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Medical-Surgical Nursing Review and Resource Manual
EXAM WITH 250 QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES LATEST UPDATED
VERSION THIS YEAR 2026-2027
Medical-Surgical Nursing Review and Resource Manual, 4th Edition
300 Practice Questions with Answers & Rationales
Part 1: Core Nursing Concepts
1. A nurse is caring for a postoperative patient who is 6 hours post-surgery. The patient's vital
signs are: heart rate 110 bpm, blood pressure 98/62 mmHg, respiratory rate 22/min, and
temperature 37.2°C. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Increase the IV fluid rate
C) Notify the healthcare provider immediately
D) Assess for occult bleeding
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Answer: D
Tachycardia and hypotension in a postoperative patient are early signs of hypovolemic shock
from occult bleeding; assessment must precede notification and intervention.
2. A patient with heart failure is prescribed furosemide. Which laboratory value requires the
most immediate nursing intervention?
A) Sodium 135 mEq/L
B) Potassium 3.1 mEq/L
C) Glucose 110 mg/dL
D) BUN 20 mg/dL
Answer: B
Furosemide is a loop diuretic that causes potassium wasting; a potassium of 3.1 mEq/L is
critically low and increases the risk of cardiac arrhythmias.
3. The nurse is providing discharge teaching to a patient with newly diagnosed diabetes
mellitus. Which statement indicates the patient understands the teaching?
A) "I will check my blood sugar only when I feel dizzy"
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B) "I should rotate my insulin injection sites"
C) "I can stop my insulin when my blood sugar is normal"
D) "I should take my insulin only with meals"
Answer: B
Rotating insulin injection sites prevents lipohypertrophy and ensures consistent absorption;
blood sugar should be checked regularly regardless of symptoms.
4. A patient is receiving a blood transfusion and develops chills, fever, and flank pain 30
minutes after the transfusion began. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer an antihistamine
C) Stop the transfusion immediately
D) Notify the blood bank
Answer: C
Chills, fever, and flank pain indicate an acute hemolytic transfusion reaction; stopping the
transfusion is the priority to prevent further complications.
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5. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of
88% on room air. The nurse should administer oxygen at which flow rate?
A) 1-2 L/min via nasal cannula
B) 4-6 L/min via nasal cannula
C) 8-10 L/min via face mask
D) 15 L/min via non-rebreather mask
Answer: A
Patients with COPD rely on hypoxic drive; high-flow oxygen can suppress respiratory drive; low-
flow oxygen at 1-2 L/min is the standard of care.
6. A nurse is preparing to administer a medication that has a high potential for abuse. Which
schedule of controlled substance is this medication classified as?
A) Schedule II
B) Schedule III
C) Schedule IV
D) Schedule V
Medical-Surgical Nursing Review and Resource Manual
EXAM WITH 250 QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES LATEST UPDATED
VERSION THIS YEAR 2026-2027
Medical-Surgical Nursing Review and Resource Manual, 4th Edition
300 Practice Questions with Answers & Rationales
Part 1: Core Nursing Concepts
1. A nurse is caring for a postoperative patient who is 6 hours post-surgery. The patient's vital
signs are: heart rate 110 bpm, blood pressure 98/62 mmHg, respiratory rate 22/min, and
temperature 37.2°C. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Increase the IV fluid rate
C) Notify the healthcare provider immediately
D) Assess for occult bleeding
, Page 2 of 181
Answer: D
Tachycardia and hypotension in a postoperative patient are early signs of hypovolemic shock
from occult bleeding; assessment must precede notification and intervention.
2. A patient with heart failure is prescribed furosemide. Which laboratory value requires the
most immediate nursing intervention?
A) Sodium 135 mEq/L
B) Potassium 3.1 mEq/L
C) Glucose 110 mg/dL
D) BUN 20 mg/dL
Answer: B
Furosemide is a loop diuretic that causes potassium wasting; a potassium of 3.1 mEq/L is
critically low and increases the risk of cardiac arrhythmias.
3. The nurse is providing discharge teaching to a patient with newly diagnosed diabetes
mellitus. Which statement indicates the patient understands the teaching?
A) "I will check my blood sugar only when I feel dizzy"
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B) "I should rotate my insulin injection sites"
C) "I can stop my insulin when my blood sugar is normal"
D) "I should take my insulin only with meals"
Answer: B
Rotating insulin injection sites prevents lipohypertrophy and ensures consistent absorption;
blood sugar should be checked regularly regardless of symptoms.
4. A patient is receiving a blood transfusion and develops chills, fever, and flank pain 30
minutes after the transfusion began. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer an antihistamine
C) Stop the transfusion immediately
D) Notify the blood bank
Answer: C
Chills, fever, and flank pain indicate an acute hemolytic transfusion reaction; stopping the
transfusion is the priority to prevent further complications.
, Page 4 of 181
5. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of
88% on room air. The nurse should administer oxygen at which flow rate?
A) 1-2 L/min via nasal cannula
B) 4-6 L/min via nasal cannula
C) 8-10 L/min via face mask
D) 15 L/min via non-rebreather mask
Answer: A
Patients with COPD rely on hypoxic drive; high-flow oxygen can suppress respiratory drive; low-
flow oxygen at 1-2 L/min is the standard of care.
6. A nurse is preparing to administer a medication that has a high potential for abuse. Which
schedule of controlled substance is this medication classified as?
A) Schedule II
B) Schedule III
C) Schedule IV
D) Schedule V
