NUR 1280 – MEDICAL-SURGICAL NURSING EXAM 2 QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD
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Core Domains
Cardiovascular System Disorders and Management
Respiratory System Disorders and Critical Care
Gastrointestinal and Hepatobiliary Disorders
Renal and Urological Disorders
Endocrine Disorders and Diabetes Management
Neurological System and Intracranial Disorders
Musculoskeletal and Integumentary Disorders
Perioperative Care and Postoperative Complications
Immune System, Oncology, and Infectious Diseases
Professional Practice: Ethics, Legal Compliance, and Prioritization
,Introduction
This exam assesses comprehensive knowledge and clinical judgment essential for medical-surgical nursing
practice. It evaluates your ability to apply foundational theory, professional standards, regulatory compliance,
and ethical decision-making in real-world scenarios. The multiple-choice and scenario-based structure
emphasizes critical thinking, prioritization, and evidence-based interventions across diverse patient
populations. Success requires not only memorization but the capacity to recognize complications, sequence
assessments appropriately, and make safe clinical decisions under pressure. This test bank mirrors the difficulty
and content distribution of national certification exams and nursing school finals, preparing you for both
academic success and competent bedside practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with chronic heart failure presents with sudden onset of severe shortness of breath, crackles
throughout both lung fields, and SpO₂ 84% on room air. What is the nurse's FIRST action?
A. Administer 4 mg IV morphine
B. Place the patient in high Fowler's position
C. Administer 40 mg IV furosemide
D. Obtain a 12-lead ECG
🟢 Correct answer: B
🔴 RATIONALE: In acute pulmonary edema, the FIRST action is to improve oxygenation by placing the patient
in high Fowler's position, which decreases venous return and maximizes lung expansion. Medications
(morphine, furosemide) and ECG follow after positioning.
,Question 2
Which laboratory finding in a patient with liver cirrhosis requires immediate intervention?
A. Platelets 95,000/mm³
B. Albumin 2.1 g/dL
C. Ammonia 180 µg/dL
D. INR 2.3
🟢 Correct answer: C
🔴 RATIONALE: Elevated ammonia (180 µg/dL) indicates hepatic encephalopathy risk and requires
immediate intervention (lactulose, protein restriction). Low platelets, albumin, and elevated INR are expected
in cirrhosis but not immediately life-threatening.
Question 3
A postoperative patient after abdominal surgery develops sudden chest pain, tachypnea, and SpO₂ 88%. DVT is
suspected. What is the priority diagnostic test?
A. Chest X-ray
B. CT pulmonary angiography
C. D-dimer assay
D. Venous Doppler ultrasound
🟢 Correct answer: B
, 🔴 RATIONALE: CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism in stable
patients. D-dimer is less specific; chest X-ray and Doppler do not confirm PE.
Question 4
Which statement by a patient with type 1 diabetes indicates understanding of sick-day management?
A. "I'll stop my insulin if I can't eat."
B. "I'll check my blood glucose every 4 hours and continue insulin."
C. "I'll take only half my usual insulin dose."
D. "I'll wait until I feel better to check my glucose."
🟢 Correct answer: B
🔴 RATIONALE: During illness, patients must continue insulin and monitor glucose every 4 hours to prevent
hyperglycemia and DKA. Stopping or reducing insulin without monitoring is dangerous.
Question 5
A patient with COPD has an arterial blood gas showing pH 7.28, PaCO₂ 62 mmHg, PaO₂ 58 mmHg, HCO₃⁻ 28
mEq/L. What does this indicate?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
🟢 Correct answer: B
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD
Core Domains
Cardiovascular System Disorders and Management
Respiratory System Disorders and Critical Care
Gastrointestinal and Hepatobiliary Disorders
Renal and Urological Disorders
Endocrine Disorders and Diabetes Management
Neurological System and Intracranial Disorders
Musculoskeletal and Integumentary Disorders
Perioperative Care and Postoperative Complications
Immune System, Oncology, and Infectious Diseases
Professional Practice: Ethics, Legal Compliance, and Prioritization
,Introduction
This exam assesses comprehensive knowledge and clinical judgment essential for medical-surgical nursing
practice. It evaluates your ability to apply foundational theory, professional standards, regulatory compliance,
and ethical decision-making in real-world scenarios. The multiple-choice and scenario-based structure
emphasizes critical thinking, prioritization, and evidence-based interventions across diverse patient
populations. Success requires not only memorization but the capacity to recognize complications, sequence
assessments appropriately, and make safe clinical decisions under pressure. This test bank mirrors the difficulty
and content distribution of national certification exams and nursing school finals, preparing you for both
academic success and competent bedside practice.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient with chronic heart failure presents with sudden onset of severe shortness of breath, crackles
throughout both lung fields, and SpO₂ 84% on room air. What is the nurse's FIRST action?
A. Administer 4 mg IV morphine
B. Place the patient in high Fowler's position
C. Administer 40 mg IV furosemide
D. Obtain a 12-lead ECG
🟢 Correct answer: B
🔴 RATIONALE: In acute pulmonary edema, the FIRST action is to improve oxygenation by placing the patient
in high Fowler's position, which decreases venous return and maximizes lung expansion. Medications
(morphine, furosemide) and ECG follow after positioning.
,Question 2
Which laboratory finding in a patient with liver cirrhosis requires immediate intervention?
A. Platelets 95,000/mm³
B. Albumin 2.1 g/dL
C. Ammonia 180 µg/dL
D. INR 2.3
🟢 Correct answer: C
🔴 RATIONALE: Elevated ammonia (180 µg/dL) indicates hepatic encephalopathy risk and requires
immediate intervention (lactulose, protein restriction). Low platelets, albumin, and elevated INR are expected
in cirrhosis but not immediately life-threatening.
Question 3
A postoperative patient after abdominal surgery develops sudden chest pain, tachypnea, and SpO₂ 88%. DVT is
suspected. What is the priority diagnostic test?
A. Chest X-ray
B. CT pulmonary angiography
C. D-dimer assay
D. Venous Doppler ultrasound
🟢 Correct answer: B
, 🔴 RATIONALE: CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism in stable
patients. D-dimer is less specific; chest X-ray and Doppler do not confirm PE.
Question 4
Which statement by a patient with type 1 diabetes indicates understanding of sick-day management?
A. "I'll stop my insulin if I can't eat."
B. "I'll check my blood glucose every 4 hours and continue insulin."
C. "I'll take only half my usual insulin dose."
D. "I'll wait until I feel better to check my glucose."
🟢 Correct answer: B
🔴 RATIONALE: During illness, patients must continue insulin and monitor glucose every 4 hours to prevent
hyperglycemia and DKA. Stopping or reducing insulin without monitoring is dangerous.
Question 5
A patient with COPD has an arterial blood gas showing pH 7.28, PaCO₂ 62 mmHg, PaO₂ 58 mmHg, HCO₃⁻ 28
mEq/L. What does this indicate?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
🟢 Correct answer: B
