1
ADULT HEALTH & MEDICAL-SURGICAL NURSING MIDTERM
& FINAL EXAM – UPDATED PRACTICE QUESTIONS
(2026-27 LATEST VERSION)
1. A patient with heart failure presents with dyspnea,
orthopnea, and pulmonary crackles. Which medication is most
appropriate for symptom relief?
A. Metoprolol
B. Digoxin
C. Furosemide
D. Lisinopril
Correct Answer: C
Rationale:
Furosemide, a loop diuretic, reduces fluid overload and
pulmonary congestion, relieving symptoms of heart failure.
2. Which lab result is most indicative of acute myocardial
infarction?
A. Elevated BNP
B. Elevated troponin I/T
,2
C. Elevated CRP
D. Elevated CK-MB only
Correct Answer: B
Rationale:
Troponins are highly specific for myocardial cell injury and
remain elevated for 7–10 days post-MI.
3. A patient with COPD is receiving oxygen via nasal cannula at
2 L/min. The patient becomes drowsy and confused. What is
the priority action?
A. Increase oxygen to 4 L/min
B. Assess for CO2 retention
C. Encourage coughing
D. Administer bronchodilator
Correct Answer: B
Rationale:
COPD patients may rely on hypoxic drive; excess oxygen can
lead to CO2 retention and respiratory acidosis.
4. A patient with type 1 diabetes presents with fruity breath,
Kussmaul respirations, and polyuria. Which lab is expected?
,3
A. Hypoglycemia
B. Hyperglycemia with metabolic acidosis
C. Hypokalemia
D. Normal glucose
Correct Answer: B
Rationale:
Classic signs of diabetic ketoacidosis (DKA): hyperglycemia,
metabolic acidosis, ketonemia, and ketonuria.
5. Which electrolyte imbalance is most concerning in acute
kidney injury (AKI)?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypercalcemia
Correct Answer: C
Rationale:
AKI reduces renal potassium excretion, increasing risk for life-
threatening arrhythmias.
6. A patient on heparin therapy develops sudden leg pain,
swelling, and redness. What is the priority nursing action?
, 4
A. Continue heparin
B. Apply heat
C. Notify provider and assess for DVT
D. Administer NSAIDs
Correct Answer: C
Rationale:
Heparin may prevent new clots but does not dissolve existing
thrombi; signs suggest DVT, requiring assessment and
intervention.
7. Which assessment finding indicates peritonitis in a patient
with peritoneal dialysis?
A. Cloudy dialysate effluent
B. Abdominal rigidity and rebound tenderness
C. Mild abdominal bloating
D. Decreased urine output
Correct Answer: B
Rationale:
Peritonitis presents with severe abdominal pain, rigidity,
rebound tenderness, and systemic signs like fever.
ADULT HEALTH & MEDICAL-SURGICAL NURSING MIDTERM
& FINAL EXAM – UPDATED PRACTICE QUESTIONS
(2026-27 LATEST VERSION)
1. A patient with heart failure presents with dyspnea,
orthopnea, and pulmonary crackles. Which medication is most
appropriate for symptom relief?
A. Metoprolol
B. Digoxin
C. Furosemide
D. Lisinopril
Correct Answer: C
Rationale:
Furosemide, a loop diuretic, reduces fluid overload and
pulmonary congestion, relieving symptoms of heart failure.
2. Which lab result is most indicative of acute myocardial
infarction?
A. Elevated BNP
B. Elevated troponin I/T
,2
C. Elevated CRP
D. Elevated CK-MB only
Correct Answer: B
Rationale:
Troponins are highly specific for myocardial cell injury and
remain elevated for 7–10 days post-MI.
3. A patient with COPD is receiving oxygen via nasal cannula at
2 L/min. The patient becomes drowsy and confused. What is
the priority action?
A. Increase oxygen to 4 L/min
B. Assess for CO2 retention
C. Encourage coughing
D. Administer bronchodilator
Correct Answer: B
Rationale:
COPD patients may rely on hypoxic drive; excess oxygen can
lead to CO2 retention and respiratory acidosis.
4. A patient with type 1 diabetes presents with fruity breath,
Kussmaul respirations, and polyuria. Which lab is expected?
,3
A. Hypoglycemia
B. Hyperglycemia with metabolic acidosis
C. Hypokalemia
D. Normal glucose
Correct Answer: B
Rationale:
Classic signs of diabetic ketoacidosis (DKA): hyperglycemia,
metabolic acidosis, ketonemia, and ketonuria.
5. Which electrolyte imbalance is most concerning in acute
kidney injury (AKI)?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypercalcemia
Correct Answer: C
Rationale:
AKI reduces renal potassium excretion, increasing risk for life-
threatening arrhythmias.
6. A patient on heparin therapy develops sudden leg pain,
swelling, and redness. What is the priority nursing action?
, 4
A. Continue heparin
B. Apply heat
C. Notify provider and assess for DVT
D. Administer NSAIDs
Correct Answer: C
Rationale:
Heparin may prevent new clots but does not dissolve existing
thrombi; signs suggest DVT, requiring assessment and
intervention.
7. Which assessment finding indicates peritonitis in a patient
with peritoneal dialysis?
A. Cloudy dialysate effluent
B. Abdominal rigidity and rebound tenderness
C. Mild abdominal bloating
D. Decreased urine output
Correct Answer: B
Rationale:
Peritonitis presents with severe abdominal pain, rigidity,
rebound tenderness, and systemic signs like fever.
