Med-Surg & APEA Mastery: 200 High-Yield Questions with
Rationales
1. A patient with COPD is experiencing shortness of breath. Which position
improves ventilation?
A. Prone
B. High-Fowler’s
C. Supine
D. Trendelenburg
Answer: B
Rationale: High-Fowler’s expands the lungs, reduces work of breathing, and improves
chest expansion in COPD patients.
2. Crackles in the lower lobes most likely indicate:
A. Bronchospasm
B. Fluid in alveoli
C. Thick mucus
D. Collapsed lung
Answer: B
Rationale: Crackles are caused by air moving through fluid; commonly seen in
pneumonia and heart failure.
3. Which lab is most concerning in a patient with DKA?
A. pH 7.32
B. K+ 6.1
,C. HCO₃ 23
D. Na+ 138
Answer: B
Rationale: DKA often causes high potassium, which can trigger fatal dysrhythmias.
4. The FIRST intervention for suspected hypovolemic shock is:
A. Warm blankets
B. Start IV fluids
C. Insert NG tube
D. Oral fluids
Answer: B
Rationale: Isotonic IV fluids restore circulating volume and prevent organ failure.
5. Which weight change in HF is most concerning?
A. 0.5 kg in 48 hours
B. 1 kg in a week
C. 2 kg in 2 days
D. 0.2 kg in a day
Answer: C
Rationale: Rapid weight gain = fluid retention, risk for pulmonary edema.
6. Cyanosis appears when:
A. Hemoglobin is normal
B. Oxygen saturation is low
,C. Blood pressure increases
D. Glucose is elevated
Answer: B
Rationale: Cyanosis = inadequate oxygenation.
7. Blood glucose 55 mg/dL: first action?
A. IV insulin
B. 4 oz fruit juice
C. Water
D. Electrolytes
Answer: B
Rationale: Rule of 15: give fast-acting carbs, recheck in 15 min.
8. Improvement in pneumonia is indicated by:
A. Increased RR
B. Decreased O₃
C. Persistent crackles
D. Decreased WBC
Answer: D
Rationale: Lower WBC = infection resolving.
9. Post-op patient reports calf pain. Suspect:
A. Hypokalemia
B. DVT
, C. Dehydration
D. Infection
Answer: B
Rationale: Unilateral calf pain + tenderness = classic DVT sign.
10. Which ABG indicates respiratory alkalosis?
A. pH 7.50, CO₃ 29
B. pH 7.20, CO₃ 60
C. pH 7.32, HCO₃ 18
D. pH 7.25, HCO₃ 14
Answer: A
Rationale: High pH + low CO₃ = hyperventilation → alkalosis.
11. Renal failure commonly causes:
A. Low K+
B. High K+
C. Low phosphorus
D. High sodium
Answer: B
Rationale: Kidneys cannot excrete potassium → hyperkalemia.
12. Which food must celiac patients avoid?
A. Rice
B. Wheat bread
Rationales
1. A patient with COPD is experiencing shortness of breath. Which position
improves ventilation?
A. Prone
B. High-Fowler’s
C. Supine
D. Trendelenburg
Answer: B
Rationale: High-Fowler’s expands the lungs, reduces work of breathing, and improves
chest expansion in COPD patients.
2. Crackles in the lower lobes most likely indicate:
A. Bronchospasm
B. Fluid in alveoli
C. Thick mucus
D. Collapsed lung
Answer: B
Rationale: Crackles are caused by air moving through fluid; commonly seen in
pneumonia and heart failure.
3. Which lab is most concerning in a patient with DKA?
A. pH 7.32
B. K+ 6.1
,C. HCO₃ 23
D. Na+ 138
Answer: B
Rationale: DKA often causes high potassium, which can trigger fatal dysrhythmias.
4. The FIRST intervention for suspected hypovolemic shock is:
A. Warm blankets
B. Start IV fluids
C. Insert NG tube
D. Oral fluids
Answer: B
Rationale: Isotonic IV fluids restore circulating volume and prevent organ failure.
5. Which weight change in HF is most concerning?
A. 0.5 kg in 48 hours
B. 1 kg in a week
C. 2 kg in 2 days
D. 0.2 kg in a day
Answer: C
Rationale: Rapid weight gain = fluid retention, risk for pulmonary edema.
6. Cyanosis appears when:
A. Hemoglobin is normal
B. Oxygen saturation is low
,C. Blood pressure increases
D. Glucose is elevated
Answer: B
Rationale: Cyanosis = inadequate oxygenation.
7. Blood glucose 55 mg/dL: first action?
A. IV insulin
B. 4 oz fruit juice
C. Water
D. Electrolytes
Answer: B
Rationale: Rule of 15: give fast-acting carbs, recheck in 15 min.
8. Improvement in pneumonia is indicated by:
A. Increased RR
B. Decreased O₃
C. Persistent crackles
D. Decreased WBC
Answer: D
Rationale: Lower WBC = infection resolving.
9. Post-op patient reports calf pain. Suspect:
A. Hypokalemia
B. DVT
, C. Dehydration
D. Infection
Answer: B
Rationale: Unilateral calf pain + tenderness = classic DVT sign.
10. Which ABG indicates respiratory alkalosis?
A. pH 7.50, CO₃ 29
B. pH 7.20, CO₃ 60
C. pH 7.32, HCO₃ 18
D. pH 7.25, HCO₃ 14
Answer: A
Rationale: High pH + low CO₃ = hyperventilation → alkalosis.
11. Renal failure commonly causes:
A. Low K+
B. High K+
C. Low phosphorus
D. High sodium
Answer: B
Rationale: Kidneys cannot excrete potassium → hyperkalemia.
12. Which food must celiac patients avoid?
A. Rice
B. Wheat bread
