1|Page
MEDICAL-SURGICAL NURSING 11TH
EDITION — PATIENT SAFETY
PRACTICE EXAM [QUESTION 1-100]
AND ANSWERS UPDATED 2026/2027 |
100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+
GRADED | INSTANT DOWNLOAD
INTRODUCTION
The Medical-Surgical Nursing 11th Edition — Patient Safety Practice Exam is an advanced
practice resource designed to strengthen clinical judgment, prioritization, risk reduction, and safe
nursing decision-making in complex adult-health situations. It is appropriate for nursing students
preparing for medical-surgical examinations, competency assessments, and NCLEX-style
clinical-judgment questions. Patient safety is fundamental to professional nursing because errors
involving medications, falls, infection prevention, communication, equipment, deterioration, and
clinical handoffs can produce serious patient harm.
This practice exam uses difficult, scenario-based multiple-choice questions requiring application
rather than simple recall. Questions emphasize recognizing immediate threats to safety,
identifying subtle changes in patient condition, selecting appropriate interventions, preventing
complications, communicating critical information, and distinguishing expected findings from
emergencies. Each item contains four answer choices with one best answer and a detailed
rationale explaining the clinical reasoning behind the correct response and why the alternatives
are inappropriate. Working through the questions systematically can help students identify
knowledge gaps, improve prioritization skills, and develop safer decision-making habits for
examinations and clinical practice.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
1. Clinical Deterioration & ABCs, rapid assessment, escalation,
1–15 15%
Prioritization unstable patients
High-alert medications, adverse effects,
2. Medication Safety 16–28 13%
reconciliation, administration
3. Infection Prevention & Isolation, HAIs, sepsis, PPE, device-
29–40 12%
Control associated infections
,2|Page
Content Area Questions Key Topics Weight
4. Falls, Mobility & Injury Falls, restraints, mobility, transfers,
41–50 10%
Prevention orthopedic safety
5. Communication, Handoffs & SBAR, delegation, reporting, scope of
51–60 10%
Delegation practice
6. Equipment & Procedure Oxygen, IV therapy, drains, tubes,
61–70 10%
Safety monitoring equipment
Rapid response, code situations, shock,
7. Emergency & Disaster Safety 71–80 10%
emergencies
8. Perioperative & Postoperative Surgical complications, aspiration,
81–88 8%
Safety hemorrhage, prevention
Older adults, cognitive impairment, high-
9. Special-Population Safety 89–94 6%
risk patients
10. Quality, Error Prevention & Near misses, reporting, root causes, safety
95–100 6%
Systems Safety culture
QUESTIONS 1-100
1. CLINICAL DETERIORATION & PRIORITIZATION
Q1:
A nurse receives handoff on four medical-surgical patients. Which patient should the nurse
assess first?
A) A patient with chronic heart failure who reports a 2-lb weight gain over 3 days
B) A patient with pneumonia who has new confusion, respiratory rate of 30/min, and blood
pressure of 86/52 mm Hg
C) A patient with diabetes whose premeal glucose is 218 mg/dL
D) A patient with chronic kidney disease who reports mild ankle edema
Rationale: B is correct because new altered mental status, tachypnea, and hypotension indicate
possible sepsis with impaired tissue perfusion and potential shock. Immediate assessment and
intervention are required. A is important but represents a less immediate deterioration. C
requires glucose management but does not indicate the same immediate threat to life. D may
reflect chronic fluid imbalance and is not the highest priority compared with signs of systemic
hypoperfusion.
Q2:
A postoperative patient suddenly becomes restless and develops a respiratory rate of 32/min,
oxygen saturation of 84%, and heart rate of 126/min. What is the nurse's priority action?
,3|Page
A) Administer the prescribed opioid for postoperative pain
B) Obtain a routine chest x-ray
C) Apply supplemental oxygen and immediately assess airway and breathing while
activating appropriate emergency assistance
D) Encourage the patient to ambulate to improve ventilation
Rationale: C is correct because severe hypoxemia with acute respiratory distress requires
immediate ABC intervention. Oxygen should be provided while the airway and respiratory status
are rapidly assessed and help is obtained. A could worsen respiratory depression. B delays
treatment of a potentially life-threatening problem. D is unsafe because the patient is unstable.
Q3:
A patient receiving IV morphine becomes difficult to arouse, has a respiratory rate of 7/min, and
oxygen saturation of 79%. Which intervention is most appropriate?
A) Reassess the patient in 30 minutes
B) Support ventilation, administer prescribed naloxone, and obtain emergency assistance
C) Place the patient flat and increase the opioid infusion
D) Encourage oral fluids
Rationale: B is correct because profound respiratory depression after opioid administration is
an emergency. Airway and ventilation support and naloxone are indicated according to protocol.
A dangerously delays treatment. C would worsen opioid-induced respiratory depression. D does
not correct hypoventilation.
Q4:
A patient with suspected stroke suddenly develops aphasia and right-sided weakness while
eating. What should the nurse do first?
A) Give aspirin immediately
B) Place food in the patient's mouth to test swallowing
C) Stop oral intake, assess airway and neurologic status, and activate the stroke response
D) Lower the head of the bed completely
Rationale: C is correct because sudden focal neurologic deficits require immediate stroke
evaluation while protecting the airway and preventing aspiration. A medication should not be
administered before appropriate assessment and brain imaging. B increases aspiration risk. D is
inappropriate because positioning should support airway protection and clinical status.
Q5:
A patient with a central venous catheter develops sudden dyspnea, chest pain, hypotension, and
absent breath sounds on one side shortly after catheter manipulation. Which complication should
the nurse suspect?
, 4|Page
A) Pulmonary edema
B) Aspiration pneumonia
C) Tension pneumothorax
D) Atelectasis
Rationale: C is correct because acute respiratory distress, hypotension, and unilateral absent
breath sounds after central-line manipulation strongly suggest pneumothorax with possible
tension physiology. Pulmonary edema usually produces bilateral findings. Aspiration pneumonia
generally develops over a longer period. Atelectasis is usually less dramatic and does not
typically cause sudden profound hemodynamic compromise.
Q6:
A patient with heart failure suddenly develops severe dyspnea, pink frothy sputum, diffuse
crackles, and oxygen saturation of 78%. Which action has the highest priority?
A) Encourage oral fluids
B) Place the patient supine
C) Position the patient upright, provide oxygen, and rapidly escalate care
D) Obtain a daily weight
Rationale: C is correct because the findings indicate acute pulmonary edema and severe
oxygenation impairment. Upright positioning and oxygen support improve ventilation while
emergency treatment is initiated. A increases fluid burden. B worsens pulmonary congestion and
breathing mechanics. D is useful for chronic heart-failure monitoring but is irrelevant during an
acute respiratory emergency.
Q7:
A patient with suspected internal bleeding becomes pale and diaphoretic with a heart rate of
132/min and blood pressure of 78/44 mm Hg. Which finding requires the most immediate
response?
A) Hemoglobin of 10.2 g/dL
B) Urine output of 35 mL/hr
C) Blood pressure of 78/44 mm Hg with altered mental status
D) Mild abdominal discomfort
Rationale: C is correct because profound hypotension accompanied by altered mental status
indicates inadequate cerebral and systemic perfusion and possible hemorrhagic shock. A
moderately decreased hemoglobin may lag behind acute blood loss. B is concerning but less
immediately life-threatening than severe hypotension and altered consciousness. D is
nonspecific.
Q8:
MEDICAL-SURGICAL NURSING 11TH
EDITION — PATIENT SAFETY
PRACTICE EXAM [QUESTION 1-100]
AND ANSWERS UPDATED 2026/2027 |
100% VERIFIED | DETAILED
RATIONALES – PASS GUARANTEED A+
GRADED | INSTANT DOWNLOAD
INTRODUCTION
The Medical-Surgical Nursing 11th Edition — Patient Safety Practice Exam is an advanced
practice resource designed to strengthen clinical judgment, prioritization, risk reduction, and safe
nursing decision-making in complex adult-health situations. It is appropriate for nursing students
preparing for medical-surgical examinations, competency assessments, and NCLEX-style
clinical-judgment questions. Patient safety is fundamental to professional nursing because errors
involving medications, falls, infection prevention, communication, equipment, deterioration, and
clinical handoffs can produce serious patient harm.
This practice exam uses difficult, scenario-based multiple-choice questions requiring application
rather than simple recall. Questions emphasize recognizing immediate threats to safety,
identifying subtle changes in patient condition, selecting appropriate interventions, preventing
complications, communicating critical information, and distinguishing expected findings from
emergencies. Each item contains four answer choices with one best answer and a detailed
rationale explaining the clinical reasoning behind the correct response and why the alternatives
are inappropriate. Working through the questions systematically can help students identify
knowledge gaps, improve prioritization skills, and develop safer decision-making habits for
examinations and clinical practice.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
1. Clinical Deterioration & ABCs, rapid assessment, escalation,
1–15 15%
Prioritization unstable patients
High-alert medications, adverse effects,
2. Medication Safety 16–28 13%
reconciliation, administration
3. Infection Prevention & Isolation, HAIs, sepsis, PPE, device-
29–40 12%
Control associated infections
,2|Page
Content Area Questions Key Topics Weight
4. Falls, Mobility & Injury Falls, restraints, mobility, transfers,
41–50 10%
Prevention orthopedic safety
5. Communication, Handoffs & SBAR, delegation, reporting, scope of
51–60 10%
Delegation practice
6. Equipment & Procedure Oxygen, IV therapy, drains, tubes,
61–70 10%
Safety monitoring equipment
Rapid response, code situations, shock,
7. Emergency & Disaster Safety 71–80 10%
emergencies
8. Perioperative & Postoperative Surgical complications, aspiration,
81–88 8%
Safety hemorrhage, prevention
Older adults, cognitive impairment, high-
9. Special-Population Safety 89–94 6%
risk patients
10. Quality, Error Prevention & Near misses, reporting, root causes, safety
95–100 6%
Systems Safety culture
QUESTIONS 1-100
1. CLINICAL DETERIORATION & PRIORITIZATION
Q1:
A nurse receives handoff on four medical-surgical patients. Which patient should the nurse
assess first?
A) A patient with chronic heart failure who reports a 2-lb weight gain over 3 days
B) A patient with pneumonia who has new confusion, respiratory rate of 30/min, and blood
pressure of 86/52 mm Hg
C) A patient with diabetes whose premeal glucose is 218 mg/dL
D) A patient with chronic kidney disease who reports mild ankle edema
Rationale: B is correct because new altered mental status, tachypnea, and hypotension indicate
possible sepsis with impaired tissue perfusion and potential shock. Immediate assessment and
intervention are required. A is important but represents a less immediate deterioration. C
requires glucose management but does not indicate the same immediate threat to life. D may
reflect chronic fluid imbalance and is not the highest priority compared with signs of systemic
hypoperfusion.
Q2:
A postoperative patient suddenly becomes restless and develops a respiratory rate of 32/min,
oxygen saturation of 84%, and heart rate of 126/min. What is the nurse's priority action?
,3|Page
A) Administer the prescribed opioid for postoperative pain
B) Obtain a routine chest x-ray
C) Apply supplemental oxygen and immediately assess airway and breathing while
activating appropriate emergency assistance
D) Encourage the patient to ambulate to improve ventilation
Rationale: C is correct because severe hypoxemia with acute respiratory distress requires
immediate ABC intervention. Oxygen should be provided while the airway and respiratory status
are rapidly assessed and help is obtained. A could worsen respiratory depression. B delays
treatment of a potentially life-threatening problem. D is unsafe because the patient is unstable.
Q3:
A patient receiving IV morphine becomes difficult to arouse, has a respiratory rate of 7/min, and
oxygen saturation of 79%. Which intervention is most appropriate?
A) Reassess the patient in 30 minutes
B) Support ventilation, administer prescribed naloxone, and obtain emergency assistance
C) Place the patient flat and increase the opioid infusion
D) Encourage oral fluids
Rationale: B is correct because profound respiratory depression after opioid administration is
an emergency. Airway and ventilation support and naloxone are indicated according to protocol.
A dangerously delays treatment. C would worsen opioid-induced respiratory depression. D does
not correct hypoventilation.
Q4:
A patient with suspected stroke suddenly develops aphasia and right-sided weakness while
eating. What should the nurse do first?
A) Give aspirin immediately
B) Place food in the patient's mouth to test swallowing
C) Stop oral intake, assess airway and neurologic status, and activate the stroke response
D) Lower the head of the bed completely
Rationale: C is correct because sudden focal neurologic deficits require immediate stroke
evaluation while protecting the airway and preventing aspiration. A medication should not be
administered before appropriate assessment and brain imaging. B increases aspiration risk. D is
inappropriate because positioning should support airway protection and clinical status.
Q5:
A patient with a central venous catheter develops sudden dyspnea, chest pain, hypotension, and
absent breath sounds on one side shortly after catheter manipulation. Which complication should
the nurse suspect?
, 4|Page
A) Pulmonary edema
B) Aspiration pneumonia
C) Tension pneumothorax
D) Atelectasis
Rationale: C is correct because acute respiratory distress, hypotension, and unilateral absent
breath sounds after central-line manipulation strongly suggest pneumothorax with possible
tension physiology. Pulmonary edema usually produces bilateral findings. Aspiration pneumonia
generally develops over a longer period. Atelectasis is usually less dramatic and does not
typically cause sudden profound hemodynamic compromise.
Q6:
A patient with heart failure suddenly develops severe dyspnea, pink frothy sputum, diffuse
crackles, and oxygen saturation of 78%. Which action has the highest priority?
A) Encourage oral fluids
B) Place the patient supine
C) Position the patient upright, provide oxygen, and rapidly escalate care
D) Obtain a daily weight
Rationale: C is correct because the findings indicate acute pulmonary edema and severe
oxygenation impairment. Upright positioning and oxygen support improve ventilation while
emergency treatment is initiated. A increases fluid burden. B worsens pulmonary congestion and
breathing mechanics. D is useful for chronic heart-failure monitoring but is irrelevant during an
acute respiratory emergency.
Q7:
A patient with suspected internal bleeding becomes pale and diaphoretic with a heart rate of
132/min and blood pressure of 78/44 mm Hg. Which finding requires the most immediate
response?
A) Hemoglobin of 10.2 g/dL
B) Urine output of 35 mL/hr
C) Blood pressure of 78/44 mm Hg with altered mental status
D) Mild abdominal discomfort
Rationale: C is correct because profound hypotension accompanied by altered mental status
indicates inadequate cerebral and systemic perfusion and possible hemorrhagic shock. A
moderately decreased hemoglobin may lag behind acute blood loss. B is concerning but less
immediately life-threatening than severe hypotension and altered consciousness. D is
nonspecific.
Q8:
