Nightingale College BSN HESI 266 Med-Surg Exam Practice
Questions {2 NEW VERSIONS} Practice Questions with
Correct Answers and Detailed Explanations
Q1. A patient with Chronic Kidney Disease (CKD) is prescribed Spironolactone.
Which lab value is the priority for the nurse to monitor?
A. Sodium 135 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Magnesium 2.0 mEq/L
Correct Answer: B. Potassium 5.8 mEq/L
Spironolactone is a potassium-sparing diuretic. In CKD, the kidneys cannot excrete
potassium effectively, placing the patient at high risk for life-threatening hyperkalemia, which
can cause fatal cardiac dysrhythmias.
,Q2. A nurse is caring for a patient post-TURP with continuous bladder irrigation
(CBI). The nurse notes the return is dark red with multiple large clots. What is the
priority action?
A. Document the findings
B. Decrease the irrigation rate
C. Increase the irrigation rate
D. Notify the provider for immediate surgery
Correct Answer: C. Increase the irrigation rate
To keep the catheter patent and prevent total occlusion by clots, the irrigation rate must be
increased until the drainage turns light pink. If clots completely obstruct the catheter, urinary
retention and bladder distension can occur.
Q3. Which assessment finding is the most critical for a patient who just returned from
a thyroidectomy?
A. Complaints of mild throat pain
B. Difficulty swallowing water
C. Laryngeal stridor and hoarseness
D. A heart rate of 88 bpm
Correct Answer: C. Laryngeal stridor and hoarseness
Stridor indicates an airway obstruction, likely due to laryngeal nerve damage or edema. This
is a medical emergency requiring immediate intervention to prevent complete airway
compromise.
,Q4. A patient is prescribed Apixaban (Eliquis) for Atrial Fibrillation. Which symptom
should the nurse instruct the patient to report immediately?
A. Dry mouth
B. Increased appetite
C. Frequent nosebleeds (epistaxis)
D. Occasional mild headaches
Correct Answer: C. Frequent nosebleeds (epistaxis)
Apixaban is an anticoagulant. Epistaxis, hematuria, or bruising are signs of excessive
bleeding that require immediate intervention. Anticoagulants carry a significant risk of life-
threatening hemorrhage.
Q5. A patient presents to the ER with symptoms of a stroke. What is the first
diagnostic test the nurse anticipates?
A. MRI of the brain
B. Non-contrast CT scan of the head
C. Lumbar puncture
D. EEG
Correct Answer: B. Non-contrast CT scan of the head
A CT scan is the fastest way to differentiate between an ischemic and a hemorrhagic stroke,
which determines whether tPA can be given. This imaging modality is essential before
initiating thrombolytic therapy.
, Q6. Which medication order should a nurse question for a patient with a history of a
Gastrointestinal (GI) bleed?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Pantoprazole
Correct Answer: B. Ibuprofen
NSAIDs like Ibuprofen inhibit prostaglandins that protect the stomach lining, significantly
increasing the risk of further GI bleeding. Acetaminophen is a safer alternative for pain
management in these patients.
Q7. A patient with heart failure gains 3 lbs in 24 hours. What is the priority nursing
intervention?
A. Assess for peripheral edema
B. Auscultate lung sounds
C. Notify the healthcare provider
D. Increase the furosemide dose
Correct Answer: C. Notify the healthcare provider
A 3 lb weight gain in 24 hours indicates significant fluid retention (1 liter = 2.2 lbs) and may
indicate worsening heart failure. The provider must be notified immediately for evaluation of
diuretic therapy adjustment.
Questions {2 NEW VERSIONS} Practice Questions with
Correct Answers and Detailed Explanations
Q1. A patient with Chronic Kidney Disease (CKD) is prescribed Spironolactone.
Which lab value is the priority for the nurse to monitor?
A. Sodium 135 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Magnesium 2.0 mEq/L
Correct Answer: B. Potassium 5.8 mEq/L
Spironolactone is a potassium-sparing diuretic. In CKD, the kidneys cannot excrete
potassium effectively, placing the patient at high risk for life-threatening hyperkalemia, which
can cause fatal cardiac dysrhythmias.
,Q2. A nurse is caring for a patient post-TURP with continuous bladder irrigation
(CBI). The nurse notes the return is dark red with multiple large clots. What is the
priority action?
A. Document the findings
B. Decrease the irrigation rate
C. Increase the irrigation rate
D. Notify the provider for immediate surgery
Correct Answer: C. Increase the irrigation rate
To keep the catheter patent and prevent total occlusion by clots, the irrigation rate must be
increased until the drainage turns light pink. If clots completely obstruct the catheter, urinary
retention and bladder distension can occur.
Q3. Which assessment finding is the most critical for a patient who just returned from
a thyroidectomy?
A. Complaints of mild throat pain
B. Difficulty swallowing water
C. Laryngeal stridor and hoarseness
D. A heart rate of 88 bpm
Correct Answer: C. Laryngeal stridor and hoarseness
Stridor indicates an airway obstruction, likely due to laryngeal nerve damage or edema. This
is a medical emergency requiring immediate intervention to prevent complete airway
compromise.
,Q4. A patient is prescribed Apixaban (Eliquis) for Atrial Fibrillation. Which symptom
should the nurse instruct the patient to report immediately?
A. Dry mouth
B. Increased appetite
C. Frequent nosebleeds (epistaxis)
D. Occasional mild headaches
Correct Answer: C. Frequent nosebleeds (epistaxis)
Apixaban is an anticoagulant. Epistaxis, hematuria, or bruising are signs of excessive
bleeding that require immediate intervention. Anticoagulants carry a significant risk of life-
threatening hemorrhage.
Q5. A patient presents to the ER with symptoms of a stroke. What is the first
diagnostic test the nurse anticipates?
A. MRI of the brain
B. Non-contrast CT scan of the head
C. Lumbar puncture
D. EEG
Correct Answer: B. Non-contrast CT scan of the head
A CT scan is the fastest way to differentiate between an ischemic and a hemorrhagic stroke,
which determines whether tPA can be given. This imaging modality is essential before
initiating thrombolytic therapy.
, Q6. Which medication order should a nurse question for a patient with a history of a
Gastrointestinal (GI) bleed?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Pantoprazole
Correct Answer: B. Ibuprofen
NSAIDs like Ibuprofen inhibit prostaglandins that protect the stomach lining, significantly
increasing the risk of further GI bleeding. Acetaminophen is a safer alternative for pain
management in these patients.
Q7. A patient with heart failure gains 3 lbs in 24 hours. What is the priority nursing
intervention?
A. Assess for peripheral edema
B. Auscultate lung sounds
C. Notify the healthcare provider
D. Increase the furosemide dose
Correct Answer: C. Notify the healthcare provider
A 3 lb weight gain in 24 hours indicates significant fluid retention (1 liter = 2.2 lbs) and may
indicate worsening heart failure. The provider must be notified immediately for evaluation of
diuretic therapy adjustment.
