BRUNNER & SUDDARTH'S MEDICAL-
SURGICAL NURSING 16TH EDITION
COMPLETE PREMIUM TEST BANK
This premium test bank features high-yield multiple-choice questions
mapped directly to the 16th edition of Brunner & Suddarth's Textbook of
Medical-Surgical Nursing. Designed specifically for nursing students
preparing for rigorous exams, each question features precise clinical
scenarios with italicized answers and comprehensive, bold-italic rationales.
It provides the ultimate resource for master-level preparation in fluid
dynamics, advanced cardiac care, critical respiratory interventions, and
shock states.
Module 1: Fluid, Electrolyte, and Acid-Base
Imbalances
Q1. A nurse is caring for a client with a
nasogastric (NG) tube attached to low
intermittent suction for 3 days. The nurse notes
that the client has developed hyperreflexia,
muscle cramping, and a positive Trousseau’s
sign. Which laboratory value should the nurse
review immediately?
A. Serum sodium 132 mEq/L
B. Serum potassium 5.2 mEq/L
C. Serum calcium 7.2 mg/dL
D. Serum magnesium 2.8 mEq/L
Answer: C. Serum calcium 7.2 mg/dL
Rationale: Prolonged nasogastric suctioning can
lead to metabolic alkalosis, which increases the
,binding of calcium to albumin, reducing the
amount of ionized (active) calcium in the blood.
A positive Trousseau’s sign and muscle
hyperreflexia are classic clinical manifestations
of acute hypocalcemia (normal range: 8.5–10.5
mg/dL). Rapid recognition prevents progression
to laryngospasm or seizures.
Q2. A client with an acute exacerbation of
chronic obstructive pulmonary disease (COPD)
is admitted. The arterial blood gas (ABG)
analysis reveals: pH 7.31, PaCO2 58 mmHg,
HCO3 28 mEq/L, and PaO2 65 mmHg. How
should the nurse interpret these findings?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: B. Partially compensated respiratory
acidosis
Rationale: The pH is below normal (7.35–1.45),
indicating acidosis. The PaCO2 is elevated
(normal: 35–45 mmHg), confirming a respiratory
source. The HCO3 is also elevated (normal: 22–
26 mEq/L), which demonstrates that the kidneys
are actively retaining bicarbonate to compensate
,for the retained acid. Because the pH has not
returned to the normal range, the compensation
is partial.
Q3. A client is prescribed a 3% hypertonic saline
infusion for severe, symptomatic hyponatremia
(serum sodium 114 mEq/L). Which assessment
finding requires the nurse to stop the infusion
immediately?
A. Serum sodium increases to 118 mEq/L in 4 hours
B. New-onset crackles at the lung bases and jugular
venous distention
C. Client reports extreme thirst and dry mucous
membranes
D. Blood pressure increases from 110/60 mmHg to
128/74 mmHg
Answer: B. New-onset crackles at the lung bases
and jugular venous distention
Rationale: Hypertonic saline (3% NaCl) is a high-
alert fluid that pulls water out of cells and into
the extracellular fluid compartment. The most
dangerous complication of this rapid shift is
fluid volume overload, which can quickly
precipitate acute pulmonary edema and heart
failure. New crackles and jugular venous
, distention are primary indicators of circulatory
overload.
Module 2: Advanced Cardiovascular
Management
Q4. The nurse is analyzing an electrocardiogram
(ECG) strip for a client reporting sudden chest
palpitations. The strip shows an absence of P
waves, a highly irregular ventricular rhythm (R-R
intervals are completely variable), and a narrow
QRS complex. The ventricular rate is 134 bpm.
Which medication does the nurse anticipate
administering first?
A. Intravenous Atropine
B. Intravenous Diltiazem
C. Intravenous Epinephrine
D. Oral Amiodarone
Answer: B. Intravenous Diltiazem
Rationale: The ECG characteristics describe
atrial fibrillation with rapid ventricular response
(RVR). The primary immediate goal in stable
atrial fibrillation with RVR is rate control to
preserve cardiac output. Diltiazem is a calcium
channel blocker frequently given as an IV bolus
SURGICAL NURSING 16TH EDITION
COMPLETE PREMIUM TEST BANK
This premium test bank features high-yield multiple-choice questions
mapped directly to the 16th edition of Brunner & Suddarth's Textbook of
Medical-Surgical Nursing. Designed specifically for nursing students
preparing for rigorous exams, each question features precise clinical
scenarios with italicized answers and comprehensive, bold-italic rationales.
It provides the ultimate resource for master-level preparation in fluid
dynamics, advanced cardiac care, critical respiratory interventions, and
shock states.
Module 1: Fluid, Electrolyte, and Acid-Base
Imbalances
Q1. A nurse is caring for a client with a
nasogastric (NG) tube attached to low
intermittent suction for 3 days. The nurse notes
that the client has developed hyperreflexia,
muscle cramping, and a positive Trousseau’s
sign. Which laboratory value should the nurse
review immediately?
A. Serum sodium 132 mEq/L
B. Serum potassium 5.2 mEq/L
C. Serum calcium 7.2 mg/dL
D. Serum magnesium 2.8 mEq/L
Answer: C. Serum calcium 7.2 mg/dL
Rationale: Prolonged nasogastric suctioning can
lead to metabolic alkalosis, which increases the
,binding of calcium to albumin, reducing the
amount of ionized (active) calcium in the blood.
A positive Trousseau’s sign and muscle
hyperreflexia are classic clinical manifestations
of acute hypocalcemia (normal range: 8.5–10.5
mg/dL). Rapid recognition prevents progression
to laryngospasm or seizures.
Q2. A client with an acute exacerbation of
chronic obstructive pulmonary disease (COPD)
is admitted. The arterial blood gas (ABG)
analysis reveals: pH 7.31, PaCO2 58 mmHg,
HCO3 28 mEq/L, and PaO2 65 mmHg. How
should the nurse interpret these findings?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: B. Partially compensated respiratory
acidosis
Rationale: The pH is below normal (7.35–1.45),
indicating acidosis. The PaCO2 is elevated
(normal: 35–45 mmHg), confirming a respiratory
source. The HCO3 is also elevated (normal: 22–
26 mEq/L), which demonstrates that the kidneys
are actively retaining bicarbonate to compensate
,for the retained acid. Because the pH has not
returned to the normal range, the compensation
is partial.
Q3. A client is prescribed a 3% hypertonic saline
infusion for severe, symptomatic hyponatremia
(serum sodium 114 mEq/L). Which assessment
finding requires the nurse to stop the infusion
immediately?
A. Serum sodium increases to 118 mEq/L in 4 hours
B. New-onset crackles at the lung bases and jugular
venous distention
C. Client reports extreme thirst and dry mucous
membranes
D. Blood pressure increases from 110/60 mmHg to
128/74 mmHg
Answer: B. New-onset crackles at the lung bases
and jugular venous distention
Rationale: Hypertonic saline (3% NaCl) is a high-
alert fluid that pulls water out of cells and into
the extracellular fluid compartment. The most
dangerous complication of this rapid shift is
fluid volume overload, which can quickly
precipitate acute pulmonary edema and heart
failure. New crackles and jugular venous
, distention are primary indicators of circulatory
overload.
Module 2: Advanced Cardiovascular
Management
Q4. The nurse is analyzing an electrocardiogram
(ECG) strip for a client reporting sudden chest
palpitations. The strip shows an absence of P
waves, a highly irregular ventricular rhythm (R-R
intervals are completely variable), and a narrow
QRS complex. The ventricular rate is 134 bpm.
Which medication does the nurse anticipate
administering first?
A. Intravenous Atropine
B. Intravenous Diltiazem
C. Intravenous Epinephrine
D. Oral Amiodarone
Answer: B. Intravenous Diltiazem
Rationale: The ECG characteristics describe
atrial fibrillation with rapid ventricular response
(RVR). The primary immediate goal in stable
atrial fibrillation with RVR is rate control to
preserve cardiac output. Diltiazem is a calcium
channel blocker frequently given as an IV bolus
