PNLE Medical-Surgical Nursing Reviewer 2025/2026 – Advanced Adult Health Comprehensive Exam Prep | High-Yield Practice Questions with Verified Answers & Detailed Rationales | Philippine Nursing Licensure Examination (Board Exam) Success Guide

PNLE MEdicaL-SurgicaL NurSiNg rEviEwEr
2025/2026 – advaNcEd aduLt HEaLtH
coMPrEHENSivE ExaM PrEP | HigH-YiELd PracticE
QuEStioNS witH vErifiEd aNSwErS & dEtaiLEd
ratioNaLES | PHiLiPPiNE NurSiNg LicENSurE
ExaMiNatioN (Board ExaM) SuccESS guidE
Question 1:
A nurse is caring for a patient with congestive heart failure. Which of the following findings
would indicate worsening heart failure?

• A) Decreased blood pressure

• B) Increase in respiratory rate
• C) Increased urine output

• D) Elevated serum potassium levels

Correct Option: B) Increase in respiratory rate
Rationale: An increase in respiratory rate may indicate worsening heart failure due to fluid
overload and pulmonary congestion, leading to difficulty breathing.



Question 2:
A patient arrives at the emergency department with acute chest pain. What is the nurse's priority
assessment?

• A) Obtain the patient's medical history

• B) Measure vital signs
• C) Perform an ECG

• D) Start an intravenous line
Correct Option: C) Perform an ECG
Rationale: In acute chest pain scenarios, performing an ECG is critical to assess for possible
myocardial infarction or other cardiac events, which can guide immediate treatment.



Question 3:
In caring for a patient with diabetes mellitus, which statement by the patient indicates a need for
further education?
• A) "I should check my blood sugar levels before meals."

, • B) "I can eat whatever I want as long as I take my insulin."

• C) "I need to balance my carbohydrate intake with my physical activity."

• D) "I will carry glucose tablets with me in case I get hypoglycemic."

Correct Option: B) "I can eat whatever I want as long as I take my insulin."
Rationale: This statement indicates a misunderstanding of diabetes management, as patients
need to monitor their diet alongside insulin therapy to maintain blood glucose levels within target
ranges.

Question 4:
A nurse is administering a blood transfusion. What is the most critical action for the nurse to take
before starting the transfusion?

• A) Ensure the blood is warm

• B) Verify patient identity and blood compatibility

• C) Explain the procedure to the patient

• D) Monitor vital signs after transfusion starts

Correct Option: B) Verify patient identity and blood compatibility
Rationale: Verifying patient identity and blood compatibility is crucial to prevent transfusion
reactions, which can be life-threatening.



Question 5:
Which assessment finding in a post-operative patient would indicate a potential complication?

• A) Clear urine output

• B) Pain at the surgical site
• C) Temperature of 100.4°F (38°C)

• D) Sudden onset of shortness of breath
Correct Option: D) Sudden onset of shortness of breath
Rationale: Sudden onset of shortness of breath can indicate a serious complication such as
pulmonary embolism or pneumothorax.



Question 6:
A patient has been diagnosed with chronic obstructive pulmonary disease (COPD). Which
lifestyle modification should the nurse prioritize?

, • A) Increase fluid intake

• B) Start a high-intensity exercise program

• C) Quit smoking

• D) Decrease dietary salt intake
Correct Option: C) Quit smoking
Rationale: Smoking cessation is the most crucial intervention to slow disease progression and
improve respiratory function in COPD patients.



Question 7:
A patient arriving in the emergency department with acute chest pain should receive which of the
following assessments first?

• A) Obtain a medical history

• B) Measure blood pressure

• C) Perform an ECG
• D) Start an IV line

Correct Option: C) Perform an ECG
Rationale: An ECG is critical to assess for myocardial infarction and other cardiac issues that
require immediate intervention.


Question 8:
What is the primary concern when a patient is receiving high-dose corticosteroids?
• A) Hyperglycemia

• B) Fluid retention

• C) Osteoporosis

• D) Infection risk

Correct Option: D) Infection risk
Rationale: High-dose corticosteroids suppress the immune system, leading to increased
susceptibility to infections.

, Question 9:
A nurse is caring for a patient with renal failure. Which lab value should the nurse monitor
closely?

• A) Sodium

• B) Hemoglobin

• C) Serum creatinine

• D) Calcium

Correct Option: C) Serum creatinine
Rationale: Serum creatinine is a key indicator of kidney function and should be closely
monitored in patients with renal failure.


Question 10:
In a patient with heart failure, what finding would most likely indicate fluid overload?

• A) Increased urine output

• B) Weight loss

• C) Elevated blood pressure
• D) Peripheral edema

Correct Option: D) Peripheral edema
Rationale: Peripheral edema is a common sign of fluid overload in heart failure patients,
indicating the body's inability to manage excess fluid.


Question 11:
A patient recovering from a stroke is being discharged. What should the nurse emphasize about
medication adherence?

• A) Medications can be discontinued if symptoms improve

• B) Take medications only when experiencing symptoms
• C) Adhere to the prescribed medication regimen consistently

• D) Medications are not necessary if a healthy diet is followed

Correct Option: C) Adhere to the prescribed medication regimen consistently
Rationale: Consistent adherence to medication is crucial for preventing further strokes and
managing risk factors.