CJE MED SURG II NEWEST 2026
ACTUAL EXAM – COMPLETE 250-
QUESTION BANK WITH VERIFIED
ANSWERS Most Recent / [Already
Graded A+]
• A patient with cardiac tamponade is showing signs of decreased
cardiac output. What is the underlying pathophysiology?
o Answer: Fluid accumulation in the pericardial sac
compresses the heart, limiting ventricular filling and reducing
stroke volume.
• A nurse is caring for a patient with angina pectoris who reports
chest pain after eating a large meal. What is the primary reason for
this occurrence?
o Answer: Blood is shunted to the gastrointestinal tract,
reducing myocardial oxygen supply.
• A patient is prescribed sublingual nitroglycerin for angina. Which
instruction should the nurse include in the teaching?
o Answer: Place the tablet under the tongue, allow it to
dissolve, and do not swallow it. Take up to 3 doses 5 minutes
apart, and call 911 if pain persists after the first dose.
• A patient is scheduled for a cardiac stress test. What is the primary
purpose of this test?
o Answer: To evaluate the heart's ability to respond to
increased oxygen demand during physical exertion.
• A patient's lab results show an elevated BNP level greater than 100
pg/mL. What condition does this most likely indicate?
o Answer: Heart failure, due to increased ventricular pressure
stimulating BNP release.
,• A patient is in ventricular fibrillation. What is the priority nursing
intervention?
o Answer: Immediate defibrillation, followed by administration
of antiarrhythmic medications such as amiodarone or
lidocaine.
• A patient presents with pulseless ventricular tachycardia. What is
the immediate treatment of choice?
o Answer: Immediate defibrillation.
• A patient has a regular but rapid heart rhythm with no discernible
P-waves on the ECG. What rhythm is this most consistent with?
o Answer: Atrial fibrillation.
• A patient's ECG shows a "saw-tooth" pattern of flutter waves. What
rhythm should the nurse suspect?
o Answer: Atrial flutter.
• A patient is in asystole. Which intervention should the nurse avoid?
o Answer: Defibrillation.
• A patient has just received a permanent pacemaker. Which
instruction should the nurse include in discharge teaching?
o Answer: Avoid raising both arms above the head or heavy
lifting for at least 2 weeks.
• A patient with Acute Respiratory Distress Syndrome (ARDS)
continues to have low oxygen saturation despite high-flow oxygen.
What is the hallmark finding on a chest X-ray for this patient?
o Answer: Bilateral "white out" infiltrates.
• A patient with suspected pulmonary embolism has a positive D-
dimer test. What does this result indicate?
o Answer: The presence of clot breakdown products,
indicating thrombus formation and lysis.
• A patient with COPD is receiving supplemental oxygen and
becomes increasingly drowsy. What is the most likely cause?
o Answer: Oxygen-induced hypercapnia (CO₂ narcosis) due to
loss of hypoxic respiratory drive.
, • A patient with increased intracranial pressure (ICP) shows
hypertension, bradycardia, and irregular respirations. What is this
triad of symptoms called?
o Answer: Cushing's Triad.
• A patient is experiencing status epilepticus. What is the first-line
medication that should be administered?
o Answer: IV lorazepam or IV diazepam.
• A patient with Diabetic Ketoacidosis (DKA) presents with fruity
breath odor and Kussmaul respirations. What is the priority
treatment?
o Answer: IV fluids, IV regular insulin infusion, and potassium
replacement.
• A patient with Hyperosmolar Hyperglycemic State (HHS) has a
blood glucose of 850 mg/dL but no significant ketones. What is
the primary distinguishing feature of HHS compared to DKA?
o Answer: Severe dehydration and neurological changes
without significant acidosis.
• A patient with untreated hypothyroidism presents with severe
lethargy, hypothermia, and altered mental status. What is this life-
threatening condition called?
o Answer: Myxedema coma.
• A patient is diagnosed with hypothyroidism. Which lab finding
would the nurse expect?
o Answer: Low T3/T4 levels and elevated TSH.
• A patient with hyperthyroidism is receiving dietary teaching. What
nutritional recommendation should the nurse provide?
o Answer: A high-protein, high-calorie, low-fiber diet.
• A patient has a stage 2 pressure ulcer. What are the characteristic
findings of this stage?
o Answer: Partial-thickness skin loss with exposed dermis,
presenting as a shallow open ulcer with a pink or red wound
bed.
ACTUAL EXAM – COMPLETE 250-
QUESTION BANK WITH VERIFIED
ANSWERS Most Recent / [Already
Graded A+]
• A patient with cardiac tamponade is showing signs of decreased
cardiac output. What is the underlying pathophysiology?
o Answer: Fluid accumulation in the pericardial sac
compresses the heart, limiting ventricular filling and reducing
stroke volume.
• A nurse is caring for a patient with angina pectoris who reports
chest pain after eating a large meal. What is the primary reason for
this occurrence?
o Answer: Blood is shunted to the gastrointestinal tract,
reducing myocardial oxygen supply.
• A patient is prescribed sublingual nitroglycerin for angina. Which
instruction should the nurse include in the teaching?
o Answer: Place the tablet under the tongue, allow it to
dissolve, and do not swallow it. Take up to 3 doses 5 minutes
apart, and call 911 if pain persists after the first dose.
• A patient is scheduled for a cardiac stress test. What is the primary
purpose of this test?
o Answer: To evaluate the heart's ability to respond to
increased oxygen demand during physical exertion.
• A patient's lab results show an elevated BNP level greater than 100
pg/mL. What condition does this most likely indicate?
o Answer: Heart failure, due to increased ventricular pressure
stimulating BNP release.
,• A patient is in ventricular fibrillation. What is the priority nursing
intervention?
o Answer: Immediate defibrillation, followed by administration
of antiarrhythmic medications such as amiodarone or
lidocaine.
• A patient presents with pulseless ventricular tachycardia. What is
the immediate treatment of choice?
o Answer: Immediate defibrillation.
• A patient has a regular but rapid heart rhythm with no discernible
P-waves on the ECG. What rhythm is this most consistent with?
o Answer: Atrial fibrillation.
• A patient's ECG shows a "saw-tooth" pattern of flutter waves. What
rhythm should the nurse suspect?
o Answer: Atrial flutter.
• A patient is in asystole. Which intervention should the nurse avoid?
o Answer: Defibrillation.
• A patient has just received a permanent pacemaker. Which
instruction should the nurse include in discharge teaching?
o Answer: Avoid raising both arms above the head or heavy
lifting for at least 2 weeks.
• A patient with Acute Respiratory Distress Syndrome (ARDS)
continues to have low oxygen saturation despite high-flow oxygen.
What is the hallmark finding on a chest X-ray for this patient?
o Answer: Bilateral "white out" infiltrates.
• A patient with suspected pulmonary embolism has a positive D-
dimer test. What does this result indicate?
o Answer: The presence of clot breakdown products,
indicating thrombus formation and lysis.
• A patient with COPD is receiving supplemental oxygen and
becomes increasingly drowsy. What is the most likely cause?
o Answer: Oxygen-induced hypercapnia (CO₂ narcosis) due to
loss of hypoxic respiratory drive.
, • A patient with increased intracranial pressure (ICP) shows
hypertension, bradycardia, and irregular respirations. What is this
triad of symptoms called?
o Answer: Cushing's Triad.
• A patient is experiencing status epilepticus. What is the first-line
medication that should be administered?
o Answer: IV lorazepam or IV diazepam.
• A patient with Diabetic Ketoacidosis (DKA) presents with fruity
breath odor and Kussmaul respirations. What is the priority
treatment?
o Answer: IV fluids, IV regular insulin infusion, and potassium
replacement.
• A patient with Hyperosmolar Hyperglycemic State (HHS) has a
blood glucose of 850 mg/dL but no significant ketones. What is
the primary distinguishing feature of HHS compared to DKA?
o Answer: Severe dehydration and neurological changes
without significant acidosis.
• A patient with untreated hypothyroidism presents with severe
lethargy, hypothermia, and altered mental status. What is this life-
threatening condition called?
o Answer: Myxedema coma.
• A patient is diagnosed with hypothyroidism. Which lab finding
would the nurse expect?
o Answer: Low T3/T4 levels and elevated TSH.
• A patient with hyperthyroidism is receiving dietary teaching. What
nutritional recommendation should the nurse provide?
o Answer: A high-protein, high-calorie, low-fiber diet.
• A patient has a stage 2 pressure ulcer. What are the characteristic
findings of this stage?
o Answer: Partial-thickness skin loss with exposed dermis,
presenting as a shallow open ulcer with a pink or red wound
bed.
