MEDICAL SURGICAL DETAILED
ANSWER KEY - AN IDEAL TEST
PREPARATION MATERIAL
LATEST MOCK PRACTICE SET
174 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
MEDICAL SURGICAL DETAILED ANSWER KEY - AN IDEAL TEST PREPARATION MATERIAL PRACTICE
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES/ MED SURG PROCTORED EXAM PREP
GUIDE. It contains 174 carefully selected questions that reflect the most current exam content and testing
strategies. Each question is accompanied by a correct answer and a detailed rationale that explains the
underlying concepts and reasoning required to master the material.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering questions
under simulated exam
conditions
Review Summary 174 Questions
Foundations - Application - Medical Surgical Detailed KEY AN Ideal Preparation Material AND Correct
WITH Rationales/ MED SURG Proctored PREP Guide Medical-surgical Nursing Undergraduate YEAR 4 OR
Graduate Advanced Med-surg
All answers with rationales
,Table of Contents
Section A - Cardiovascular Disorders Section B - Respiratory Disorders
Questions 1 to 44 Questions 45 to 88
Section C - Gastrointestinal Disorders Section D - Renal AND Urinary
Questions 89 to 132 Disorders
Questions 133 to 174
,Section A - Cardiovascular Disorders
Q1.
A patient with acute kidney injury has a serum potassium of 6.2 mEq/L and ECG shows
peaked T waves. Which intervention should the nurse prepare FIRST?
A. Intravenous calcium gluconate B. Sodium polystyrene sulfonate
(Kayexalate)
C. Intravenous regular insulin and dextrose D. Hemodialysis
Correct: A - Intravenous calcium gluconate
Rationale:
IV calcium gluconate rapidly stabilizes the cardiac membrane, reducing risk of ventricular
arrhythmia. Kayexalate and insulin/dextrose lower potassium slowly, and dialysis is delayed;
calcium is the priority when ECG changes are present.
Q2.
When caring for a patient with suspected acute coronary syndrome, which finding is
MOST consistent with unstable angina rather than NSTEMI?
A. Elevated high-sensitivity troponin levels B. ST-segment depression on ECG
C. Chest pain that resolves with rest D. New-onset angina at rest
Correct: C - Chest pain that resolves with rest
Rationale:
Unstable angina is characterized by reversible myocardial ischemia without infarction; thus
pain typically resolves with rest or nitroglycerin, and biomarkers remain normal. Elevated
troponin and ST depression suggest NSTEMI; new-onset angina at rest is a feature of both.
Q3.
A patient with ARDS is on volume-controlled ventilation with a tidal volume of 8 mL/kg
ideal body weight. The plateau pressure is 32 cm H2O. Which action is most appropriate?
A. Increase PEEP to improve oxygenation B. Decrease tidal volume to 6 mL/kg
C. Switch to pressure-controlled ventilation D. Increase respiratory rate to maintain
minute ventilation
Correct: B - Decrease tidal volume to 6 mL/kg
Page 3
, Section A - Cardiovascular Disorders
Rationale:
In ARDS, lung-protective ventilation uses low tidal volumes (6 mL/kg) to limit plateau pressure
below 30 cm H2O, reducing ventilator-induced lung injury. Current settings may cause
barotrauma; decreasing tidal volume is priority. PEEP and rate adjustments are secondary.
Q4.
A patient with cirrhosis develops acute kidney injury. Urinalysis shows no proteinuria, and
fractional excretion of sodium is <1%. Which type of kidney injury is most likely?
A. Acute tubular necrosis B. Prerenal azotemia due to hepatorenal
syndrome
C. Postrenal obstruction D. Glomerulonephritis
Correct: B - Prerenal azotemia due to hepatorenal syndrome
Rationale:
Hepatorenal syndrome is a functional prerenal failure in cirrhosis, characterized by low urine
sodium and FeNa <1% without significant proteinuria or casts. Acute tubular necrosis typically
has FeNa >2% and muddy brown casts. Postrenal and glomerular causes are less consistent.
Q5.
Which assessment finding is MOST indicative of early increased intracranial pressure
(ICP)?
A. Decreased level of consciousness B. Unilateral pupillary dilation
C. Cushing's triad (hypertension, D. Posturing (decorticate or decerebrate)
bradycardia, irregular breathing)
Correct: A - Decreased level of consciousness
Rationale:
Early increased ICP often presents with subtle changes in level of consciousness due to
cerebral hypoperfusion. Pupillary changes, Cushing's triad, and posturing are late signs
indicating brainstem compression. Glasgow Coma Scale decline is an early warning.
Q6.
In a patient with diabetic ketoacidosis, which laboratory finding is MOST consistent with
the underlying pathophysiology?
A. Serum bicarbonate 18 mEq/L B. Anion gap 16 mEq/L
C. Serum osmolality 285 mOsm/kg D. Serum potassium 5.5 mEq/L
Correct: B - Anion gap 16 mEq/L
Page 4
ANSWER KEY - AN IDEAL TEST
PREPARATION MATERIAL
LATEST MOCK PRACTICE SET
174 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
MEDICAL SURGICAL DETAILED ANSWER KEY - AN IDEAL TEST PREPARATION MATERIAL PRACTICE
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES/ MED SURG PROCTORED EXAM PREP
GUIDE. It contains 174 carefully selected questions that reflect the most current exam content and testing
strategies. Each question is accompanied by a correct answer and a detailed rationale that explains the
underlying concepts and reasoning required to master the material.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering questions
under simulated exam
conditions
Review Summary 174 Questions
Foundations - Application - Medical Surgical Detailed KEY AN Ideal Preparation Material AND Correct
WITH Rationales/ MED SURG Proctored PREP Guide Medical-surgical Nursing Undergraduate YEAR 4 OR
Graduate Advanced Med-surg
All answers with rationales
,Table of Contents
Section A - Cardiovascular Disorders Section B - Respiratory Disorders
Questions 1 to 44 Questions 45 to 88
Section C - Gastrointestinal Disorders Section D - Renal AND Urinary
Questions 89 to 132 Disorders
Questions 133 to 174
,Section A - Cardiovascular Disorders
Q1.
A patient with acute kidney injury has a serum potassium of 6.2 mEq/L and ECG shows
peaked T waves. Which intervention should the nurse prepare FIRST?
A. Intravenous calcium gluconate B. Sodium polystyrene sulfonate
(Kayexalate)
C. Intravenous regular insulin and dextrose D. Hemodialysis
Correct: A - Intravenous calcium gluconate
Rationale:
IV calcium gluconate rapidly stabilizes the cardiac membrane, reducing risk of ventricular
arrhythmia. Kayexalate and insulin/dextrose lower potassium slowly, and dialysis is delayed;
calcium is the priority when ECG changes are present.
Q2.
When caring for a patient with suspected acute coronary syndrome, which finding is
MOST consistent with unstable angina rather than NSTEMI?
A. Elevated high-sensitivity troponin levels B. ST-segment depression on ECG
C. Chest pain that resolves with rest D. New-onset angina at rest
Correct: C - Chest pain that resolves with rest
Rationale:
Unstable angina is characterized by reversible myocardial ischemia without infarction; thus
pain typically resolves with rest or nitroglycerin, and biomarkers remain normal. Elevated
troponin and ST depression suggest NSTEMI; new-onset angina at rest is a feature of both.
Q3.
A patient with ARDS is on volume-controlled ventilation with a tidal volume of 8 mL/kg
ideal body weight. The plateau pressure is 32 cm H2O. Which action is most appropriate?
A. Increase PEEP to improve oxygenation B. Decrease tidal volume to 6 mL/kg
C. Switch to pressure-controlled ventilation D. Increase respiratory rate to maintain
minute ventilation
Correct: B - Decrease tidal volume to 6 mL/kg
Page 3
, Section A - Cardiovascular Disorders
Rationale:
In ARDS, lung-protective ventilation uses low tidal volumes (6 mL/kg) to limit plateau pressure
below 30 cm H2O, reducing ventilator-induced lung injury. Current settings may cause
barotrauma; decreasing tidal volume is priority. PEEP and rate adjustments are secondary.
Q4.
A patient with cirrhosis develops acute kidney injury. Urinalysis shows no proteinuria, and
fractional excretion of sodium is <1%. Which type of kidney injury is most likely?
A. Acute tubular necrosis B. Prerenal azotemia due to hepatorenal
syndrome
C. Postrenal obstruction D. Glomerulonephritis
Correct: B - Prerenal azotemia due to hepatorenal syndrome
Rationale:
Hepatorenal syndrome is a functional prerenal failure in cirrhosis, characterized by low urine
sodium and FeNa <1% without significant proteinuria or casts. Acute tubular necrosis typically
has FeNa >2% and muddy brown casts. Postrenal and glomerular causes are less consistent.
Q5.
Which assessment finding is MOST indicative of early increased intracranial pressure
(ICP)?
A. Decreased level of consciousness B. Unilateral pupillary dilation
C. Cushing's triad (hypertension, D. Posturing (decorticate or decerebrate)
bradycardia, irregular breathing)
Correct: A - Decreased level of consciousness
Rationale:
Early increased ICP often presents with subtle changes in level of consciousness due to
cerebral hypoperfusion. Pupillary changes, Cushing's triad, and posturing are late signs
indicating brainstem compression. Glasgow Coma Scale decline is an early warning.
Q6.
In a patient with diabetic ketoacidosis, which laboratory finding is MOST consistent with
the underlying pathophysiology?
A. Serum bicarbonate 18 mEq/L B. Anion gap 16 mEq/L
C. Serum osmolality 285 mOsm/kg D. Serum potassium 5.5 mEq/L
Correct: B - Anion gap 16 mEq/L
Page 4
