MEDSURG-BC — Medical-Surgical Nursing
Board Certified Exam| YEAR 2026–2027 |
Comprehensive 150-Question Practice Test with
Answers & Rationales| Pdf Access ALREADY
GRADED A+.
Questions 1–25: Cardiovascular & Respiratory
1. A patient with acute heart failure suddenly develops severe dyspnea, crackles, and pink
frothy sputum. Which action is the priority?
A. Place the patient supine
B. Administer oxygen and position upright
C. Encourage oral fluids
D. Obtain a stool specimen
Answer: B. Administer oxygen and position upright.
Rationale: These findings indicate acute pulmonary edema. Upright positioning improves
ventilation, while oxygen supports gas exchange.
2. A patient taking digoxin reports nausea, vomiting, and yellow-green visual disturbances.
What should the nurse suspect?
A. Digoxin toxicity
B. Hypoglycemia
C. Hyperkalemia
D. Dehydration
Answer: A. Digoxin toxicity.
Rationale: GI symptoms, visual changes, and dysrhythmias are classic manifestations of digoxin
toxicity.
,3. Which assessment finding is most concerning in a patient with chest pain?
A. Pain relieved by rest
B. Diaphoresis with crushing substernal chest pain
C. Mild pain after eating
D. Pain reproducible with palpation
Answer: B. Diaphoresis with crushing substernal chest pain.
Rationale: Crushing substernal pain accompanied by diaphoresis strongly suggests acute
coronary syndrome and requires urgent evaluation.
4. A patient with atrial fibrillation is prescribed an anticoagulant. The primary purpose is to
reduce the risk of:
A. Pneumonia
B. Stroke
C. Heart failure
D. Hypertension
Answer: B. Stroke.
Rationale: Atrial fibrillation can cause blood stasis and thrombus formation, increasing embolic
stroke risk.
5. Which finding is expected in left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver only
D. Peripheral edema only
Answer: A. Pulmonary crackles.
Rationale: Left ventricular dysfunction causes pulmonary venous congestion, producing
dyspnea and crackles.
6. A patient receiving IV furosemide should be monitored closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
, Answer: B. Hypokalemia.
Rationale: Loop diuretics increase urinary potassium loss.
7. Which finding is most consistent with peripheral arterial disease?
A. Warm legs with bounding pulses
B. Intermittent claudication and diminished pulses
C. Bilateral dependent edema
D. Brown ankle discoloration only
Answer: B. Intermittent claudication and diminished pulses.
Rationale: Reduced arterial blood flow commonly causes exertional pain, coolness, and
diminished peripheral pulses.
8. A patient with suspected myocardial infarction has chest pain. Which diagnostic test is most
immediately important?
A. ECG
B. Colonoscopy
C. Bone scan
D. Urinalysis
Answer: A. ECG.
Rationale: A 12-lead ECG helps rapidly identify myocardial ischemia or infarction and guides
treatment.
9. A patient receiving a beta blocker has a heart rate of 48/min and dizziness. What should the
nurse do?
A. Give the medication immediately
B. Hold the medication and assess further according to parameters/orders
C. Encourage exercise
D. Give another beta blocker
Answer: B. Hold the medication and assess further according to parameters/orders.
Rationale: Significant bradycardia with symptoms may require withholding the medication and
notifying the appropriate provider.
Board Certified Exam| YEAR 2026–2027 |
Comprehensive 150-Question Practice Test with
Answers & Rationales| Pdf Access ALREADY
GRADED A+.
Questions 1–25: Cardiovascular & Respiratory
1. A patient with acute heart failure suddenly develops severe dyspnea, crackles, and pink
frothy sputum. Which action is the priority?
A. Place the patient supine
B. Administer oxygen and position upright
C. Encourage oral fluids
D. Obtain a stool specimen
Answer: B. Administer oxygen and position upright.
Rationale: These findings indicate acute pulmonary edema. Upright positioning improves
ventilation, while oxygen supports gas exchange.
2. A patient taking digoxin reports nausea, vomiting, and yellow-green visual disturbances.
What should the nurse suspect?
A. Digoxin toxicity
B. Hypoglycemia
C. Hyperkalemia
D. Dehydration
Answer: A. Digoxin toxicity.
Rationale: GI symptoms, visual changes, and dysrhythmias are classic manifestations of digoxin
toxicity.
,3. Which assessment finding is most concerning in a patient with chest pain?
A. Pain relieved by rest
B. Diaphoresis with crushing substernal chest pain
C. Mild pain after eating
D. Pain reproducible with palpation
Answer: B. Diaphoresis with crushing substernal chest pain.
Rationale: Crushing substernal pain accompanied by diaphoresis strongly suggests acute
coronary syndrome and requires urgent evaluation.
4. A patient with atrial fibrillation is prescribed an anticoagulant. The primary purpose is to
reduce the risk of:
A. Pneumonia
B. Stroke
C. Heart failure
D. Hypertension
Answer: B. Stroke.
Rationale: Atrial fibrillation can cause blood stasis and thrombus formation, increasing embolic
stroke risk.
5. Which finding is expected in left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver only
D. Peripheral edema only
Answer: A. Pulmonary crackles.
Rationale: Left ventricular dysfunction causes pulmonary venous congestion, producing
dyspnea and crackles.
6. A patient receiving IV furosemide should be monitored closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
, Answer: B. Hypokalemia.
Rationale: Loop diuretics increase urinary potassium loss.
7. Which finding is most consistent with peripheral arterial disease?
A. Warm legs with bounding pulses
B. Intermittent claudication and diminished pulses
C. Bilateral dependent edema
D. Brown ankle discoloration only
Answer: B. Intermittent claudication and diminished pulses.
Rationale: Reduced arterial blood flow commonly causes exertional pain, coolness, and
diminished peripheral pulses.
8. A patient with suspected myocardial infarction has chest pain. Which diagnostic test is most
immediately important?
A. ECG
B. Colonoscopy
C. Bone scan
D. Urinalysis
Answer: A. ECG.
Rationale: A 12-lead ECG helps rapidly identify myocardial ischemia or infarction and guides
treatment.
9. A patient receiving a beta blocker has a heart rate of 48/min and dizziness. What should the
nurse do?
A. Give the medication immediately
B. Hold the medication and assess further according to parameters/orders
C. Encourage exercise
D. Give another beta blocker
Answer: B. Hold the medication and assess further according to parameters/orders.
Rationale: Significant bradycardia with symptoms may require withholding the medication and
notifying the appropriate provider.
