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Epic Adult Med Surg Nurse 100 Assessment: 100 Practice Questions with Answers
Below are 100 questions covering the key domains of the Epic Adult Med Surg Nurse 100
Assessment: clinical judgment, EHR competency, medication safety, and nursing workflows.
Each question includes the correct answer and a brief rationale.
Section 1: Clinical Judgment & Prioritization (Questions 1–25)
Q1. A patient with acute respiratory distress has an oxygen saturation of 84% on room air.
Which action should the nurse take first?
A. Obtain a complete medication history
B. Apply oxygen as prescribed and assess respiratory status
C. Encourage oral fluids
D. Document the finding and reassess in 1 hour
Answer: B
Rationale: Severe hypoxemia requires immediate attention to oxygenation and respiratory
status. Airway and breathing take priority over history, fluids, or documentation .
Q2. Which finding in a patient with pneumonia requires the most immediate intervention?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86% with increasing respiratory distress
D. Mild fatigue during activity
Answer: C
Rationale: Significant hypoxemia and respiratory distress indicate impaired gas exchange and
take priority over cough, low-grade fever, or fatigue .
Q3. Which assessment finding is most characteristic of a pneumothorax?
A. Bilateral crackles
B. Absent or markedly decreased breath sounds on one side
C. Bradycardia with hypertension
D. Bilateral dependent edema
Answer: B
Rationale: Air in the pleural space causes unilateral decreased or absent breath sounds on
the affected side .
Q4. A patient with COPD is receiving oxygen. Which nursing action is appropriate?
A. Continuously increase oxygen to the highest possible level
B. Administer oxygen as prescribed and monitor respiratory status
C. Discontinue oxygen when the patient reports fatigue
D. Encourage prolonged breath-holding
,2
Answer: B
Rationale: Oxygen should be carefully titrated according to the prescribed target and the
patient's clinical status, especially in COPD patients who may be CO2 retainers .
Q5. Which intervention helps a patient with COPD improve ventilation?
A. Encourage pursed-lip breathing
B. Encourage rapid shallow breathing
C. Keep the patient completely supine
D. Restrict all activity
Answer: A
Rationale: Pursed-lip breathing helps prolong exhalation and reduces air trapping in patients
with COPD .
Q6. Which finding is most concerning in a patient with acute heart failure?
A. Mild fatigue
B. New severe dyspnea with pulmonary crackles
C. Increased appetite
D. Warm, dry skin
Answer: B
Rationale: Acute dyspnea and pulmonary crackles may indicate pulmonary edema and
impaired oxygenation, which requires immediate intervention .
Q7. Which intervention is commonly used to monitor fluid status in a patient with heart
failure?
A. Daily weights
B. Weekly temperature only
C. Measuring height daily
D. Monitoring hair growth
Answer: A
Rationale: Daily weights provide a sensitive indicator of changes in fluid retention. A weight
gain of 2–3 pounds in 24 hours suggests fluid overload .
Q8. Which finding is consistent with left-sided heart failure?
A. Pulmonary crackles and dyspnea
B. Isolated jaundice
C. Increased bowel sounds
D. Peripheral edema only
, 3
Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing crackles, dyspnea, and orthopnea .
Q9. A client with COPD has an O2 saturation of 88%. Which action should the nurse take?
A. Administer oxygen at 6 L/min via nasal cannula
B. Administer oxygen at 1–2 L/min via nasal cannula
C. Withhold oxygen and reassess in 1 hour
D. Place the client in a supine position
Answer: B
Rationale: Clients with COPD who are CO2 retainers need low-flow oxygen (1–2 L/min) to
avoid suppressing their hypoxic drive. High-flow oxygen can cause CO2 narcosis .
Q10. A nurse is assessing a client with left-sided heart failure. Which finding should the
nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing crackles, dyspnea, and orthopnea. JVD, peripheral edema, and hepatomegaly are
signs of right-sided heart failure .
Q11. A patient with acute dyspnea requires immediate assessment of which components?
A. Skin color only
B. Airway, breathing, oxygenation, and severity
C. Medication list only
D. Bowel sounds
Answer: B
Rationale: For acute dyspnea, the priority is to assess airway, breathing, oxygenation, and
severity to guide immediate interventions .
Q12. A new unilateral weakness and speech difficulty should be treated as:
A. A medication side effect
B. A possible acute stroke requiring urgent evaluation
C. A normal aging change
D. An anxiety response
Epic Adult Med Surg Nurse 100 Assessment: 100 Practice Questions with Answers
Below are 100 questions covering the key domains of the Epic Adult Med Surg Nurse 100
Assessment: clinical judgment, EHR competency, medication safety, and nursing workflows.
Each question includes the correct answer and a brief rationale.
Section 1: Clinical Judgment & Prioritization (Questions 1–25)
Q1. A patient with acute respiratory distress has an oxygen saturation of 84% on room air.
Which action should the nurse take first?
A. Obtain a complete medication history
B. Apply oxygen as prescribed and assess respiratory status
C. Encourage oral fluids
D. Document the finding and reassess in 1 hour
Answer: B
Rationale: Severe hypoxemia requires immediate attention to oxygenation and respiratory
status. Airway and breathing take priority over history, fluids, or documentation .
Q2. Which finding in a patient with pneumonia requires the most immediate intervention?
A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 86% with increasing respiratory distress
D. Mild fatigue during activity
Answer: C
Rationale: Significant hypoxemia and respiratory distress indicate impaired gas exchange and
take priority over cough, low-grade fever, or fatigue .
Q3. Which assessment finding is most characteristic of a pneumothorax?
A. Bilateral crackles
B. Absent or markedly decreased breath sounds on one side
C. Bradycardia with hypertension
D. Bilateral dependent edema
Answer: B
Rationale: Air in the pleural space causes unilateral decreased or absent breath sounds on
the affected side .
Q4. A patient with COPD is receiving oxygen. Which nursing action is appropriate?
A. Continuously increase oxygen to the highest possible level
B. Administer oxygen as prescribed and monitor respiratory status
C. Discontinue oxygen when the patient reports fatigue
D. Encourage prolonged breath-holding
,2
Answer: B
Rationale: Oxygen should be carefully titrated according to the prescribed target and the
patient's clinical status, especially in COPD patients who may be CO2 retainers .
Q5. Which intervention helps a patient with COPD improve ventilation?
A. Encourage pursed-lip breathing
B. Encourage rapid shallow breathing
C. Keep the patient completely supine
D. Restrict all activity
Answer: A
Rationale: Pursed-lip breathing helps prolong exhalation and reduces air trapping in patients
with COPD .
Q6. Which finding is most concerning in a patient with acute heart failure?
A. Mild fatigue
B. New severe dyspnea with pulmonary crackles
C. Increased appetite
D. Warm, dry skin
Answer: B
Rationale: Acute dyspnea and pulmonary crackles may indicate pulmonary edema and
impaired oxygenation, which requires immediate intervention .
Q7. Which intervention is commonly used to monitor fluid status in a patient with heart
failure?
A. Daily weights
B. Weekly temperature only
C. Measuring height daily
D. Monitoring hair growth
Answer: A
Rationale: Daily weights provide a sensitive indicator of changes in fluid retention. A weight
gain of 2–3 pounds in 24 hours suggests fluid overload .
Q8. Which finding is consistent with left-sided heart failure?
A. Pulmonary crackles and dyspnea
B. Isolated jaundice
C. Increased bowel sounds
D. Peripheral edema only
, 3
Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing crackles, dyspnea, and orthopnea .
Q9. A client with COPD has an O2 saturation of 88%. Which action should the nurse take?
A. Administer oxygen at 6 L/min via nasal cannula
B. Administer oxygen at 1–2 L/min via nasal cannula
C. Withhold oxygen and reassess in 1 hour
D. Place the client in a supine position
Answer: B
Rationale: Clients with COPD who are CO2 retainers need low-flow oxygen (1–2 L/min) to
avoid suppressing their hypoxic drive. High-flow oxygen can cause CO2 narcosis .
Q10. A nurse is assessing a client with left-sided heart failure. Which finding should the
nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing crackles, dyspnea, and orthopnea. JVD, peripheral edema, and hepatomegaly are
signs of right-sided heart failure .
Q11. A patient with acute dyspnea requires immediate assessment of which components?
A. Skin color only
B. Airway, breathing, oxygenation, and severity
C. Medication list only
D. Bowel sounds
Answer: B
Rationale: For acute dyspnea, the priority is to assess airway, breathing, oxygenation, and
severity to guide immediate interventions .
Q12. A new unilateral weakness and speech difficulty should be treated as:
A. A medication side effect
B. A possible acute stroke requiring urgent evaluation
C. A normal aging change
D. An anxiety response
