RN Adult Medical Surgical 2026 Proctored Exam
Bundle- All Passing Versions
1. Which finding is most characteristic of an acute myocardial infarction
(MI)?
o A. Sharp pain worse on inspiration
o B. Crushing chest pain unrelieved by rest
o C. Burning pain relieved by antacids
o D. Pain reproduced by palpation
o Rationale: MI pain is typically crushing, substernal, and may
radiate to the jaw/left arm; it is not relieved by rest or nitroglycerin.
2. A client with heart failure should report which daily weight change?
o A. 1 lb gain in 24 hours
o B. 2–3 lb gain in 24 hours
o C. 1 lb loss in 24 hours
o D. Stable weight for 3 days
o Rationale: Rapid weight gain indicates fluid retention and
worsening heart failure; report gains >2–3 lb/day or >5 lb/week.
3. Which sign indicates digoxin toxicity?
o A. Tachycardia
o B. Hypertension
o C. Bradycardia and visual changes
o D. Increased appetite
, o Rationale: Digoxin toxicity can cause bradycardia, nausea,
anorexia, confusion, and yellow-green visual halos.
4. A client on warfarin should avoid which action?
o A. Using a soft toothbrush
o B. Eating large amounts of leafy green vegetables
o C. Wearing a medical alert bracelet
o D. Keeping INR appointments
o Rationale: Vitamin K–rich foods can antagonize warfarin; intake
should be consistent, not excessive.
5. Which lab value is monitored during IV heparin therapy?
o A. PT/INR
o B. aPTT
o C. Bleeding time
o D. Platelet count only
o Rationale: aPTT monitors heparin. Protamine sulfate is the
antidote.
6. A client with a new pacemaker should be taught to:
o A. Avoid all electrical devices
o B. Carry a pacemaker ID card
o C. Sleep only on the left side
o D. Stop checking pulse
o Rationale: Clients should carry an ID card and report dizziness,
hiccups, or palpitations.
7. Which instruction is appropriate for a client with DVT?
, o A. Massage the calf to improve circulation
o B. Apply cold packs continuously
o C. Do not massage the affected leg
o D. Ambulate vigorously
o Rationale: Massaging a DVT can dislodge the clot and cause
pulmonary embolism.
8. Which diet is recommended for hypertension?
o A. High sodium, low potassium
o B. DASH diet
o C. High saturated fat
o D. Fluid restriction
o Rationale: DASH emphasizes fruits, vegetables, low-fat dairy, and
reduced sodium.
9. Which finding is typical of peripheral arterial disease (PAD)?
o A. Dependent rubor and intermittent claudication
o B. Warm, swollen extremities
o C. Pain relieved by elevating legs
o D. Strong pedal pulses
o Rationale: PAD causes decreased pulses, cool shiny skin, and pain
with exercise relieved by rest.
10.A classic triad of aortic stenosis includes:
• A. Fever, rash, joint pain
• B. Angina, syncope, dyspnea
• C. Hematuria, flank pain, fever
, • D. Weight loss, heat intolerance, tremor
• Rationale: Aortic stenosis can cause exertional angina, syncope, and
dyspnea.
11.Which oxygen target is appropriate for a client with COPD?
• A. 100% oxygen
• B. SpO2 88–92%
• C. SpO2 70–80%
• D. No oxygen ever
• Rationale: Excessive oxygen can suppress respiratory drive in COPD;
target 88–92%.
12.Which medication is given first during an acute asthma attack?
• A. Albuterol
• B. Montelukast
• C. Inhaled corticosteroid
• D. Theophylline
• Rationale: Short-acting beta agonists provide rapid bronchodilation.
13.Which intervention helps prevent pneumonia in a postoperative client?
• A. Bed rest
• B. Incentive spirometry
• C. Fluid restriction
• D. Supine positioning
• Rationale: Incentive spirometry promotes lung expansion and prevents
atelectasis.
14.Which precautions are required for tuberculosis?
Bundle- All Passing Versions
1. Which finding is most characteristic of an acute myocardial infarction
(MI)?
o A. Sharp pain worse on inspiration
o B. Crushing chest pain unrelieved by rest
o C. Burning pain relieved by antacids
o D. Pain reproduced by palpation
o Rationale: MI pain is typically crushing, substernal, and may
radiate to the jaw/left arm; it is not relieved by rest or nitroglycerin.
2. A client with heart failure should report which daily weight change?
o A. 1 lb gain in 24 hours
o B. 2–3 lb gain in 24 hours
o C. 1 lb loss in 24 hours
o D. Stable weight for 3 days
o Rationale: Rapid weight gain indicates fluid retention and
worsening heart failure; report gains >2–3 lb/day or >5 lb/week.
3. Which sign indicates digoxin toxicity?
o A. Tachycardia
o B. Hypertension
o C. Bradycardia and visual changes
o D. Increased appetite
, o Rationale: Digoxin toxicity can cause bradycardia, nausea,
anorexia, confusion, and yellow-green visual halos.
4. A client on warfarin should avoid which action?
o A. Using a soft toothbrush
o B. Eating large amounts of leafy green vegetables
o C. Wearing a medical alert bracelet
o D. Keeping INR appointments
o Rationale: Vitamin K–rich foods can antagonize warfarin; intake
should be consistent, not excessive.
5. Which lab value is monitored during IV heparin therapy?
o A. PT/INR
o B. aPTT
o C. Bleeding time
o D. Platelet count only
o Rationale: aPTT monitors heparin. Protamine sulfate is the
antidote.
6. A client with a new pacemaker should be taught to:
o A. Avoid all electrical devices
o B. Carry a pacemaker ID card
o C. Sleep only on the left side
o D. Stop checking pulse
o Rationale: Clients should carry an ID card and report dizziness,
hiccups, or palpitations.
7. Which instruction is appropriate for a client with DVT?
, o A. Massage the calf to improve circulation
o B. Apply cold packs continuously
o C. Do not massage the affected leg
o D. Ambulate vigorously
o Rationale: Massaging a DVT can dislodge the clot and cause
pulmonary embolism.
8. Which diet is recommended for hypertension?
o A. High sodium, low potassium
o B. DASH diet
o C. High saturated fat
o D. Fluid restriction
o Rationale: DASH emphasizes fruits, vegetables, low-fat dairy, and
reduced sodium.
9. Which finding is typical of peripheral arterial disease (PAD)?
o A. Dependent rubor and intermittent claudication
o B. Warm, swollen extremities
o C. Pain relieved by elevating legs
o D. Strong pedal pulses
o Rationale: PAD causes decreased pulses, cool shiny skin, and pain
with exercise relieved by rest.
10.A classic triad of aortic stenosis includes:
• A. Fever, rash, joint pain
• B. Angina, syncope, dyspnea
• C. Hematuria, flank pain, fever
, • D. Weight loss, heat intolerance, tremor
• Rationale: Aortic stenosis can cause exertional angina, syncope, and
dyspnea.
11.Which oxygen target is appropriate for a client with COPD?
• A. 100% oxygen
• B. SpO2 88–92%
• C. SpO2 70–80%
• D. No oxygen ever
• Rationale: Excessive oxygen can suppress respiratory drive in COPD;
target 88–92%.
12.Which medication is given first during an acute asthma attack?
• A. Albuterol
• B. Montelukast
• C. Inhaled corticosteroid
• D. Theophylline
• Rationale: Short-acting beta agonists provide rapid bronchodilation.
13.Which intervention helps prevent pneumonia in a postoperative client?
• A. Bed rest
• B. Incentive spirometry
• C. Fluid restriction
• D. Supine positioning
• Rationale: Incentive spirometry promotes lung expansion and prevents
atelectasis.
14.Which precautions are required for tuberculosis?
