BSN3A Medical-Surgical Nursing Exam
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1. A patient with left-sided heart failure is being assessed by the
nurse. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion
because the left ventricle cannot effectively pump blood into systemic
circulation. Crackles, dyspnea, orthopnea, and pulmonary edema are
common findings.
2. A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing intervention is most
appropriate?
A. Administer oxygen at the highest possible flow rate
B. Discontinue oxygen if the patient becomes drowsy
C. Use the prescribed low-flow oxygen and monitor respiratory status
D. Encourage the patient to breathe rapidly
1|Page
,Answer: C. Use the prescribed low-flow oxygen and monitor
respiratory status
Rationale: Patients with COPD may require carefully titrated oxygen
therapy. The nurse should administer oxygen as prescribed and
monitor oxygen saturation, respiratory rate, mental status, and
overall respiratory function.
3. A patient with diabetes mellitus becomes shaky, diaphoretic, and
confused. Which complication should the nurse suspect?
A. Hypercalcemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Hypoglycemia
Answer: D. Hypoglycemia
Rationale: Shakiness, sweating, confusion, weakness, and tachycardia
are classic manifestations of hypoglycemia. Prompt treatment with a
rapidly absorbed carbohydrate is required when the patient is
conscious and able to swallow.
4. Which assessment finding is most concerning in a patient
experiencing an acute myocardial infarction?
A. Mild fatigue
B. Heart rate of 82 beats/min
C. New onset of ventricular dysrhythmia
D. Blood pressure of 128/76 mmHg
Answer: C. New onset of ventricular dysrhythmia
2|Page
,Rationale: Ventricular dysrhythmias can rapidly compromise cardiac
output and become life-threatening after myocardial infarction.
Continuous cardiac monitoring is important in these patients.
5. A patient with chronic kidney disease has an elevated serum
potassium level. Which finding should the nurse report immediately?
A. Muscle weakness
B. Mild fatigue
C. Peaked T waves on the ECG
D. Increased thirst
Answer: C. Peaked T waves on the ECG
Rationale: Hyperkalemia can cause dangerous cardiac conduction
abnormalities. Peaked T waves are an important ECG manifestation
and may precede more severe dysrhythmias or cardiac arrest.
6. A patient with pneumonia has thick respiratory secretions. Which
intervention should the nurse prioritize?
A. Restrict oral fluids
B. Encourage prolonged bed rest
C. Encourage appropriate hydration and coughing exercises
D. Keep the patient supine
Answer: C. Encourage appropriate hydration and coughing exercises
Rationale: Adequate hydration helps thin respiratory secretions, while
coughing and deep-breathing exercises promote airway clearance and
improve ventilation.
3|Page
, 7. Which finding is most consistent with an acute exacerbation of
asthma?
A. Bradycardia
B. Expiratory wheezing and prolonged expiration
C. Productive cough with pink frothy sputum
D. Bilateral dependent edema
Answer: B. Expiratory wheezing and prolonged expiration
Rationale: Asthma causes bronchoconstriction and airway
inflammation, resulting in wheezing, dyspnea, chest tightness, and
prolonged expiration.
8. A patient with suspected pulmonary embolism suddenly develops
dyspnea and chest pain. What is the nurse's priority action?
A. Encourage ambulation
B. Place the patient in Trendelenburg position
C. Administer oxygen as prescribed and assess respiratory status
D. Encourage oral fluids
Answer: C. Administer oxygen as prescribed and assess respiratory
status
Rationale: Pulmonary embolism can cause acute hypoxemia and
respiratory compromise. Maintaining oxygenation and rapidly
assessing the patient's condition are immediate priorities.
9. Which laboratory value is most important for monitoring a patient
receiving warfarin therapy?
4|Page
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1. A patient with left-sided heart failure is being assessed by the
nurse. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion
because the left ventricle cannot effectively pump blood into systemic
circulation. Crackles, dyspnea, orthopnea, and pulmonary edema are
common findings.
2. A patient with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which nursing intervention is most
appropriate?
A. Administer oxygen at the highest possible flow rate
B. Discontinue oxygen if the patient becomes drowsy
C. Use the prescribed low-flow oxygen and monitor respiratory status
D. Encourage the patient to breathe rapidly
1|Page
,Answer: C. Use the prescribed low-flow oxygen and monitor
respiratory status
Rationale: Patients with COPD may require carefully titrated oxygen
therapy. The nurse should administer oxygen as prescribed and
monitor oxygen saturation, respiratory rate, mental status, and
overall respiratory function.
3. A patient with diabetes mellitus becomes shaky, diaphoretic, and
confused. Which complication should the nurse suspect?
A. Hypercalcemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Hypoglycemia
Answer: D. Hypoglycemia
Rationale: Shakiness, sweating, confusion, weakness, and tachycardia
are classic manifestations of hypoglycemia. Prompt treatment with a
rapidly absorbed carbohydrate is required when the patient is
conscious and able to swallow.
4. Which assessment finding is most concerning in a patient
experiencing an acute myocardial infarction?
A. Mild fatigue
B. Heart rate of 82 beats/min
C. New onset of ventricular dysrhythmia
D. Blood pressure of 128/76 mmHg
Answer: C. New onset of ventricular dysrhythmia
2|Page
,Rationale: Ventricular dysrhythmias can rapidly compromise cardiac
output and become life-threatening after myocardial infarction.
Continuous cardiac monitoring is important in these patients.
5. A patient with chronic kidney disease has an elevated serum
potassium level. Which finding should the nurse report immediately?
A. Muscle weakness
B. Mild fatigue
C. Peaked T waves on the ECG
D. Increased thirst
Answer: C. Peaked T waves on the ECG
Rationale: Hyperkalemia can cause dangerous cardiac conduction
abnormalities. Peaked T waves are an important ECG manifestation
and may precede more severe dysrhythmias or cardiac arrest.
6. A patient with pneumonia has thick respiratory secretions. Which
intervention should the nurse prioritize?
A. Restrict oral fluids
B. Encourage prolonged bed rest
C. Encourage appropriate hydration and coughing exercises
D. Keep the patient supine
Answer: C. Encourage appropriate hydration and coughing exercises
Rationale: Adequate hydration helps thin respiratory secretions, while
coughing and deep-breathing exercises promote airway clearance and
improve ventilation.
3|Page
, 7. Which finding is most consistent with an acute exacerbation of
asthma?
A. Bradycardia
B. Expiratory wheezing and prolonged expiration
C. Productive cough with pink frothy sputum
D. Bilateral dependent edema
Answer: B. Expiratory wheezing and prolonged expiration
Rationale: Asthma causes bronchoconstriction and airway
inflammation, resulting in wheezing, dyspnea, chest tightness, and
prolonged expiration.
8. A patient with suspected pulmonary embolism suddenly develops
dyspnea and chest pain. What is the nurse's priority action?
A. Encourage ambulation
B. Place the patient in Trendelenburg position
C. Administer oxygen as prescribed and assess respiratory status
D. Encourage oral fluids
Answer: C. Administer oxygen as prescribed and assess respiratory
status
Rationale: Pulmonary embolism can cause acute hypoxemia and
respiratory compromise. Maintaining oxygenation and rapidly
assessing the patient's condition are immediate priorities.
9. Which laboratory value is most important for monitoring a patient
receiving warfarin therapy?
4|Page
