Herzing NSG523 Med Surg Nursing III Exam 2
Practice Exam Questions and Answers (2026) |
150 NCLEX-Style Questions with Detailed
Rationales | Updated Med-Surg III Study Guide |
Instant PDF Download
Introduction
Prepare confidently for your Herzing University NSG523 Medical-Surgical Nursing III Exam
2 with this comprehensive 2026 updated practice exam. This study guide features 150 original
NCLEX-style multiple-choice questions with correct answers and detailed rationales to
strengthen clinical judgment, critical thinking, and exam readiness. Designed to reinforce core
medical-surgical nursing concepts, it is an excellent resource for classroom success and
comprehensive exam preparation.
Coverage
Cardiovascular Disorders & Acute Coronary Syndrome (ACS)
Heart Failure & Cardiac Dysrhythmias
Hypertension & Shock
Respiratory Disorders (COPD, Asthma, ARDS, Pneumonia, Pulmonary Embolism)
Mechanical Ventilation & Oxygen Therapy
Acute Kidney Injury (AKI) & Chronic Kidney Disease (CKD)
Fluid, Electrolyte & Acid–Base Imbalances
Diabetes Mellitus, DKA & HHS
Thyroid & Adrenal Disorders
Liver Disease, Cirrhosis & Pancreatitis
Gastrointestinal Bleeding
Stroke, Seizures & Increased Intracranial Pressure
Hematologic Disorders & Blood Transfusions
Disseminated Intravascular Coagulation (DIC)
Medical-Surgical Pharmacology
Laboratory Interpretation
Priority Nursing Interventions
NGN Clinical Judgment & Patient Safety
,1. A nurse is caring for a patient admitted with an acute ST-elevation myocardial
infarction (STEMI). Which intervention should the nurse implement first after
assessing the patient's airway, breathing, and circulation?
A. Administer a stool softener
B. Obtain a 12-lead electrocardiogram and prepare for rapid reperfusion therapy
C. Encourage ambulation
D. Restrict oral fluids
Answer: B
Rationale: Early identification of STEMI and rapid reperfusion therapy significantly reduce
myocardial damage. Obtaining a 12-lead ECG within 10 minutes of arrival is a priority
intervention.*
2. A patient with left-sided heart failure suddenly develops severe dyspnea, pink
frothy sputum, and bilateral crackles. Which complication should the nurse suspect?
A. Deep vein thrombosis
B. Pulmonary embolism
C. Acute pulmonary edema
D. Pleural effusion
Answer: C
Rationale: Left ventricular failure causes increased pulmonary capillary pressure, leading to
fluid accumulation in the alveoli and pulmonary edema.*
,3. Which assessment finding is most concerning in a patient receiving intravenous
unfractionated heparin?
A. Heart rate of 82 beats/minute
B. Blood pressure of 126/74 mm Hg
C. Black, tarry stools
D. Oxygen saturation of 96%
Answer: C
Rationale: Melena suggests gastrointestinal bleeding, a serious complication of
anticoagulant therapy requiring immediate evaluation.*
4. A patient with septic shock has a serum lactate level of 5.8 mmol/L. What does this
finding most likely indicate?
A. Improved tissue perfusion
B. Hyperventilation
C. Inadequate tissue oxygenation and anaerobic metabolism
D. Normal physiologic response
Answer: C
Rationale: Elevated lactate indicates tissue hypoperfusion and anaerobic metabolism, a
hallmark of severe sepsis and septic shock.*
, 5. Which assessment finding would the nurse expect in a patient experiencing
cardiogenic shock?
A. Warm, flushed skin
B. Bounding peripheral pulses
C. Cool, clammy skin with hypotension and decreased urine output
D. Increased urinary output
Answer: C
Rationale: Cardiogenic shock results in poor cardiac output, leading to tissue hypoperfusion,
cool skin, oliguria, and hypotension.*
6. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which assessment finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Increasing drowsiness with a respiratory rate of 8 breaths/minute
C. Mild productive cough
D. Barrel-shaped chest
Answer: B
Rationale: Respiratory depression may indicate worsening hypercapnia requiring immediate
evaluation.*
7. Which arterial blood gas result is consistent with respiratory acidosis?
Practice Exam Questions and Answers (2026) |
150 NCLEX-Style Questions with Detailed
Rationales | Updated Med-Surg III Study Guide |
Instant PDF Download
Introduction
Prepare confidently for your Herzing University NSG523 Medical-Surgical Nursing III Exam
2 with this comprehensive 2026 updated practice exam. This study guide features 150 original
NCLEX-style multiple-choice questions with correct answers and detailed rationales to
strengthen clinical judgment, critical thinking, and exam readiness. Designed to reinforce core
medical-surgical nursing concepts, it is an excellent resource for classroom success and
comprehensive exam preparation.
Coverage
Cardiovascular Disorders & Acute Coronary Syndrome (ACS)
Heart Failure & Cardiac Dysrhythmias
Hypertension & Shock
Respiratory Disorders (COPD, Asthma, ARDS, Pneumonia, Pulmonary Embolism)
Mechanical Ventilation & Oxygen Therapy
Acute Kidney Injury (AKI) & Chronic Kidney Disease (CKD)
Fluid, Electrolyte & Acid–Base Imbalances
Diabetes Mellitus, DKA & HHS
Thyroid & Adrenal Disorders
Liver Disease, Cirrhosis & Pancreatitis
Gastrointestinal Bleeding
Stroke, Seizures & Increased Intracranial Pressure
Hematologic Disorders & Blood Transfusions
Disseminated Intravascular Coagulation (DIC)
Medical-Surgical Pharmacology
Laboratory Interpretation
Priority Nursing Interventions
NGN Clinical Judgment & Patient Safety
,1. A nurse is caring for a patient admitted with an acute ST-elevation myocardial
infarction (STEMI). Which intervention should the nurse implement first after
assessing the patient's airway, breathing, and circulation?
A. Administer a stool softener
B. Obtain a 12-lead electrocardiogram and prepare for rapid reperfusion therapy
C. Encourage ambulation
D. Restrict oral fluids
Answer: B
Rationale: Early identification of STEMI and rapid reperfusion therapy significantly reduce
myocardial damage. Obtaining a 12-lead ECG within 10 minutes of arrival is a priority
intervention.*
2. A patient with left-sided heart failure suddenly develops severe dyspnea, pink
frothy sputum, and bilateral crackles. Which complication should the nurse suspect?
A. Deep vein thrombosis
B. Pulmonary embolism
C. Acute pulmonary edema
D. Pleural effusion
Answer: C
Rationale: Left ventricular failure causes increased pulmonary capillary pressure, leading to
fluid accumulation in the alveoli and pulmonary edema.*
,3. Which assessment finding is most concerning in a patient receiving intravenous
unfractionated heparin?
A. Heart rate of 82 beats/minute
B. Blood pressure of 126/74 mm Hg
C. Black, tarry stools
D. Oxygen saturation of 96%
Answer: C
Rationale: Melena suggests gastrointestinal bleeding, a serious complication of
anticoagulant therapy requiring immediate evaluation.*
4. A patient with septic shock has a serum lactate level of 5.8 mmol/L. What does this
finding most likely indicate?
A. Improved tissue perfusion
B. Hyperventilation
C. Inadequate tissue oxygenation and anaerobic metabolism
D. Normal physiologic response
Answer: C
Rationale: Elevated lactate indicates tissue hypoperfusion and anaerobic metabolism, a
hallmark of severe sepsis and septic shock.*
, 5. Which assessment finding would the nurse expect in a patient experiencing
cardiogenic shock?
A. Warm, flushed skin
B. Bounding peripheral pulses
C. Cool, clammy skin with hypotension and decreased urine output
D. Increased urinary output
Answer: C
Rationale: Cardiogenic shock results in poor cardiac output, leading to tissue hypoperfusion,
cool skin, oliguria, and hypotension.*
6. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which assessment finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Increasing drowsiness with a respiratory rate of 8 breaths/minute
C. Mild productive cough
D. Barrel-shaped chest
Answer: B
Rationale: Respiratory depression may indicate worsening hypercapnia requiring immediate
evaluation.*
7. Which arterial blood gas result is consistent with respiratory acidosis?
