Med-Surg CMS Proctored Exam Practice Test
2026-2027 | Verified Answers | Clinical
Judgment & Patient Care Scenarios
MANAGEMENT OF CARE (20 Qs)
Q1
The nurse receives report on four patients. Which patient should the nurse assess
FIRST?
A. Heart-failure patient with 2+ pitting ankle edema
B. Post-op day 1 abdominal-surgery patient with pain 7/10
C. Pneumonia patient on 2 L NC with SpO₂ 89 %
D. Diabetic patient scheduled for fasting glucose in 30 min
Correct: C
Rationale: SpO₂ 89 % is an acute ABC threat; requires immediate airway/oxygen
evaluation. Edema (A) is chronic, pain (B) expected, fasting test (D) routine.
Q2
A post-op hip-replacement patient voices desire to ambulate to bathroom. The nurse
notes the patient is on fall-risk precautions and feels dizzy when standing. Which action
is BEST?
,A. Allow ambulation; patient has right to move
B. Assist patient with gait belt and walker to bathroom
C. Offer bedpan and remind of fall-risk status
D. Obtain physician order for physical-therapy evaluation
Correct: B
Rationale: Preserve autonomy while ensuring safety—nurse assists with appropriate
aids. Bedpan (C) is restrictive; PT eval (D) delays immediate need.
Q3
A float RN is assigned to a cardiac step-down unit. Which task is MOST appropriate to
request reassignment?
A. Administer PO metoprolol
B. Monitor dobutamine drip at 5 mcg/kg/min
C. Obtain 12-lead ECG
D. Teach discharge medications
Correct: B
Rationale: Vasoactive drips require unit-specific competency; others are within general
RN scope.
Q4
During shift report, the off-going nurse states, “I gave heparin 30 minutes late, but PTT
was therapeutic.” The receiving nurse should
,A. Document the late administration and file event report
B. Accept explanation; therapeutic PTT confirms safety
C. Assess patient for clotting signs
D. Call pharmacist for dose adjustment
Correct: A
Rationale: Late administration of high-alert medication is a medication error requiring
event report for quality review, regardless of lab result.
Q5 (SATA)
A nurse is delegating tasks to an experienced UAP for a stable heart-failure patient.
Which tasks are appropriate? (Select all that apply.)
A. Measure and record daily weight
B. Assist with ambulation to bathroom
C. Auscultate lung sounds after incentive spirometer
D. Reinforce low-sodium diet teaching
E. Report abnormal vital signs
F. Assess peripheral edema
Correct: A, B, E
Rationale: UAP can perform routine, non-invasive tasks and report findings; assessment
and teaching (C,D,F) require RN judgment.
, Q6
A patient is being discharged on warfarin. Which statement by the patient indicates
NEED for further teaching?
A. “I’ll take my pill at the same time daily.”
B. “I’ll avoid large spinach salads.”
C. “I’ll double my dose if I miss yesterday’s pill.”
D. “I’ll have my INR checked regularly.”
Correct: C
Rationale: Doubling warfarin increases bleeding risk; patient should skip missed dose
and resume schedule.
Q7
A nurse discovers an insulin pen was used on multiple patients. Which action is MOST
appropriate?
A. Discard pen and document incident
B. Notify infection control and complete event report
C. Re-label pen for single-patient use
D. Continue use if needle was changed
Correct: B
Rationale: Pen sharing is a serious infection-control breach; requires event report,
patient notification, and policy review.
2026-2027 | Verified Answers | Clinical
Judgment & Patient Care Scenarios
MANAGEMENT OF CARE (20 Qs)
Q1
The nurse receives report on four patients. Which patient should the nurse assess
FIRST?
A. Heart-failure patient with 2+ pitting ankle edema
B. Post-op day 1 abdominal-surgery patient with pain 7/10
C. Pneumonia patient on 2 L NC with SpO₂ 89 %
D. Diabetic patient scheduled for fasting glucose in 30 min
Correct: C
Rationale: SpO₂ 89 % is an acute ABC threat; requires immediate airway/oxygen
evaluation. Edema (A) is chronic, pain (B) expected, fasting test (D) routine.
Q2
A post-op hip-replacement patient voices desire to ambulate to bathroom. The nurse
notes the patient is on fall-risk precautions and feels dizzy when standing. Which action
is BEST?
,A. Allow ambulation; patient has right to move
B. Assist patient with gait belt and walker to bathroom
C. Offer bedpan and remind of fall-risk status
D. Obtain physician order for physical-therapy evaluation
Correct: B
Rationale: Preserve autonomy while ensuring safety—nurse assists with appropriate
aids. Bedpan (C) is restrictive; PT eval (D) delays immediate need.
Q3
A float RN is assigned to a cardiac step-down unit. Which task is MOST appropriate to
request reassignment?
A. Administer PO metoprolol
B. Monitor dobutamine drip at 5 mcg/kg/min
C. Obtain 12-lead ECG
D. Teach discharge medications
Correct: B
Rationale: Vasoactive drips require unit-specific competency; others are within general
RN scope.
Q4
During shift report, the off-going nurse states, “I gave heparin 30 minutes late, but PTT
was therapeutic.” The receiving nurse should
,A. Document the late administration and file event report
B. Accept explanation; therapeutic PTT confirms safety
C. Assess patient for clotting signs
D. Call pharmacist for dose adjustment
Correct: A
Rationale: Late administration of high-alert medication is a medication error requiring
event report for quality review, regardless of lab result.
Q5 (SATA)
A nurse is delegating tasks to an experienced UAP for a stable heart-failure patient.
Which tasks are appropriate? (Select all that apply.)
A. Measure and record daily weight
B. Assist with ambulation to bathroom
C. Auscultate lung sounds after incentive spirometer
D. Reinforce low-sodium diet teaching
E. Report abnormal vital signs
F. Assess peripheral edema
Correct: A, B, E
Rationale: UAP can perform routine, non-invasive tasks and report findings; assessment
and teaching (C,D,F) require RN judgment.
, Q6
A patient is being discharged on warfarin. Which statement by the patient indicates
NEED for further teaching?
A. “I’ll take my pill at the same time daily.”
B. “I’ll avoid large spinach salads.”
C. “I’ll double my dose if I miss yesterday’s pill.”
D. “I’ll have my INR checked regularly.”
Correct: C
Rationale: Doubling warfarin increases bleeding risk; patient should skip missed dose
and resume schedule.
Q7
A nurse discovers an insulin pen was used on multiple patients. Which action is MOST
appropriate?
A. Discard pen and document incident
B. Notify infection control and complete event report
C. Re-label pen for single-patient use
D. Continue use if needle was changed
Correct: B
Rationale: Pen sharing is a serious infection-control breach; requires event report,
patient notification, and policy review.
