SHIFTKEY MEDICAL-SURGICAL
LPN/RN ASSESSMENT 3 QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Medical-Surgical Nursing Principles
• Cardiovascular and Respiratory Care
• Gastrointestinal and Renal Care
• Neurological and Musculoskeletal Care
• Endocrine, Hematologic, and Postoperative Care
• Infection Control and Safety
• Pharmacology and Medication Administration
Introduction
The ShiftKey Medical-Surgical assessment evaluates the clinical
competency and critical thinking of practical and registered
nurses in acute care settings. This examination assesses
foundational theory, applied professional knowledge, and the
ability to prioritize care in real-world scenarios. Questions are
structured as multiple-choice and scenario-based items that
emphasize decision-making, regulatory compliance, and ethical
standards. Candidates are expected to demonstrate proficiency in
managing diverse patient populations while maintaining safety
and adhering to evidence-based practice guidelines.
Section One: Questions 1–100
,1. A nurse is caring for a client who has a new prescription
for enoxaparin. Which of the following actions should the
nurse take when administering this medication?
A. Massage the injection site after administration
B. Administer the medication intramuscularly into the deltoid
C. Inject the medication into the abdomen at a 90-degree angle
D. Aspirate for blood return before injecting the medication
RATIONALE: Enoxaparin is a low molecular weight heparin
administered via deep subcutaneous injection. The abdomen is
the preferred site, and the needle should be inserted at a 90-
degree angle. The injection site should not be massaged to avoid
hematoma formation, and aspiration is not performed because it
can cause tissue damage and bruising.
2. A client is admitted with a suspected pulmonary
embolism. Which of the following findings should the
nurse expect to assess?
A. Bradycardia and hypertension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with yellow sputum
D. Unilateral leg edema and warmth
RATIONALE: Pulmonary embolism typically presents with
sudden onset dyspnea, pleuritic chest pain that worsens with
inspiration, tachycardia, and hypoxemia. Unilateral leg edema and
warmth are signs of deep vein thrombosis, which can precede a
PE, but are not the direct pulmonary manifestation.
3. A nurse is reviewing the laboratory results of a client
who has chronic kidney disease. Which of the following
,findings should the nurse report to the provider
immediately?
A. Hemoglobin 10.2 g/dL
B. Blood urea nitrogen 35 mg/dL
C. Serum potassium 6.8 mEq/L
D. Serum creatinine 2.5 mg/dL
RATIONALE: A serum potassium level of 6.8 mEq/L indicates
severe hyperkalemia, which can cause life-threatening cardiac
dysrhythmias in clients with chronic kidney disease. This finding
requires immediate intervention, including potential
administration of calcium gluconate, insulin, and sodium
bicarbonate.
4. A client who had abdominal surgery 2 days ago reports
sudden onset of shortness of breath and chest pain. The
nurse notes the client's heart rate is 118 bpm and oxygen
saturation is 88% on room air. Which action should the
nurse take first?
A. Administer prescribed analgesic for pain
B. Apply oxygen and raise the head of the bed
C. Encourage the client to use the incentive spirometer
D. Notify the provider and await orders
RATIONALE: The client's presentation suggests a possible
pulmonary embolism. The priority nursing action is to improve
oxygenation by applying supplemental oxygen and positioning the
client upright to facilitate breathing. Further interventions,
including notification of the provider, should follow initial
stabilization measures.
, 5. A nurse is teaching a client about a low-sodium diet.
Which of the following statements by the client indicates a
need for further teaching?
A. "I will read food labels to check for sodium content."
B. "I will use herbs and spices instead of salt to flavor food."
C. "I will eat canned soups because they are convenient."
D. "I will avoid processed meats such as bacon and ham."
RATIONALE: Canned soups are typically high in sodium and
should be avoided or consumed in limited quantities on a low-
sodium diet. The client's statement indicates a misunderstanding
of appropriate food choices for sodium restriction.
6. A client with heart failure is prescribed digoxin. The
nurse notes the client's apical pulse is 52 beats per
minute. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Document the finding and reassess in 1 hour
D. Administer the medication with food
RATIONALE: Digoxin should be withheld when the adult apical
pulse is below 60 beats per minute due to the risk of
exacerbating bradycardia and potential digoxin toxicity. The
provider should be notified for further instructions.
7. A nurse is caring for a client who has an ileostomy.
Which of the following findings should the nurse report to
the provider?
LPN/RN ASSESSMENT 3 QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Medical-Surgical Nursing Principles
• Cardiovascular and Respiratory Care
• Gastrointestinal and Renal Care
• Neurological and Musculoskeletal Care
• Endocrine, Hematologic, and Postoperative Care
• Infection Control and Safety
• Pharmacology and Medication Administration
Introduction
The ShiftKey Medical-Surgical assessment evaluates the clinical
competency and critical thinking of practical and registered
nurses in acute care settings. This examination assesses
foundational theory, applied professional knowledge, and the
ability to prioritize care in real-world scenarios. Questions are
structured as multiple-choice and scenario-based items that
emphasize decision-making, regulatory compliance, and ethical
standards. Candidates are expected to demonstrate proficiency in
managing diverse patient populations while maintaining safety
and adhering to evidence-based practice guidelines.
Section One: Questions 1–100
,1. A nurse is caring for a client who has a new prescription
for enoxaparin. Which of the following actions should the
nurse take when administering this medication?
A. Massage the injection site after administration
B. Administer the medication intramuscularly into the deltoid
C. Inject the medication into the abdomen at a 90-degree angle
D. Aspirate for blood return before injecting the medication
RATIONALE: Enoxaparin is a low molecular weight heparin
administered via deep subcutaneous injection. The abdomen is
the preferred site, and the needle should be inserted at a 90-
degree angle. The injection site should not be massaged to avoid
hematoma formation, and aspiration is not performed because it
can cause tissue damage and bruising.
2. A client is admitted with a suspected pulmonary
embolism. Which of the following findings should the
nurse expect to assess?
A. Bradycardia and hypertension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with yellow sputum
D. Unilateral leg edema and warmth
RATIONALE: Pulmonary embolism typically presents with
sudden onset dyspnea, pleuritic chest pain that worsens with
inspiration, tachycardia, and hypoxemia. Unilateral leg edema and
warmth are signs of deep vein thrombosis, which can precede a
PE, but are not the direct pulmonary manifestation.
3. A nurse is reviewing the laboratory results of a client
who has chronic kidney disease. Which of the following
,findings should the nurse report to the provider
immediately?
A. Hemoglobin 10.2 g/dL
B. Blood urea nitrogen 35 mg/dL
C. Serum potassium 6.8 mEq/L
D. Serum creatinine 2.5 mg/dL
RATIONALE: A serum potassium level of 6.8 mEq/L indicates
severe hyperkalemia, which can cause life-threatening cardiac
dysrhythmias in clients with chronic kidney disease. This finding
requires immediate intervention, including potential
administration of calcium gluconate, insulin, and sodium
bicarbonate.
4. A client who had abdominal surgery 2 days ago reports
sudden onset of shortness of breath and chest pain. The
nurse notes the client's heart rate is 118 bpm and oxygen
saturation is 88% on room air. Which action should the
nurse take first?
A. Administer prescribed analgesic for pain
B. Apply oxygen and raise the head of the bed
C. Encourage the client to use the incentive spirometer
D. Notify the provider and await orders
RATIONALE: The client's presentation suggests a possible
pulmonary embolism. The priority nursing action is to improve
oxygenation by applying supplemental oxygen and positioning the
client upright to facilitate breathing. Further interventions,
including notification of the provider, should follow initial
stabilization measures.
, 5. A nurse is teaching a client about a low-sodium diet.
Which of the following statements by the client indicates a
need for further teaching?
A. "I will read food labels to check for sodium content."
B. "I will use herbs and spices instead of salt to flavor food."
C. "I will eat canned soups because they are convenient."
D. "I will avoid processed meats such as bacon and ham."
RATIONALE: Canned soups are typically high in sodium and
should be avoided or consumed in limited quantities on a low-
sodium diet. The client's statement indicates a misunderstanding
of appropriate food choices for sodium restriction.
6. A client with heart failure is prescribed digoxin. The
nurse notes the client's apical pulse is 52 beats per
minute. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Document the finding and reassess in 1 hour
D. Administer the medication with food
RATIONALE: Digoxin should be withheld when the adult apical
pulse is below 60 beats per minute due to the risk of
exacerbating bradycardia and potential digoxin toxicity. The
provider should be notified for further instructions.
7. A nurse is caring for a client who has an ileostomy.
Which of the following findings should the nurse report to
the provider?
