100 Scenario-Based MCQs with Answers and Solutions.

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100 Scenario-Based MCQs with Answers and Solutions
Created by - Nurses Hub App
Question 1
Scenario: A 55-year-old patient with chest pain is admitted to the ER. The ECG
shows ST elevation.
Question: What should the nurse prepare for?
A) Administer aspirin immediately
B) Prepare for cardiac catheterization
C) Start oxygen at 6 L/min
D) Monitor blood pressure only
Answer: B) Prepare for cardiac catheterization
Rationale: ST elevation on ECG suggests acute myocardial infarction, often
requiring urgent cardiac catheterization for reperfusion. Aspirin and oxygen are
supportive but not the priority, and monitoring alone is insufficient.

Question 2
Scenario: A 30-year-old postpartum woman reports heavy vaginal bleeding and
dizziness.
Question: What is the nurse’s priority action?
A) Massage the fundus
B) Notify the physician immediately
C) Encourage fluid intake
D) Apply a cold pack
Answer: B) Notify the physician immediately
Rationale: Heavy postpartum bleeding with dizziness suggests postpartum
hemorrhage, a medical emergency. Notifying the physician is the priority for rapid
intervention. Fundal massage may be indicated but follows notification.

Question 3
Scenario: A patient with a history of diabetes reports shakiness and sweating.
Blood glucose is 60 mg/dL.
Question: What should the nurse do first?
A) Administer 15 g of fast-acting carbohydrate
B) Give insulin per sliding scale
C) Monitor blood glucose hourly
D) Notify the physician


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Answer: A) Administer 15 g of fast-acting carbohydrate
Rationale: Symptoms and a blood glucose of 60 mg/dL indicate hypoglycemia.
Administering 15 g of fast-acting carbohydrate (e.g., juice) is the priority to raise
glucose levels. Insulin worsens hypoglycemia, and monitoring or notification
follows treatment.

Question 4
Scenario: A 65-year-old patient with COPD is admitted with dyspnea and
wheezing. Oxygen saturation is 89%.
Question: What is the nurse’s first action?
A) Administer a bronchodilator via nebulizer
B) Increase oxygen to 4 L/min
C) Encourage pursed-lip breathing
D) Obtain a chest X-ray
Answer: A) Administer a bronchodilator via
nebulizer
Rationale: Dyspnea and wheezing in COPD indicate
bronchospasm. A bronchodilator (e.g., albuterol) is
the priority to open airways. Oxygen, breathing
techniques, or imaging are secondary.

Question 5
Scenario: A nurse is preparing to administer
morphine 4 mg IV. The vial is labeled 10 mg/mL.
Question: How many milliliters should the nurse
administer?
A) 0.2 mL
B) 0.4 mL
C) 0.8 mL
D) 1 mL
Answer: B) 0.4 mL
Rationale: Using the formula: Volume (mL) = Desired dose (mg) / Concentration
(mg/mL), 4 mg / 10 mg/mL = 0.4 mL. The nurse should administer 0.4 mL.

Question 6
Scenario: A patient with a tracheostomy is coughing and has difficulty breathing.
The nurse notes thick secretions.

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Question: What is the nurse’s priority action?
A) Suction the tracheostomy
B) Change the tracheostomy tube
C) Administer oxygen at 6 L/min
D) Notify the physician
Answer: A) Suction the tracheostomy
Rationale: Thick secretions can obstruct a tracheostomy. Suctioning clears the
airway, ensuring patency. Changing the tube, increasing oxygen, or notifying the
physician follows if needed.

Question 7
Scenario: A 40-year-old patient with a history of seizures has a tonic-clonic seizure
lasting 4 minutes.
Question: What is the nurse’s priority action during the seizure?
A) Restrain the patient’s limbs
B) Protect the patient from injury
C) Administer lorazepam IV
D) Insert an oral airway
Answer: B) Protect the patient from injury
Rationale: During a seizure, the priority is to protect the patient by removing
hazards and padding the environment. Restraints or oral airways are unsafe, and
lorazepam is administered by trained personnel per protocol.

Question 8
Scenario: A patient with a history of heart failure reports a 6 lb weight gain in 3
days.
Question: What should the nurse suspect?
A) Improved cardiac function
B) Fluid retention
C) Increased muscle mass
D) Normal weight fluctuation
Answer: B) Fluid retention
Rationale: Rapid weight gain in heart failure indicates fluid retention, worsening
the condition. Improved function, muscle mass, or normal fluctuations are
unlikely in this timeframe.

Question 9

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Scenario: A nurse is caring for a patient with a central venous catheter. The site is
red and swollen.
Question: What should the nurse do?
A) Continue the infusion
B) Remove the catheter and notify the physician
C) Apply a warm compress
D) Elevate the limb
Answer: B) Remove the catheter and notify the physician
Rationale: Redness and swelling suggest infection or thrombosis. Removing the
catheter prevents complications, and the physician must be notified. Continuing
the infusion or other interventions is unsafe.

Question 10
Scenario: A 28-year-old pregnant woman at 34 weeks
gestation reports decreased fetal movement.
Question: What is the nurse’s priority action?
A) Prepare for immediate delivery
B) Perform a non-stress test
C) Reassure the patient
D) Encourage fluid intake
Answer: B) Perform a non-stress test
Rationale: Decreased fetal movement may indicate
fetal distress. A non-stress test assesses fetal well-
being. Delivery, reassurance, or fluids are
inappropriate without assessment.

Question 11
Scenario: A patient with a history of hypertension is
prescribed lisinopril and reports a dry cough.
Question: What should the nurse do?
A) Continue the medication
B) Notify the physician
C) Administer an antihistamine
D) Encourage fluid intake
Answer: B) Notify the physician
Rationale: Dry cough is a common side effect of ACE inhibitors like lisinopril. The


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