RN Adult Medical-Surgical (Med-Surg) 2026 | Ultimate Study Guide and Practice Test
This study guide covers the major adult health nursing concepts
commonly encountered in medical-surgical nursing, including
cardiovascular, respiratory, neurological, endocrine, gastrointestinal,
renal, musculoskeletal, and hematologic disorders. Students will review
patient assessment, clinical manifestations, diagnostic testing,
pharmacological therapies, nursing interventions, priority setting,
delegation, and evidence-based management of acute and chronic health
conditions. The material is designed to strengthen clinical judgment,
enhance critical-thinking skills, and support success on nursing
examinations, comprehensive predictors, and NCLEX-style assessments
RN Adult Medical-Surgical (Med-Surg) 2026 | Ultimate
Study Guide and Practice Test
]
SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1–35)
,1. A nurse is caring for a client with heart failure who is prescribed furosemide
(Lasix). Which laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is a
significant adverse effect that can lead to cardiac arrhythmias. Potassium levels should be
monitored closely, and the client may require potassium supplementation.
2. A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse provide?
A) "Take the medication at the first sign of chest pain."
B) "Take the medication with a full glass of water."
C) "Swallow the tablet whole without chewing."
D) "Take the medication only with food."
Answer: A) "Take the medication at the first sign of chest pain."
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. The tablet is
placed under the tongue and allowed to dissolve. The client should lie or sit down to
prevent hypotension. If pain persists after 5 minutes, call 911 and take a second dose (up
to 3 tablets).
3. A client with hypertension is prescribed lisinopril. Which adverse effect is most
commonly associated with this medication?
A) Hyperkalemia
B) Persistent dry cough
C) Peripheral edema
D) Weight gain
,Answer: B) Persistent dry cough
Rationale: ACE inhibitors such as lisinopril commonly cause a persistent dry cough due to
bradykinin accumulation. If the cough becomes bothersome, the provider may consider
switching to an ARB, which does not typically cause this side effect.
4. A nurse is caring for a client who is 2 hours post-myocardial infarction. Which
finding requires immediate intervention?
A) Heart rate of 88 beats/min
B) Blood pressure of 110/70 mmHg
C) Chest pain rated 6/10
D) Oxygen saturation of 92%
Answer: C) Chest pain rated 6/10
Rationale: Chest pain in a post-MI client may indicate ongoing ischemia or re-infarction.
This requires immediate assessment and intervention. The provider should be notified, and
pain should be treated per protocol. Oxygen saturation of 92% is acceptable for some
clients.
5. A client with heart failure is prescribed digoxin. Which finding indicates a
therapeutic response?
A) Decreased heart rate
B) Increased urine output
C) Decreased edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin improves cardiac contractility, leading to increased cardiac output,
decreased heart rate, decreased edema, and increased urine output. All are signs of
therapeutic response. The nurse should also monitor for signs of digoxin toxicity.
, 6. A client is prescribed warfarin. The nurse should instruct the client to maintain
consistent intake of:
A) Green leafy vegetables
B) Dairy products
C) Citrus fruits
D) Red meats
Answer: A) Green leafy vegetables
Rationale: Green leafy vegetables are rich in vitamin K, which antagonizes the effects of
warfarin. Clients should maintain consistent vitamin K intake to keep INR stable. Sudden
changes in diet can affect INR significantly. Clients should not avoid these foods
completely but rather keep intake consistent.
7. A client is prescribed clopidogrel (Plavix). The nurse should teach the client to
monitor for:
A) Bleeding
B) Hypertension
C) Hyperglycemia
D) Tachycardia
Answer: A) Bleeding
Rationale: Clopidogrel is a P2Y12 platelet inhibitor that prevents platelet aggregation,
increasing the risk of bleeding. Clients should be educated about signs of bleeding
(bruising, petechiae, epistaxis, hematuria, GI bleeding) and when to seek medical
attention.
8. A nurse is caring for a client receiving IV heparin. Which laboratory value should
be monitored to assess therapeutic effect?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
This study guide covers the major adult health nursing concepts
commonly encountered in medical-surgical nursing, including
cardiovascular, respiratory, neurological, endocrine, gastrointestinal,
renal, musculoskeletal, and hematologic disorders. Students will review
patient assessment, clinical manifestations, diagnostic testing,
pharmacological therapies, nursing interventions, priority setting,
delegation, and evidence-based management of acute and chronic health
conditions. The material is designed to strengthen clinical judgment,
enhance critical-thinking skills, and support success on nursing
examinations, comprehensive predictors, and NCLEX-style assessments
RN Adult Medical-Surgical (Med-Surg) 2026 | Ultimate
Study Guide and Practice Test
]
SECTION 1: CARDIOVASCULAR DISORDERS (Questions
1–35)
,1. A nurse is caring for a client with heart failure who is prescribed furosemide
(Lasix). Which laboratory value should the nurse monitor most closely?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is a
significant adverse effect that can lead to cardiac arrhythmias. Potassium levels should be
monitored closely, and the client may require potassium supplementation.
2. A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse provide?
A) "Take the medication at the first sign of chest pain."
B) "Take the medication with a full glass of water."
C) "Swallow the tablet whole without chewing."
D) "Take the medication only with food."
Answer: A) "Take the medication at the first sign of chest pain."
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. The tablet is
placed under the tongue and allowed to dissolve. The client should lie or sit down to
prevent hypotension. If pain persists after 5 minutes, call 911 and take a second dose (up
to 3 tablets).
3. A client with hypertension is prescribed lisinopril. Which adverse effect is most
commonly associated with this medication?
A) Hyperkalemia
B) Persistent dry cough
C) Peripheral edema
D) Weight gain
,Answer: B) Persistent dry cough
Rationale: ACE inhibitors such as lisinopril commonly cause a persistent dry cough due to
bradykinin accumulation. If the cough becomes bothersome, the provider may consider
switching to an ARB, which does not typically cause this side effect.
4. A nurse is caring for a client who is 2 hours post-myocardial infarction. Which
finding requires immediate intervention?
A) Heart rate of 88 beats/min
B) Blood pressure of 110/70 mmHg
C) Chest pain rated 6/10
D) Oxygen saturation of 92%
Answer: C) Chest pain rated 6/10
Rationale: Chest pain in a post-MI client may indicate ongoing ischemia or re-infarction.
This requires immediate assessment and intervention. The provider should be notified, and
pain should be treated per protocol. Oxygen saturation of 92% is acceptable for some
clients.
5. A client with heart failure is prescribed digoxin. Which finding indicates a
therapeutic response?
A) Decreased heart rate
B) Increased urine output
C) Decreased edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin improves cardiac contractility, leading to increased cardiac output,
decreased heart rate, decreased edema, and increased urine output. All are signs of
therapeutic response. The nurse should also monitor for signs of digoxin toxicity.
, 6. A client is prescribed warfarin. The nurse should instruct the client to maintain
consistent intake of:
A) Green leafy vegetables
B) Dairy products
C) Citrus fruits
D) Red meats
Answer: A) Green leafy vegetables
Rationale: Green leafy vegetables are rich in vitamin K, which antagonizes the effects of
warfarin. Clients should maintain consistent vitamin K intake to keep INR stable. Sudden
changes in diet can affect INR significantly. Clients should not avoid these foods
completely but rather keep intake consistent.
7. A client is prescribed clopidogrel (Plavix). The nurse should teach the client to
monitor for:
A) Bleeding
B) Hypertension
C) Hyperglycemia
D) Tachycardia
Answer: A) Bleeding
Rationale: Clopidogrel is a P2Y12 platelet inhibitor that prevents platelet aggregation,
increasing the risk of bleeding. Clients should be educated about signs of bleeding
(bruising, petechiae, epistaxis, hematuria, GI bleeding) and when to seek medical
attention.
8. A nurse is caring for a client receiving IV heparin. Which laboratory value should
be monitored to assess therapeutic effect?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
