COMPREHENSIVE BSN MEDICAL-
SURGICAL NURSING PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which cardiac monitor finding is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
Conceptual Explanation: Hyperkalemia, common in CKD, causes characteristic ECG
changes including tall, peaked T waves, widened QRS complexes, and eventually cardiac
arrest if not treated.
2. Which clinical manifestation should a nurse prioritize when assessing a patient for a
suspected tension pneumothorax?
A. Tracheal deviation toward the affected side
B. Hypertension and bradycardia
,C. Increased breath sounds on the affected side
D. Tracheal deviation toward the unaffected side
Answer: D
Conceptual Explanation: A tension pneumothorax causes air to build up in the pleural
space, shifting the mediastinum and deviating the trachea toward the opposite (unaffected)
side, leading to obstructive shock.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which IV fluid should the nurse
expect to administer once the blood glucose reaches 250 mg/dL?
A. 0.9% Normal Saline
B. Lactated Ringer’s
C. 0.45% Normal Saline with 5% Dextrose
D. 3% Hypertonic Saline
Answer: C
Conceptual Explanation: In DKA management, dextrose is added to the IV fluids once
glucose drops to around 250 mg/dL to prevent hypoglycemia and cerebral edema as
insulin continues to treat the acidosis.
, 4. A patient with a history of cirrhosis begins to exhibit confusion, flapping tremors of the
hands (asterixis), and a musty breath odor. Which medication does the nurse anticipate
administering?
A. Spironolactone
B. Vitamin K
C. Propranolol
D. Lactulose
Answer: D
Conceptual Explanation: These are signs of hepatic encephalopathy caused by high
ammonia levels. Lactulose promotes the excretion of ammonia through the stool.
5. During the first 24 hours after a major burn injury (emergent phase), which electrolyte
imbalance is the nurse most likely to observe?
A. Hypernatremia and hypokalemia
B. Hyponatremia and hyperkalemia
C. Hypocalcemia and hypernatremia
D. Hypermagnesemia and hypokalemia
Answer: B
SURGICAL NURSING PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which cardiac monitor finding is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
Conceptual Explanation: Hyperkalemia, common in CKD, causes characteristic ECG
changes including tall, peaked T waves, widened QRS complexes, and eventually cardiac
arrest if not treated.
2. Which clinical manifestation should a nurse prioritize when assessing a patient for a
suspected tension pneumothorax?
A. Tracheal deviation toward the affected side
B. Hypertension and bradycardia
,C. Increased breath sounds on the affected side
D. Tracheal deviation toward the unaffected side
Answer: D
Conceptual Explanation: A tension pneumothorax causes air to build up in the pleural
space, shifting the mediastinum and deviating the trachea toward the opposite (unaffected)
side, leading to obstructive shock.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which IV fluid should the nurse
expect to administer once the blood glucose reaches 250 mg/dL?
A. 0.9% Normal Saline
B. Lactated Ringer’s
C. 0.45% Normal Saline with 5% Dextrose
D. 3% Hypertonic Saline
Answer: C
Conceptual Explanation: In DKA management, dextrose is added to the IV fluids once
glucose drops to around 250 mg/dL to prevent hypoglycemia and cerebral edema as
insulin continues to treat the acidosis.
, 4. A patient with a history of cirrhosis begins to exhibit confusion, flapping tremors of the
hands (asterixis), and a musty breath odor. Which medication does the nurse anticipate
administering?
A. Spironolactone
B. Vitamin K
C. Propranolol
D. Lactulose
Answer: D
Conceptual Explanation: These are signs of hepatic encephalopathy caused by high
ammonia levels. Lactulose promotes the excretion of ammonia through the stool.
5. During the first 24 hours after a major burn injury (emergent phase), which electrolyte
imbalance is the nurse most likely to observe?
A. Hypernatremia and hypokalemia
B. Hyponatremia and hyperkalemia
C. Hypocalcemia and hypernatremia
D. Hypermagnesemia and hypokalemia
Answer: B
