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Medical-Surgical Nursing Final Practice
Exam – Questions & Answers with
Rationale
1. A patient with chronic kidney disease is experiencing hyperkalemia. Which intervention
is most appropriate?
A) Administer IV potassium
B) Encourage high-potassium foods
C) Administer sodium polystyrene sulfonate (Kayexalate) ✅
D) Restrict fluids
Answer: C) Administer sodium polystyrene sulfonate (Kayexalate)
Explanation: Kayexalate removes excess potassium from the body, reducing risk of cardiac
complications.
2. A patient with heart failure is prescribed furosemide. Which lab value should the nurse
monitor closely?
A) Sodium
B) Potassium ✅
C) Hemoglobin
D) Glucose
Answer: B) Potassium
Explanation: Loop diuretics can cause hypokalemia, which increases risk of cardiac
arrhythmias.
3. Which assessment finding indicates fluid overload in a patient with heart failure?
A) Dry mucous membranes
B) Peripheral edema ✅
C) Hypotension
D) Bradycardia
Answer: B) Peripheral edema
Explanation: Fluid retention often manifests as peripheral edema in heart failure patients.
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4. A patient post-thyroidectomy reports tingling around the lips and fingers. What is the
priority action?
A) Assess respiratory status
B) Administer calcium gluconate ✅
C) Encourage oral fluids
D) Apply a warm blanket
Answer: B) Administer calcium gluconate
Explanation: Tingling indicates possible hypocalcemia due to parathyroid involvement.
Immediate calcium replacement is required.
5. Which nursing intervention is appropriate for a patient with COPD experiencing
shortness of breath?
A) Place patient in supine position
B) Encourage pursed-lip breathing ✅
C) Limit oxygen therapy
D) Administer sedatives
Answer: B) Encourage pursed-lip breathing
Explanation: Pursed-lip breathing helps reduce air trapping and improves oxygenation.
6. A patient with diabetes presents with fruity-smelling breath, rapid respirations, and
confusion. Which condition is suspected?
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA) ✅
C) Hyperosmolar hyperglycemic state
D) Insulin shock
Answer: B) Diabetic ketoacidosis (DKA)
Explanation: Fruity breath, Kussmaul respirations, and altered mental status are classic DKA
signs.
7. Which lab result indicates anemia in a patient?
A) Hemoglobin 8 g/dL ✅
B) WBC 7,000/mm³
C) Platelets 250,000/mm³
D) Sodium 140 mEq/L
Answer: A) Hemoglobin 8 g/dL
Explanation: Hemoglobin below normal ranges indicates anemia.
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8. A patient with a nasogastric tube has a sudden drop in urine output. What should the
nurse assess first?
A) NG tube placement
B) Signs of dehydration ✅
C) Bowel sounds
D) Pain level
Answer: B) Signs of dehydration
Explanation: NG suction can cause fluid loss leading to decreased urine output.
9. Which patient is at greatest risk for developing pressure ulcers?
A) Ambulatory post-op patient
B) Elderly bedridden patient ✅
C) Young patient with asthma
D) Patient receiving physical therapy
Answer: B) Elderly bedridden patient
Explanation: Immobility, poor perfusion, and age-related skin changes increase pressure ulcer
risk.
10. A patient on heparin therapy reports sudden chest pain and shortness of breath. What
is the priority action?
A) Administer nitroglycerin
B) Notify the provider ✅
C) Encourage deep breathing
D) Apply a warm compress
Answer: B) Notify the provider
Explanation: Signs may indicate pulmonary embolism, requiring urgent intervention.
11. Which intervention is essential for a patient with acute pancreatitis?
A) Encourage high-fat foods
B) Maintain NPO status ✅
C) Provide vigorous exercise
D) Administer antacids
Answer: B) Maintain NPO status
Explanation: Resting the pancreas reduces enzymatic stimulation and inflammation.
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Medical-Surgical Nursing Final Practice
Exam – Questions & Answers with
Rationale
1. A patient with chronic kidney disease is experiencing hyperkalemia. Which intervention
is most appropriate?
A) Administer IV potassium
B) Encourage high-potassium foods
C) Administer sodium polystyrene sulfonate (Kayexalate) ✅
D) Restrict fluids
Answer: C) Administer sodium polystyrene sulfonate (Kayexalate)
Explanation: Kayexalate removes excess potassium from the body, reducing risk of cardiac
complications.
2. A patient with heart failure is prescribed furosemide. Which lab value should the nurse
monitor closely?
A) Sodium
B) Potassium ✅
C) Hemoglobin
D) Glucose
Answer: B) Potassium
Explanation: Loop diuretics can cause hypokalemia, which increases risk of cardiac
arrhythmias.
3. Which assessment finding indicates fluid overload in a patient with heart failure?
A) Dry mucous membranes
B) Peripheral edema ✅
C) Hypotension
D) Bradycardia
Answer: B) Peripheral edema
Explanation: Fluid retention often manifests as peripheral edema in heart failure patients.
Page 1 of Medical-Surgical
26 Medical-Surgical
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4. A patient post-thyroidectomy reports tingling around the lips and fingers. What is the
priority action?
A) Assess respiratory status
B) Administer calcium gluconate ✅
C) Encourage oral fluids
D) Apply a warm blanket
Answer: B) Administer calcium gluconate
Explanation: Tingling indicates possible hypocalcemia due to parathyroid involvement.
Immediate calcium replacement is required.
5. Which nursing intervention is appropriate for a patient with COPD experiencing
shortness of breath?
A) Place patient in supine position
B) Encourage pursed-lip breathing ✅
C) Limit oxygen therapy
D) Administer sedatives
Answer: B) Encourage pursed-lip breathing
Explanation: Pursed-lip breathing helps reduce air trapping and improves oxygenation.
6. A patient with diabetes presents with fruity-smelling breath, rapid respirations, and
confusion. Which condition is suspected?
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA) ✅
C) Hyperosmolar hyperglycemic state
D) Insulin shock
Answer: B) Diabetic ketoacidosis (DKA)
Explanation: Fruity breath, Kussmaul respirations, and altered mental status are classic DKA
signs.
7. Which lab result indicates anemia in a patient?
A) Hemoglobin 8 g/dL ✅
B) WBC 7,000/mm³
C) Platelets 250,000/mm³
D) Sodium 140 mEq/L
Answer: A) Hemoglobin 8 g/dL
Explanation: Hemoglobin below normal ranges indicates anemia.
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8. A patient with a nasogastric tube has a sudden drop in urine output. What should the
nurse assess first?
A) NG tube placement
B) Signs of dehydration ✅
C) Bowel sounds
D) Pain level
Answer: B) Signs of dehydration
Explanation: NG suction can cause fluid loss leading to decreased urine output.
9. Which patient is at greatest risk for developing pressure ulcers?
A) Ambulatory post-op patient
B) Elderly bedridden patient ✅
C) Young patient with asthma
D) Patient receiving physical therapy
Answer: B) Elderly bedridden patient
Explanation: Immobility, poor perfusion, and age-related skin changes increase pressure ulcer
risk.
10. A patient on heparin therapy reports sudden chest pain and shortness of breath. What
is the priority action?
A) Administer nitroglycerin
B) Notify the provider ✅
C) Encourage deep breathing
D) Apply a warm compress
Answer: B) Notify the provider
Explanation: Signs may indicate pulmonary embolism, requiring urgent intervention.
11. Which intervention is essential for a patient with acute pancreatitis?
A) Encourage high-fat foods
B) Maintain NPO status ✅
C) Provide vigorous exercise
D) Administer antacids
Answer: B) Maintain NPO status
Explanation: Resting the pancreas reduces enzymatic stimulation and inflammation.
Page 3 of Medical-Surgical
26 Medical-Surgical
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Nursing
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