Page 1 of 58
MEDICAL-SURGICAL NURSING – 2026 EXAM
REVIEW & PRACTICE TEST QUESTIONS WITH
DETAILED RATIONALES
Medical-Surgical Nursing / Nursing Practice and Clinical Judgment
Exam coverage:
I. Section 1, Questions 1-25: Foundations: Covers core
concepts, ethics, communication, and patient-centered
care .
II. Section 2, Questions 26-50: Cardiopulmonary: Focuses on
respiratory and cardiac disorders, treatments, and
assessments .
III. Section 3, Questions 51-75: Neuro/Endocrine: Emphasizes
neurological and endocrine disorders, medications, and
acute interventions .
IV. Section 4, Questions 76-100: Body Systems: Covers GI,
renal, integumentary, and critical lab/diagnostic findings
Section 1: Question 1-25: Foundations of Medical-Surgical
Nursing
1. What action reflects The Joint Commission's contribution
to a health-care organization's improvement initiatives?
, Page 2 of 58
A. Excluding nurses from safety and improvement initiatives
B. Setting standards for quality care, QI, and patient safety
C. Focusing only on emergency management and infection
prevention
D. Eluding the National Patient Safety Goals
CORRECT ANSWER: B
RATIONALE: The Joint Commission's primary role in healthcare
is to establish and enforce standards that drive quality
improvement and patient safety. This foundational concept
from OpenStax Medical-Surgical Nursing highlights the
accrediting body's mission to elevate care standards across all
settings .
2. What component reflects a key element of Patient-
Centered Care (PCC)?
A. Excluding the patient's family from the care setting
B. Ignoring the patient's emotional well-being
C. Customizing care based on the patient's values and
perspectives
D. Respecting the patient's physical comfort only
CORRECT ANSWER: C
RATIONALE: Patient-centered care is fundamentally about
respecting and integrating the patient's unique values,
preferences, and expressed needs into the care plan. This
includes their cultural background, personal beliefs, and
emotional state, making it a holistic approach to nursing .
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3. Ms. Hutto is complaining of pain (8 out of 10) in her lower
back and abdomen. As the patient's nurse, you determine
her abdomen is soft but distended, with positive bowel
sounds in all four quadrants. Interventions such as
ambulation, position changes, warm compresses, and warm
prune juice have provided no relief. This scenario highlights
what component of the ISBAR communication tool?
A. Situation
B. Background
C. Assessment
D. Recommendation or request
CORRECT ANSWER: C
RATIONALE: In the ISBAR framework, "Assessment" is the
professional's clinical judgment and interpretation of the
situation. The nurse's determination that the abdomen is soft
yet distended and that interventions have failed is a critical
assessment that must be communicated effectively .
4. What is the primary goal of an intercollaborative care
team in the context of patient-centered care?
A. Achieving financial targets
B. Streamlining administrative processes
C. Improving patient outcomes through personalized care
D. Minimizing the workload for health-care providers
, Page 4 of 58
CORRECT ANSWER: C
RATIONALE: Intercollaborative teams exist to leverage the
expertise of various professionals (nurses, physicians,
therapists, social workers) to create a comprehensive,
personalized care plan. This directly aims to improve patient
outcomes by addressing all facets of a patient's health .
5. A nurse is caring for a 72-year-old female with a diagnosis
of atrial fibrillation. When making his shift change report, the
nurse realizes that 4 hours ago, he administered 0.5 mg of
the patient's antiarrhythmic medication instead of 5.0 mg.
When the nurse realizes the error and calls the physician to
report the incident, what ethical principle is described in
this situation?
A. Nonmaleficence
B. Justice
C. Autonomy
D. Beneficence
CORRECT ANSWER: A
RATIONALE: Nonmaleficence is the ethical duty to "do no
harm." By reporting the medication error, the nurse is acting to
prevent potential harm to the patient and is upholding their
professional obligation to be transparent about mistakes .
6. What option is a social determinant of health?
MEDICAL-SURGICAL NURSING – 2026 EXAM
REVIEW & PRACTICE TEST QUESTIONS WITH
DETAILED RATIONALES
Medical-Surgical Nursing / Nursing Practice and Clinical Judgment
Exam coverage:
I. Section 1, Questions 1-25: Foundations: Covers core
concepts, ethics, communication, and patient-centered
care .
II. Section 2, Questions 26-50: Cardiopulmonary: Focuses on
respiratory and cardiac disorders, treatments, and
assessments .
III. Section 3, Questions 51-75: Neuro/Endocrine: Emphasizes
neurological and endocrine disorders, medications, and
acute interventions .
IV. Section 4, Questions 76-100: Body Systems: Covers GI,
renal, integumentary, and critical lab/diagnostic findings
Section 1: Question 1-25: Foundations of Medical-Surgical
Nursing
1. What action reflects The Joint Commission's contribution
to a health-care organization's improvement initiatives?
, Page 2 of 58
A. Excluding nurses from safety and improvement initiatives
B. Setting standards for quality care, QI, and patient safety
C. Focusing only on emergency management and infection
prevention
D. Eluding the National Patient Safety Goals
CORRECT ANSWER: B
RATIONALE: The Joint Commission's primary role in healthcare
is to establish and enforce standards that drive quality
improvement and patient safety. This foundational concept
from OpenStax Medical-Surgical Nursing highlights the
accrediting body's mission to elevate care standards across all
settings .
2. What component reflects a key element of Patient-
Centered Care (PCC)?
A. Excluding the patient's family from the care setting
B. Ignoring the patient's emotional well-being
C. Customizing care based on the patient's values and
perspectives
D. Respecting the patient's physical comfort only
CORRECT ANSWER: C
RATIONALE: Patient-centered care is fundamentally about
respecting and integrating the patient's unique values,
preferences, and expressed needs into the care plan. This
includes their cultural background, personal beliefs, and
emotional state, making it a holistic approach to nursing .
, Page 3 of 58
3. Ms. Hutto is complaining of pain (8 out of 10) in her lower
back and abdomen. As the patient's nurse, you determine
her abdomen is soft but distended, with positive bowel
sounds in all four quadrants. Interventions such as
ambulation, position changes, warm compresses, and warm
prune juice have provided no relief. This scenario highlights
what component of the ISBAR communication tool?
A. Situation
B. Background
C. Assessment
D. Recommendation or request
CORRECT ANSWER: C
RATIONALE: In the ISBAR framework, "Assessment" is the
professional's clinical judgment and interpretation of the
situation. The nurse's determination that the abdomen is soft
yet distended and that interventions have failed is a critical
assessment that must be communicated effectively .
4. What is the primary goal of an intercollaborative care
team in the context of patient-centered care?
A. Achieving financial targets
B. Streamlining administrative processes
C. Improving patient outcomes through personalized care
D. Minimizing the workload for health-care providers
, Page 4 of 58
CORRECT ANSWER: C
RATIONALE: Intercollaborative teams exist to leverage the
expertise of various professionals (nurses, physicians,
therapists, social workers) to create a comprehensive,
personalized care plan. This directly aims to improve patient
outcomes by addressing all facets of a patient's health .
5. A nurse is caring for a 72-year-old female with a diagnosis
of atrial fibrillation. When making his shift change report, the
nurse realizes that 4 hours ago, he administered 0.5 mg of
the patient's antiarrhythmic medication instead of 5.0 mg.
When the nurse realizes the error and calls the physician to
report the incident, what ethical principle is described in
this situation?
A. Nonmaleficence
B. Justice
C. Autonomy
D. Beneficence
CORRECT ANSWER: A
RATIONALE: Nonmaleficence is the ethical duty to "do no
harm." By reporting the medication error, the nurse is acting to
prevent potential harm to the patient and is upholding their
professional obligation to be transparent about mistakes .
6. What option is a social determinant of health?
