PN MEDICAL-SURGICAL NURSING EXAM QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A+
CORE DOMAINS
• Cardiovascular and Hematologic Disorders
• Respiratory Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Disorders
• Renal and Urinary Disorders
• Neurological and Sensory Disorders
• Musculoskeletal and Integumentary Disorders
• Perioperative and Emergency Care
• Oncology and Palliative Care
• Pharmacology and Medication Safety
INTRODUCTION
This comprehensive examination is designed for practical nursing students
preparing for a PN Medical-Surgical Nursing Exam. It contains verified
questions with correct answers and detailed rationales covering the core
domains of adult medical-surgical nursing. The examination mirrors the
format of standardized PN exams and emphasizes clinical judgment,
prioritization, and safe decision-making. Each question is accompanied by
a detailed rationale to reinforce understanding of medical-surgical nursing
concepts and prepare candidates for real-world clinical practice.
SECTION ONE: QUESTIONS 1–100
1. A client with heart failure is prescribed furosemide. Which finding
indicates a therapeutic response?
A. Weight loss of 2 kg over 3 days
B. Increased jugular venous distension
,C. Decreased urine output
D. Weight gain of 1 kg
A. Weight loss of 2 kg over 3 days
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload. Therapeutic response is indicated by weight loss, decreased
edema, and decreased jugular venous distension. Increased JVD and
weight gain indicate worsening heart failure.
2. A client with a suspected deep vein thrombosis (DVT). Which
finding is most characteristic?
A. Unilateral calf pain and swelling
B. Bilateral pitting edema
C. Warm, reddened area on the chest
D. Cool, pale extremity
A. Unilateral calf pain and swelling
RATIONALE: DVT typically presents with unilateral calf pain,
tenderness, and swelling. Bilateral edema is more common in heart failure;
a warm, reddened area on the chest suggests cellulitis; a cool, pale
extremity suggests arterial insufficiency.
3. A nurse is assessing a client with a suspected pulmonary
embolism. Which diagnostic test is most definitive?
A. CT pulmonary angiography
B. Chest X-ray
C. D-dimer
D. Arterial blood gas
A. CT pulmonary angiography
RATIONALE: CT pulmonary angiography is the gold standard for
diagnosing pulmonary embolism. D-dimer is a screening tool, and chest X-
ray and ABG are supportive but not definitive.
4. A client with a tracheostomy is being suctioned. Which finding
indicates the need to stop suctioning?
,A. Heart rate decreases from 90 to 50 bpm
B. Client coughs during suctioning
C. Suction catheter meets resistance
D. Secretions are thick and yellow
A. Heart rate decreases from 90 to 50 bpm
RATIONALE: Bradycardia during suctioning indicates vagal stimulation
and hypoxia. Suctioning should be stopped immediately, and the client
should be reoxygenated.
5. The nurse is assessing a client with a suspected stroke. Which
finding is a contraindication to thrombolytic therapy?
A. Blood pressure of 180/100 mm Hg
B. Onset of symptoms 2 hours ago
C. Blood glucose of 120 mg/dL
D. History of migraine headaches
A. Blood pressure of 180/100 mm Hg
RATIONALE: Uncontrolled hypertension (systolic >185 mm Hg or
diastolic >110 mm Hg) is a contraindication to thrombolytic therapy due to
the risk of intracranial hemorrhage.
6. A client with chronic obstructive pulmonary disease (COPD) is
prescribed oxygen. Which flow rate is appropriate?
A. 1-2 L/min via nasal cannula
B. 4-6 L/min via nasal cannula
C. 8-10 L/min via face mask
D. 15 L/min via non-rebreather mask
A. 1-2 L/min via nasal cannula
RATIONALE: In COPD, the hypoxic drive may be the primary stimulus
for breathing. High-flow oxygen can suppress respiratory drive and cause
CO2 retention. Low-flow oxygen (1-2 L/min) is typically appropriate.
7. A client with a diagnosis of heart failure is prescribed a beta-
blocker. Which finding indicates a therapeutic response?
, A. Decreased heart rate and blood pressure
B. Increased heart rate
C. Increased edema
D. Weight gain
A. Decreased heart rate and blood pressure
RATIONALE: Beta-blockers reduce heart rate and blood pressure,
decreasing myocardial oxygen demand and improving survival in heart
failure. Edema and weight gain indicate worsening heart failure.
8. A client is admitted with a diagnosis of severe dehydration. Which
finding is most characteristic?
A. Poor skin turgor and dry mucous membranes
B. Bounding pulses and hypertension
C. Weight gain and edema
D. Crackles in the lungs
A. Poor skin turgor and dry mucous membranes
RATIONALE: Severe dehydration presents with poor skin turgor, dry
mucous membranes, tachycardia, hypotension, and decreased urine
output. Bounding pulses and edema indicate fluid overload.
9. A nurse is assessing a client with a suspected basilar skull fracture.
Which finding is most characteristic?
A. Battle's sign and raccoon eyes
B. Positive Babinski sign
C. Pinpoint pupils
D. Decerebrate posturing
A. Battle's sign and raccoon eyes
RATIONALE: Basilar skull fracture is associated with Battle's sign
(ecchymosis behind the ear) and raccoon eyes (periorbital ecchymosis).
Clear or bloody drainage from the nose or ears (CSF leak) may also be
present.
ANSWERS | 100% CORRECT | GRADE A+
CORE DOMAINS
• Cardiovascular and Hematologic Disorders
• Respiratory Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Disorders
• Renal and Urinary Disorders
• Neurological and Sensory Disorders
• Musculoskeletal and Integumentary Disorders
• Perioperative and Emergency Care
• Oncology and Palliative Care
• Pharmacology and Medication Safety
INTRODUCTION
This comprehensive examination is designed for practical nursing students
preparing for a PN Medical-Surgical Nursing Exam. It contains verified
questions with correct answers and detailed rationales covering the core
domains of adult medical-surgical nursing. The examination mirrors the
format of standardized PN exams and emphasizes clinical judgment,
prioritization, and safe decision-making. Each question is accompanied by
a detailed rationale to reinforce understanding of medical-surgical nursing
concepts and prepare candidates for real-world clinical practice.
SECTION ONE: QUESTIONS 1–100
1. A client with heart failure is prescribed furosemide. Which finding
indicates a therapeutic response?
A. Weight loss of 2 kg over 3 days
B. Increased jugular venous distension
,C. Decreased urine output
D. Weight gain of 1 kg
A. Weight loss of 2 kg over 3 days
RATIONALE: Furosemide is a loop diuretic used to reduce fluid
overload. Therapeutic response is indicated by weight loss, decreased
edema, and decreased jugular venous distension. Increased JVD and
weight gain indicate worsening heart failure.
2. A client with a suspected deep vein thrombosis (DVT). Which
finding is most characteristic?
A. Unilateral calf pain and swelling
B. Bilateral pitting edema
C. Warm, reddened area on the chest
D. Cool, pale extremity
A. Unilateral calf pain and swelling
RATIONALE: DVT typically presents with unilateral calf pain,
tenderness, and swelling. Bilateral edema is more common in heart failure;
a warm, reddened area on the chest suggests cellulitis; a cool, pale
extremity suggests arterial insufficiency.
3. A nurse is assessing a client with a suspected pulmonary
embolism. Which diagnostic test is most definitive?
A. CT pulmonary angiography
B. Chest X-ray
C. D-dimer
D. Arterial blood gas
A. CT pulmonary angiography
RATIONALE: CT pulmonary angiography is the gold standard for
diagnosing pulmonary embolism. D-dimer is a screening tool, and chest X-
ray and ABG are supportive but not definitive.
4. A client with a tracheostomy is being suctioned. Which finding
indicates the need to stop suctioning?
,A. Heart rate decreases from 90 to 50 bpm
B. Client coughs during suctioning
C. Suction catheter meets resistance
D. Secretions are thick and yellow
A. Heart rate decreases from 90 to 50 bpm
RATIONALE: Bradycardia during suctioning indicates vagal stimulation
and hypoxia. Suctioning should be stopped immediately, and the client
should be reoxygenated.
5. The nurse is assessing a client with a suspected stroke. Which
finding is a contraindication to thrombolytic therapy?
A. Blood pressure of 180/100 mm Hg
B. Onset of symptoms 2 hours ago
C. Blood glucose of 120 mg/dL
D. History of migraine headaches
A. Blood pressure of 180/100 mm Hg
RATIONALE: Uncontrolled hypertension (systolic >185 mm Hg or
diastolic >110 mm Hg) is a contraindication to thrombolytic therapy due to
the risk of intracranial hemorrhage.
6. A client with chronic obstructive pulmonary disease (COPD) is
prescribed oxygen. Which flow rate is appropriate?
A. 1-2 L/min via nasal cannula
B. 4-6 L/min via nasal cannula
C. 8-10 L/min via face mask
D. 15 L/min via non-rebreather mask
A. 1-2 L/min via nasal cannula
RATIONALE: In COPD, the hypoxic drive may be the primary stimulus
for breathing. High-flow oxygen can suppress respiratory drive and cause
CO2 retention. Low-flow oxygen (1-2 L/min) is typically appropriate.
7. A client with a diagnosis of heart failure is prescribed a beta-
blocker. Which finding indicates a therapeutic response?
, A. Decreased heart rate and blood pressure
B. Increased heart rate
C. Increased edema
D. Weight gain
A. Decreased heart rate and blood pressure
RATIONALE: Beta-blockers reduce heart rate and blood pressure,
decreasing myocardial oxygen demand and improving survival in heart
failure. Edema and weight gain indicate worsening heart failure.
8. A client is admitted with a diagnosis of severe dehydration. Which
finding is most characteristic?
A. Poor skin turgor and dry mucous membranes
B. Bounding pulses and hypertension
C. Weight gain and edema
D. Crackles in the lungs
A. Poor skin turgor and dry mucous membranes
RATIONALE: Severe dehydration presents with poor skin turgor, dry
mucous membranes, tachycardia, hypotension, and decreased urine
output. Bounding pulses and edema indicate fluid overload.
9. A nurse is assessing a client with a suspected basilar skull fracture.
Which finding is most characteristic?
A. Battle's sign and raccoon eyes
B. Positive Babinski sign
C. Pinpoint pupils
D. Decerebrate posturing
A. Battle's sign and raccoon eyes
RATIONALE: Basilar skull fracture is associated with Battle's sign
(ecchymosis behind the ear) and raccoon eyes (periorbital ecchymosis).
Clear or bloody drainage from the nose or ears (CSF leak) may also be
present.
