NSG 3250 Medical-Surgical Nursing Comprehensive
Examination — Latest Practice Exam 2026
Questions 1–25
1. A nurse is assessing a patient with suspected hypovolemic shock. Which finding is most
concerning?
A. Warm, flushed skin
B. Bradycardia
C. Tachycardia and hypotension
D. Bounding peripheral pulses
Answer: C.
Hypovolemic shock causes decreased circulating volume, resulting in tachycardia,
hypotension, cool skin, and poor tissue perfusion.
2. Which assessment finding is most characteristic of left-sided heart failure?
A. Peripheral edema only
B. Ascites
C. Pulmonary crackles and dyspnea
D. Enlarged liver
Answer: C.
Left-sided heart failure causes pulmonary congestion, producing dyspnea, orthopnea,
crackles, and sometimes pulmonary edema.
,3. A patient taking furosemide should be monitored closely for which electrolyte imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B.
Furosemide is a loop diuretic that increases urinary potassium excretion and can cause
hypokalemia.
4. Which ECG change is commonly associated with hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. U waves
D. ST elevation only
Answer: B.
Hyperkalemia can produce tall, peaked T waves and, as potassium rises further, QRS
widening and dangerous dysrhythmias.
5. Which symptom is most suggestive of hypoglycemia?
A. Warm, dry skin
B. Polyuria
,C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: C.
Hypoglycemia activates the sympathetic nervous system, producing sweating, tremors,
palpitations, hunger, and anxiety.
6. A conscious patient with diabetes has a blood glucose of 52 mg/dL. What should the
nurse do first?
A. Administer long-acting insulin
B. Encourage exercise
C. Give approximately 15 g of rapid-acting carbohydrate
D. Restrict oral fluids
Answer: C.
The conscious patient should receive about 15 g of fast-acting carbohydrate, followed by
reassessment of blood glucose.
7. Which finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Severe hypoglycemia
B. Respiratory alkalosis
C. Kussmaul respirations
D. Bradycardia
, Answer: C.
DKA produces metabolic acidosis. Kussmaul respirations are deep, rapid respirations that
compensate by eliminating carbon dioxide.
8. Which patient is at greatest risk for developing a pressure injury?
A. Ambulatory young adult
B. Patient who exercises daily
C. Immobile patient with impaired sensation
D. Patient with normal nutritional status
Answer: C.
Immobility, sensory impairment, poor nutrition, moisture, and impaired circulation increase
pressure-injury risk.
9. Which intervention is most appropriate for preventing pressure injuries?
A. Massage reddened areas
B. Keep the patient in one position
C. Reposition the patient regularly and relieve pressure
D. Limit protein intake
Answer: C.
Regular repositioning and pressure redistribution protect tissues from prolonged ischemia.
Examination — Latest Practice Exam 2026
Questions 1–25
1. A nurse is assessing a patient with suspected hypovolemic shock. Which finding is most
concerning?
A. Warm, flushed skin
B. Bradycardia
C. Tachycardia and hypotension
D. Bounding peripheral pulses
Answer: C.
Hypovolemic shock causes decreased circulating volume, resulting in tachycardia,
hypotension, cool skin, and poor tissue perfusion.
2. Which assessment finding is most characteristic of left-sided heart failure?
A. Peripheral edema only
B. Ascites
C. Pulmonary crackles and dyspnea
D. Enlarged liver
Answer: C.
Left-sided heart failure causes pulmonary congestion, producing dyspnea, orthopnea,
crackles, and sometimes pulmonary edema.
,3. A patient taking furosemide should be monitored closely for which electrolyte imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B.
Furosemide is a loop diuretic that increases urinary potassium excretion and can cause
hypokalemia.
4. Which ECG change is commonly associated with hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. U waves
D. ST elevation only
Answer: B.
Hyperkalemia can produce tall, peaked T waves and, as potassium rises further, QRS
widening and dangerous dysrhythmias.
5. Which symptom is most suggestive of hypoglycemia?
A. Warm, dry skin
B. Polyuria
,C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: C.
Hypoglycemia activates the sympathetic nervous system, producing sweating, tremors,
palpitations, hunger, and anxiety.
6. A conscious patient with diabetes has a blood glucose of 52 mg/dL. What should the
nurse do first?
A. Administer long-acting insulin
B. Encourage exercise
C. Give approximately 15 g of rapid-acting carbohydrate
D. Restrict oral fluids
Answer: C.
The conscious patient should receive about 15 g of fast-acting carbohydrate, followed by
reassessment of blood glucose.
7. Which finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Severe hypoglycemia
B. Respiratory alkalosis
C. Kussmaul respirations
D. Bradycardia
, Answer: C.
DKA produces metabolic acidosis. Kussmaul respirations are deep, rapid respirations that
compensate by eliminating carbon dioxide.
8. Which patient is at greatest risk for developing a pressure injury?
A. Ambulatory young adult
B. Patient who exercises daily
C. Immobile patient with impaired sensation
D. Patient with normal nutritional status
Answer: C.
Immobility, sensory impairment, poor nutrition, moisture, and impaired circulation increase
pressure-injury risk.
9. Which intervention is most appropriate for preventing pressure injuries?
A. Massage reddened areas
B. Keep the patient in one position
C. Reposition the patient regularly and relieve pressure
D. Limit protein intake
Answer: C.
Regular repositioning and pressure redistribution protect tissues from prolonged ischemia.
