Med-Surg & Pharmacology Practice Question Bank
MEDICAL-SURGICAL NURSING
& PHARMACOLOGY
Comprehensive Practice Question Bank
Original Practice Questions with Answers and Detailed Rationales
153 Questions | 17 Content Sections | Med-Surg & Pharmacology
Study Guide Prepared for Academic Review Use
Edition
Note: This is an original, independently authored practice question bank created for exam-preparation purposes. It is not affiliated with,
sponsored by, or reproduced from any proprietary vendor examination.
Page 1 of 66
, Med-Surg & Pharmacology Practice Question Bank
Table of Contents
153 original questions across 17 content sections, organized by body system and pharmacologic class.
1. Section 1: Cardiovascular Disorders (Medical-Surgical Nursing) ................................................. Questions 1–15
2. Section 2: Respiratory Disorders (Medical-Surgical Nursing) ..................................................... Questions 16–27
3. Section 3: Renal and Genitourinary Disorders (Medical-Surgical Nursing) ............................... Questions 28–37
4. Section 4: Endocrine Disorders (Medical-Surgical Nursing) ....................................................... Questions 38–47
5. Section 5: Gastrointestinal Disorders (Medical-Surgical Nursing) ............................................. Questions 48–57
6. Section 6: Neurological Disorders (Medical-Surgical Nursing) ................................................... Questions 58–67
7. Section 7: Musculoskeletal Disorders (Medical-Surgical Nursing) ............................................. Questions 68–76
8. Section 8: Hematology and Oncology (Medical-Surgical Nursing)............................................. Questions 77–85
9. Section 9: Perioperative Care and Clinical Prioritization (Medical-Surgical Nursing) ............... Questions 86–94
10. Section 10: Cardiovascular Pharmacology (Pharmacology) ................................................ Questions 95–104
11. Section 11: Anticoagulants and Antiplatelets (Pharmacology) ......................................... Questions 105–112
12. Section 12: Endocrine and Diabetes Pharmacology (Pharmacology)............................... Questions 113–120
13. Section 13: Pain Management and Opioid Pharmacology (Pharmacology) .................... Questions 121–127
14. Section 14: Antibiotics and Anti-Infective Pharmacology (Pharmacology)...................... Questions 128–135
15. Section 15: Respiratory Pharmacology (Pharmacology) ................................................... Questions 136–141
16. Section 16: Gastrointestinal Pharmacology (Pharmacology) ............................................ Questions 142–147
17. Section 17: Psychotropic Pharmacology (Pharmacology) ................................................. Questions 148–153
Page 2 of 66
, Med-Surg & Pharmacology Practice Question Bank
Section 1: Cardiovascular Disorders
MEDICAL-SURGICAL NURSING
Question 1
A client with heart failure develops confusion, anorexia, and green-tinged vision while taking digoxin.
What is the nurse's priority action?
A. Administer the next scheduled dose as ordered
B. Hold the dose and notify the provider
C. Recheck vital signs in four hours
D. Document the findings and reassess at the next visit
Correct Answer: B
Rationale: Confusion, anorexia, and visual disturbances (halos, green-yellow vision) are classic signs of
digoxin toxicity. The nurse must hold the dose and notify the provider immediately so a serum digoxin level
and potassium level can be checked, since hypokalemia potentiates toxicity. Administering another dose
could worsen a potentially life-threatening dysrhythmia.
Question 2
Which finding in a client with chronic heart failure best indicates worsening left-sided failure rather than
right-sided failure?
A. Bilateral lower extremity edema
B. Jugular venous distension
C. Crackles heard bilaterally on auscultation
D. Hepatomegaly and ascites
Correct Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation, producing
pulmonary crackles, dyspnea, and orthopnea. Peripheral edema, jugular venous distension, hepatomegaly,
and ascites are systemic (venous) congestion findings characteristic of right-sided failure.
Question 3
A client reports substernal chest pressure radiating to the left arm with associated diaphoresis and
nausea. Which action should the nurse take first?
A. Obtain a 12-lead ECG
B. Administer sublingual nitroglycerin
C. Draw cardiac biomarkers
D. Notify the rapid response team
Page 3 of 66
, Med-Surg & Pharmacology Practice Question Bank
Correct Answer: A
Rationale: The priority for suspected acute coronary syndrome is a 12-lead ECG within 10 minutes of
symptom onset, because it guides the entire treatment pathway (e.g., identifying ST-elevation MI for
emergent reperfusion). Nitroglycerin, biomarkers, and further escalation follow once ECG data confirms the
clinical picture.
Question 4
The nurse is caring for a client with cardiac tamponade. Which combination of findings should the nurse
expect (Beck's triad)?
A. Hypertension, bradycardia, and widened pulse pressure
B. Hypotension, jugular venous distension, and muffled heart sounds
C. Fever, tachypnea, and pleuritic chest pain
D. Bradycardia, warm extremities, and bounding pulses
Correct Answer: B
Rationale: Beck's triad — hypotension, distended neck veins, and muffled/distant heart sounds — reflects
the impaired ventricular filling caused by fluid compressing the heart in the pericardial sac. Recognizing this
triad allows early identification of a medical emergency requiring pericardiocentesis.
Question 5
A client in hypertensive crisis has a blood pressure of 220/130 mmHg and is receiving IV nicardipine.
What is the priority nursing consideration?
A. Lower the blood pressure to less than 120/80 mmHg within the first hour
B. Reduce the mean arterial pressure by no more than 25% within the first hour
C. Withhold the infusion until the systolic pressure is below 160 mmHg
D. Administer a fluid bolus to prevent hypotension
Correct Answer: B
Rationale: In hypertensive emergencies, blood pressure is lowered gradually — typically no more than 25%
reduction in mean arterial pressure within the first hour — to avoid precipitating cerebral, coronary, or renal
hypoperfusion from too rapid a drop.
Question 6
Which teaching point is most important for a client recovering from acute pericarditis?
A. Sit upright and lean forward if chest pain worsens when lying flat
B. Increase potassium intake to prevent dysrhythmias
C. Avoid all forms of physical activity indefinitely
D. Apply heat directly to the chest during pain episodes
Page 4 of 66
MEDICAL-SURGICAL NURSING
& PHARMACOLOGY
Comprehensive Practice Question Bank
Original Practice Questions with Answers and Detailed Rationales
153 Questions | 17 Content Sections | Med-Surg & Pharmacology
Study Guide Prepared for Academic Review Use
Edition
Note: This is an original, independently authored practice question bank created for exam-preparation purposes. It is not affiliated with,
sponsored by, or reproduced from any proprietary vendor examination.
Page 1 of 66
, Med-Surg & Pharmacology Practice Question Bank
Table of Contents
153 original questions across 17 content sections, organized by body system and pharmacologic class.
1. Section 1: Cardiovascular Disorders (Medical-Surgical Nursing) ................................................. Questions 1–15
2. Section 2: Respiratory Disorders (Medical-Surgical Nursing) ..................................................... Questions 16–27
3. Section 3: Renal and Genitourinary Disorders (Medical-Surgical Nursing) ............................... Questions 28–37
4. Section 4: Endocrine Disorders (Medical-Surgical Nursing) ....................................................... Questions 38–47
5. Section 5: Gastrointestinal Disorders (Medical-Surgical Nursing) ............................................. Questions 48–57
6. Section 6: Neurological Disorders (Medical-Surgical Nursing) ................................................... Questions 58–67
7. Section 7: Musculoskeletal Disorders (Medical-Surgical Nursing) ............................................. Questions 68–76
8. Section 8: Hematology and Oncology (Medical-Surgical Nursing)............................................. Questions 77–85
9. Section 9: Perioperative Care and Clinical Prioritization (Medical-Surgical Nursing) ............... Questions 86–94
10. Section 10: Cardiovascular Pharmacology (Pharmacology) ................................................ Questions 95–104
11. Section 11: Anticoagulants and Antiplatelets (Pharmacology) ......................................... Questions 105–112
12. Section 12: Endocrine and Diabetes Pharmacology (Pharmacology)............................... Questions 113–120
13. Section 13: Pain Management and Opioid Pharmacology (Pharmacology) .................... Questions 121–127
14. Section 14: Antibiotics and Anti-Infective Pharmacology (Pharmacology)...................... Questions 128–135
15. Section 15: Respiratory Pharmacology (Pharmacology) ................................................... Questions 136–141
16. Section 16: Gastrointestinal Pharmacology (Pharmacology) ............................................ Questions 142–147
17. Section 17: Psychotropic Pharmacology (Pharmacology) ................................................. Questions 148–153
Page 2 of 66
, Med-Surg & Pharmacology Practice Question Bank
Section 1: Cardiovascular Disorders
MEDICAL-SURGICAL NURSING
Question 1
A client with heart failure develops confusion, anorexia, and green-tinged vision while taking digoxin.
What is the nurse's priority action?
A. Administer the next scheduled dose as ordered
B. Hold the dose and notify the provider
C. Recheck vital signs in four hours
D. Document the findings and reassess at the next visit
Correct Answer: B
Rationale: Confusion, anorexia, and visual disturbances (halos, green-yellow vision) are classic signs of
digoxin toxicity. The nurse must hold the dose and notify the provider immediately so a serum digoxin level
and potassium level can be checked, since hypokalemia potentiates toxicity. Administering another dose
could worsen a potentially life-threatening dysrhythmia.
Question 2
Which finding in a client with chronic heart failure best indicates worsening left-sided failure rather than
right-sided failure?
A. Bilateral lower extremity edema
B. Jugular venous distension
C. Crackles heard bilaterally on auscultation
D. Hepatomegaly and ascites
Correct Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation, producing
pulmonary crackles, dyspnea, and orthopnea. Peripheral edema, jugular venous distension, hepatomegaly,
and ascites are systemic (venous) congestion findings characteristic of right-sided failure.
Question 3
A client reports substernal chest pressure radiating to the left arm with associated diaphoresis and
nausea. Which action should the nurse take first?
A. Obtain a 12-lead ECG
B. Administer sublingual nitroglycerin
C. Draw cardiac biomarkers
D. Notify the rapid response team
Page 3 of 66
, Med-Surg & Pharmacology Practice Question Bank
Correct Answer: A
Rationale: The priority for suspected acute coronary syndrome is a 12-lead ECG within 10 minutes of
symptom onset, because it guides the entire treatment pathway (e.g., identifying ST-elevation MI for
emergent reperfusion). Nitroglycerin, biomarkers, and further escalation follow once ECG data confirms the
clinical picture.
Question 4
The nurse is caring for a client with cardiac tamponade. Which combination of findings should the nurse
expect (Beck's triad)?
A. Hypertension, bradycardia, and widened pulse pressure
B. Hypotension, jugular venous distension, and muffled heart sounds
C. Fever, tachypnea, and pleuritic chest pain
D. Bradycardia, warm extremities, and bounding pulses
Correct Answer: B
Rationale: Beck's triad — hypotension, distended neck veins, and muffled/distant heart sounds — reflects
the impaired ventricular filling caused by fluid compressing the heart in the pericardial sac. Recognizing this
triad allows early identification of a medical emergency requiring pericardiocentesis.
Question 5
A client in hypertensive crisis has a blood pressure of 220/130 mmHg and is receiving IV nicardipine.
What is the priority nursing consideration?
A. Lower the blood pressure to less than 120/80 mmHg within the first hour
B. Reduce the mean arterial pressure by no more than 25% within the first hour
C. Withhold the infusion until the systolic pressure is below 160 mmHg
D. Administer a fluid bolus to prevent hypotension
Correct Answer: B
Rationale: In hypertensive emergencies, blood pressure is lowered gradually — typically no more than 25%
reduction in mean arterial pressure within the first hour — to avoid precipitating cerebral, coronary, or renal
hypoperfusion from too rapid a drop.
Question 6
Which teaching point is most important for a client recovering from acute pericarditis?
A. Sit upright and lean forward if chest pain worsens when lying flat
B. Increase potassium intake to prevent dysrhythmias
C. Avoid all forms of physical activity indefinitely
D. Apply heat directly to the chest during pain episodes
Page 4 of 66
