NUR 1280 – MEDICAL-SURGICAL NURSING FINAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT
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Core Domains
,Cardiovascular System Disorders and Management
Respiratory System Conditions and Interventions
Gastrointestinal and Nutritional Disorders
Endocrine System Dysfunction and Diabetes Care
Neurological System Acute and Chronic Conditions
Renal and Urinary System Pathology
Musculoskeletal System Injuries and Diseases
Integumentary System and Wound Care
Professional Ethics, Legal Compliance, and Safety Standards
Critical Thinking and Clinical Decision-Making in Real-World Scenarios This comprehensive assessment
evaluates core competencies essential for medical-surgical nursing practice. The exam is designed to measure a
nurse's ability to apply foundational theory, applied professional knowledge, regulatory and legal compliance,
ethics, and professional standards in clinical settings. It consists of 100 multiple-choice and scenario-based
questions that emphasize real-world application and decision-making skills. Candidates will encounter diverse
clinical scenarios requiring critical thinking, prioritization, and evidence-based interventions. Success on this
exam demonstrates readiness for safe, effective patient care in medical-surgical environments and validates
mastery of high-y topics including cardiovascular, respiratory, gastrointestinal, endocrine, neurological, renal,
musculoskeletal, and integumentary systems, along with professional role responsibilities.
SECTION ONE: QUESTIONS 1–100
,Question 1
A patient with acute myocardial infarction arrives at the emergency department. Which intervention should the
nurse prioritize first?
A. Administer subcutaneous enoxaparin
B. Obtain a 12-lead electrocardiogram
C. Give oral aspirin 325 mg
D. Start intravenous normal saline
🟢 Correct answer: B
🔴 RATIONALE: Obtaining a 12-lead ECG is the priority first intervention to confirm MI diagnosis, determine
infarct location, and guide immediate treatment such as reperfusion therapy. Aspirin is given promptly but after
ECG confirmation. Anticoagulants and fluids are secondary interventions.
Question 2
Which finding in a patient with chronic obstructive pulmonary disease (COPD) indicates imminent respiratory
failure?
A. Increased spooning of breath sounds
B. PaO₂ of 62 mmHg on room air
C. Sudden absence of wheezing with decreased breath sounds
D. Serum bicarbonate of 32 mEq/L
🟢 Correct answer: C
, 🔴 RATIONALE: Sudden absence of wheezing with decreased breath sounds suggests "silent chest," indicating
severe airway obstruction and imminent respiratory failure. This is a critical finding requiring immediate
intervention. Other options reflect chronic COPD changes or stable hypoxemia.
Question 3
A postoperative patient develops a fever of 39.4°C (103°F) on day 3 after abdominal surgery. The nurse should
first:
A. Administer acetaminophen 650 mg
B. Inspect the surgical wound for signs of infection
C. Obtain blood cultures from two sites
D. Increase IV fluid rate to 200 mL/hr
🟢 Correct answer: B
🔴 RATIONALE: Inspecting the surgical wound is the first priority to identify localized infection signs (redness,
warmth, purulence) that may explain the fever. Wound inspection guides whether cultures and antibiotics are
needed. Antipyretics and fluids are supportive but not diagnostic.
Question 4
Which laboratory value requires immediate intervention in a patient with diabetic ketoacidosis (DKA)?
A. Glucose 420 mg/dL
B. pH 7.18
C. Potassium 2.9 mEq/L
D. Bicarbonate 12 mEq/L
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT
DOWNLOAD PDF
Core Domains
,Cardiovascular System Disorders and Management
Respiratory System Conditions and Interventions
Gastrointestinal and Nutritional Disorders
Endocrine System Dysfunction and Diabetes Care
Neurological System Acute and Chronic Conditions
Renal and Urinary System Pathology
Musculoskeletal System Injuries and Diseases
Integumentary System and Wound Care
Professional Ethics, Legal Compliance, and Safety Standards
Critical Thinking and Clinical Decision-Making in Real-World Scenarios This comprehensive assessment
evaluates core competencies essential for medical-surgical nursing practice. The exam is designed to measure a
nurse's ability to apply foundational theory, applied professional knowledge, regulatory and legal compliance,
ethics, and professional standards in clinical settings. It consists of 100 multiple-choice and scenario-based
questions that emphasize real-world application and decision-making skills. Candidates will encounter diverse
clinical scenarios requiring critical thinking, prioritization, and evidence-based interventions. Success on this
exam demonstrates readiness for safe, effective patient care in medical-surgical environments and validates
mastery of high-y topics including cardiovascular, respiratory, gastrointestinal, endocrine, neurological, renal,
musculoskeletal, and integumentary systems, along with professional role responsibilities.
SECTION ONE: QUESTIONS 1–100
,Question 1
A patient with acute myocardial infarction arrives at the emergency department. Which intervention should the
nurse prioritize first?
A. Administer subcutaneous enoxaparin
B. Obtain a 12-lead electrocardiogram
C. Give oral aspirin 325 mg
D. Start intravenous normal saline
🟢 Correct answer: B
🔴 RATIONALE: Obtaining a 12-lead ECG is the priority first intervention to confirm MI diagnosis, determine
infarct location, and guide immediate treatment such as reperfusion therapy. Aspirin is given promptly but after
ECG confirmation. Anticoagulants and fluids are secondary interventions.
Question 2
Which finding in a patient with chronic obstructive pulmonary disease (COPD) indicates imminent respiratory
failure?
A. Increased spooning of breath sounds
B. PaO₂ of 62 mmHg on room air
C. Sudden absence of wheezing with decreased breath sounds
D. Serum bicarbonate of 32 mEq/L
🟢 Correct answer: C
, 🔴 RATIONALE: Sudden absence of wheezing with decreased breath sounds suggests "silent chest," indicating
severe airway obstruction and imminent respiratory failure. This is a critical finding requiring immediate
intervention. Other options reflect chronic COPD changes or stable hypoxemia.
Question 3
A postoperative patient develops a fever of 39.4°C (103°F) on day 3 after abdominal surgery. The nurse should
first:
A. Administer acetaminophen 650 mg
B. Inspect the surgical wound for signs of infection
C. Obtain blood cultures from two sites
D. Increase IV fluid rate to 200 mL/hr
🟢 Correct answer: B
🔴 RATIONALE: Inspecting the surgical wound is the first priority to identify localized infection signs (redness,
warmth, purulence) that may explain the fever. Wound inspection guides whether cultures and antibiotics are
needed. Antipyretics and fluids are supportive but not diagnostic.
Question 4
Which laboratory value requires immediate intervention in a patient with diabetic ketoacidosis (DKA)?
A. Glucose 420 mg/dL
B. pH 7.18
C. Potassium 2.9 mEq/L
D. Bicarbonate 12 mEq/L
