MED-SURG CERTIFICATION PRACTICE QUESTIONS |
FROM QUESTION TO PERFECTION| STUDY WITH
CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,A newly diabetic patient will receive instructions from his nurse. Which of the following actions
should the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer. Answer: B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
The post hysterectomy patient with calls the clinic stating that she has been having difficulty
with incontinence. Which of the following statements if made by the patient, indicates that
further teaching is needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void Answer: C.
A patient saying that he or she will only drink fluids when eating meals indicates that they don't
know what to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient
states to the RN that he is short of breath, has no appetite and hurts everywhere. Which of the
following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication Answer: C
A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages
should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes.
Answer: A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less
critical than A. Best answer is A.
A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which
of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement. Answer: A
B and C are recommendations that the RN can share after he/she determines the patient's
sleeping and waking patterns. So remove B and C. D is an inquiry, but is concerned about the
past (when the person retired). Remove D. A is the best answer.
The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the
patient is diaphoretic and confused. The vital signs are:
Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects the
physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
ciprofloxacin (cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. Answer: B
A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued,
is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following
responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. Answer: C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
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3
, B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. Answer: C
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia Answer: C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. Infection
comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85%
over 4 hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe Answer: 4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail
polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an asthma
attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. Answer: D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a calm
environment. Helping the patient breathe with pursed lips will facilitate the expiration of
trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer.
She states that she doesn't want anyone to see her in this condition, even her husband. This
nurse's best response is:
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
FROM QUESTION TO PERFECTION| STUDY WITH
CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,A newly diabetic patient will receive instructions from his nurse. Which of the following actions
should the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer. Answer: B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
The post hysterectomy patient with calls the clinic stating that she has been having difficulty
with incontinence. Which of the following statements if made by the patient, indicates that
further teaching is needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void Answer: C.
A patient saying that he or she will only drink fluids when eating meals indicates that they don't
know what to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient
states to the RN that he is short of breath, has no appetite and hurts everywhere. Which of the
following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication Answer: C
A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages
should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes.
Answer: A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less
critical than A. Best answer is A.
A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which
of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement. Answer: A
B and C are recommendations that the RN can share after he/she determines the patient's
sleeping and waking patterns. So remove B and C. D is an inquiry, but is concerned about the
past (when the person retired). Remove D. A is the best answer.
The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the
patient is diaphoretic and confused. The vital signs are:
Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects the
physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
ciprofloxacin (cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. Answer: B
A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued,
is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following
responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. Answer: C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. Answer: C
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia Answer: C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. Infection
comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85%
over 4 hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe Answer: 4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail
polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an asthma
attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. Answer: D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a calm
environment. Helping the patient breathe with pursed lips will facilitate the expiration of
trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer.
She states that she doesn't want anyone to see her in this condition, even her husband. This
nurse's best response is:
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
