Kaplan Med-Surg Exam 2026/2027 Verified Exams
Comprehensive Assessment
2026-2027 | Total Questions: 150 | 100% VERIFIED
Introduction
This comprehensive assessment measures the core knowledge required of nursing
candidates preparing for the Kaplan Medical-Surgical examination. The assessment spans
eight domains: Medical-Surgical Nursing Fundamentals; Respiratory and Cardiovascular
Disorders; Gastrointestinal and Renal Systems; Endocrine and Hematologic Conditions;
Neurological and Musculoskeletal Alterations; Oncology and Immune System Disorders;
Pharmacological Therapies; and Patient Safety and Quality Improvement. Each question
tests a distinct sub-topic mapped to the official Kaplan blueprint, requiring applied clinical
judgment, safe intervention selection, and prioritization rather than simple recall. Mastery
of this material demonstrates readiness for academic progression toward licensure and
supports safe, competent medical-surgical nursing clinical execution across adult client
populations.
Question 1. The nurse auscultates heart sounds in a client and hears a soft blowing sound
between S1 and S2 at the second right intercostal space. This finding is documented as:
A. A systolic murmur auscultated at the aortic area
B. A diastolic murmur at the tricuspid area
C. A pericardial friction rub at the apex
D. An S3 gallop in the mitral area
Correct Answer: A — A systolic murmur auscultated at the aortic area
Rationale: A blowing sound between S1 and S2 occurs during systole, and the second
right intercostal space is the aortic listening post. Diastolic timing, friction rub, and S3
gallop each describe different sounds and locations.
Question 2. When documenting in the medical record, the nurse should:
A. Chart for another nurse using her login when she is busy
B. Record entries chronologically, objectively, and legibly, using only approved
abbreviations and never leaving blank lines
C. Use white-out to correct an error on the paper record
D. Leave blank lines between entries so others can add notes
Correct Answer: B — Record entries chronologically, objectively, and legibly,
using only approved abbreviations and never leaving blank lines
Rationale: Objective chronological entries with approved terminology maintain a
defensible legal record. Charting for others, correcting fluid, and blank lines invite
falsification or alteration claims.
,Question 3. A client admitted with suspected active tuberculosis requires which admission
interventions?
A. Contact precautions only with gowns and gloves
B. Airborne precautions, a private negative-pressure room, N95 respirator use by staff,
and notification of public health authorities
C. A shared room with other respiratory clients
D. Standard precautions alone without any respiratory isolation
Correct Answer: B — Airborne precautions, a private negative-pressure room,
N95 respirator use by staff, and notification of public health authorities
Rationale: Pulmonary tuberculosis spreads by droplet nuclei requiring airborne
isolation and public health reporting. Contact precautions, shared rooms, and standard
precautions alone fail to contain aerosol transmission.
Question 4. Which assessment finding in an adult receiving a continuous heparin infusion
is the most urgent to report?
A. Mild bruising at the previous intravenous site
B. Unusual thirst after lunch
C. A bruise on the shin from a wheelchair bump yesterday
D. Melena with a platelet count of 42,000 per microliter
Correct Answer: D — Melena with a platelet count of 42,000 per microliter
Rationale: Gastrointestinal bleeding plus marked thrombocytopenia signals
hemorrhage or heparin-induced thrombocytopenia, both emergencies. Site bruising,
thirst, and a single shin bruise are expected or unrelated findings.
Question 5. A client's morning laboratory panel shows potassium of 2.9 mEq/L. Before
administering prescribed potassium, the nurse should verify that the client:
A. Has no further food allergies
B. Has adequate urine output
C. Has completed the morning bath
D. Has no upcoming visitors scheduled
Correct Answer: B — Has adequate urine output
Rationale: Potassium is dangerous without renal excretion, so urine output must be
confirmed before administration. Food allergies, bathing, and visitors have no bearing
on potassium safety.
Question 6. The charge nurse is making assignments for the oncoming shift. Which client is
appropriate to assign to a float registered nurse from the medical unit?
A. A client with pneumonia requiring intravenous antibiotics and routine monitoring
B. A client on a specialized chemotherapy protocol requiring certified staff
C. A client requiring continuous titration of multiple vasoactive drips
D. A client on a ventilator requiring hemodynamic monitoring with an arterial line
, Correct Answer: A — A client with pneumonia requiring intravenous antibiotics
and routine monitoring
Rationale: The pneumonia client needs standard medical-surgical skills within a float
nurse's competence. Chemotherapy protocols, vasoactive titration, and complex
ventilator management require specialty-trained staff.
Question 7. A client refuses a prescribed blood transfusion on religious grounds after
signing an advance directive. The nurse's best action is to:
A. Transfuse the client while she is sedated later
B. Ask family members to override the refusal
C. Document the refusal, notify the provider, ensure the advance directive is in the chart,
and continue supportive care
D. Tell the client she will be discharged immediately
Correct Answer: C — Document the refusal, notify the provider, ensure the
advance directive is in the chart, and continue supportive care
Rationale: A capacitated adult's informed refusal is legally binding, and documentation
with continued care honors autonomy. Covert transfusion is battery, family override
violates rights, and discharge threats are coercive.
Question 8. Before obtaining informed consent for an invasive procedure from a hard-of-
hearing client, the nurse should:
A. Ask the client's teenage child to interpret quickly
B. Have the client sign the form and explain later
C. Speak loudly into the client's ear from across the room
D. Arrange a qualified interpreter or appropriate assistive device and verify the client's
understanding of the procedure
Correct Answer: D — Arrange a qualified interpreter or appropriate assistive
device and verify the client's understanding of the procedure
Rationale: Consent requires clear communication through qualified interpretation or
amplification. Children cannot interpret legally, uninformed signatures are invalid, and
shouting is disrespectful and ineffective.
Question 9. The nurse is preparing to administer medications through a nasogastric
feeding tube. The correct technique includes:
A. Crushing all medications together into one slurry
B. Verifying placement, flushing with 15 to 30 mL of water before and after each
medication and between drugs
C. Adding crushed medication directly into the full feeding bag
D. Giving medications while the client lies flat, then removing the tube
Correct Answer: B — Verifying placement, flushing with 15 to 30 mL of water
before and after each medication and between drugs
, Rationale: Separate administration with flushes prevents tube occlusion and drug
interactions. Mixed slurries clog tubes, bag mixing alters absorption, and flat positioning
risks aspiration.
Question 10. A client who speaks limited English is in visible pain but cannot describe it.
The nurse should:
A. Wait until an English-speaking family member arrives to begin assessment
B. Assume the client has no pain because nothing is described
C. Use a validated pain scale with visual descriptors and a professional interpreter to
assess and treat the pain
D. Give a placebo to test whether the pain is real
Correct Answer: C — Use a validated pain scale with visual descriptors and a
professional interpreter to assess and treat the pain
Rationale: Validated visual scales with professional interpretation permit accurate
assessment and treatment. Delayed assessment, assumption of painlessness, and
placebos are unethical and unsafe.
Question 11. When a fire alarm sounds on another unit, the nurse on a medical floor should
first:
A. Evacuate the building immediately without accounting for clients
B. Remain with assigned clients, close doors, and follow the facility emergency
operations plan
C. Run to the other unit to help without notifying anyone
D. Open all client doors to let smoke escape
Correct Answer: B — Remain with assigned clients, close doors, and follow the
facility emergency operations plan
Rationale: Local response protects the nurse's own clients while the plan directs
broader action. Uncoordinated evacuation, abandonment, and open doors endanger
clients and staff.
Question 12. A client's telemetry shows a flat line in one lead only, with the client talking
and asymptomatic. The nurse should:
A. Start chest compressions immediately
B. Check the electrodes, cables, and connections for dislodgement before calling a code
C. Call the family about the emergency
D. Defibrillate the client at maximum energy
Correct Answer: B — Check the electrodes, cables, and connections for
dislodgement before calling a code
Rationale: A single flat lead with an asymptomatic client indicates lead failure, not
arrest. Compressing, defibrillating, and alarming families harm a living client.
Comprehensive Assessment
2026-2027 | Total Questions: 150 | 100% VERIFIED
Introduction
This comprehensive assessment measures the core knowledge required of nursing
candidates preparing for the Kaplan Medical-Surgical examination. The assessment spans
eight domains: Medical-Surgical Nursing Fundamentals; Respiratory and Cardiovascular
Disorders; Gastrointestinal and Renal Systems; Endocrine and Hematologic Conditions;
Neurological and Musculoskeletal Alterations; Oncology and Immune System Disorders;
Pharmacological Therapies; and Patient Safety and Quality Improvement. Each question
tests a distinct sub-topic mapped to the official Kaplan blueprint, requiring applied clinical
judgment, safe intervention selection, and prioritization rather than simple recall. Mastery
of this material demonstrates readiness for academic progression toward licensure and
supports safe, competent medical-surgical nursing clinical execution across adult client
populations.
Question 1. The nurse auscultates heart sounds in a client and hears a soft blowing sound
between S1 and S2 at the second right intercostal space. This finding is documented as:
A. A systolic murmur auscultated at the aortic area
B. A diastolic murmur at the tricuspid area
C. A pericardial friction rub at the apex
D. An S3 gallop in the mitral area
Correct Answer: A — A systolic murmur auscultated at the aortic area
Rationale: A blowing sound between S1 and S2 occurs during systole, and the second
right intercostal space is the aortic listening post. Diastolic timing, friction rub, and S3
gallop each describe different sounds and locations.
Question 2. When documenting in the medical record, the nurse should:
A. Chart for another nurse using her login when she is busy
B. Record entries chronologically, objectively, and legibly, using only approved
abbreviations and never leaving blank lines
C. Use white-out to correct an error on the paper record
D. Leave blank lines between entries so others can add notes
Correct Answer: B — Record entries chronologically, objectively, and legibly,
using only approved abbreviations and never leaving blank lines
Rationale: Objective chronological entries with approved terminology maintain a
defensible legal record. Charting for others, correcting fluid, and blank lines invite
falsification or alteration claims.
,Question 3. A client admitted with suspected active tuberculosis requires which admission
interventions?
A. Contact precautions only with gowns and gloves
B. Airborne precautions, a private negative-pressure room, N95 respirator use by staff,
and notification of public health authorities
C. A shared room with other respiratory clients
D. Standard precautions alone without any respiratory isolation
Correct Answer: B — Airborne precautions, a private negative-pressure room,
N95 respirator use by staff, and notification of public health authorities
Rationale: Pulmonary tuberculosis spreads by droplet nuclei requiring airborne
isolation and public health reporting. Contact precautions, shared rooms, and standard
precautions alone fail to contain aerosol transmission.
Question 4. Which assessment finding in an adult receiving a continuous heparin infusion
is the most urgent to report?
A. Mild bruising at the previous intravenous site
B. Unusual thirst after lunch
C. A bruise on the shin from a wheelchair bump yesterday
D. Melena with a platelet count of 42,000 per microliter
Correct Answer: D — Melena with a platelet count of 42,000 per microliter
Rationale: Gastrointestinal bleeding plus marked thrombocytopenia signals
hemorrhage or heparin-induced thrombocytopenia, both emergencies. Site bruising,
thirst, and a single shin bruise are expected or unrelated findings.
Question 5. A client's morning laboratory panel shows potassium of 2.9 mEq/L. Before
administering prescribed potassium, the nurse should verify that the client:
A. Has no further food allergies
B. Has adequate urine output
C. Has completed the morning bath
D. Has no upcoming visitors scheduled
Correct Answer: B — Has adequate urine output
Rationale: Potassium is dangerous without renal excretion, so urine output must be
confirmed before administration. Food allergies, bathing, and visitors have no bearing
on potassium safety.
Question 6. The charge nurse is making assignments for the oncoming shift. Which client is
appropriate to assign to a float registered nurse from the medical unit?
A. A client with pneumonia requiring intravenous antibiotics and routine monitoring
B. A client on a specialized chemotherapy protocol requiring certified staff
C. A client requiring continuous titration of multiple vasoactive drips
D. A client on a ventilator requiring hemodynamic monitoring with an arterial line
, Correct Answer: A — A client with pneumonia requiring intravenous antibiotics
and routine monitoring
Rationale: The pneumonia client needs standard medical-surgical skills within a float
nurse's competence. Chemotherapy protocols, vasoactive titration, and complex
ventilator management require specialty-trained staff.
Question 7. A client refuses a prescribed blood transfusion on religious grounds after
signing an advance directive. The nurse's best action is to:
A. Transfuse the client while she is sedated later
B. Ask family members to override the refusal
C. Document the refusal, notify the provider, ensure the advance directive is in the chart,
and continue supportive care
D. Tell the client she will be discharged immediately
Correct Answer: C — Document the refusal, notify the provider, ensure the
advance directive is in the chart, and continue supportive care
Rationale: A capacitated adult's informed refusal is legally binding, and documentation
with continued care honors autonomy. Covert transfusion is battery, family override
violates rights, and discharge threats are coercive.
Question 8. Before obtaining informed consent for an invasive procedure from a hard-of-
hearing client, the nurse should:
A. Ask the client's teenage child to interpret quickly
B. Have the client sign the form and explain later
C. Speak loudly into the client's ear from across the room
D. Arrange a qualified interpreter or appropriate assistive device and verify the client's
understanding of the procedure
Correct Answer: D — Arrange a qualified interpreter or appropriate assistive
device and verify the client's understanding of the procedure
Rationale: Consent requires clear communication through qualified interpretation or
amplification. Children cannot interpret legally, uninformed signatures are invalid, and
shouting is disrespectful and ineffective.
Question 9. The nurse is preparing to administer medications through a nasogastric
feeding tube. The correct technique includes:
A. Crushing all medications together into one slurry
B. Verifying placement, flushing with 15 to 30 mL of water before and after each
medication and between drugs
C. Adding crushed medication directly into the full feeding bag
D. Giving medications while the client lies flat, then removing the tube
Correct Answer: B — Verifying placement, flushing with 15 to 30 mL of water
before and after each medication and between drugs
, Rationale: Separate administration with flushes prevents tube occlusion and drug
interactions. Mixed slurries clog tubes, bag mixing alters absorption, and flat positioning
risks aspiration.
Question 10. A client who speaks limited English is in visible pain but cannot describe it.
The nurse should:
A. Wait until an English-speaking family member arrives to begin assessment
B. Assume the client has no pain because nothing is described
C. Use a validated pain scale with visual descriptors and a professional interpreter to
assess and treat the pain
D. Give a placebo to test whether the pain is real
Correct Answer: C — Use a validated pain scale with visual descriptors and a
professional interpreter to assess and treat the pain
Rationale: Validated visual scales with professional interpretation permit accurate
assessment and treatment. Delayed assessment, assumption of painlessness, and
placebos are unethical and unsafe.
Question 11. When a fire alarm sounds on another unit, the nurse on a medical floor should
first:
A. Evacuate the building immediately without accounting for clients
B. Remain with assigned clients, close doors, and follow the facility emergency
operations plan
C. Run to the other unit to help without notifying anyone
D. Open all client doors to let smoke escape
Correct Answer: B — Remain with assigned clients, close doors, and follow the
facility emergency operations plan
Rationale: Local response protects the nurse's own clients while the plan directs
broader action. Uncoordinated evacuation, abandonment, and open doors endanger
clients and staff.
Question 12. A client's telemetry shows a flat line in one lead only, with the client talking
and asymptomatic. The nurse should:
A. Start chest compressions immediately
B. Check the electrodes, cables, and connections for dislodgement before calling a code
C. Call the family about the emergency
D. Defibrillate the client at maximum energy
Correct Answer: B — Check the electrodes, cables, and connections for
dislodgement before calling a code
Rationale: A single flat lead with an asymptomatic client indicates lead failure, not
arrest. Compressing, defibrillating, and alarming families harm a living client.
