MED-SURG CERTIFICATION QUESTIONS UPDATED
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
1. A newly diabetic patient will receive instructions from his nurse. Which of the following actions should
the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer.
Answer:
B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
Question:
2. The post hysterectomy patient with calls the clinic stating that she has been having difficulty with
incontinence. Which of the following statements if made by the patient, indicates that further teaching is
needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void
Answer:
C.
A patient saying that he or she will only drink fluids when eating meals indicates that they don't know what
to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
Question:
3. An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient states to
the RN that he is short of breath, has no appetite and hurts everywhere. Which of the following statements
by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication
Answer:
C
,Question:
4. A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages should
the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes.
Answer:
A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less critical than
A. Best answer is A.
Question:
5. A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which of the
following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement.
Answer:
A
B and C are recommendations that the RN can share after he/she determines the patient's sleeping and
waking patterns. So remove B and C. D is an inquiry, but is concerned about the past (when the person
retired). Remove D. A is the best answer.
Question:
6. The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the patient is
diaphoretic and confused. The vital signs are: Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110,
respiration is 22. The nurse expects the physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and ciprofloxacin
(cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl.
Answer:
B
Question:
7. A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued, is
sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following responses by
the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables.
Answer:
C
Need more info
,Question:
8. The RN performs blood pressure screening at the local community center. Which of the following
individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins.
Answer:
C
Question:
9. For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia
Answer:
C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent structures, and
failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICA- TION IS BLEEDING. Infection comes
2-3 days later.
Question:
10. When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85% over 4
hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe
Answer:
4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail polish, or dark
skin pigmentation.
Question:
11. To decrease a patient's shortness of breath and a sense of impending doom during an asthma attack, the
nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing.
Answer:
D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is important for the
nurse to stay with the patient for ongoing assessment and to provide a calm environment. Helping the
patient breathe with pursed lips will facilitate the expiration of trapped air and help the patient regain
control of his or her breathing.
, Question:
12. A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer. She
states that she doesn't want anyone to see her in this condition, even her husband. This nurse's best
response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?"
Answer:
D
The nurse should allow the patient to share her concerns and express her feelings in a nonjudgmental
environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
Question:
13. A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery
Answer:
C
Tricuspid valve is located between right atrium and right ventricle
MITRAL VALVE- left atrium and left ventricle
Question:
14. If the Purkinje system is damaged, conduction of the electrical impulse is impaired through the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His
Answer:
C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular myocardium; if
the pattern of contraction is disrupted, the ventricles will not efficiently eject blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje fibers
Question:
15. The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization
Answer:
B. Atrial depolarization
Ventricular repolarization is represented by the QRS There is no distinctly visible wave representing atrial
repolarization in the ECG because it occurs during ventricular depolarization, ventricular repolarization is
shown as the interval between the start of the QRS complex and the end of the T wave
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
1. A newly diabetic patient will receive instructions from his nurse. Which of the following actions should
the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer.
Answer:
B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
Question:
2. The post hysterectomy patient with calls the clinic stating that she has been having difficulty with
incontinence. Which of the following statements if made by the patient, indicates that further teaching is
needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void
Answer:
C.
A patient saying that he or she will only drink fluids when eating meals indicates that they don't know what
to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
Question:
3. An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient states to
the RN that he is short of breath, has no appetite and hurts everywhere. Which of the following statements
by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication
Answer:
C
,Question:
4. A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages should
the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes.
Answer:
A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less critical than
A. Best answer is A.
Question:
5. A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which of the
following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement.
Answer:
A
B and C are recommendations that the RN can share after he/she determines the patient's sleeping and
waking patterns. So remove B and C. D is an inquiry, but is concerned about the past (when the person
retired). Remove D. A is the best answer.
Question:
6. The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the patient is
diaphoretic and confused. The vital signs are: Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110,
respiration is 22. The nurse expects the physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and ciprofloxacin
(cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl.
Answer:
B
Question:
7. A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued, is
sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following responses by
the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables.
Answer:
C
Need more info
,Question:
8. The RN performs blood pressure screening at the local community center. Which of the following
individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins.
Answer:
C
Question:
9. For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia
Answer:
C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent structures, and
failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICA- TION IS BLEEDING. Infection comes
2-3 days later.
Question:
10. When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85% over 4
hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe
Answer:
4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail polish, or dark
skin pigmentation.
Question:
11. To decrease a patient's shortness of breath and a sense of impending doom during an asthma attack, the
nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing.
Answer:
D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is important for the
nurse to stay with the patient for ongoing assessment and to provide a calm environment. Helping the
patient breathe with pursed lips will facilitate the expiration of trapped air and help the patient regain
control of his or her breathing.
, Question:
12. A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer. She
states that she doesn't want anyone to see her in this condition, even her husband. This nurse's best
response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?"
Answer:
D
The nurse should allow the patient to share her concerns and express her feelings in a nonjudgmental
environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
Question:
13. A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery
Answer:
C
Tricuspid valve is located between right atrium and right ventricle
MITRAL VALVE- left atrium and left ventricle
Question:
14. If the Purkinje system is damaged, conduction of the electrical impulse is impaired through the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His
Answer:
C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular myocardium; if
the pattern of contraction is disrupted, the ventricles will not efficiently eject blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje fibers
Question:
15. The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization
Answer:
B. Atrial depolarization
Ventricular repolarization is represented by the QRS There is no distinctly visible wave representing atrial
repolarization in the ECG because it occurs during ventricular depolarization, ventricular repolarization is
shown as the interval between the start of the QRS complex and the end of the T wave
