Adult Medical-Surgical
Nursing Exam 1 – Foundations of
Medical-Surgical Nursing Questions
and Answers with Rationale 2026
Question 1
A nurse is caring for a client admitted with dehydration.
Which assessment finding is most concerning?
A. Moist mucous membranes
B. Urine output of 15 mL/hr
C. Blood pressure 128/76 mmHg
D. Heart rate 76 beats/min
Answer: B. Urine output of 15 mL/hr
Rationale: Normal urine output for an adult is at least 30
mL/hr. Low urine output indicates decreased kidney
perfusion and significant dehydration requiring prompt
intervention.
Question 2
,Which assessment finding is an early sign of hypoxia?
A. Bradycardia
B. Cyanosis
C. Restlessness
D. Hypotension
Answer: C. Restlessness
Rationale: Early signs of hypoxia include restlessness,
anxiety, tachycardia, and tachypnea. Cyanosis and
bradycardia are late findings.
Question 3
A nurse is assessing a client with left-sided heart failure.
Which finding is expected?
A. Peripheral edema
B. Ascites
C. Crackles in the lungs
D. Jugular vein distention
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary
congestion, resulting in crackles, dyspnea, orthopnea, and
decreased oxygenation.
,Question 4
Which electrolyte imbalance places the client at greatest
risk for cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.1 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.8 mEq/L
Rationale: Hypokalemia can cause dangerous cardiac
dysrhythmias and muscle weakness. Normal potassium is
3.5–5.0 mEq/L.
Question 5
Which laboratory value is most important to monitor in a
client receiving IV heparin?
A. INR
B. Hemoglobin A1C
C. aPTT
D. BNP
Answer: C. aPTT
, Rationale: Activated partial thromboplastin time (aPTT)
is used to monitor the therapeutic effect of unfractionated
heparin.
Question 6
A nurse is caring for a client with COPD. Which oxygen
delivery method is most appropriate for stable oxygen
therapy?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at low flow
C. Face tent
D. Venturi mask delivering high FiO₂ to all clients
Answer: B. Nasal cannula at low flow
Rationale: Many stable clients with COPD require low-
flow oxygen to achieve their prescribed oxygen saturation
goal while minimizing the risk of oxygen-induced
hypercapnia in susceptible individuals.
Question 7
Which assessment finding is most consistent with
hyperkalemia?
Nursing Exam 1 – Foundations of
Medical-Surgical Nursing Questions
and Answers with Rationale 2026
Question 1
A nurse is caring for a client admitted with dehydration.
Which assessment finding is most concerning?
A. Moist mucous membranes
B. Urine output of 15 mL/hr
C. Blood pressure 128/76 mmHg
D. Heart rate 76 beats/min
Answer: B. Urine output of 15 mL/hr
Rationale: Normal urine output for an adult is at least 30
mL/hr. Low urine output indicates decreased kidney
perfusion and significant dehydration requiring prompt
intervention.
Question 2
,Which assessment finding is an early sign of hypoxia?
A. Bradycardia
B. Cyanosis
C. Restlessness
D. Hypotension
Answer: C. Restlessness
Rationale: Early signs of hypoxia include restlessness,
anxiety, tachycardia, and tachypnea. Cyanosis and
bradycardia are late findings.
Question 3
A nurse is assessing a client with left-sided heart failure.
Which finding is expected?
A. Peripheral edema
B. Ascites
C. Crackles in the lungs
D. Jugular vein distention
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary
congestion, resulting in crackles, dyspnea, orthopnea, and
decreased oxygenation.
,Question 4
Which electrolyte imbalance places the client at greatest
risk for cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.1 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.8 mEq/L
Rationale: Hypokalemia can cause dangerous cardiac
dysrhythmias and muscle weakness. Normal potassium is
3.5–5.0 mEq/L.
Question 5
Which laboratory value is most important to monitor in a
client receiving IV heparin?
A. INR
B. Hemoglobin A1C
C. aPTT
D. BNP
Answer: C. aPTT
, Rationale: Activated partial thromboplastin time (aPTT)
is used to monitor the therapeutic effect of unfractionated
heparin.
Question 6
A nurse is caring for a client with COPD. Which oxygen
delivery method is most appropriate for stable oxygen
therapy?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at low flow
C. Face tent
D. Venturi mask delivering high FiO₂ to all clients
Answer: B. Nasal cannula at low flow
Rationale: Many stable clients with COPD require low-
flow oxygen to achieve their prescribed oxygen saturation
goal while minimizing the risk of oxygen-induced
hypercapnia in susceptible individuals.
Question 7
Which assessment finding is most consistent with
hyperkalemia?
