinical assessment, care planning, pharmacological interventions, patient education, and emergency response.
Questions are presented in multiple-choice and scenario-based formats that mirror real-world clinical decision-making. Emphasis is placed on
applying evidence-based practice, prioritizing patient safety, recognizing complications early, and demonstrating professional judgment in
diverse healthcare settings. Success on this exam indicates readiness for clinical practice and certification in adult medical-surgical nursing.
Section One: Questions 1–100
Question 1
A patient with chronic obstructive pulmonary disease (COPD) presents with increased shortness of breath and cyanosis. Which assessment finding
should the nurse prioritize?
A. Heart rate of 92 beats per minute
B. Oxygen saturation of 88% on room air
C. Respiratory rate of 22 breaths per minute
D. Blood pressure of 138/86 mmHg
🟢 B. Oxygen saturation of 88% on room air
🔴 RATIONALE: Oxygen saturation below 90% indicates hypoxemia and requires immediate intervention in COPD patients. Cyanosis combined
with low SpO2 signals inadequate oxygenation that can lead to organ damage if not corrected promptly.
,Question 2
Which medication requires monitoring of prothrombin time (PT) and international normalized ratio (INR)?
A. Aspirin
B. Heparin
C. Warfarin
D. Clopidogrel
🟢 C. Warfarin
🔴 RATIONALE: Warfarin interferes with vitamin K-dependent clotting factors and requires PT/INR monitoring to maintain therapeutic levels (1.5-
2 times control). Heparin is monitored via aPTT, not PT/INR.
Question 3
A patient post-thoracentesis requires which nursing intervention?
A. Keep patient supine for 4 hours
B. Auscultate breath sounds frequently
C. Restrict fluid intake for 24 hours
D. Apply warm compress to puncture site
🟢 B. Auscultate breath sounds frequently
🔴 RATIONALE: Post-thoracentesis care includes frequent auscultation of breath sounds to detect complications like pneumothorax, monitoring
vital signs, and checking for fluid leakage at the puncture site.
Question 4
What is the antidote for warfarin overdose?
A. Protamine sulfate
B. Vitamin K
C. Fresh frozen plasma
D. platelets
🟢 B. Vitamin K
,🔴 RATIONALE: Vitamin K is the specific antidote for warfarin overdose as it reverses warfarin's anticoagulant effect by restoring synthesis of
vitamin K-dependent clotting factors.
Question 5
A patient with diabetes mellitus has a blood glucose of 45 mg/dL. What is the priority nursing action?
A. Administer insulin subcutaneously
B. Give 15-20 grams of fast-acting carbohydrates
C. Call the healthcare provider immediately
D. Document the finding and recheck in 1 hour
🟢 B. Give 15-20 grams of fast-acting carbohydrates
🔴 RATIONALE: Blood glucose below 70 mg/dL indicates hypoglycemia requiring immediate treatment with fast-acting carbohydrates (15-20g) to
prevent neuroglycopenic complications and seizures.
Question 6
Which finding indicates successful treatment of dehydration?
A. Urine specific gravity of 1.032
B. Heart rate of 110 beats per minute
C. Moist mucous membranes
D. Blood pressure of 90/58 mmHg
🟢 C. Moist mucous membranes
🔴 RATIONALE: Moist mucous membranes indicate adequate hydration. Urine specific gravity >1.030, tachycardia, and hypotension are signs of
continued dehydration.
Question 7
A patient with Addison's disease is at highest risk for which complication?
, A. Hyperglycemia
B. Adrenal crisis
C. Hypertension
D. Hypernatremia
🟢 B. Adrenal crisis
🔴 RATIONALE: Addison's disease involves adrenal insufficiency, placing patients at risk for adrenal crisis (acute cortisol deficiency) characterized
by hypovolemia, hypotension, and electrolyte imbalances.
Question 8
What is the therapeutic range for prothrombin time in patients on warfarin?
A. 1.0-1.2 times control
B. 1.5-2 times control
C. 2.5-3.5 times control
D. 3-4 times control
🟢 B. 1.5-2 times control
🔴 RATIONALE: Therapeutic PT for warfarin is 1.5-2 times the control value. This range provides adequate anticoagulation while minimizing
bleeding risk.
Question 9
Which diet is recommended for a patient with multiple wounds requiring healing?
A. High-fat, low-protein diet
B. High vitamin C, high protein, high carb
C. Low-sodium, low-potassium diet
D. Clear liquid diet only
🟢 B. High vitamin C, high protein, high carb
🔴 RATIONALE: Wound healing requires high vitamin C (collagen synthesis), high protein (tissue growth), and high carbohydrates (energy).
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
* Cardiovascular System Management
* Respiratory System and Critical Care
* Endocrine Disorders and Diabetes Management
* Gastrointestinal and Hepatobiliary Care
* Renal and Urinary System Management
* Neurological and Musculoskeletal Care
* Perioperative Nursing and Postoperative Care
* Fluid, Electrolyte, and Acid-Base Balance
* Infectious Disease and Immune Response
* Ethics, Legal Compliance, and Professional Standards*
This comprehensive assessment is designed to evaluate nursing competency in adult medical-surgical practice. The exam measures critical
knowledge areas including clinical assessment, care planning, pharmacological interventions, patient education, and emergency response.
Questions are presented in multiple-choice and scenario-based formats that mirror real-world clinical decision-making. Emphasis is placed on
applying evidence-based practice, prioritizing patient safety, recognizing complications early, and demonstrating professional judgment in
diverse healthcare settings. Success on this exam indicates readiness for clinical practice and certification in adult medical-surgical nursing.
Section One: Questions 1–100
Question 1
A patient with chronic obstructive pulmonary disease (COPD) presents with increased shortness of breath and cyanosis. Which assessment finding
should the nurse prioritize?
A. Heart rate of 92 beats per minute
B. Oxygen saturation of 88% on room air
C. Respiratory rate of 22 breaths per minute
D. Blood pressure of 138/86 mmHg
🟢 B. Oxygen saturation of 88% on room air
🔴 RATIONALE: Oxygen saturation below 90% indicates hypoxemia and requires immediate intervention in COPD patients. Cyanosis combined
with low SpO2 signals inadequate oxygenation that can lead to organ damage if not corrected promptly.
,Question 2
Which medication requires monitoring of prothrombin time (PT) and international normalized ratio (INR)?
A. Aspirin
B. Heparin
C. Warfarin
D. Clopidogrel
🟢 C. Warfarin
🔴 RATIONALE: Warfarin interferes with vitamin K-dependent clotting factors and requires PT/INR monitoring to maintain therapeutic levels (1.5-
2 times control). Heparin is monitored via aPTT, not PT/INR.
Question 3
A patient post-thoracentesis requires which nursing intervention?
A. Keep patient supine for 4 hours
B. Auscultate breath sounds frequently
C. Restrict fluid intake for 24 hours
D. Apply warm compress to puncture site
🟢 B. Auscultate breath sounds frequently
🔴 RATIONALE: Post-thoracentesis care includes frequent auscultation of breath sounds to detect complications like pneumothorax, monitoring
vital signs, and checking for fluid leakage at the puncture site.
Question 4
What is the antidote for warfarin overdose?
A. Protamine sulfate
B. Vitamin K
C. Fresh frozen plasma
D. platelets
🟢 B. Vitamin K
,🔴 RATIONALE: Vitamin K is the specific antidote for warfarin overdose as it reverses warfarin's anticoagulant effect by restoring synthesis of
vitamin K-dependent clotting factors.
Question 5
A patient with diabetes mellitus has a blood glucose of 45 mg/dL. What is the priority nursing action?
A. Administer insulin subcutaneously
B. Give 15-20 grams of fast-acting carbohydrates
C. Call the healthcare provider immediately
D. Document the finding and recheck in 1 hour
🟢 B. Give 15-20 grams of fast-acting carbohydrates
🔴 RATIONALE: Blood glucose below 70 mg/dL indicates hypoglycemia requiring immediate treatment with fast-acting carbohydrates (15-20g) to
prevent neuroglycopenic complications and seizures.
Question 6
Which finding indicates successful treatment of dehydration?
A. Urine specific gravity of 1.032
B. Heart rate of 110 beats per minute
C. Moist mucous membranes
D. Blood pressure of 90/58 mmHg
🟢 C. Moist mucous membranes
🔴 RATIONALE: Moist mucous membranes indicate adequate hydration. Urine specific gravity >1.030, tachycardia, and hypotension are signs of
continued dehydration.
Question 7
A patient with Addison's disease is at highest risk for which complication?
, A. Hyperglycemia
B. Adrenal crisis
C. Hypertension
D. Hypernatremia
🟢 B. Adrenal crisis
🔴 RATIONALE: Addison's disease involves adrenal insufficiency, placing patients at risk for adrenal crisis (acute cortisol deficiency) characterized
by hypovolemia, hypotension, and electrolyte imbalances.
Question 8
What is the therapeutic range for prothrombin time in patients on warfarin?
A. 1.0-1.2 times control
B. 1.5-2 times control
C. 2.5-3.5 times control
D. 3-4 times control
🟢 B. 1.5-2 times control
🔴 RATIONALE: Therapeutic PT for warfarin is 1.5-2 times the control value. This range provides adequate anticoagulation while minimizing
bleeding risk.
Question 9
Which diet is recommended for a patient with multiple wounds requiring healing?
A. High-fat, low-protein diet
B. High vitamin C, high protein, high carb
C. Low-sodium, low-potassium diet
D. Clear liquid diet only
🟢 B. High vitamin C, high protein, high carb
🔴 RATIONALE: Wound healing requires high vitamin C (collagen synthesis), high protein (tissue growth), and high carbohydrates (energy).
