Brunner & Suddarth–Based Nursing Exam Review 2026: 300 Original
Medical-Surgical Practice Questions and Answers with Rationales
[100% Correct/Verified/Latest Update 2026]
1. A nurse is assessing a patient with hypovolemia. Which finding is
most consistent with this condition?
A. Bounding pulse
B. Increased urine output
C. Tachycardia
D. Hypertensio
Answer: C. Tachycardia
Rationale: Reduced circulating volume activates the sympathetic
nervous system, producing tachycardia as the body attempts to maintain
cardiac output.
2. Which assessment finding is most concerning in a patient
receiving oxygen therapy?
A. Oxygen saturation of 96%
B. Respiratory rate of 18/min
C. New onset confusion and headache
D. Heart rate of 76/min
Answer: C. New onset confusion and headache
Rationale: New neurologic changes may indicate inadequate
oxygenation or, in susceptible patients, complications associated with
excessive oxygen administration.
,3. A patient with heart failure has increasing dyspnea and bilateral
crackles. Which intervention should the nurse implement first?
A. Encourage oral fluids
B. Place the patient in high-Fowler position
C. Place the patient flat
D. Encourage ambulation
Answer: B. Place the patient in high-Fowler position
Rationale: Upright positioning improves lung expansion and decreases
venous return, helping reduce pulmonary congestion.
4. Which laboratory value should the nurse monitor most closely in
a patient receiving warfarin?
A. INR
B. Serum sodium
C. Hemoglobin A1c
D. Serum amylase
Answer: A. INR
Rationale: The international normalized ratio is used to monitor the
anticoagulant effect of warfarin and guide dosing.
5. A patient taking digoxin reports nausea, poor appetite, and seeing
yellow halos around lights. What should the nurse suspect?
A. Hypoglycemia
B. Digoxin toxicity
C. Fluid overload
D. Iron deficiency
Answer: B. Digoxin toxicity
Rationale: Gastrointestinal symptoms and visual disturbances are
,classic manifestations of digoxin toxicity. Bradycardia and dysrhythmias
may also occur.
6. Which finding is characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distention
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion, which
may produce dyspnea, orthopnea, and crackles.
7. A patient with chronic obstructive pulmonary disease is receiving
oxygen. Which prescription should the nurse question?
A. Oxygen at a prescribed low flow rate
B. Monitoring oxygen saturation
C. Positioning upright
D. High-concentration oxygen without monitoring
Answer: D. High-concentration oxygen without monitoring
Rationale: Some patients with advanced COPD may be sensitive to
excessive oxygen administration. Oxygen should be carefully titrated
and monitored according to the prescription and clinical condition.
8. Which assessment finding is most consistent with hypokalemia?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Severe hypertension
, Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue,
constipation, and potentially dangerous cardiac dysrhythmias.
9. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval only
C. ST elevation in every lead
D. Narrowed QRS with absent P waves only
Answer: A. Peaked T waves
Rationale: Tall, peaked T waves are an early ECG manifestation of
hyperkalemia. More severe hyperkalemia can cause progressive
conduction abnormalities.
10. A patient with diabetes becomes shaky, sweaty, and confused.
What should the nurse suspect?
A. Hypercalcemia
B. Hypoglycemia
C. Hypernatremia
D. Ketoacidosis
Answer: B. Hypoglycemia
Rationale: Sweating, tremor, hunger, confusion, and altered behavior
are common manifestations of low blood glucose.
11. Which instruction is appropriate for a patient with type 2
diabetes regarding foot care?
A. Walk barefoot indoors
B. Soak the feet in hot water daily
Medical-Surgical Practice Questions and Answers with Rationales
[100% Correct/Verified/Latest Update 2026]
1. A nurse is assessing a patient with hypovolemia. Which finding is
most consistent with this condition?
A. Bounding pulse
B. Increased urine output
C. Tachycardia
D. Hypertensio
Answer: C. Tachycardia
Rationale: Reduced circulating volume activates the sympathetic
nervous system, producing tachycardia as the body attempts to maintain
cardiac output.
2. Which assessment finding is most concerning in a patient
receiving oxygen therapy?
A. Oxygen saturation of 96%
B. Respiratory rate of 18/min
C. New onset confusion and headache
D. Heart rate of 76/min
Answer: C. New onset confusion and headache
Rationale: New neurologic changes may indicate inadequate
oxygenation or, in susceptible patients, complications associated with
excessive oxygen administration.
,3. A patient with heart failure has increasing dyspnea and bilateral
crackles. Which intervention should the nurse implement first?
A. Encourage oral fluids
B. Place the patient in high-Fowler position
C. Place the patient flat
D. Encourage ambulation
Answer: B. Place the patient in high-Fowler position
Rationale: Upright positioning improves lung expansion and decreases
venous return, helping reduce pulmonary congestion.
4. Which laboratory value should the nurse monitor most closely in
a patient receiving warfarin?
A. INR
B. Serum sodium
C. Hemoglobin A1c
D. Serum amylase
Answer: A. INR
Rationale: The international normalized ratio is used to monitor the
anticoagulant effect of warfarin and guide dosing.
5. A patient taking digoxin reports nausea, poor appetite, and seeing
yellow halos around lights. What should the nurse suspect?
A. Hypoglycemia
B. Digoxin toxicity
C. Fluid overload
D. Iron deficiency
Answer: B. Digoxin toxicity
Rationale: Gastrointestinal symptoms and visual disturbances are
,classic manifestations of digoxin toxicity. Bradycardia and dysrhythmias
may also occur.
6. Which finding is characteristic of left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distention
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion, which
may produce dyspnea, orthopnea, and crackles.
7. A patient with chronic obstructive pulmonary disease is receiving
oxygen. Which prescription should the nurse question?
A. Oxygen at a prescribed low flow rate
B. Monitoring oxygen saturation
C. Positioning upright
D. High-concentration oxygen without monitoring
Answer: D. High-concentration oxygen without monitoring
Rationale: Some patients with advanced COPD may be sensitive to
excessive oxygen administration. Oxygen should be carefully titrated
and monitored according to the prescription and clinical condition.
8. Which assessment finding is most consistent with hypokalemia?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Severe hypertension
, Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue,
constipation, and potentially dangerous cardiac dysrhythmias.
9. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval only
C. ST elevation in every lead
D. Narrowed QRS with absent P waves only
Answer: A. Peaked T waves
Rationale: Tall, peaked T waves are an early ECG manifestation of
hyperkalemia. More severe hyperkalemia can cause progressive
conduction abnormalities.
10. A patient with diabetes becomes shaky, sweaty, and confused.
What should the nurse suspect?
A. Hypercalcemia
B. Hypoglycemia
C. Hypernatremia
D. Ketoacidosis
Answer: B. Hypoglycemia
Rationale: Sweating, tremor, hunger, confusion, and altered behavior
are common manifestations of low blood glucose.
11. Which instruction is appropriate for a patient with type 2
diabetes regarding foot care?
A. Walk barefoot indoors
B. Soak the feet in hot water daily
