BSN HESI 266 MED SURG EXAM | LATEST EDITION |
NIGHTINGALE COLLEGE | QUESTIONS AND ANSWERS | LATEST
EXAM
Questions
1. A patient with chronic obstructive pulmonary disease (COPD) reports
increasing shortness of breath and a productive cough. Which assessment
finding requires immediate intervention?
A. Mild wheezing
B. SpO₂ 82% on room air
C. Productive cough with yellow sputum
D. Use of accessory muscles while breathing
Answer: B. SpO₂ 82% on room air
2. The nurse is caring for a patient with heart failure who has a new
prescription for furosemide. What is the most important electrolyte to
monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
3. A patient with type 1 diabetes is experiencing confusion, sweating, and
tremors. The nurse suspects hypoglycemia. What is the priority
intervention?
A. Administer insulin
B. Give 15–20 grams of fast-acting carbohydrate
C. Check hemoglobin A1c
D. Encourage exercise
Answer: B. Give 15–20 grams of fast-acting carbohydrate
4. A patient with a history of myocardial infarction reports chest pain
radiating to the left arm. Which action should the nurse take first?
A. Administer aspirin
B. Obtain a 12-lead ECG
C. Apply oxygen
, D. Notify the healthcare provider
Answer: B. Obtain a 12-lead ECG
5. A patient is receiving warfarin therapy. Which laboratory value should the
nurse monitor to ensure therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A. INR
6. Which patient is at greatest risk for developing deep vein thrombosis
(DVT)?
A. 25-year-old with asthma
B. 60-year-old post-operative orthopedic patient
C. 45-year-old with diabetes
D. 30-year-old on oral contraceptives
Answer: B. 60-year-old post-operative orthopedic patient
7. A nurse is providing discharge teaching for a patient with hypertension.
Which statement indicates understanding?
A. "I will take my blood pressure medication only when my readings are
high."
B. "I should limit my sodium intake and exercise regularly."
C. "I can continue smoking as long as I take my medication."
D. "Stress has no impact on my blood pressure."
Answer: B. "I should limit my sodium intake and exercise regularly."
8. A patient with acute pancreatitis has a serum amylase level of 450 U/L.
Which nursing intervention is most appropriate?
A. Encourage high-fat meals
B. Maintain NPO status and administer IV fluids
C. Provide insulin therapy
D. Start oral antibiotics
Answer: B. Maintain NPO status and administer IV fluids
9. A patient with chronic kidney disease reports fatigue and pallor. Which
lab value should the nurse assess first?
A. Blood glucose
B. Hemoglobin
C. Serum creatinine
, D. Serum potassium
Answer: B. Hemoglobin
10.A patient presents with sudden, severe headache, nuchal rigidity, and
photophobia. Which condition should the nurse suspect?
A. Migraine
B. Subarachnoid hemorrhage
C. Sinusitis
D. Tension headache
Answer: B. Subarachnoid hemorrhage
11.A patient is post-operative day 2 following abdominal surgery and reports
abdominal distention and absent bowel sounds. What is the priority
nursing action?
A. Administer pain medication
B. Notify the healthcare provider
C. Encourage ambulation
D. Provide oral fluids
Answer: B. Notify the healthcare provider
12.The nurse is assessing a patient with cirrhosis. Which finding indicates
hepatic encephalopathy?
A. Jaundice and ascites
B. Confusion and asterixis
C. Elevated AST and ALT
D. Palmar erythema
Answer: B. Confusion and asterixis
13.A patient with a peptic ulcer reports black, tarry stools. What is the
priority nursing action?
A. Encourage increased fiber intake
B. Assess vital signs and notify the provider
C. Schedule an upper GI endoscopy in one week
D. Administer antacids
Answer: B. Assess vital signs and notify the provider
14.A patient with COPD is prescribed albuterol inhaler. Which instruction is
correct?
A. "Use this inhaler only when you have a severe attack."
B. "Rinse your mouth after each use."
C. "Use this inhaler before activities that may trigger shortness of breath."
D. "Limit fluid intake to prevent side effects."
, Answer: C. "Use this inhaler before activities that may trigger
shortness of breath."
15.A nurse is preparing to administer packed red blood cells to a patient.
Which action is essential before starting the transfusion?
A. Verify patient identity and blood compatibility
B. Administer diuretics
C. Shaking the blood bag to mix contents
D. Check blood glucose level
Answer: A. Verify patient identity and blood compatibility
16.A patient is receiving IV potassium chloride. Which nursing intervention
is priority?
A. Administer IV push rapidly
B. Monitor ECG for dysrhythmias
C. Encourage high potassium diet
D. Check blood glucose levels
Answer: B. Monitor ECG for dysrhythmias
17.Which symptom is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Peripheral edema and jugular venous distention
C. Dyspnea at rest
D. Orthopnea
Answer: B. Peripheral edema and jugular venous distention
18.A patient with hypothyroidism is prescribed levothyroxine. Which
instruction is correct?
A. "Take the medication with food in the evening."
B. "Take the medication in the morning on an empty stomach."
C. "Discontinue if fatigue resolves."
D. "Avoid monitoring thyroid function tests."
Answer: B. "Take the medication in the morning on an empty
stomach."
19.A patient with a history of stroke is exhibiting slurred speech and facial
droop. What is the priority action?
A. Start physical therapy
B. Administer aspirin
C. Notify the healthcare provider immediately
D. Provide thickened liquids
Answer: C. Notify the healthcare provider immediately
NIGHTINGALE COLLEGE | QUESTIONS AND ANSWERS | LATEST
EXAM
Questions
1. A patient with chronic obstructive pulmonary disease (COPD) reports
increasing shortness of breath and a productive cough. Which assessment
finding requires immediate intervention?
A. Mild wheezing
B. SpO₂ 82% on room air
C. Productive cough with yellow sputum
D. Use of accessory muscles while breathing
Answer: B. SpO₂ 82% on room air
2. The nurse is caring for a patient with heart failure who has a new
prescription for furosemide. What is the most important electrolyte to
monitor?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
3. A patient with type 1 diabetes is experiencing confusion, sweating, and
tremors. The nurse suspects hypoglycemia. What is the priority
intervention?
A. Administer insulin
B. Give 15–20 grams of fast-acting carbohydrate
C. Check hemoglobin A1c
D. Encourage exercise
Answer: B. Give 15–20 grams of fast-acting carbohydrate
4. A patient with a history of myocardial infarction reports chest pain
radiating to the left arm. Which action should the nurse take first?
A. Administer aspirin
B. Obtain a 12-lead ECG
C. Apply oxygen
, D. Notify the healthcare provider
Answer: B. Obtain a 12-lead ECG
5. A patient is receiving warfarin therapy. Which laboratory value should the
nurse monitor to ensure therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A. INR
6. Which patient is at greatest risk for developing deep vein thrombosis
(DVT)?
A. 25-year-old with asthma
B. 60-year-old post-operative orthopedic patient
C. 45-year-old with diabetes
D. 30-year-old on oral contraceptives
Answer: B. 60-year-old post-operative orthopedic patient
7. A nurse is providing discharge teaching for a patient with hypertension.
Which statement indicates understanding?
A. "I will take my blood pressure medication only when my readings are
high."
B. "I should limit my sodium intake and exercise regularly."
C. "I can continue smoking as long as I take my medication."
D. "Stress has no impact on my blood pressure."
Answer: B. "I should limit my sodium intake and exercise regularly."
8. A patient with acute pancreatitis has a serum amylase level of 450 U/L.
Which nursing intervention is most appropriate?
A. Encourage high-fat meals
B. Maintain NPO status and administer IV fluids
C. Provide insulin therapy
D. Start oral antibiotics
Answer: B. Maintain NPO status and administer IV fluids
9. A patient with chronic kidney disease reports fatigue and pallor. Which
lab value should the nurse assess first?
A. Blood glucose
B. Hemoglobin
C. Serum creatinine
, D. Serum potassium
Answer: B. Hemoglobin
10.A patient presents with sudden, severe headache, nuchal rigidity, and
photophobia. Which condition should the nurse suspect?
A. Migraine
B. Subarachnoid hemorrhage
C. Sinusitis
D. Tension headache
Answer: B. Subarachnoid hemorrhage
11.A patient is post-operative day 2 following abdominal surgery and reports
abdominal distention and absent bowel sounds. What is the priority
nursing action?
A. Administer pain medication
B. Notify the healthcare provider
C. Encourage ambulation
D. Provide oral fluids
Answer: B. Notify the healthcare provider
12.The nurse is assessing a patient with cirrhosis. Which finding indicates
hepatic encephalopathy?
A. Jaundice and ascites
B. Confusion and asterixis
C. Elevated AST and ALT
D. Palmar erythema
Answer: B. Confusion and asterixis
13.A patient with a peptic ulcer reports black, tarry stools. What is the
priority nursing action?
A. Encourage increased fiber intake
B. Assess vital signs and notify the provider
C. Schedule an upper GI endoscopy in one week
D. Administer antacids
Answer: B. Assess vital signs and notify the provider
14.A patient with COPD is prescribed albuterol inhaler. Which instruction is
correct?
A. "Use this inhaler only when you have a severe attack."
B. "Rinse your mouth after each use."
C. "Use this inhaler before activities that may trigger shortness of breath."
D. "Limit fluid intake to prevent side effects."
, Answer: C. "Use this inhaler before activities that may trigger
shortness of breath."
15.A nurse is preparing to administer packed red blood cells to a patient.
Which action is essential before starting the transfusion?
A. Verify patient identity and blood compatibility
B. Administer diuretics
C. Shaking the blood bag to mix contents
D. Check blood glucose level
Answer: A. Verify patient identity and blood compatibility
16.A patient is receiving IV potassium chloride. Which nursing intervention
is priority?
A. Administer IV push rapidly
B. Monitor ECG for dysrhythmias
C. Encourage high potassium diet
D. Check blood glucose levels
Answer: B. Monitor ECG for dysrhythmias
17.Which symptom is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Peripheral edema and jugular venous distention
C. Dyspnea at rest
D. Orthopnea
Answer: B. Peripheral edema and jugular venous distention
18.A patient with hypothyroidism is prescribed levothyroxine. Which
instruction is correct?
A. "Take the medication with food in the evening."
B. "Take the medication in the morning on an empty stomach."
C. "Discontinue if fatigue resolves."
D. "Avoid monitoring thyroid function tests."
Answer: B. "Take the medication in the morning on an empty
stomach."
19.A patient with a history of stroke is exhibiting slurred speech and facial
droop. What is the priority action?
A. Start physical therapy
B. Administer aspirin
C. Notify the healthcare provider immediately
D. Provide thickened liquids
Answer: C. Notify the healthcare provider immediately
