MED SURG CMS PROCTORED EXAM 2026/2027 | Q&A |
Comprehensive Med-Surg Mastery
Questions 1–200 | Questions and Answers with Detailed
Rationales | 100% Pass Guaranteed | Graded A+
1. A nurse is assessing a client who is 2 hours postoperative following a thyroidectomy.
Which of the following findings should the nurse report to the provider immediately?
A. Pain at the surgical site
B. Hoarseness of the voice
C. Laryngeal stridor
D. Difficulty swallowing
Correct Answer: C
Rationale: Laryngeal stridor indicates respiratory obstruction due to edema or hematoma
formation, which is a life-threatening complication following thyroidectomy. Pain (A),
hoarseness (B), and difficulty swallowing (D) are expected findings postoperatively.
2. A nurse is caring for a client who has been prescribed lithium carbonate. Which of
the following findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and ataxia
D. Increased thirst
Correct Answer: C
Rationale: Coarse hand tremors and ataxia indicate moderate to severe lithium toxicity. A
serum lithium level of 0.8 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). Fine hand
tremors and increased thirst are common side effects, not toxicity.
3. A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
1
,A. "Increase your intake of leafy green vegetables."
B. "Take aspirin for headaches."
C. "Use an electric razor when shaving."
D. "Double your dose if you miss a dose."
Correct Answer: C
Rationale: Clients on warfarin should use an electric razor to reduce the risk of bleeding
from cuts. Leafy green vegetables are high in vitamin K and should be consumed
consistently, not increased. Aspirin increases bleeding risk. Doubling doses is dangerous.
4. A nurse is preparing to administer heparin subcutaneously. Which of the following
actions should the nurse take?
A. Aspirate before injecting the medication
B. Massage the site after the injection
C. Administer the injection in the abdomen at least 2 inches from the umbilicus
D. Use a 23-gauge, 1.5-inch needle
Correct Answer: C
Rationale: Subcutaneous heparin should be administered in the abdomen, at least 2 inches
from the umbilicus, to ensure absorption and avoid irritation. Aspiration is not
recommended. Massaging the site can cause bruising and hematoma. A 25-gauge, 3/8 to
5/8-inch needle is used for subcutaneous injections.
5. A nurse is caring for a client who has a new prescription for levothyroxine. Which of
the following instructions should the nurse include?
A. "Take the medication with food."
B. "Take the medication at bedtime."
C. "Take the medication on an empty stomach."
D. "Take the medication with calcium supplements."
Correct Answer: C
Rationale: Levothyroxine should be taken on an empty stomach, 30–60 minutes before
breakfast, for optimal absorption. Food, calcium, and iron interfere with absorption.
2
, 6. A nurse is providing teaching to a client who has a new prescription for metformin.
Which of the following instructions should the nurse include?
A. "Take the medication with food to reduce GI upset."
B. "Take the medication on an empty stomach."
C. "Expect weight gain as a side effect."
D. "You can drink alcohol while taking this medication."
Correct Answer: A
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects.
Weight loss, not gain, is common. Alcohol should be avoided due to the risk of lactic
acidosis.
7. A nurse is caring for a client who has a new prescription for furosemide. Which of the
following instructions should the nurse include?
A. "Take the medication at bedtime."
B. "Increase your intake of potassium-rich foods."
C. "Avoid sunlight while taking this medication."
D. "Take the medication with an antacid."
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Clients should
increase intake of potassium-rich foods. The medication should be taken in the morning to
avoid nocturia. Photosensitivity is not a common effect. Antacids can reduce absorption.
8. A nurse is assessing a client who has been receiving furosemide. Which of the
following findings indicates hypokalemia?
A. Muscle weakness
B. Hypertension
C. Bradycardia
D. Hyperreflexia
3
, Correct Answer: A
Rationale: Hypokalemia presents with muscle weakness, fatigue, and cardiac arrhythmias.
Hypertension, bradycardia, and hyperreflexia are not typical.
9. A nurse is preparing to administer enoxaparin. Which of the following laboratory
values should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Serum potassium
Correct Answer: C
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). Platelet count
should be monitored. PT/INR monitors warfarin. aPTT monitors unfractionated heparin.
10. A nurse is providing teaching to a client about the use of a metered-dose inhaler
(MDI) with a spacer. Which of the following instructions should the nurse include?
A. "Inhale rapidly and deeply after activating the inhaler."
B. "Activate the inhaler before placing it in your mouth."
C. "Wait 1 to 2 minutes between puffs."
D. "Exhale through the mouthpiece after inhalation."
Correct Answer: C
Rationale: The client should wait 1 to 2 minutes between puffs to allow for optimal
medication absorption. Inhalation should be slow and deep. The inhaler should be activated
after placing it in the mouth. Exhalation should occur before, not after, inhalation.
11. A nurse is caring for a client who has a new diagnosis of peptic ulcer disease. Which
of the following medications should the nurse anticipate administering?
A. Omeprazole
B. Metformin
4
Comprehensive Med-Surg Mastery
Questions 1–200 | Questions and Answers with Detailed
Rationales | 100% Pass Guaranteed | Graded A+
1. A nurse is assessing a client who is 2 hours postoperative following a thyroidectomy.
Which of the following findings should the nurse report to the provider immediately?
A. Pain at the surgical site
B. Hoarseness of the voice
C. Laryngeal stridor
D. Difficulty swallowing
Correct Answer: C
Rationale: Laryngeal stridor indicates respiratory obstruction due to edema or hematoma
formation, which is a life-threatening complication following thyroidectomy. Pain (A),
hoarseness (B), and difficulty swallowing (D) are expected findings postoperatively.
2. A nurse is caring for a client who has been prescribed lithium carbonate. Which of
the following findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and ataxia
D. Increased thirst
Correct Answer: C
Rationale: Coarse hand tremors and ataxia indicate moderate to severe lithium toxicity. A
serum lithium level of 0.8 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). Fine hand
tremors and increased thirst are common side effects, not toxicity.
3. A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
1
,A. "Increase your intake of leafy green vegetables."
B. "Take aspirin for headaches."
C. "Use an electric razor when shaving."
D. "Double your dose if you miss a dose."
Correct Answer: C
Rationale: Clients on warfarin should use an electric razor to reduce the risk of bleeding
from cuts. Leafy green vegetables are high in vitamin K and should be consumed
consistently, not increased. Aspirin increases bleeding risk. Doubling doses is dangerous.
4. A nurse is preparing to administer heparin subcutaneously. Which of the following
actions should the nurse take?
A. Aspirate before injecting the medication
B. Massage the site after the injection
C. Administer the injection in the abdomen at least 2 inches from the umbilicus
D. Use a 23-gauge, 1.5-inch needle
Correct Answer: C
Rationale: Subcutaneous heparin should be administered in the abdomen, at least 2 inches
from the umbilicus, to ensure absorption and avoid irritation. Aspiration is not
recommended. Massaging the site can cause bruising and hematoma. A 25-gauge, 3/8 to
5/8-inch needle is used for subcutaneous injections.
5. A nurse is caring for a client who has a new prescription for levothyroxine. Which of
the following instructions should the nurse include?
A. "Take the medication with food."
B. "Take the medication at bedtime."
C. "Take the medication on an empty stomach."
D. "Take the medication with calcium supplements."
Correct Answer: C
Rationale: Levothyroxine should be taken on an empty stomach, 30–60 minutes before
breakfast, for optimal absorption. Food, calcium, and iron interfere with absorption.
2
, 6. A nurse is providing teaching to a client who has a new prescription for metformin.
Which of the following instructions should the nurse include?
A. "Take the medication with food to reduce GI upset."
B. "Take the medication on an empty stomach."
C. "Expect weight gain as a side effect."
D. "You can drink alcohol while taking this medication."
Correct Answer: A
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects.
Weight loss, not gain, is common. Alcohol should be avoided due to the risk of lactic
acidosis.
7. A nurse is caring for a client who has a new prescription for furosemide. Which of the
following instructions should the nurse include?
A. "Take the medication at bedtime."
B. "Increase your intake of potassium-rich foods."
C. "Avoid sunlight while taking this medication."
D. "Take the medication with an antacid."
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Clients should
increase intake of potassium-rich foods. The medication should be taken in the morning to
avoid nocturia. Photosensitivity is not a common effect. Antacids can reduce absorption.
8. A nurse is assessing a client who has been receiving furosemide. Which of the
following findings indicates hypokalemia?
A. Muscle weakness
B. Hypertension
C. Bradycardia
D. Hyperreflexia
3
, Correct Answer: A
Rationale: Hypokalemia presents with muscle weakness, fatigue, and cardiac arrhythmias.
Hypertension, bradycardia, and hyperreflexia are not typical.
9. A nurse is preparing to administer enoxaparin. Which of the following laboratory
values should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Serum potassium
Correct Answer: C
Rationale: Enoxaparin can cause heparin-induced thrombocytopenia (HIT). Platelet count
should be monitored. PT/INR monitors warfarin. aPTT monitors unfractionated heparin.
10. A nurse is providing teaching to a client about the use of a metered-dose inhaler
(MDI) with a spacer. Which of the following instructions should the nurse include?
A. "Inhale rapidly and deeply after activating the inhaler."
B. "Activate the inhaler before placing it in your mouth."
C. "Wait 1 to 2 minutes between puffs."
D. "Exhale through the mouthpiece after inhalation."
Correct Answer: C
Rationale: The client should wait 1 to 2 minutes between puffs to allow for optimal
medication absorption. Inhalation should be slow and deep. The inhaler should be activated
after placing it in the mouth. Exhalation should occur before, not after, inhalation.
11. A nurse is caring for a client who has a new diagnosis of peptic ulcer disease. Which
of the following medications should the nurse anticipate administering?
A. Omeprazole
B. Metformin
4
