MED SURG CMS PROCTORED EXAM
2026/2027| Verified Q&A |
Comprehensive Med-Surg Mastery
GRADED A+ (INSTANT DOWMLOAD)
Cardiovascular
1. A patient with acute myocardial infarction reports chest
pain rated 8/10. What is the nurse's priority action?
A. Administer prescribed nitroglycerin and reassess
B. Document the pain
C. Offer a snack
D. Call family
Answer: A
Rationale: Chest pain in MI indicates myocardial ischemia
requiring immediate intervention. Administering nitroglycerin
addresses the underlying ischemia. Documentation alone does
not treat the patient, food is irrelevant during acute MI, and family
notification is secondary to patient stabilization.
2. A nurse assesses a patient with heart failure who suddenly
develops crackles and pink frothy sputum. What is the
priority action?
A. Encourage fluids
B. Place patient flat
,C. Administer oxygen
D. Delay intervention until chest x-ray
Answer: C
Rationale: Pink frothy sputum and crackles indicate pulmonary
edema—an airway/breathing emergency requiring immediate
oxygen administration.
3. Which laboratory finding requires immediate intervention?
A. Sodium 136 mEq/L
B. Potassium 6.2 mEq/L
C. Glucose 110 mg/dL
D. Calcium 9.1 mg/dL
Answer: B
Rationale: Severe hyperkalemia (potassium >5.0 mEq/L) can
cause fatal cardiac dysrhythmias and requires prompt
intervention.
4. A patient receiving warfarin has an INR of 5.2. What action
should the nurse take?
A. Hold medication and notify provider
B. Continue as ordered
,C. Double the dose
D. Encourage green leafy vegetables
Answer: A
Rationale: Therapeutic INR for most indications is 2.0–3.0. An INR
of 5.2 indicates excessive anticoagulation and increased bleeding
risk. The medication should be held and the provider notified.
5. Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. ST depression only
C. Narrow QRS
D. Sinus tachycardia
Answer: A
Rationale: Peaked (tall, tented) T waves are the classic ECG
finding in hyperkalemia.
6. A patient with chronic heart failure reports a 5-lb weight
gain in 3 days. What should the nurse do FIRST?
A. Encourage a low-sodium diet
B. Assess for peripheral edema and crackles
C. Increase the diuretic dose without consulting
D. Restrict all oral fluids to 500 mL/day
, Answer: B
Rationale: Rapid weight gain suggests fluid retention. The nurse
must assess for worsening heart failure (edema, lung crackles)
before notifying the provider for possible diuretic adjustment.
7. Which assessment finding is expected in right-sided heart
failure?
A. Crackles only
B. Pulmonary edema
C. Peripheral edema
D. Stridor
Answer: C
Rationale: Right-sided heart failure presents with signs of
systemic congestion including peripheral edema, jugular venous
distention, and hepatomegaly. Left-sided failure causes
pulmonary symptoms like crackles.
8. A client is prescribed clopidogrel after placement of a
drug-eluting stent. Which statement indicates understanding?
A. "I can stop this medication if I have no chest pain."
B. "I should report unusual bleeding or bruising."
C. "I can take ibuprofen for headaches."
D. "I don't need to worry about bleeding."
2026/2027| Verified Q&A |
Comprehensive Med-Surg Mastery
GRADED A+ (INSTANT DOWMLOAD)
Cardiovascular
1. A patient with acute myocardial infarction reports chest
pain rated 8/10. What is the nurse's priority action?
A. Administer prescribed nitroglycerin and reassess
B. Document the pain
C. Offer a snack
D. Call family
Answer: A
Rationale: Chest pain in MI indicates myocardial ischemia
requiring immediate intervention. Administering nitroglycerin
addresses the underlying ischemia. Documentation alone does
not treat the patient, food is irrelevant during acute MI, and family
notification is secondary to patient stabilization.
2. A nurse assesses a patient with heart failure who suddenly
develops crackles and pink frothy sputum. What is the
priority action?
A. Encourage fluids
B. Place patient flat
,C. Administer oxygen
D. Delay intervention until chest x-ray
Answer: C
Rationale: Pink frothy sputum and crackles indicate pulmonary
edema—an airway/breathing emergency requiring immediate
oxygen administration.
3. Which laboratory finding requires immediate intervention?
A. Sodium 136 mEq/L
B. Potassium 6.2 mEq/L
C. Glucose 110 mg/dL
D. Calcium 9.1 mg/dL
Answer: B
Rationale: Severe hyperkalemia (potassium >5.0 mEq/L) can
cause fatal cardiac dysrhythmias and requires prompt
intervention.
4. A patient receiving warfarin has an INR of 5.2. What action
should the nurse take?
A. Hold medication and notify provider
B. Continue as ordered
,C. Double the dose
D. Encourage green leafy vegetables
Answer: A
Rationale: Therapeutic INR for most indications is 2.0–3.0. An INR
of 5.2 indicates excessive anticoagulation and increased bleeding
risk. The medication should be held and the provider notified.
5. Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. ST depression only
C. Narrow QRS
D. Sinus tachycardia
Answer: A
Rationale: Peaked (tall, tented) T waves are the classic ECG
finding in hyperkalemia.
6. A patient with chronic heart failure reports a 5-lb weight
gain in 3 days. What should the nurse do FIRST?
A. Encourage a low-sodium diet
B. Assess for peripheral edema and crackles
C. Increase the diuretic dose without consulting
D. Restrict all oral fluids to 500 mL/day
, Answer: B
Rationale: Rapid weight gain suggests fluid retention. The nurse
must assess for worsening heart failure (edema, lung crackles)
before notifying the provider for possible diuretic adjustment.
7. Which assessment finding is expected in right-sided heart
failure?
A. Crackles only
B. Pulmonary edema
C. Peripheral edema
D. Stridor
Answer: C
Rationale: Right-sided heart failure presents with signs of
systemic congestion including peripheral edema, jugular venous
distention, and hepatomegaly. Left-sided failure causes
pulmonary symptoms like crackles.
8. A client is prescribed clopidogrel after placement of a
drug-eluting stent. Which statement indicates understanding?
A. "I can stop this medication if I have no chest pain."
B. "I should report unusual bleeding or bruising."
C. "I can take ibuprofen for headaches."
D. "I don't need to worry about bleeding."
