1|Page
MEDICAL-SURGICAL NURSING 11TH
EDITION — SATA AND MULTIPLE-
RESPONSE PRACTICE [QUESTIONS 1-
100] AND ANSWERS UPDATED 2026/2027 |
DETAILED RATIONALES
INTRODUCTION
This advanced SATA and multiple-response practice examination is designed for nursing
students preparing for medical-surgical nursing examinations and NCLEX-style assessments. It
focuses on clinical judgment rather than simple recall, requiring the learner to recognize
significant assessment findings, identify complications, prioritize interventions, evaluate
treatment responses, and distinguish expected from dangerous changes in patient condition.
The questions address major medical-surgical nursing domains, including cardiovascular,
respiratory, neurologic, renal, endocrine, gastrointestinal, hepatic, hematologic, immune,
musculoskeletal, integumentary, infectious, perioperative, and multisystem disorders. Many
questions use realistic patient scenarios containing competing clinical cues so that students must
determine which findings or interventions are most clinically significant.
Questions use Select All That Apply (SATA) and multiple-response formats. More than one
option may be correct, and students should select every option supported by the clinical
evidence. Detailed rationales explain both correct and incorrect selections. For best preparation,
answer each question independently before reviewing the rationale, then identify whether errors
resulted from knowledge gaps, failure to recognize deterioration, incorrect prioritization, or
misinterpretation of clinical data.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
ACS, HF, dysrhythmias, shock, vascular
Cardiovascular 1–15 15%
disorders
COPD, asthma, pneumonia, PE, respiratory
Respiratory 16–27 12%
failure
Stroke, seizures, ICP, meningitis, spinal
Neurologic 28–39 12%
injury
Renal/Urinary 40–48 AKI, CKD, dialysis, electrolytes 9%
Diabetes, DKA, HHS, thyroid/adrenal
Endocrine 49–57 9%
disorders
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Content Area Questions Key Topics Weight
GI bleeding, pancreatitis, cirrhosis,
GI/Hepatic 58–67 10%
obstruction
Anemia, transfusion, anticoagulation,
Hematologic/Immune 68–75 8%
immunity
Musculoskeletal/Integumentary 76–82 Fractures, burns, pressure injuries 7%
Sepsis, infection control, antimicrobial
Infection/Sepsis 83–88 6%
therapy
Perioperative/Multisystem 89–100 Complications, fluids, prioritization 12%
QUESTIONS 1–100
CARDIOVASCULAR
Q1:
A patient admitted with acute decompensated heart failure develops worsening dyspnea. Which
findings support pulmonary edema? Select all that apply.
A) Pink, frothy sputum
B) Bilateral inspiratory crackles
C) Orthopnea
D) Clear lung sounds with oxygen saturation of 99%
Rationale: A, B, and C are correct because pulmonary edema commonly produces fluid-filled
alveoli, causing crackles, severe dyspnea, orthopnea, and potentially pink frothy sputum. D is
incorrect because clear lungs and normal oxygenation do not support acute pulmonary edema.
Q2:
A patient with acute coronary syndrome is being monitored in the emergency department. Which
findings require immediate escalation? Select all that apply.
A) Persistent crushing chest pain despite prescribed therapy
B) New ST-segment changes
C) Blood pressure of 78/46 mmHg
D) Mild anxiety with stable vital signs
Rationale: A, B, and C are correct because persistent ischemic pain, new ischemic ECG
changes, and profound hypotension may indicate ongoing myocardial injury or cardiogenic
shock. D is incorrect because mild anxiety with stable hemodynamics is not the highest-priority
finding.
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Q3:
A patient taking digoxin for heart failure develops possible toxicity. Which findings should the
nurse recognize? Select all that apply.
A) Nausea and anorexia
B) Yellow-green visual disturbances
C) Bradycardia
D) Increased appetite with tachycardia
Rationale: A, B, and C are correct because gastrointestinal symptoms, visual disturbances, and
bradycardia are classic manifestations of digoxin toxicity. D is incorrect because increased
appetite and tachycardia are not characteristic findings.
Q4:
A patient receiving IV furosemide develops laboratory abnormalities. Which findings are most
concerning? Select all that apply.
A) Potassium 2.7 mEq/L
B) Magnesium 1.2 mg/dL
C) New ventricular ectopy
D) Sodium 139 mEq/L
Rationale: A, B, and C are correct because loop diuretics can cause potassium and magnesium
depletion, increasing dysrhythmia risk. D represents a normal sodium value and is not
concerning in this context.
Q5:
A patient with heart failure is being discharged. Which findings should prompt the patient to
contact the healthcare provider? Select all that apply.
A) Rapid weight gain over several days
B) Increasing ankle edema
C) New orthopnea
D) Stable weight with improved exercise tolerance
Rationale: A, B, and C are correct because they suggest worsening fluid retention and heart
failure. D indicates clinical improvement rather than deterioration.
Q6:
A patient with atrial fibrillation is prescribed anticoagulation. Which assessment findings should
concern the nurse? Select all that apply.
, 4|Page
A) Black, tarry stool
B) Hematuria
C) Sudden severe headache
D) Mild bruising at an old IV site
Rationale: A, B, and C are correct because they may indicate clinically significant bleeding,
including GI, urinary, or intracranial hemorrhage. D may occur with anticoagulation but is less
immediately concerning when mild and localized.
Q7:
A patient develops cardiogenic shock following a large myocardial infarction. Which findings
would the nurse expect? Select all that apply.
A) Cool, clammy skin
B) Oliguria
C) Altered mental status
D) Bounding peripheral pulses with warm skin
Rationale: A, B, and C are correct because reduced cardiac output causes systemic
hypoperfusion, producing cool skin, reduced renal perfusion, and neurologic changes. D is
inconsistent with typical cardiogenic shock.
Q8:
A patient with peripheral arterial disease receives discharge teaching. Which instructions are
appropriate? Select all that apply.
A) Participate in a prescribed walking program
B) Avoid smoking
C) Protect the feet from injury
D) Routinely elevate the legs above the heart
Rationale: A, B, and C are correct because exercise can improve functional circulation, smoking
cessation reduces vascular injury, and foot protection prevents complications. D is generally
inappropriate for significant arterial insufficiency because elevation can further reduce arterial
perfusion.
Q9:
A patient receiving an ACE inhibitor develops facial swelling. Which actions are appropriate?
Select all that apply.
A) Assess airway patency
B) Notify the provider immediately
MEDICAL-SURGICAL NURSING 11TH
EDITION — SATA AND MULTIPLE-
RESPONSE PRACTICE [QUESTIONS 1-
100] AND ANSWERS UPDATED 2026/2027 |
DETAILED RATIONALES
INTRODUCTION
This advanced SATA and multiple-response practice examination is designed for nursing
students preparing for medical-surgical nursing examinations and NCLEX-style assessments. It
focuses on clinical judgment rather than simple recall, requiring the learner to recognize
significant assessment findings, identify complications, prioritize interventions, evaluate
treatment responses, and distinguish expected from dangerous changes in patient condition.
The questions address major medical-surgical nursing domains, including cardiovascular,
respiratory, neurologic, renal, endocrine, gastrointestinal, hepatic, hematologic, immune,
musculoskeletal, integumentary, infectious, perioperative, and multisystem disorders. Many
questions use realistic patient scenarios containing competing clinical cues so that students must
determine which findings or interventions are most clinically significant.
Questions use Select All That Apply (SATA) and multiple-response formats. More than one
option may be correct, and students should select every option supported by the clinical
evidence. Detailed rationales explain both correct and incorrect selections. For best preparation,
answer each question independently before reviewing the rationale, then identify whether errors
resulted from knowledge gaps, failure to recognize deterioration, incorrect prioritization, or
misinterpretation of clinical data.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
ACS, HF, dysrhythmias, shock, vascular
Cardiovascular 1–15 15%
disorders
COPD, asthma, pneumonia, PE, respiratory
Respiratory 16–27 12%
failure
Stroke, seizures, ICP, meningitis, spinal
Neurologic 28–39 12%
injury
Renal/Urinary 40–48 AKI, CKD, dialysis, electrolytes 9%
Diabetes, DKA, HHS, thyroid/adrenal
Endocrine 49–57 9%
disorders
,2|Page
Content Area Questions Key Topics Weight
GI bleeding, pancreatitis, cirrhosis,
GI/Hepatic 58–67 10%
obstruction
Anemia, transfusion, anticoagulation,
Hematologic/Immune 68–75 8%
immunity
Musculoskeletal/Integumentary 76–82 Fractures, burns, pressure injuries 7%
Sepsis, infection control, antimicrobial
Infection/Sepsis 83–88 6%
therapy
Perioperative/Multisystem 89–100 Complications, fluids, prioritization 12%
QUESTIONS 1–100
CARDIOVASCULAR
Q1:
A patient admitted with acute decompensated heart failure develops worsening dyspnea. Which
findings support pulmonary edema? Select all that apply.
A) Pink, frothy sputum
B) Bilateral inspiratory crackles
C) Orthopnea
D) Clear lung sounds with oxygen saturation of 99%
Rationale: A, B, and C are correct because pulmonary edema commonly produces fluid-filled
alveoli, causing crackles, severe dyspnea, orthopnea, and potentially pink frothy sputum. D is
incorrect because clear lungs and normal oxygenation do not support acute pulmonary edema.
Q2:
A patient with acute coronary syndrome is being monitored in the emergency department. Which
findings require immediate escalation? Select all that apply.
A) Persistent crushing chest pain despite prescribed therapy
B) New ST-segment changes
C) Blood pressure of 78/46 mmHg
D) Mild anxiety with stable vital signs
Rationale: A, B, and C are correct because persistent ischemic pain, new ischemic ECG
changes, and profound hypotension may indicate ongoing myocardial injury or cardiogenic
shock. D is incorrect because mild anxiety with stable hemodynamics is not the highest-priority
finding.
,3|Page
Q3:
A patient taking digoxin for heart failure develops possible toxicity. Which findings should the
nurse recognize? Select all that apply.
A) Nausea and anorexia
B) Yellow-green visual disturbances
C) Bradycardia
D) Increased appetite with tachycardia
Rationale: A, B, and C are correct because gastrointestinal symptoms, visual disturbances, and
bradycardia are classic manifestations of digoxin toxicity. D is incorrect because increased
appetite and tachycardia are not characteristic findings.
Q4:
A patient receiving IV furosemide develops laboratory abnormalities. Which findings are most
concerning? Select all that apply.
A) Potassium 2.7 mEq/L
B) Magnesium 1.2 mg/dL
C) New ventricular ectopy
D) Sodium 139 mEq/L
Rationale: A, B, and C are correct because loop diuretics can cause potassium and magnesium
depletion, increasing dysrhythmia risk. D represents a normal sodium value and is not
concerning in this context.
Q5:
A patient with heart failure is being discharged. Which findings should prompt the patient to
contact the healthcare provider? Select all that apply.
A) Rapid weight gain over several days
B) Increasing ankle edema
C) New orthopnea
D) Stable weight with improved exercise tolerance
Rationale: A, B, and C are correct because they suggest worsening fluid retention and heart
failure. D indicates clinical improvement rather than deterioration.
Q6:
A patient with atrial fibrillation is prescribed anticoagulation. Which assessment findings should
concern the nurse? Select all that apply.
, 4|Page
A) Black, tarry stool
B) Hematuria
C) Sudden severe headache
D) Mild bruising at an old IV site
Rationale: A, B, and C are correct because they may indicate clinically significant bleeding,
including GI, urinary, or intracranial hemorrhage. D may occur with anticoagulation but is less
immediately concerning when mild and localized.
Q7:
A patient develops cardiogenic shock following a large myocardial infarction. Which findings
would the nurse expect? Select all that apply.
A) Cool, clammy skin
B) Oliguria
C) Altered mental status
D) Bounding peripheral pulses with warm skin
Rationale: A, B, and C are correct because reduced cardiac output causes systemic
hypoperfusion, producing cool skin, reduced renal perfusion, and neurologic changes. D is
inconsistent with typical cardiogenic shock.
Q8:
A patient with peripheral arterial disease receives discharge teaching. Which instructions are
appropriate? Select all that apply.
A) Participate in a prescribed walking program
B) Avoid smoking
C) Protect the feet from injury
D) Routinely elevate the legs above the heart
Rationale: A, B, and C are correct because exercise can improve functional circulation, smoking
cessation reduces vascular injury, and foot protection prevents complications. D is generally
inappropriate for significant arterial insufficiency because elevation can further reduce arterial
perfusion.
Q9:
A patient receiving an ACE inhibitor develops facial swelling. Which actions are appropriate?
Select all that apply.
A) Assess airway patency
B) Notify the provider immediately
