266 BSN MEDICAL SURGICAL EXAM/BSN 266 MEDICAL
SURGICAL ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS FULLY REVISED EXAM WITH MOST
TESTED EXAM QUESTIONS A NEW UPDATED VERSION
LATEST 2026-2027 (100% VERIFIED ANSWERS)
GUARANTEED SUCCESS PASS A+
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired effect?
a) Increase in jugular venous distention
b) Decrease in peripheral edema
c) Increase in blood pressure
d) Decrease in urine output
Correct Answer: b
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. The desired effect is a reduction in extracellular fluid volume, which
manifests as decreased peripheral edema, decreased jugular venous distention, and
increased urine output. A decrease in blood pressure may occur but is not the
primary desired effect in this context.
2. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who has a prescription for oxygen at 2 L/min via nasal cannula.
,Which assessment finding would indicate a potential complication of this
therapy?
a) Respiratory rate of 18 breaths per minute
b) Patient reporting a decrease in dyspnea
c) Pulse oximetry reading of 92%
d) Patient becoming lethargic and confused
Correct Answer: d
Rationale: In patients with COPD and chronic hypercapnia, the respiratory drive is
often stimulated by hypoxemia (hypoxic drive). Administering high-flow oxygen can
eliminate this drive, leading to hypoventilation, carbon dioxide retention, and
subsequent lethargy, confusion, or even respiratory failure. A respiratory rate of 18,
decreased dyspnea, and SpO2 of 92% are generally desired outcomes.
3. A patient is admitted with acute pancreatitis. Which laboratory value is
most specific for this diagnosis?
a) Elevated serum amylase
b) Elevated serum lipase
c) Elevated serum glucose
d) Elevated white blood cell count
Correct Answer: b
Rationale: Serum lipase is more specific and sensitive for acute pancreatitis than
serum amylase. Lipase remains elevated for a longer period, making it a more
reliable diagnostic indicator, especially in late presentations. While amylase,
glucose, and WBCs may be elevated, they are less specific.
4. A patient with type 1 diabetes mellitus is experiencing nausea, vomiting,
and abdominal pain. The nurse notes a fruity odor on the patient's breath and
,deep, rapid respirations. Which condition is the patient most likely
experiencing?
a) Hypoglycemia
b) Diabetic ketoacidosis (DKA)
c) Hyperosmolar hyperglycemic state (HHS)
d) Lactic acidosis
Correct Answer: b
Rationale: The classic signs of Diabetic Ketoacidosis (DKA) include hyperglycemia,
ketosis, metabolic acidosis (manifested by Kussmaul respirations), and a fruity odor
on the breath from acetone. Hypoglycemia would present with diaphoresis and
tremors. HHS typically presents with severe hyperglycemia but without significant
ketosis. Lactic acidosis is associated with hypoxia or certain medications.
5. A patient is prescribed warfarin for atrial fibrillation. Which laboratory test
is the primary indicator for monitoring the therapeutic effect of this
medication?
a) Activated partial thromboplastin time (aPTT)
b) Prothrombin time (PT) and International Normalized Ratio (INR)
c) Platelet count
d) Bleeding time
Correct Answer: b
Rationale: Warfarin is a vitamin K antagonist that affects the extrinsic pathway of
coagulation, which is monitored by the Prothrombin Time (PT) and International
Normalized Ratio (INR). The aPTT is used to monitor heparin therapy. Platelet
count and bleeding time assess platelet function and primary hemostasis.
, 6. A patient post-myocardial infarction is prescribed sublingual nitroglycerin
for chest pain. What is the most important instruction the nurse should give
the patient regarding the administration of this medication?
a) "Swallow the tablet with a full glass of water."
b) "Take one tablet every 5 minutes up to three tablets, and call 911 if pain is
not relieved."
c) "Chew the tablet thoroughly before swallowing."
d) "You can take this medication with sildenafil for better effect."
Correct Answer: b
Rationale: The standard protocol for sublingual nitroglycerin is to take one tablet at
the onset of chest pain. If pain is not relieved after 5 minutes, the patient should take
a second tablet, and a third after another 5 minutes if needed. If pain persist s after
the third tablet, it is a medical emergency, and 911 should be called. It is absorbed
sublingually and should not be swallowed. Concurrent use with phosphodiesterase
inhibitors like sildenafil is contraindicated due to severe hypotension.
7. The nurse is assessing a patient with cirrhosis. Which finding is most
concerning and indicates a potential life-threatening complication?
a) Spider angiomas on the chest
b) Ascites
c) Jaundice
d) Hematemesis
Correct Answer: d
Rationale: Hematemesis (vomiting blood) in a patient with cirrhosis often indicates
bleeding from esophageal varices, which is a life-threatening medical emergency.
Spider angiomas, ascites, and jaundice are significant manifestations of cirrhosis but
are not immediately life-threatening in the same way as an acute variceal bleed.
SURGICAL ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS FULLY REVISED EXAM WITH MOST
TESTED EXAM QUESTIONS A NEW UPDATED VERSION
LATEST 2026-2027 (100% VERIFIED ANSWERS)
GUARANTEED SUCCESS PASS A+
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired effect?
a) Increase in jugular venous distention
b) Decrease in peripheral edema
c) Increase in blood pressure
d) Decrease in urine output
Correct Answer: b
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. The desired effect is a reduction in extracellular fluid volume, which
manifests as decreased peripheral edema, decreased jugular venous distention, and
increased urine output. A decrease in blood pressure may occur but is not the
primary desired effect in this context.
2. A nurse is caring for a patient with chronic obstructive pulmonary disease
(COPD) who has a prescription for oxygen at 2 L/min via nasal cannula.
,Which assessment finding would indicate a potential complication of this
therapy?
a) Respiratory rate of 18 breaths per minute
b) Patient reporting a decrease in dyspnea
c) Pulse oximetry reading of 92%
d) Patient becoming lethargic and confused
Correct Answer: d
Rationale: In patients with COPD and chronic hypercapnia, the respiratory drive is
often stimulated by hypoxemia (hypoxic drive). Administering high-flow oxygen can
eliminate this drive, leading to hypoventilation, carbon dioxide retention, and
subsequent lethargy, confusion, or even respiratory failure. A respiratory rate of 18,
decreased dyspnea, and SpO2 of 92% are generally desired outcomes.
3. A patient is admitted with acute pancreatitis. Which laboratory value is
most specific for this diagnosis?
a) Elevated serum amylase
b) Elevated serum lipase
c) Elevated serum glucose
d) Elevated white blood cell count
Correct Answer: b
Rationale: Serum lipase is more specific and sensitive for acute pancreatitis than
serum amylase. Lipase remains elevated for a longer period, making it a more
reliable diagnostic indicator, especially in late presentations. While amylase,
glucose, and WBCs may be elevated, they are less specific.
4. A patient with type 1 diabetes mellitus is experiencing nausea, vomiting,
and abdominal pain. The nurse notes a fruity odor on the patient's breath and
,deep, rapid respirations. Which condition is the patient most likely
experiencing?
a) Hypoglycemia
b) Diabetic ketoacidosis (DKA)
c) Hyperosmolar hyperglycemic state (HHS)
d) Lactic acidosis
Correct Answer: b
Rationale: The classic signs of Diabetic Ketoacidosis (DKA) include hyperglycemia,
ketosis, metabolic acidosis (manifested by Kussmaul respirations), and a fruity odor
on the breath from acetone. Hypoglycemia would present with diaphoresis and
tremors. HHS typically presents with severe hyperglycemia but without significant
ketosis. Lactic acidosis is associated with hypoxia or certain medications.
5. A patient is prescribed warfarin for atrial fibrillation. Which laboratory test
is the primary indicator for monitoring the therapeutic effect of this
medication?
a) Activated partial thromboplastin time (aPTT)
b) Prothrombin time (PT) and International Normalized Ratio (INR)
c) Platelet count
d) Bleeding time
Correct Answer: b
Rationale: Warfarin is a vitamin K antagonist that affects the extrinsic pathway of
coagulation, which is monitored by the Prothrombin Time (PT) and International
Normalized Ratio (INR). The aPTT is used to monitor heparin therapy. Platelet
count and bleeding time assess platelet function and primary hemostasis.
, 6. A patient post-myocardial infarction is prescribed sublingual nitroglycerin
for chest pain. What is the most important instruction the nurse should give
the patient regarding the administration of this medication?
a) "Swallow the tablet with a full glass of water."
b) "Take one tablet every 5 minutes up to three tablets, and call 911 if pain is
not relieved."
c) "Chew the tablet thoroughly before swallowing."
d) "You can take this medication with sildenafil for better effect."
Correct Answer: b
Rationale: The standard protocol for sublingual nitroglycerin is to take one tablet at
the onset of chest pain. If pain is not relieved after 5 minutes, the patient should take
a second tablet, and a third after another 5 minutes if needed. If pain persist s after
the third tablet, it is a medical emergency, and 911 should be called. It is absorbed
sublingually and should not be swallowed. Concurrent use with phosphodiesterase
inhibitors like sildenafil is contraindicated due to severe hypotension.
7. The nurse is assessing a patient with cirrhosis. Which finding is most
concerning and indicates a potential life-threatening complication?
a) Spider angiomas on the chest
b) Ascites
c) Jaundice
d) Hematemesis
Correct Answer: d
Rationale: Hematemesis (vomiting blood) in a patient with cirrhosis often indicates
bleeding from esophageal varices, which is a life-threatening medical emergency.
Spider angiomas, ascites, and jaundice are significant manifestations of cirrhosis but
are not immediately life-threatening in the same way as an acute variceal bleed.
