SHIFTKEY MEDICAL-SURGICAL LPN/RN
ASSESSMENT 1 EXAMINATION COMPLETE
QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
The Shift Key Medical-Surgical LPN/RN Assessment 1 is a competency-based
examination designed to evaluate the clinical knowledge, critical thinking, and
prioritization skills of Licensed Practical Nurses (LPNs) and Registered Nurses
(RNs) seeking per diem or contract assignments through the Shift Key platform.
The assessment focuses on medical-surgical nursing across the adult lifespan and
covers essential topics including:
• Infection control and isolation precautions
• Medication administration and safety
• Fluid and electrolyte balance
• Perioperative nursing care
• Cardiovascular, respiratory, gastrointestinal, renal, and endocrine
disorders
• Neurological and musculoskeletal conditions
• Oncological and hematological disorders
• Wound care and pressure injury management
• Prioritization, delegation, and clinical judgment
Questions 1–50: Fundamentals, Infection Control & Medication
Safety
,1. A patient with heart failure is prescribed furosemide. What is the priority
nursing assessment before administration?
A. Blood pressure
B. Serum potassium level
C. Urine output
D. Weight
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, which can
lead to hypokalemia and life-threatening arrhythmias. Checking the serum
potassium level before administration is the priority.
2. Which clinical manifestation is most indicative of a pulmonary embolism?
A. Sudden dyspnea and tachycardia
B. Productive cough with yellow sputum
C. Bradycardia and hypertension
D. Wheezing and barrel chest
Correct Answer: A
Rationale: Pulmonary embolism typically presents with sudden onset of dyspnea
and tachycardia due to acute obstruction of pulmonary blood flow.
3. A patient with type 2 diabetes reports shakiness and diaphoresis. What is
the nurse's first action?
A. Administer insulin
B. Check blood glucose level
C. Give the patient a snack
D. Notify the physician
Correct Answer: B
Rationale: Shakiness and diaphoresis suggest hypoglycemia. Checking the blood
glucose level confirms the diagnosis and guides treatment.
,4. What is the priority nursing intervention for a patient with a new
colostomy?
A. Change the pouch every 24 hours
B. Assess stoma appearance
C. Irrigate the colostomy daily
D. Restrict oral fluids
Correct Answer: B
Rationale: Assessing the stoma for color, size, and output ensures it is functioning
properly and identifies complications like ischemia early.
5. A patient with COPD is receiving oxygen at 2 L/min via nasal cannula.
What should the nurse monitor to prevent complications?
A. Respiratory rate only
B. Oxygen saturation (target 88–92%)
C. Blood pressure every 15 minutes
D. Arterial blood gases every hour
Correct Answer: B
Rationale: In COPD, excessive oxygen can suppress the respiratory drive.
Monitoring oxygen saturation ensures safe delivery within the target range of 88–
92%.
6. Which finding indicates a potential complication in a post-operative patient
24 hours after abdominal surgery?
A. Absent bowel sounds
B. Serosanguineous wound drainage
C. Pain at the incision site
D. Temperature of 99.1°F (37.3°C)
Correct Answer: A
, Rationale: Absent bowel sounds may indicate a post-operative ileus or
obstruction, requiring immediate assessment.
7. A patient with a history of atrial fibrillation is on warfarin. Which dietary
teaching is most important?
A. Increase vitamin K intake
B. Limit green leafy vegetables
C. Avoid all dairy products
D. Increase potassium-rich foods
Correct Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes
warfarin. Consistent intake is required to maintain therapeutic INR.
8. What is the priority nursing action for a patient experiencing an
anaphylactic reaction?
A. Administer epinephrine
B. Start an IV line
C. Administer diphenhydramine
D. Obtain a chest X-ray
Correct Answer: A
Rationale: Epinephrine is the first-line treatment for anaphylaxis to reverse
bronchoconstriction and hypotension.
9. A patient with a fractured femur is in traction. What is the nurse's priority
assessment?
A. Skin integrity under traction
B. Dietary intake
C. Bowel sounds
D. Urine specific gravity
ASSESSMENT 1 EXAMINATION COMPLETE
QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
The Shift Key Medical-Surgical LPN/RN Assessment 1 is a competency-based
examination designed to evaluate the clinical knowledge, critical thinking, and
prioritization skills of Licensed Practical Nurses (LPNs) and Registered Nurses
(RNs) seeking per diem or contract assignments through the Shift Key platform.
The assessment focuses on medical-surgical nursing across the adult lifespan and
covers essential topics including:
• Infection control and isolation precautions
• Medication administration and safety
• Fluid and electrolyte balance
• Perioperative nursing care
• Cardiovascular, respiratory, gastrointestinal, renal, and endocrine
disorders
• Neurological and musculoskeletal conditions
• Oncological and hematological disorders
• Wound care and pressure injury management
• Prioritization, delegation, and clinical judgment
Questions 1–50: Fundamentals, Infection Control & Medication
Safety
,1. A patient with heart failure is prescribed furosemide. What is the priority
nursing assessment before administration?
A. Blood pressure
B. Serum potassium level
C. Urine output
D. Weight
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, which can
lead to hypokalemia and life-threatening arrhythmias. Checking the serum
potassium level before administration is the priority.
2. Which clinical manifestation is most indicative of a pulmonary embolism?
A. Sudden dyspnea and tachycardia
B. Productive cough with yellow sputum
C. Bradycardia and hypertension
D. Wheezing and barrel chest
Correct Answer: A
Rationale: Pulmonary embolism typically presents with sudden onset of dyspnea
and tachycardia due to acute obstruction of pulmonary blood flow.
3. A patient with type 2 diabetes reports shakiness and diaphoresis. What is
the nurse's first action?
A. Administer insulin
B. Check blood glucose level
C. Give the patient a snack
D. Notify the physician
Correct Answer: B
Rationale: Shakiness and diaphoresis suggest hypoglycemia. Checking the blood
glucose level confirms the diagnosis and guides treatment.
,4. What is the priority nursing intervention for a patient with a new
colostomy?
A. Change the pouch every 24 hours
B. Assess stoma appearance
C. Irrigate the colostomy daily
D. Restrict oral fluids
Correct Answer: B
Rationale: Assessing the stoma for color, size, and output ensures it is functioning
properly and identifies complications like ischemia early.
5. A patient with COPD is receiving oxygen at 2 L/min via nasal cannula.
What should the nurse monitor to prevent complications?
A. Respiratory rate only
B. Oxygen saturation (target 88–92%)
C. Blood pressure every 15 minutes
D. Arterial blood gases every hour
Correct Answer: B
Rationale: In COPD, excessive oxygen can suppress the respiratory drive.
Monitoring oxygen saturation ensures safe delivery within the target range of 88–
92%.
6. Which finding indicates a potential complication in a post-operative patient
24 hours after abdominal surgery?
A. Absent bowel sounds
B. Serosanguineous wound drainage
C. Pain at the incision site
D. Temperature of 99.1°F (37.3°C)
Correct Answer: A
, Rationale: Absent bowel sounds may indicate a post-operative ileus or
obstruction, requiring immediate assessment.
7. A patient with a history of atrial fibrillation is on warfarin. Which dietary
teaching is most important?
A. Increase vitamin K intake
B. Limit green leafy vegetables
C. Avoid all dairy products
D. Increase potassium-rich foods
Correct Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes
warfarin. Consistent intake is required to maintain therapeutic INR.
8. What is the priority nursing action for a patient experiencing an
anaphylactic reaction?
A. Administer epinephrine
B. Start an IV line
C. Administer diphenhydramine
D. Obtain a chest X-ray
Correct Answer: A
Rationale: Epinephrine is the first-line treatment for anaphylaxis to reverse
bronchoconstriction and hypotension.
9. A patient with a fractured femur is in traction. What is the nurse's priority
assessment?
A. Skin integrity under traction
B. Dietary intake
C. Bowel sounds
D. Urine specific gravity
