Medical Surgical Telemetry RN Exam 2026: 400 Actual Questions and Correct Answers with Rationales | Latest Update Graded A+ | Guaranteed Pass | Certification Review Guide

Are you preparing for the Medical-Surgical or Telemetry RN certification exam? Look no further! This comprehensive study guide contains 400 actual exam questions carefully curated to mirror the real test format, complete with correct answers and evidence-based rationales to reinforce your clinical judgment and ensure you pass with confidence. WHAT'S INSIDE: This powerhouse question bank covers 20+ essential clinical areas tested on the Medical-Surgical and Telemetry RN exams: Cardiac Care & Telemetry – Rhythm interpretation (AFib, atrial flutter, SVT, VT, heart blocks), cardiovascular medications (digoxin, amiodarone, beta-blockers, ACE inhibitors), heart failure management, acute coronary syndromes, pacemakers, arterial lines, and post-CABG care Respiratory Management – Oxygen delivery systems (Venturi, non-rebreather, nasal cannula), mechanical ventilation, chest tubes, COPD, asthma, pneumonia, ARDS, pulmonary embolism, tuberculosis, and tracheostomy care Gastrointestinal & Renal Nursing – Cirrhosis, pancreatitis, diverticulitis, bowel obstructions, ostomies, hepatitis, acute/chronic kidney disease, dialysis, nephrostomy tubes, and kidney stones Neurological Assessment – Stroke care, increased ICP, seizure management, spinal cord injuries, traumatic brain injuries, meningitis, Guillain-Barré syndrome, myasthenia gravis, Parkinson's disease, and Alzheimer's Endocrine Disorders – DKA, hypoglycemia, thyroid disorders, Addison's disease, Cushing's syndrome, SIADH, and diabetes management Perioperative Care – Preoperative and postoperative nursing interventions, malignant hyperthermia, wound care, drains, and patient-controlled analgesia Pharmacology – Medication administration, adverse effects, antidotes, patient education, and high-alert medications Patient Safety & Infection Control – Isolation precautions, fall prevention, pressure ulcer prevention, blood transfusions, and hand hygiene Fluid & Electrolyte Imbalance – Hyperkalemia, hyponatremia, hypocalcemia, hypomagnesemia, acid-base imbalances, and fluid overload Emergency & Critical Care – Cardiac arrest, anaphylaxis, opioid overdose, burn injuries, cervical spine injuries, sepsis, and snake bites Maternal, Pediatric & Gerontological Nursing – Preeclampsia, placenta previa, abruptio placentae, fetal distress, epiglottitis, croup, cystic fibrosis, tetralogy of Fallot, dementia, and osteoporosis Oncology Nursing – Chemotherapy side effects, neutropenia, radiation dermatitis, leukemia, and vincristine toxicity Psychosocial & Ethical Considerations – Grief stages, advance directives, religious preferences, and STI reporting MEDICAL SURGICAL-TELEMETRY RN EXAM 400 ACTUAL QUESTIONS AND CORRECT ANSWERS WITH RATIONALE LATEST UPDATE ALREADY GRADED A+ ASSURED PASS INTRODUCTION This comprehensive examination preparation guide is designed for Registered Nurses preparing for Medical-Surgical and Telemetry certification examinations. The question bank covers essential clinical concepts including: • Cardiac Care & Telemetry: Rhythm interpretation, cardiovascular medications, heart failure management, and acute coronary syndromes • Respiratory Management: Oxygen therapy, mechanical ventilation, chest tubes, and respiratory disorders • Gastrointestinal & Renal Nursing: Digestive disorders, renal failure, dialysis, and fluid/electrolyte balance • Neurological Assessment: Stroke care, increased ICP, seizure management, and neurological emergencies • Endocrine Disorders: Diabetes management, thyroid disorders, and adrenal conditions • Perioperative Care: Preoperative and postoperative nursing interventions • Pharmacology: Medication administration, adverse effects, and patient education • Patient Safety & Quality: Infection control, fall prevention, and ethical/legal considerations Each question includes four multiple-choice options with the correct answer clearly indicated along with an evidence-based rationale to enhance understanding and clinical judgment. This resource is ideal for NCLEX preparation, certification review, and ongoing professional development. SECTION 1: CARDIAC & TELEMETRY Q.1 The nurse is analyzing a cardiac rhythm strip and notes the following: absent P waves, irregular R-R intervals, and a ventricular rate of 140 beats per minute. What is the most appropriate initial nursing action? A) Administer adenosine 6 mg IV push B) Assess the patient's level of consciousness and vital signs C) Prepare for immediate defibrillation D) Begin CPR Correct Answer: B Rationale: The rhythm described is atrial fibrillation with rapid ventricular response (RVR). The nurse's first action should always be to assess the patient's clinical status, including level of consciousness and vital signs, to determine hemodynamic stability. If the patient is stable, treatment may include rate control medications. If unstable, synchronized cardioversion is indicated. Defibrillation is not appropriate for atrial fibrillation. Q.2 A patient is receiving digoxin (Lanoxin). Which assessment finding should the nurse report immediately to the healthcare provider? A) Heart rate of 88 beats per minute B) Serum potassium level of 4.2 mEq/L C) Visual disturbances and nausea D) Blood pressure of 118/76 mm Hg Correct Answer: C Rationale: Visual disturbances (such as yellow-green halos), nausea, and anorexia are classic signs of digoxin toxicity. Other signs include bradycardia, arrhythmias, and confusion. The nurse should hold the medication and notify the provider immediately. Q.3 The nurse is caring for a patient with heart failure who has a potassium level of 3.0 mEq/L. Which action should the nurse take first? A) Administer the prescribed potassium supplement B) Place the patient on continuous cardiac monitoring C) Encourage the patient to eat bananas and oranges D) Notify the healthcare provider immediately Correct Answer: B Rationale: Hypokalemia increases the risk for cardiac dysrhythmias, especially in patients with heart failure. The nurse should first place the patient on continuous cardiac monitoring to detect any life-threatening arrhythmias, then administer prescribed potassium and notify the provider. Q.4 A patient is admitted with acute decompensated heart failure. Which assessment finding indicates the patient is experiencing left-sided heart failure? A) Peripheral edema B) Jugular vein distention C) Crackles in the lung bases D) Hepatomegaly Correct Answer: C Rationale: Left-sided heart failure leads to pulmonary congestion, which manifests as crackles in the lung bases, dyspnea, orthopnea, and pink frothy sputum. Right-sided heart failure causes systemic congestion with peripheral edema, JVD, and hepatomegaly. Q.5 The nurse is teaching a patient about the use of sublingual nitroglycerin for angina. Which statement by the patient indicates a need for further teaching? A) "I should call 911 if the pain doesn't go away after taking three tablets." B) "I should take one tablet every 5 minutes up to three tablets." C) "I should swallow the tablet with water for faster relief." D) "I should sit or lie down when taking the medication." Correct Answer: C Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to dissolve—not swallowed with water. Swallowing the tablet would reduce its effectiveness because it would undergo first-pass metabolism in the liver. The patient should sit or lie down to prevent hypotension and call 911 if pain persists after three tablets