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MEDICAL-SURGICAL NURSING – LPN/RPN
EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
MEDICAL-SURGICAL NURSING – LPN/RPN EXAM
250 Practice Questions with Rationales
EXAM OVERVIEW
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-45)
1. A practical nurse is caring for a client with left-sided heart failure. Which of the
following assessment findings should the nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion because the left ventricle
cannot effectively pump blood out to the body, causing blood to back up into the lungs. This
leads to crackles, dyspnea, and orthopnea. Jugular venous distention (A), peripheral edema
(B), and hepatomegaly (D) are signs of right-sided heart failure.
2. A practical nurse is caring for a client with heart failure who reports a weight gain of
4 pounds (1.8 kg) in 2 days. What is the nurse's priority action?
A. Encourage the client to increase fluid intake
B. Notify the healthcare provider immediately
C. Restrict the client's sodium intake
D. Administer a diuretic as prescribed
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Correct Answer: B
Rationale: A sudden weight gain of 2 pounds or more in 24 hours (or 4 pounds in 2 days) is
a critical indicator of fluid retention and worsening heart failure. The practical nurse should
notify the healthcare provider immediately. While sodium restriction (C) and diuretics (D)
may be ordered, notification is the priority.
3. A practical nurse is assessing a client who is prescribed lisinopril for hypertension.
Which of the following adverse effects should the nurse instruct the client to report?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. All of the above
Correct Answer: D
Rationale: ACE inhibitors such as lisinopril can cause a persistent dry cough (A),
hyperkalemia (B), and angioedema (C). All of these should be reported to the healthcare
provider. Angioedema is a medical emergency.
4. A practical nurse is preparing to administer digoxin to a client. The nurse checks the
client's apical pulse and notes it is 52 beats per minute. What is the most appropriate
nursing action?
A. Administer the medication as prescribed
B. Hold the medication and reassess the pulse in 30 minutes
C. Administer a lower dose of the medication
D. Hold the medication and notify the healthcare provider
Correct Answer: D
Rationale: The normal parameter for withholding digoxin is an apical pulse below 60 beats
per minute in adults. A rate of 52 is below this threshold, so the practical nurse should hold
the medication and notify the provider.
5. A practical nurse is caring for a client with a deep vein thrombosis (DVT). Which of
the following is a priority nursing intervention?
A. Apply cold compresses to the affected extremity
B. Massage the affected extremity to promote circulation
C. Administer anticoagulant therapy as prescribed
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D. Encourage the client to ambulate frequently
Correct Answer: C
Rationale: Anticoagulant therapy is the priority intervention to prevent extension of the
thrombus and embolization. Cold compresses (A) and massage (B) are not recommended as
they can dislodge the clot. Ambulation (D) may be restricted initially.
6. A practical nurse is assessing a client with peripheral arterial disease (PAD). Which
of the following findings is most consistent with this condition?
A. Bilateral lower extremity edema
B. Diminished peripheral pulses
C. Warm, pink extremities
D. Visible varicose veins
Correct Answer: B
Rationale: Diminished or absent peripheral pulses are a classic sign of peripheral arterial
disease due to reduced blood flow to the extremities. Bilateral edema (A) is more consistent
with venous insufficiency or heart failure. Warm, pink extremities (C) indicate adequate
perfusion. Varicose veins (D) are associated with venous insufficiency.
7. A practical nurse is assessing a client with angina pectoris. Which of the following is a
characteristic of stable angina?
A. Pain that occurs at rest
B. Pain that is relieved by rest and nitroglycerin
C. Pain that lasts longer than 30 minutes
D. Pain that is not relieved by nitroglycerin
Correct Answer: B
Rationale: Stable angina is characterized by chest pain that is predictable, occurs with
exertion, and is relieved by rest and nitroglycerin. Pain at rest (A) or pain lasting longer than
30 minutes (C, D) is more characteristic of unstable angina or myocardial infarction.
8. A practical nurse is monitoring a client's electrocardiogram (ECG) and notes ST-
segment elevation. Which of the following conditions is most likely indicated by this
finding?
A. Myocardial infarction
B. Pericarditis
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C. Ventricular hypertrophy
D. Electrolyte imbalance
Correct Answer: A
Rationale: ST-segment elevation is a classic ECG finding indicative of a myocardial
infarction (MI). It represents acute injury to the heart muscle. Pericarditis (B) typically causes
diffuse ST-segment elevation. Ventricular hypertrophy (C) causes tall R waves. Electrolyte
imbalances (D) cause various changes but not typically ST elevation.
9. A practical nurse is providing education to a client who has been prescribed
warfarin. Which of the following statements by the client indicates a need for further
teaching?
A. "I will use a soft-bristled toothbrush to prevent bleeding."
B. "I will report any unusual bruising or bleeding to my provider."
C. "I will need to have my blood checked regularly while on this medication."
D. "I can take ibuprofen for pain since it won't interact with my medication."
Correct Answer: D
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding and should be avoided
while taking warfarin. The other statements are correct and indicate understanding of the
medication's risks and monitoring requirements.
10. A practical nurse is caring for a client who is receiving furosemide for heart failure.
Which of the following laboratory values should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium. The practical
nurse must monitor for hypokalemia, which can lead to serious cardiac arrhythmias.
11. A practical nurse is assessing a client who has a diagnosis of pericarditis. Which of
the following is a characteristic finding?
A. Chest pain that is relieved by leaning forward
B. Chest pain that is relieved by lying flat
MEDICAL-SURGICAL NURSING – LPN/RPN
EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
MEDICAL-SURGICAL NURSING – LPN/RPN EXAM
250 Practice Questions with Rationales
EXAM OVERVIEW
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-45)
1. A practical nurse is caring for a client with left-sided heart failure. Which of the
following assessment findings should the nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion because the left ventricle
cannot effectively pump blood out to the body, causing blood to back up into the lungs. This
leads to crackles, dyspnea, and orthopnea. Jugular venous distention (A), peripheral edema
(B), and hepatomegaly (D) are signs of right-sided heart failure.
2. A practical nurse is caring for a client with heart failure who reports a weight gain of
4 pounds (1.8 kg) in 2 days. What is the nurse's priority action?
A. Encourage the client to increase fluid intake
B. Notify the healthcare provider immediately
C. Restrict the client's sodium intake
D. Administer a diuretic as prescribed
, Page 2 of 80
Correct Answer: B
Rationale: A sudden weight gain of 2 pounds or more in 24 hours (or 4 pounds in 2 days) is
a critical indicator of fluid retention and worsening heart failure. The practical nurse should
notify the healthcare provider immediately. While sodium restriction (C) and diuretics (D)
may be ordered, notification is the priority.
3. A practical nurse is assessing a client who is prescribed lisinopril for hypertension.
Which of the following adverse effects should the nurse instruct the client to report?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. All of the above
Correct Answer: D
Rationale: ACE inhibitors such as lisinopril can cause a persistent dry cough (A),
hyperkalemia (B), and angioedema (C). All of these should be reported to the healthcare
provider. Angioedema is a medical emergency.
4. A practical nurse is preparing to administer digoxin to a client. The nurse checks the
client's apical pulse and notes it is 52 beats per minute. What is the most appropriate
nursing action?
A. Administer the medication as prescribed
B. Hold the medication and reassess the pulse in 30 minutes
C. Administer a lower dose of the medication
D. Hold the medication and notify the healthcare provider
Correct Answer: D
Rationale: The normal parameter for withholding digoxin is an apical pulse below 60 beats
per minute in adults. A rate of 52 is below this threshold, so the practical nurse should hold
the medication and notify the provider.
5. A practical nurse is caring for a client with a deep vein thrombosis (DVT). Which of
the following is a priority nursing intervention?
A. Apply cold compresses to the affected extremity
B. Massage the affected extremity to promote circulation
C. Administer anticoagulant therapy as prescribed
, Page 3 of 80
D. Encourage the client to ambulate frequently
Correct Answer: C
Rationale: Anticoagulant therapy is the priority intervention to prevent extension of the
thrombus and embolization. Cold compresses (A) and massage (B) are not recommended as
they can dislodge the clot. Ambulation (D) may be restricted initially.
6. A practical nurse is assessing a client with peripheral arterial disease (PAD). Which
of the following findings is most consistent with this condition?
A. Bilateral lower extremity edema
B. Diminished peripheral pulses
C. Warm, pink extremities
D. Visible varicose veins
Correct Answer: B
Rationale: Diminished or absent peripheral pulses are a classic sign of peripheral arterial
disease due to reduced blood flow to the extremities. Bilateral edema (A) is more consistent
with venous insufficiency or heart failure. Warm, pink extremities (C) indicate adequate
perfusion. Varicose veins (D) are associated with venous insufficiency.
7. A practical nurse is assessing a client with angina pectoris. Which of the following is a
characteristic of stable angina?
A. Pain that occurs at rest
B. Pain that is relieved by rest and nitroglycerin
C. Pain that lasts longer than 30 minutes
D. Pain that is not relieved by nitroglycerin
Correct Answer: B
Rationale: Stable angina is characterized by chest pain that is predictable, occurs with
exertion, and is relieved by rest and nitroglycerin. Pain at rest (A) or pain lasting longer than
30 minutes (C, D) is more characteristic of unstable angina or myocardial infarction.
8. A practical nurse is monitoring a client's electrocardiogram (ECG) and notes ST-
segment elevation. Which of the following conditions is most likely indicated by this
finding?
A. Myocardial infarction
B. Pericarditis
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C. Ventricular hypertrophy
D. Electrolyte imbalance
Correct Answer: A
Rationale: ST-segment elevation is a classic ECG finding indicative of a myocardial
infarction (MI). It represents acute injury to the heart muscle. Pericarditis (B) typically causes
diffuse ST-segment elevation. Ventricular hypertrophy (C) causes tall R waves. Electrolyte
imbalances (D) cause various changes but not typically ST elevation.
9. A practical nurse is providing education to a client who has been prescribed
warfarin. Which of the following statements by the client indicates a need for further
teaching?
A. "I will use a soft-bristled toothbrush to prevent bleeding."
B. "I will report any unusual bruising or bleeding to my provider."
C. "I will need to have my blood checked regularly while on this medication."
D. "I can take ibuprofen for pain since it won't interact with my medication."
Correct Answer: D
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding and should be avoided
while taking warfarin. The other statements are correct and indicate understanding of the
medication's risks and monitoring requirements.
10. A practical nurse is caring for a client who is receiving furosemide for heart failure.
Which of the following laboratory values should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium. The practical
nurse must monitor for hypokalemia, which can lead to serious cardiac arrhythmias.
11. A practical nurse is assessing a client who has a diagnosis of pericarditis. Which of
the following is a characteristic finding?
A. Chest pain that is relieved by leaning forward
B. Chest pain that is relieved by lying flat
