KAPLAN ADVANCED MED-SURG EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
/Cardiovascular System Nursing Care/
/Respiratory System Nursing Care/
/Renal and Urinary System Nursing Care/
/Endocrine System Nursing Care/
/Gastrointestinal System Nursing Care/
/Neurological System Nursing Care/
/Perioperative and Surgical Care/
/Fluid, Electrolyte, and Acid-Base Balance/
/Pharmacology and Medication Management/
/Ethical, Legal, and Professional Standards/
Introduction
The Kaplan Advanced Med-Surg Exam is designed to assess comprehensive knowledge and clinical judgment skills essential for advanced medical-
surgical nursing practice. This examination evaluates nurses' ability to apply foundational theory, applied professional knowledge, regulatory and
legal compliance, ethics, and professional standards in real-world clinical scenarios. The multiple-choice and scenario-based structure emphasizes
critical thinking, decision-making, and priority-setting in complex adult health conditions. Candidates will demonstrate mastery in assessing,
planning, implementing, and evaluating care for patients with acute and chronic multisystem disorders. Success on this exam indicates readiness for
advanced practice responsibilities and safe, evidence-based patient care delivery.*
,Section One: Questions 1–100
A nurse is caring for a patient with acute myocardial infarction who develops sudden shortness of breath and crackles in both lung fields. Which
intervention should the nurse prioritize first?
A. Administer subcutaneous enoxaparin
B. Place the patient in high Fowler's position
C. Obtain a 12-lead electrocardiogram
D. Administer 100% oxygen via face mask
🟢 Correct answer: B
🔴 RATIONALE: Placing the patient in high Fowler's position reduces venous return and decreases pulmonary congestion, providing immediate
relief for acute pulmonary edema. While oxygen administration is important, positioning provides faster hemodynamic improvement. Enoxaparin
and ECG are secondary interventions after stabilizing respiratory status.
A patient with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which medication should the nurse administer to rapidly lower
potassium?
A. Oral sodium polystyrene sulfonate
B. Intravenous insulin with dextrose
C. Subcutaneous epoprostenol
D. Intramuscular desmopressin
🟢 Correct answer: B
🔴 RATIONALE: Intravenous insulin with dextrose rapidly shifts potassium into cells within 15-30 minutes, providing immediate reduction for life-
threatening hyperkalemia. Sodium polystyrene sulfonate eliminates potassium but takes hours to days. Epoprostenol and desmopressin do not affect
potassium levels.
,A nurse is assessing a postoperative patient who has abdominal distension and has not voided for 8 hours. Which finding indicates parasympathetic
nervous system involvement?
A. Increased heart rate
B. Decreased bowel sounds
C. Bladder distension
D. Dilated pupils
🟢 Correct answer: C
🔴 RATIONALE: Parasympathetic stimulation promotes bladder contraction and urination. Bladder distension indicates parasympathetic
dysfunction or postoperative urinary retention. Increased heart rate, decreased bowel sounds, and dilated pupils are sympathetic responses.
A patient with type 2 diabetes presents with blood glucose of 45 mg/dL. The patient is alert but confused. Which action is most appropriate?
A. Administer 1 unit intravenous regular insulin
B. Give 15 grams rapid-acting carbohydrate
C. Administer 25 mL 50% dextrose intravenously
D. Provide 8 ounces skim milk
🟢 Correct answer: C
🔴 RATIONALE: For severe hypoglycemia with confusion, intravenous dextrose provides immediate glucose replacement. Rapid-acting
carbohydrates and milk are appropriate for mild hypoglycemia with intact cognition. Insulin would worsen hypoglycemia.
A nurse is caring for a patient with a chest tube following thoracotomy. The drainage system shows no tidal movement. What should the nurse do
first?
, A. Clamp the chest tube near the insertion site
B. Milk the chest tube vigorously
C. Assess for kinks in the tubing
D. Add sterile water to the suction control chamber
🟢 Correct answer: C
🔴 RATIONALE: Absent tidal movement may indicate kinked tubing blocking drainage. Assessing for kinks is the first non-invasive intervention.
Clamping is contraindicated without provider order. Milking is controversial and may increase pressure. Adding water doesn't address the
obstruction.
A patient with liver cirrhosis has ascites and peripheral edema. Which laboratory value best reflects the severity of protein deficiency?
A. Serum albumin 1.8 g/dL
B. Total bilirubin 4.2 mg/dL
C. Alanine aminotransferase 120 U/L
D. Hemoglobin 9.5 g/dL
🟢 Correct answer: A
🔴 RATIONALE: Serum albumin reflects protein synthesis capacity and correlates with ascites and edema severity. Normal is 3.5-5.0 g/dL. Bilirubin
and ALT indicate liver dysfunction but not protein deficiency. Hemoglobin reflects bleeding risk, not protein status.
A nurse is teaching a patient with new-onset atrial fibrillation about warfarin therapy. Which statement indicates understanding?
A. "I will take aspirin with warfarin for pain"
B. "I need regular blood tests to check my clotting time"
C. "I can eat unlimited leafy greens while on this medication"
D. "I will stop warfarin if my gums bleed"
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
/Cardiovascular System Nursing Care/
/Respiratory System Nursing Care/
/Renal and Urinary System Nursing Care/
/Endocrine System Nursing Care/
/Gastrointestinal System Nursing Care/
/Neurological System Nursing Care/
/Perioperative and Surgical Care/
/Fluid, Electrolyte, and Acid-Base Balance/
/Pharmacology and Medication Management/
/Ethical, Legal, and Professional Standards/
Introduction
The Kaplan Advanced Med-Surg Exam is designed to assess comprehensive knowledge and clinical judgment skills essential for advanced medical-
surgical nursing practice. This examination evaluates nurses' ability to apply foundational theory, applied professional knowledge, regulatory and
legal compliance, ethics, and professional standards in real-world clinical scenarios. The multiple-choice and scenario-based structure emphasizes
critical thinking, decision-making, and priority-setting in complex adult health conditions. Candidates will demonstrate mastery in assessing,
planning, implementing, and evaluating care for patients with acute and chronic multisystem disorders. Success on this exam indicates readiness for
advanced practice responsibilities and safe, evidence-based patient care delivery.*
,Section One: Questions 1–100
A nurse is caring for a patient with acute myocardial infarction who develops sudden shortness of breath and crackles in both lung fields. Which
intervention should the nurse prioritize first?
A. Administer subcutaneous enoxaparin
B. Place the patient in high Fowler's position
C. Obtain a 12-lead electrocardiogram
D. Administer 100% oxygen via face mask
🟢 Correct answer: B
🔴 RATIONALE: Placing the patient in high Fowler's position reduces venous return and decreases pulmonary congestion, providing immediate
relief for acute pulmonary edema. While oxygen administration is important, positioning provides faster hemodynamic improvement. Enoxaparin
and ECG are secondary interventions after stabilizing respiratory status.
A patient with chronic kidney disease has a serum potassium level of 6.2 mEq/L. Which medication should the nurse administer to rapidly lower
potassium?
A. Oral sodium polystyrene sulfonate
B. Intravenous insulin with dextrose
C. Subcutaneous epoprostenol
D. Intramuscular desmopressin
🟢 Correct answer: B
🔴 RATIONALE: Intravenous insulin with dextrose rapidly shifts potassium into cells within 15-30 minutes, providing immediate reduction for life-
threatening hyperkalemia. Sodium polystyrene sulfonate eliminates potassium but takes hours to days. Epoprostenol and desmopressin do not affect
potassium levels.
,A nurse is assessing a postoperative patient who has abdominal distension and has not voided for 8 hours. Which finding indicates parasympathetic
nervous system involvement?
A. Increased heart rate
B. Decreased bowel sounds
C. Bladder distension
D. Dilated pupils
🟢 Correct answer: C
🔴 RATIONALE: Parasympathetic stimulation promotes bladder contraction and urination. Bladder distension indicates parasympathetic
dysfunction or postoperative urinary retention. Increased heart rate, decreased bowel sounds, and dilated pupils are sympathetic responses.
A patient with type 2 diabetes presents with blood glucose of 45 mg/dL. The patient is alert but confused. Which action is most appropriate?
A. Administer 1 unit intravenous regular insulin
B. Give 15 grams rapid-acting carbohydrate
C. Administer 25 mL 50% dextrose intravenously
D. Provide 8 ounces skim milk
🟢 Correct answer: C
🔴 RATIONALE: For severe hypoglycemia with confusion, intravenous dextrose provides immediate glucose replacement. Rapid-acting
carbohydrates and milk are appropriate for mild hypoglycemia with intact cognition. Insulin would worsen hypoglycemia.
A nurse is caring for a patient with a chest tube following thoracotomy. The drainage system shows no tidal movement. What should the nurse do
first?
, A. Clamp the chest tube near the insertion site
B. Milk the chest tube vigorously
C. Assess for kinks in the tubing
D. Add sterile water to the suction control chamber
🟢 Correct answer: C
🔴 RATIONALE: Absent tidal movement may indicate kinked tubing blocking drainage. Assessing for kinks is the first non-invasive intervention.
Clamping is contraindicated without provider order. Milking is controversial and may increase pressure. Adding water doesn't address the
obstruction.
A patient with liver cirrhosis has ascites and peripheral edema. Which laboratory value best reflects the severity of protein deficiency?
A. Serum albumin 1.8 g/dL
B. Total bilirubin 4.2 mg/dL
C. Alanine aminotransferase 120 U/L
D. Hemoglobin 9.5 g/dL
🟢 Correct answer: A
🔴 RATIONALE: Serum albumin reflects protein synthesis capacity and correlates with ascites and edema severity. Normal is 3.5-5.0 g/dL. Bilirubin
and ALT indicate liver dysfunction but not protein deficiency. Hemoglobin reflects bleeding risk, not protein status.
A nurse is teaching a patient with new-onset atrial fibrillation about warfarin therapy. Which statement indicates understanding?
A. "I will take aspirin with warfarin for pain"
B. "I need regular blood tests to check my clotting time"
C. "I can eat unlimited leafy greens while on this medication"
D. "I will stop warfarin if my gums bleed"
