MED SURG 2 – COMPREHENSIVE QUESTIONS
AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
• CORE DOMAINS*
•
• Cardiovascular disorders and nursing management
• Respiratory disorders and oxygenation
• Neurologic disorders and neurologic assessment
• Renal and urinary disorders
• Endocrine and metabolic disorders
• Gastrointestinal and hepatobiliary disorders
• Hematologic and immune disorders
• Musculoskeletal and connective-tissue disorders
• Oncology and complex adult health management
• Perioperative care, complications, safety, and clinical decision-making
• INTRODUCTION*
•
This comprehensive assessment evaluates essential medical-surgical nursing knowledge,
clinical reasoning, assessment skills, prioritization, and evidence-based patient management
across major adult health conditions. The multiple-choice questions progress from
foundational concepts to application, analysis, and clinical judgment. Emphasis is placed on
recognizing manifestations, interpreting assessment findings, understanding
pathophysiology, identifying complications, selecting appropriate interventions,
administering therapies safely, and evaluating outcomes. Learners are expected to
distinguish between similar clinical conditions and determine the safest nursing response in
realistic situations. The explanations following each question reinforce the underlying
concepts and provide concise rationales designed to strengthen understanding, decision-
making, and preparation for examination-style questions.
SECTION ONE: QUESTIONS 1–100
CARDIOVASCULAR DISORDERS AND MANAGEMENT
Question 1. Which assessment finding is most characteristic of left-sided heart failure?
A. Dependent peripheral edema
B. Pulmonary crackles and dyspnea
C. Enlarged liver
D. Jugular venous distention
,Correct Answer: B. Pulmonary crackles and dyspnea
Explanation: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion. Crackles, dyspnea, orthopnea, and pulmonary edema are
characteristic manifestations. Peripheral edema, hepatomegaly, and jugular venous
distention are more strongly associated with right-sided failure.
Question 2. A patient with acute pulmonary edema is severely dyspneic and coughing frothy
sputum. Which intervention should the nurse implement first?
A. Place the patient in high-Fowler position
B. Encourage oral fluids
C. Place the patient flat in bed
D. Encourage ambulation
Correct Answer: A. Place the patient in high-Fowler position
Explanation: High-Fowler positioning promotes lung expansion and decreases venous return
to the heart, which can reduce pulmonary congestion. A patient with acute pulmonary
edema requires immediate support of oxygenation and ventilation.
Question 3. Which laboratory value is commonly used to evaluate ventricular stretch and
support the diagnosis of heart failure?
A. Troponin
B. BNP
C. Amylase
D. Bilirubin
Correct Answer: B. BNP
Explanation: B-type natriuretic peptide (BNP) is released by cardiac ventricles in response to
increased wall stretch. Elevated BNP can support the diagnosis and assessment of heart
failure, although it must be interpreted in the context of the patient's overall clinical
condition.
Question 4. A patient taking furosemide reports muscle weakness and palpitations. Which
electrolyte imbalance should the nurse suspect?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C. Hypokalemia
, Explanation: Furosemide is a loop diuretic that increases urinary potassium excretion.
Hypokalemia may cause muscle weakness, cramps, and potentially dangerous cardiac
dysrhythmias.
Question 5. Which instruction is most important for a patient taking digoxin?
A. Increase sodium intake
B. Measure the pulse before taking the medication
C. Take an additional dose if one is missed
D. Stop the medication whenever appetite decreases
Correct Answer: B. Measure the pulse before taking the medication
Explanation: Digoxin can slow the heart rate and cause toxicity. Patients should monitor their
pulse as instructed and report significant bradycardia. Nausea, vomiting, anorexia, visual
disturbances, and dysrhythmias can also indicate toxicity.
Question 6. Which finding is most concerning in a patient receiving digoxin?
A. Heart rate of 52/min with nausea and visual disturbances
B. Blood pressure of 128/76 mmHg
C. Respiratory rate of 18/min
D. Mild thirst after exercise
Correct Answer: A. Heart rate of 52/min with nausea and visual disturbances
Explanation: Bradycardia combined with gastrointestinal and visual symptoms is concerning
for digoxin toxicity. Digoxin toxicity can cause potentially life-threatening dysrhythmias and
requires prompt evaluation.
Question 7. A patient with stable angina reports chest discomfort that occurs while climbing
stairs and resolves after rest. How should the nurse interpret this finding?
A. It is characteristic of myocardial rupture
B. It suggests stable exertional angina
C. It indicates pulmonary embolism
D. It is diagnostic of pericarditis
Correct Answer: B. It suggests stable exertional angina
Explanation: Stable angina typically occurs predictably with exertion or stress because
myocardial oxygen demand exceeds supply. Symptoms commonly improve with rest or
prescribed nitroglycerin.
Question 8. Which instruction should the nurse give a patient prescribed sublingual
nitroglycerin?
AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
• CORE DOMAINS*
•
• Cardiovascular disorders and nursing management
• Respiratory disorders and oxygenation
• Neurologic disorders and neurologic assessment
• Renal and urinary disorders
• Endocrine and metabolic disorders
• Gastrointestinal and hepatobiliary disorders
• Hematologic and immune disorders
• Musculoskeletal and connective-tissue disorders
• Oncology and complex adult health management
• Perioperative care, complications, safety, and clinical decision-making
• INTRODUCTION*
•
This comprehensive assessment evaluates essential medical-surgical nursing knowledge,
clinical reasoning, assessment skills, prioritization, and evidence-based patient management
across major adult health conditions. The multiple-choice questions progress from
foundational concepts to application, analysis, and clinical judgment. Emphasis is placed on
recognizing manifestations, interpreting assessment findings, understanding
pathophysiology, identifying complications, selecting appropriate interventions,
administering therapies safely, and evaluating outcomes. Learners are expected to
distinguish between similar clinical conditions and determine the safest nursing response in
realistic situations. The explanations following each question reinforce the underlying
concepts and provide concise rationales designed to strengthen understanding, decision-
making, and preparation for examination-style questions.
SECTION ONE: QUESTIONS 1–100
CARDIOVASCULAR DISORDERS AND MANAGEMENT
Question 1. Which assessment finding is most characteristic of left-sided heart failure?
A. Dependent peripheral edema
B. Pulmonary crackles and dyspnea
C. Enlarged liver
D. Jugular venous distention
,Correct Answer: B. Pulmonary crackles and dyspnea
Explanation: Left-sided heart failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion. Crackles, dyspnea, orthopnea, and pulmonary edema are
characteristic manifestations. Peripheral edema, hepatomegaly, and jugular venous
distention are more strongly associated with right-sided failure.
Question 2. A patient with acute pulmonary edema is severely dyspneic and coughing frothy
sputum. Which intervention should the nurse implement first?
A. Place the patient in high-Fowler position
B. Encourage oral fluids
C. Place the patient flat in bed
D. Encourage ambulation
Correct Answer: A. Place the patient in high-Fowler position
Explanation: High-Fowler positioning promotes lung expansion and decreases venous return
to the heart, which can reduce pulmonary congestion. A patient with acute pulmonary
edema requires immediate support of oxygenation and ventilation.
Question 3. Which laboratory value is commonly used to evaluate ventricular stretch and
support the diagnosis of heart failure?
A. Troponin
B. BNP
C. Amylase
D. Bilirubin
Correct Answer: B. BNP
Explanation: B-type natriuretic peptide (BNP) is released by cardiac ventricles in response to
increased wall stretch. Elevated BNP can support the diagnosis and assessment of heart
failure, although it must be interpreted in the context of the patient's overall clinical
condition.
Question 4. A patient taking furosemide reports muscle weakness and palpitations. Which
electrolyte imbalance should the nurse suspect?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C. Hypokalemia
, Explanation: Furosemide is a loop diuretic that increases urinary potassium excretion.
Hypokalemia may cause muscle weakness, cramps, and potentially dangerous cardiac
dysrhythmias.
Question 5. Which instruction is most important for a patient taking digoxin?
A. Increase sodium intake
B. Measure the pulse before taking the medication
C. Take an additional dose if one is missed
D. Stop the medication whenever appetite decreases
Correct Answer: B. Measure the pulse before taking the medication
Explanation: Digoxin can slow the heart rate and cause toxicity. Patients should monitor their
pulse as instructed and report significant bradycardia. Nausea, vomiting, anorexia, visual
disturbances, and dysrhythmias can also indicate toxicity.
Question 6. Which finding is most concerning in a patient receiving digoxin?
A. Heart rate of 52/min with nausea and visual disturbances
B. Blood pressure of 128/76 mmHg
C. Respiratory rate of 18/min
D. Mild thirst after exercise
Correct Answer: A. Heart rate of 52/min with nausea and visual disturbances
Explanation: Bradycardia combined with gastrointestinal and visual symptoms is concerning
for digoxin toxicity. Digoxin toxicity can cause potentially life-threatening dysrhythmias and
requires prompt evaluation.
Question 7. A patient with stable angina reports chest discomfort that occurs while climbing
stairs and resolves after rest. How should the nurse interpret this finding?
A. It is characteristic of myocardial rupture
B. It suggests stable exertional angina
C. It indicates pulmonary embolism
D. It is diagnostic of pericarditis
Correct Answer: B. It suggests stable exertional angina
Explanation: Stable angina typically occurs predictably with exertion or stress because
myocardial oxygen demand exceeds supply. Symptoms commonly improve with rest or
prescribed nitroglycerin.
Question 8. Which instruction should the nurse give a patient prescribed sublingual
nitroglycerin?
