Medical Surgical Nursing Exam 1
PRACTICE QUESTIONS AND ANSWERS
LATEST UPDATE
Cardiovascular Disorders (Questions 1-15)
1. A client with ascites is scheduled for a paracentesis. Which instruction should be given to the client
before the procedure?
A) "You will need to lay flat during the procedure."
B) "You need to empty your bladder before the procedure."
C) "You will be asleep during the procedure."
D) "The doctor will inject a medication during the procedure."
Correct Answer: B
Rationale: Emptying the bladder prevents accidental puncture during paracentesis and reduces
discomfort. The procedure is typically done with local anesthesia, not general, and the patient sits
upright or lies with head elevated .
2. A client's lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets
178,000. The nurse evaluates that the client is experiencing which of the following?
A) Hypernatremia
B) Hypokalemia
C) Myelosuppression
D) Leukopenia
Correct Answer: B
*Rationale: Normal potassium range is 3.5-5.0 mEq/L. A level of 1.9 indicates severe hypokalemia. Hgb,
WBC, uric acid, sodium, and platelets are all within normal ranges .*
3. Before administering Theo-Dur (theophylline), the nurse should check the patient's:
A) Urine output
B) Blood pressure
C) Pulse
D) Temperature
,Correct Answer: C
Rationale: Theophylline is a bronchodilator that can cause tachycardia and cardiac dysrhythmias.
Assessing pulse rate before administration is essential to detect potential cardiovascular side effects .
4. Which statement is true regarding therapy with Levemir (insulin detemir)?
A) The onset is 1-2 hours.
B) It may be mixed with regular insulin.
C) It peaks in 2-3 hours.
D) The duration is 24 hours.
Correct Answer: D
*Rationale: Insulin detemir (Levemir) is a long-acting insulin with duration up to 24 hours. It should NOT
be mixed with other insulins, has onset of 3-4 hours, and is relatively peakless .*
5. A client's BP is 140/40, pulse 120, respirations 36. The nurse's initial action should be to:
A) Report the findings to the physician
B) Recheck the vital signs in one hour
C) Ask the patient if he is in pain
D) Compare the current vital signs with those on admission
Correct Answer: A
Rationale: These vital signs indicate a widened pulse pressure (difference of 100 mmHg) with tachycardia
and tachypnea, which may indicate aortic regurgitation or other serious conditions requiring immediate
physician notification .
6. A patient has hypertension and is prescribed chlorothiazide (Diuril) 500 mg PO. What nursing
instruction is essential?
A) Drink at least two quarts of liquid daily
B) Avoid hard cheeses
C) Drink orange juice or eat a banana daily
D) Do not take aspirin
Correct Answer: C
Rationale: Thiazide diuretics can cause hypokalemia. Increasing potassium-rich foods like bananas and
orange juice helps prevent this electrolyte imbalance .
7. Which person is at greatest risk for hypertension?
A) 63-year-old overweight Caucasian female who smokes
B) 52-year-old African-American female of normal weight
C) 48-year-old Hispanic-American smoker
D) 45-year-old Native American who leads a sedentary life
, Correct Answer: A
*Rationale: Risk factors for hypertension include age over 60, obesity, smoking, and family history.
Option A presents multiple non-modifiable and modifiable risk factors .*
8. Which condition would contraindicate the use of chest physiotherapy for a client with pneumonia?
A) Recent abdominal cholecystectomy
B) Diabetes mellitus
C) Rheumatoid arthritis
D) Emphysema
Correct Answer: A
Rationale: Chest physiotherapy is contraindicated after recent abdominal surgery due to risk of
disrupting surgical incisions or causing pain that impairs deep breathing .
9. A client with angina will have to make lifestyle modifications. Which statement indicates
understanding?
A) "I know that I will need to eat less, so I will only eat one meal a day."
B) "I will need to stay in bed all the time so I won't have the pain."
C) "I'll stop what I'm doing whenever I have pain and take a pill."
D) "I will need to walk more slowly and rest frequently to avoid the angina."
Correct Answer: D
Rationale: Pacing activities and resting before pain occurs is an appropriate lifestyle modification.
Nitroglycerin is taken at onset of pain, but prevention through activity modification is key .
10. What is the classification of Warfarin?
A) Antiplatelet agent
B) Anticoagulant, Vitamin K antagonist
C) Thrombolytic
D) Direct thrombin inhibitor
Correct Answer: B
Rationale: Warfarin is an anticoagulant that works as a vitamin K antagonist, inhibiting vitamin K-
dependent clotting factors II, VII, IX, and X .
11. What is the antidote for Warfarin?
A) Protamine sulfate
B) Vitamin E
C) Vitamin K
D) Fresh frozen plasma only
PRACTICE QUESTIONS AND ANSWERS
LATEST UPDATE
Cardiovascular Disorders (Questions 1-15)
1. A client with ascites is scheduled for a paracentesis. Which instruction should be given to the client
before the procedure?
A) "You will need to lay flat during the procedure."
B) "You need to empty your bladder before the procedure."
C) "You will be asleep during the procedure."
D) "The doctor will inject a medication during the procedure."
Correct Answer: B
Rationale: Emptying the bladder prevents accidental puncture during paracentesis and reduces
discomfort. The procedure is typically done with local anesthesia, not general, and the patient sits
upright or lies with head elevated .
2. A client's lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets
178,000. The nurse evaluates that the client is experiencing which of the following?
A) Hypernatremia
B) Hypokalemia
C) Myelosuppression
D) Leukopenia
Correct Answer: B
*Rationale: Normal potassium range is 3.5-5.0 mEq/L. A level of 1.9 indicates severe hypokalemia. Hgb,
WBC, uric acid, sodium, and platelets are all within normal ranges .*
3. Before administering Theo-Dur (theophylline), the nurse should check the patient's:
A) Urine output
B) Blood pressure
C) Pulse
D) Temperature
,Correct Answer: C
Rationale: Theophylline is a bronchodilator that can cause tachycardia and cardiac dysrhythmias.
Assessing pulse rate before administration is essential to detect potential cardiovascular side effects .
4. Which statement is true regarding therapy with Levemir (insulin detemir)?
A) The onset is 1-2 hours.
B) It may be mixed with regular insulin.
C) It peaks in 2-3 hours.
D) The duration is 24 hours.
Correct Answer: D
*Rationale: Insulin detemir (Levemir) is a long-acting insulin with duration up to 24 hours. It should NOT
be mixed with other insulins, has onset of 3-4 hours, and is relatively peakless .*
5. A client's BP is 140/40, pulse 120, respirations 36. The nurse's initial action should be to:
A) Report the findings to the physician
B) Recheck the vital signs in one hour
C) Ask the patient if he is in pain
D) Compare the current vital signs with those on admission
Correct Answer: A
Rationale: These vital signs indicate a widened pulse pressure (difference of 100 mmHg) with tachycardia
and tachypnea, which may indicate aortic regurgitation or other serious conditions requiring immediate
physician notification .
6. A patient has hypertension and is prescribed chlorothiazide (Diuril) 500 mg PO. What nursing
instruction is essential?
A) Drink at least two quarts of liquid daily
B) Avoid hard cheeses
C) Drink orange juice or eat a banana daily
D) Do not take aspirin
Correct Answer: C
Rationale: Thiazide diuretics can cause hypokalemia. Increasing potassium-rich foods like bananas and
orange juice helps prevent this electrolyte imbalance .
7. Which person is at greatest risk for hypertension?
A) 63-year-old overweight Caucasian female who smokes
B) 52-year-old African-American female of normal weight
C) 48-year-old Hispanic-American smoker
D) 45-year-old Native American who leads a sedentary life
, Correct Answer: A
*Rationale: Risk factors for hypertension include age over 60, obesity, smoking, and family history.
Option A presents multiple non-modifiable and modifiable risk factors .*
8. Which condition would contraindicate the use of chest physiotherapy for a client with pneumonia?
A) Recent abdominal cholecystectomy
B) Diabetes mellitus
C) Rheumatoid arthritis
D) Emphysema
Correct Answer: A
Rationale: Chest physiotherapy is contraindicated after recent abdominal surgery due to risk of
disrupting surgical incisions or causing pain that impairs deep breathing .
9. A client with angina will have to make lifestyle modifications. Which statement indicates
understanding?
A) "I know that I will need to eat less, so I will only eat one meal a day."
B) "I will need to stay in bed all the time so I won't have the pain."
C) "I'll stop what I'm doing whenever I have pain and take a pill."
D) "I will need to walk more slowly and rest frequently to avoid the angina."
Correct Answer: D
Rationale: Pacing activities and resting before pain occurs is an appropriate lifestyle modification.
Nitroglycerin is taken at onset of pain, but prevention through activity modification is key .
10. What is the classification of Warfarin?
A) Antiplatelet agent
B) Anticoagulant, Vitamin K antagonist
C) Thrombolytic
D) Direct thrombin inhibitor
Correct Answer: B
Rationale: Warfarin is an anticoagulant that works as a vitamin K antagonist, inhibiting vitamin K-
dependent clotting factors II, VII, IX, and X .
11. What is the antidote for Warfarin?
A) Protamine sulfate
B) Vitamin E
C) Vitamin K
D) Fresh frozen plasma only
