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MED-SURG MIDTERM EXAM QUESTIONS AND CORRECT ANSWERS
LATEST EDITION 2026
Med-Surg Practice Questions — Batch 1
1. A client with heart failure is prescribed furosemide. Which lab value requires immediate
follow-up?
A) Sodium 140 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.5 mg/dL
D) Magnesium 2.0 mg/dL
Answer: B
Rationale: Furosemide causes potassium wasting. Hypokalemia (below 3.5 mEq/L) can
precipitate cardiac dysrhythmias and requires immediate intervention .
2. A client who had a total hip replacement 2 days ago reports sudden shortness of breath
and chest pain. What is the nurse's priority action?
A) Administer prescribed PRN oxygen
B) Call the rapid response team
C) Apply sequential compression devices
D) Elevate the head of the bed
Answer: B
Rationale: Sudden dyspnea and chest pain post-orthopedic surgery suggest pulmonary
embolism. The priority is activating emergency response for definitive treatment .
3. A client with COPD on 4 L/min oxygen becomes drowsy with a respiratory rate of 8. What is
the priority action?
A) Increase the oxygen flow rate
B) Decrease the oxygen flow rate
C) Document findings and continue monitoring
D) Prepare for intubation
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Answer: B
Rationale: COPD clients may rely on hypoxic drive. High oxygen causes CO2 narcosis. The
priority is reducing oxygen to 1–2 L/min .
4. A postoperative client has 150 mL serosanguineous drainage in the Hemovac drain over 24
hours. What is the appropriate action?
A) Irrigate the drain with sterile saline
B) Continue monitoring the drainage
C) Clamp the drain and notify the provider
D) Advance the drain 2 cm
Answer: B
Rationale: Serosanguineous drainage of 150 mL/24 hr is expected postoperatively. Monitor and
document; intervention is not needed .
5. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this indicate?
A) Normal finding
B) Air leak in the system
C) Lung re-expansion
D) Suction is too high
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing .
6. A nurse administers morphine. Which assessment is the priority?
A) Blood pressure
B) Respiratory rate
C) Pain level
D) Temperature
Answer: B
Rationale: Opioids depress respiration. Respiratory rate is the priority assessment before and
after administration .
7. A client taking warfarin should be instructed about which dietary consideration?
A) Avoid all leafy green vegetables
B) Maintain consistent intake of leafy green vegetables
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C) Increase leafy green vegetables for vitamin K
D) Take vitamin K supplements daily
Answer: B
Rationale: Vitamin K interferes with warfarin. Clients should maintain consistent intake, not
avoid or increase it .
8. Which insulin peaks in 2–4 hours?
A) Glargine
B) Lispro
C) Regular insulin
D) NPH
Answer: C
Rationale: Regular insulin peaks in 2–4 hours. Lispro peaks in 30–90 min, NPH in 4–12 hr,
glargine has no peak .
9. A client presents with RLQ abdominal pain, nausea, and rebound tenderness. What should
the nurse suspect?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Bowel obstruction
Answer: C
Rationale: Appendicitis presents with RLQ pain and rebound tenderness (McBurney's point).
Cholecystitis causes RUQ pain .
10. Which finding indicates worsening COPD?
A) Oxygen saturation 94%
B) Barrel chest
C) Use of accessory muscles
D) Productive cough
Answer: C
Rationale: Accessory muscle use indicates increased respiratory distress and worsening COPD .
11. Which vital sign change indicates early shock?
A) Bradycardia
B) Hypertension
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C) Tachycardia
D) Hypothermia
Answer: C
Rationale: Tachycardia is an early compensatory response to maintain cardiac output. Blood
pressure drops later .
12. A client with a DVT is receiving heparin. Which lab value indicates therapeutic
anticoagulation?
A) INR 2.5
B) aPTT 60 seconds
C) Platelets 150,000
D) Hemoglobin 12 g/dL
Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control (approximately 45–70
seconds). INR monitors warfarin .
13. A client with an NG tube needs placement verification. What is the gold standard?
A) Aspiration of gastric contents
B) Listening for air over the stomach
C) X-ray confirmation
D) pH testing of aspirate
Answer: C
Rationale: X-ray is the gold standard for NG tube placement. Auscultation and pH testing are
less reliable .
14. A client refuses medication for religious reasons. What should the nurse do?
A) Administer anyway
B) Notify security
C) Document refusal
D) Persuade the patient
Answer: C
Rationale: Patients have the legal right to refuse treatment. Document the refusal and notify
the provider .
15. A client with a spinal injury needs repositioning. Which technique is appropriate?
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MED-SURG MIDTERM EXAM QUESTIONS AND CORRECT ANSWERS
LATEST EDITION 2026
Med-Surg Practice Questions — Batch 1
1. A client with heart failure is prescribed furosemide. Which lab value requires immediate
follow-up?
A) Sodium 140 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.5 mg/dL
D) Magnesium 2.0 mg/dL
Answer: B
Rationale: Furosemide causes potassium wasting. Hypokalemia (below 3.5 mEq/L) can
precipitate cardiac dysrhythmias and requires immediate intervention .
2. A client who had a total hip replacement 2 days ago reports sudden shortness of breath
and chest pain. What is the nurse's priority action?
A) Administer prescribed PRN oxygen
B) Call the rapid response team
C) Apply sequential compression devices
D) Elevate the head of the bed
Answer: B
Rationale: Sudden dyspnea and chest pain post-orthopedic surgery suggest pulmonary
embolism. The priority is activating emergency response for definitive treatment .
3. A client with COPD on 4 L/min oxygen becomes drowsy with a respiratory rate of 8. What is
the priority action?
A) Increase the oxygen flow rate
B) Decrease the oxygen flow rate
C) Document findings and continue monitoring
D) Prepare for intubation
1|Page
,2
Answer: B
Rationale: COPD clients may rely on hypoxic drive. High oxygen causes CO2 narcosis. The
priority is reducing oxygen to 1–2 L/min .
4. A postoperative client has 150 mL serosanguineous drainage in the Hemovac drain over 24
hours. What is the appropriate action?
A) Irrigate the drain with sterile saline
B) Continue monitoring the drainage
C) Clamp the drain and notify the provider
D) Advance the drain 2 cm
Answer: B
Rationale: Serosanguineous drainage of 150 mL/24 hr is expected postoperatively. Monitor and
document; intervention is not needed .
5. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this indicate?
A) Normal finding
B) Air leak in the system
C) Lung re-expansion
D) Suction is too high
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing .
6. A nurse administers morphine. Which assessment is the priority?
A) Blood pressure
B) Respiratory rate
C) Pain level
D) Temperature
Answer: B
Rationale: Opioids depress respiration. Respiratory rate is the priority assessment before and
after administration .
7. A client taking warfarin should be instructed about which dietary consideration?
A) Avoid all leafy green vegetables
B) Maintain consistent intake of leafy green vegetables
2|Page
,3
C) Increase leafy green vegetables for vitamin K
D) Take vitamin K supplements daily
Answer: B
Rationale: Vitamin K interferes with warfarin. Clients should maintain consistent intake, not
avoid or increase it .
8. Which insulin peaks in 2–4 hours?
A) Glargine
B) Lispro
C) Regular insulin
D) NPH
Answer: C
Rationale: Regular insulin peaks in 2–4 hours. Lispro peaks in 30–90 min, NPH in 4–12 hr,
glargine has no peak .
9. A client presents with RLQ abdominal pain, nausea, and rebound tenderness. What should
the nurse suspect?
A) Cholecystitis
B) Pancreatitis
C) Appendicitis
D) Bowel obstruction
Answer: C
Rationale: Appendicitis presents with RLQ pain and rebound tenderness (McBurney's point).
Cholecystitis causes RUQ pain .
10. Which finding indicates worsening COPD?
A) Oxygen saturation 94%
B) Barrel chest
C) Use of accessory muscles
D) Productive cough
Answer: C
Rationale: Accessory muscle use indicates increased respiratory distress and worsening COPD .
11. Which vital sign change indicates early shock?
A) Bradycardia
B) Hypertension
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C) Tachycardia
D) Hypothermia
Answer: C
Rationale: Tachycardia is an early compensatory response to maintain cardiac output. Blood
pressure drops later .
12. A client with a DVT is receiving heparin. Which lab value indicates therapeutic
anticoagulation?
A) INR 2.5
B) aPTT 60 seconds
C) Platelets 150,000
D) Hemoglobin 12 g/dL
Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control (approximately 45–70
seconds). INR monitors warfarin .
13. A client with an NG tube needs placement verification. What is the gold standard?
A) Aspiration of gastric contents
B) Listening for air over the stomach
C) X-ray confirmation
D) pH testing of aspirate
Answer: C
Rationale: X-ray is the gold standard for NG tube placement. Auscultation and pH testing are
less reliable .
14. A client refuses medication for religious reasons. What should the nurse do?
A) Administer anyway
B) Notify security
C) Document refusal
D) Persuade the patient
Answer: C
Rationale: Patients have the legal right to refuse treatment. Document the refusal and notify
the provider .
15. A client with a spinal injury needs repositioning. Which technique is appropriate?
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