KAPLAN MEDICAL-SURGICAL QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A
|LATEST EXAM UPDATE 2026/2027..
CORE DOMAINS *
- Fluid, Electrolyte, and Acid-Base Balance *
- Perioperative Care and Complications *
- Cardiovascular and Circulatory Disorders *
,- Respiratory Function and Oxygenation Therapy *
- Gastrointestinal, Hepatic, and Metabolic Systems *
- Renal, Urinary, and Endocrine Regulation *
- Neurological Assessment and Acute Care *
- Musculoskeletal and Integumentary Management *
, - Oncology, Immunological Diseases, and Ethics *
INTRODUCTION *
The purpose of this comprehensive assessment is to evaluate clinical competence *
and decision-making skills required for complex medical-surgical nursing practice. *
This exam systematically assesses advanced pathophysiology, pharmacological logic, *
nursing interventions, and client safety metrics across diverse adult patient *
populations. Comprising sophisticated multiple-choice and complex scenario-based *
items, the test mirrors contemporary clinical encounters requiring sharp diagnostic *
reasoning. Special emphasis is placed on standard legal-ethical frameworks, split-second *
triage priority, and real-world application of safe nursing practice, ensuring *
practitioners possess the foundational readiness to optimize client outcomes in *
acute care environments. *
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is caring for a patient who is 24 hours postoperative following an abdominal hysterectomy. The patient reports sudden chest pain and
shortness of breath. The nurse notes an oxygen saturation of 88% on room air and tachycardia. Which intervention should the nurse
implement first?
A. Administer the prescribed PRN intravenous morphine for pain.
, B. Obtain a 12-lead electrocardiogram (ECG) immediately.
C. Raise the head of the bed and apply supplemental oxygen.
D. Assess the patient’s surgical incision for signs of bleeding or dehiscence.
🟢 Correct answer: C. Raise the head of the bed and apply supplemental oxygen.
🔴 RATIONALE: The patient's clinical manifestations are highly suggestive of a pulmonary embolism, a severe postoperative complication.
Raising the head of the bed optimizes lung expansion and decreases the work of breathing, while applying oxygen directly treats the acute
hypoxemia. This is the priority stabilizing action before executing diagnostic tests or administering pain medications.
Question 2
A patient admitted with severe vomiting and diarrhea presents with the following arterial blood gas (ABG) results: pH 7.49, PaCO2 40 mmHg,
HCO3 31 mEq/L. How should the nurse interpret these laboratory values?
A. Metabolic acidosis
🟢 Correct answer: B. Metabolic alkalosis
C. Respiratory alkalosis
D. Compensated respiratory acidosis
🔴 RATIONALE: The pH is greater than 7.45, indicating alkalosis. The bicarbonate (HCO3) level is significantly elevated above the normal
range (22-26 mEq/L), while the PaCO2 remains within normal limits (35-45 mmHg). This signifies an uncompensated metabolic alkalosis,
which is consistent with the loss of gastric acid through severe vomiting.
Question 3
An intensive care nurse cares for a patient with an international normalized ratio (INR) of 6.2 who is actively bleeding from a gastrointestinal
ulcer. The patient has been taking warfarin at home. Which medication should the nurse expect the healthcare provider to prescribe to rapidly
reverse this medication?
A. Protamine sulfate
B. Heparin sodium
🟢 Correct answer: C. Vitamin K and Prothrombin Complex Concentrate (PCC)
D. Alteplase
🔴 RATIONALE: Vitamin K is the specific reversal agent for warfarin toxicity. In scenarios involving active, life-threatening bleeding and an
extremely elevated INR, Prothrombin Complex Concentrate (PCC) along with Vitamin K is administered for immediate replacement of clotting
factors to halt the hemorrhage rapidly. Protamine sulfate reverses heparin.
Question 4
A nurse reviews the laboratory results of a patient diagnosed with acute kidney injury. The patient's serum potassium level is 6.8 mEq/L.
Which clinical finding should the nurse prioritize for immediate intervention?
A. Hypoactive bowel sounds and abdominal distension
B. Complaints of muscle weakness in the lower extremities
🟢 Correct answer: C. Tall, peaked T waves on the cardiac monitor
D. Blood pressure reading of 142/88 mmHg
|LATEST EXAM UPDATE 2026/2027..
CORE DOMAINS *
- Fluid, Electrolyte, and Acid-Base Balance *
- Perioperative Care and Complications *
- Cardiovascular and Circulatory Disorders *
,- Respiratory Function and Oxygenation Therapy *
- Gastrointestinal, Hepatic, and Metabolic Systems *
- Renal, Urinary, and Endocrine Regulation *
- Neurological Assessment and Acute Care *
- Musculoskeletal and Integumentary Management *
, - Oncology, Immunological Diseases, and Ethics *
INTRODUCTION *
The purpose of this comprehensive assessment is to evaluate clinical competence *
and decision-making skills required for complex medical-surgical nursing practice. *
This exam systematically assesses advanced pathophysiology, pharmacological logic, *
nursing interventions, and client safety metrics across diverse adult patient *
populations. Comprising sophisticated multiple-choice and complex scenario-based *
items, the test mirrors contemporary clinical encounters requiring sharp diagnostic *
reasoning. Special emphasis is placed on standard legal-ethical frameworks, split-second *
triage priority, and real-world application of safe nursing practice, ensuring *
practitioners possess the foundational readiness to optimize client outcomes in *
acute care environments. *
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is caring for a patient who is 24 hours postoperative following an abdominal hysterectomy. The patient reports sudden chest pain and
shortness of breath. The nurse notes an oxygen saturation of 88% on room air and tachycardia. Which intervention should the nurse
implement first?
A. Administer the prescribed PRN intravenous morphine for pain.
, B. Obtain a 12-lead electrocardiogram (ECG) immediately.
C. Raise the head of the bed and apply supplemental oxygen.
D. Assess the patient’s surgical incision for signs of bleeding or dehiscence.
🟢 Correct answer: C. Raise the head of the bed and apply supplemental oxygen.
🔴 RATIONALE: The patient's clinical manifestations are highly suggestive of a pulmonary embolism, a severe postoperative complication.
Raising the head of the bed optimizes lung expansion and decreases the work of breathing, while applying oxygen directly treats the acute
hypoxemia. This is the priority stabilizing action before executing diagnostic tests or administering pain medications.
Question 2
A patient admitted with severe vomiting and diarrhea presents with the following arterial blood gas (ABG) results: pH 7.49, PaCO2 40 mmHg,
HCO3 31 mEq/L. How should the nurse interpret these laboratory values?
A. Metabolic acidosis
🟢 Correct answer: B. Metabolic alkalosis
C. Respiratory alkalosis
D. Compensated respiratory acidosis
🔴 RATIONALE: The pH is greater than 7.45, indicating alkalosis. The bicarbonate (HCO3) level is significantly elevated above the normal
range (22-26 mEq/L), while the PaCO2 remains within normal limits (35-45 mmHg). This signifies an uncompensated metabolic alkalosis,
which is consistent with the loss of gastric acid through severe vomiting.
Question 3
An intensive care nurse cares for a patient with an international normalized ratio (INR) of 6.2 who is actively bleeding from a gastrointestinal
ulcer. The patient has been taking warfarin at home. Which medication should the nurse expect the healthcare provider to prescribe to rapidly
reverse this medication?
A. Protamine sulfate
B. Heparin sodium
🟢 Correct answer: C. Vitamin K and Prothrombin Complex Concentrate (PCC)
D. Alteplase
🔴 RATIONALE: Vitamin K is the specific reversal agent for warfarin toxicity. In scenarios involving active, life-threatening bleeding and an
extremely elevated INR, Prothrombin Complex Concentrate (PCC) along with Vitamin K is administered for immediate replacement of clotting
factors to halt the hemorrhage rapidly. Protamine sulfate reverses heparin.
Question 4
A nurse reviews the laboratory results of a patient diagnosed with acute kidney injury. The patient's serum potassium level is 6.8 mEq/L.
Which clinical finding should the nurse prioritize for immediate intervention?
A. Hypoactive bowel sounds and abdominal distension
B. Complaints of muscle weakness in the lower extremities
🟢 Correct answer: C. Tall, peaked T waves on the cardiac monitor
D. Blood pressure reading of 142/88 mmHg
