Med-Surg Emergencies 100-question
practice exam
answers and rationales
1. A patient arrives at the emergency department with sudden onset
chest pain radiating to the left arm. Which action should the nurse
take first?
a. Administer nitroglycerin
b. Obtain a 12-lead ECG
c. Start an IV line
d. Obtain a detailed history
b. Obtain a 12-lead ECG
Rationale: Immediate ECG is the priority to identify myocardial
infarction and guide urgent interventions.
2. A patient with severe asthma is in respiratory distress. Which
intervention is highest priority?
a. Administer a corticosteroid
b. Administer a short-acting bronchodilator
c. Obtain a chest X-ray
d. Start oxygen therapy
b. Administer a short-acting bronchodilator
Rationale: Rapid bronchodilation relieves airway obstruction and is
life-saving in acute asthma exacerbation.
3. Which lab result is most critical in a patient with suspected
hypovolemic shock?
a. Serum potassium
, b. Hematocrit and hemoglobin
c. Blood glucose
d. Serum calcium
b. Hematocrit and hemoglobin
Rationale: Low hematocrit and hemoglobin indicate blood loss, which
is central to hypovolemic shock assessment.
4. A patient is admitted after a motor vehicle accident with
suspected internal bleeding. What is the priority nursing action?
a. Start IV fluids
b. Perform a full neurological assessment
c. Apply a cardiac monitor
d. Obtain a focused assessment with sonography for trauma
(FAST)
d. Obtain a focused assessment with sonography for trauma (FAST)
Rationale: FAST rapidly identifies internal bleeding to guide urgent
surgical intervention.
5. A patient develops sudden shortness of breath and pleuritic chest
pain after hip surgery. What is the nurse's priority action?
a. Obtain a D-dimer
b. Administer oxygen
c. Notify the healthcare provider immediately
d. Prepare the patient for a CT pulmonary angiogram
b. Administer oxygen
Rationale: Oxygenation is the immediate priority in suspected
pulmonary embolism to prevent hypoxemia.
6. Which symptom in a patient with a head injury indicates
increased intracranial pressure (ICP)?
a. Bradycardia with hypertension
, b. Tachycardia and hypotension
c. Hyperactive reflexes
d. Peripheral edema
a. Bradycardia with hypertension
Rationale: Cushing’s triad (bradycardia, hypertension, irregular
respirations) is a hallmark of increased ICP.
7. A patient with anaphylaxis presents with hypotension, stridor, and
hives. What is the priority intervention?
a. Administer diphenhydramine
b. Give epinephrine intramuscularly
c. Start IV fluids
d. Obtain an airway assessment
b. Give epinephrine intramuscularly
Rationale: Epinephrine is the first-line treatment for anaphylaxis to
reverse airway constriction and shock.
8. During a code blue, which action should the nurse perform first
when a patient is found unresponsive and pulseless?
a. Start chest compressions
b. Administer epinephrine
c. Call for the code team
d. Defibrillate immediately
a. Start chest compressions
Rationale: High-quality chest compressions maintain circulation and
are the priority in pulseless cardiac arrest.
9. A patient presents with acute abdominal pain, rigidity, and
rebound tenderness. What is the nurse’s priority action?
a. Prepare for surgery
b. Administer analgesics
, c. Obtain vital signs and start IV fluids
d. Obtain a CT scan
c. Obtain vital signs and start IV fluids
Rationale: Stabilization of circulation and assessment of
hemodynamic status is the priority in suspected peritonitis or
abdominal emergency.
10. Which clinical finding in a patient with septic shock requires
immediate intervention?
a. Fever of 38°C
b. Urine output of 15 mL/hr
c. Mild tachycardia
d. Mild hypotension
b. Urine output of 15 mL/hr
Rationale: Oliguria indicates inadequate perfusion and impending
organ failure in septic shock, requiring urgent intervention.
11. A patient with acute pancreatitis reports severe epigastric
pain radiating to the back. Which intervention should the nurse
prioritize?
a. Administer oral analgesics
b. Place the patient in a semi-Fowler’s position
c. Start IV fluids and pain management
d. Encourage oral intake
c. Start IV fluids and pain management
Rationale: Aggressive IV fluid replacement and pain control are
critical to prevent hypovolemia and manage severe pain.
12. A patient develops sudden confusion, agitation, and a blood
pressure of 80/50 mmHg after surgery. Which condition is most
practice exam
answers and rationales
1. A patient arrives at the emergency department with sudden onset
chest pain radiating to the left arm. Which action should the nurse
take first?
a. Administer nitroglycerin
b. Obtain a 12-lead ECG
c. Start an IV line
d. Obtain a detailed history
b. Obtain a 12-lead ECG
Rationale: Immediate ECG is the priority to identify myocardial
infarction and guide urgent interventions.
2. A patient with severe asthma is in respiratory distress. Which
intervention is highest priority?
a. Administer a corticosteroid
b. Administer a short-acting bronchodilator
c. Obtain a chest X-ray
d. Start oxygen therapy
b. Administer a short-acting bronchodilator
Rationale: Rapid bronchodilation relieves airway obstruction and is
life-saving in acute asthma exacerbation.
3. Which lab result is most critical in a patient with suspected
hypovolemic shock?
a. Serum potassium
, b. Hematocrit and hemoglobin
c. Blood glucose
d. Serum calcium
b. Hematocrit and hemoglobin
Rationale: Low hematocrit and hemoglobin indicate blood loss, which
is central to hypovolemic shock assessment.
4. A patient is admitted after a motor vehicle accident with
suspected internal bleeding. What is the priority nursing action?
a. Start IV fluids
b. Perform a full neurological assessment
c. Apply a cardiac monitor
d. Obtain a focused assessment with sonography for trauma
(FAST)
d. Obtain a focused assessment with sonography for trauma (FAST)
Rationale: FAST rapidly identifies internal bleeding to guide urgent
surgical intervention.
5. A patient develops sudden shortness of breath and pleuritic chest
pain after hip surgery. What is the nurse's priority action?
a. Obtain a D-dimer
b. Administer oxygen
c. Notify the healthcare provider immediately
d. Prepare the patient for a CT pulmonary angiogram
b. Administer oxygen
Rationale: Oxygenation is the immediate priority in suspected
pulmonary embolism to prevent hypoxemia.
6. Which symptom in a patient with a head injury indicates
increased intracranial pressure (ICP)?
a. Bradycardia with hypertension
, b. Tachycardia and hypotension
c. Hyperactive reflexes
d. Peripheral edema
a. Bradycardia with hypertension
Rationale: Cushing’s triad (bradycardia, hypertension, irregular
respirations) is a hallmark of increased ICP.
7. A patient with anaphylaxis presents with hypotension, stridor, and
hives. What is the priority intervention?
a. Administer diphenhydramine
b. Give epinephrine intramuscularly
c. Start IV fluids
d. Obtain an airway assessment
b. Give epinephrine intramuscularly
Rationale: Epinephrine is the first-line treatment for anaphylaxis to
reverse airway constriction and shock.
8. During a code blue, which action should the nurse perform first
when a patient is found unresponsive and pulseless?
a. Start chest compressions
b. Administer epinephrine
c. Call for the code team
d. Defibrillate immediately
a. Start chest compressions
Rationale: High-quality chest compressions maintain circulation and
are the priority in pulseless cardiac arrest.
9. A patient presents with acute abdominal pain, rigidity, and
rebound tenderness. What is the nurse’s priority action?
a. Prepare for surgery
b. Administer analgesics
, c. Obtain vital signs and start IV fluids
d. Obtain a CT scan
c. Obtain vital signs and start IV fluids
Rationale: Stabilization of circulation and assessment of
hemodynamic status is the priority in suspected peritonitis or
abdominal emergency.
10. Which clinical finding in a patient with septic shock requires
immediate intervention?
a. Fever of 38°C
b. Urine output of 15 mL/hr
c. Mild tachycardia
d. Mild hypotension
b. Urine output of 15 mL/hr
Rationale: Oliguria indicates inadequate perfusion and impending
organ failure in septic shock, requiring urgent intervention.
11. A patient with acute pancreatitis reports severe epigastric
pain radiating to the back. Which intervention should the nurse
prioritize?
a. Administer oral analgesics
b. Place the patient in a semi-Fowler’s position
c. Start IV fluids and pain management
d. Encourage oral intake
c. Start IV fluids and pain management
Rationale: Aggressive IV fluid replacement and pain control are
critical to prevent hypovolemia and manage severe pain.
12. A patient develops sudden confusion, agitation, and a blood
pressure of 80/50 mmHg after surgery. Which condition is most
