MED SURG 1 EXAM PREPARATION: 200 EXAM QUESTIONS
WITH DETAILED RATIONALES
1. A nurse is caring for a client who is receiving morphine via a PCA
infusion device after abdominal surgery. Which statement shows the
patient understands the device?
A. "I will wait to use the device until the pain is absolutely unbearable."
B. "I will ask my son to push the device when I am sleeping."
C. "I should call the nurse if the pain doesn't stop after using the
device."
D. "I will be careful when pushing the button so I don't overdose."
Correct Answer: C
Rationale: If the patient's pain is not relieved after using the PCA, it
could indicate a complication or that the current medication is not
effective, requiring the nurse to assess the situation. Waiting until pain
is unbearable (A) delays pain control. Having a family member push the
button (B) is dangerous and is known as PCA by proxy. The PCA device
has a lockout interval to prevent overdose (D), so the patient does not
need to worry about overdosing by pushing the button.
2. A nurse in a cardiac unit is assisting with the admission of a client
who is to undergo hemodynamic monitoring. Which of the following
actions should the nurse anticipate performing?
A. Administer large IV volumes of IV fluids.
B. Assist with insertion of a pulmonary artery catheter.
C. Position the client laterally to calculate the phlebostatic axis.
,D. Gather supplies to insert a peripheral IV catheter.
Correct Answer: B
Rationale: Hemodynamic monitoring typically involves the insertion of a
pulmonary artery catheter to measure pressures within the heart and
pulmonary arteries. Administering large IV fluids (A) is a treatment, not
a preparatory action for monitoring. The phlebostatic axis is used for
transducer leveling, and the client should be supine, not lateral (C). A
peripheral IV (D) is not sufficient for hemodynamic monitoring.
3. A nurse in an ER is completing an assessment on a client who is in
shock. Which findings should the nurse expect?
A. Heart rate 60/min
B. Seizure activity
C. Respiratory rate 42/min
D. Increased urine output
Correct Answer: C
Rationale: In shock, the body attempts to compensate for decreased
tissue perfusion, leading to an increased respiratory rate to maximize
oxygen intake. A heart rate of 60/min (A) is bradycardic and not
expected in early shock (tachycardia is expected). Seizure activity (B) is
not a primary finding of general shock unless it is late-stage
hypoperfusion or specific toxin-induced shock. Increased urine output
(D) is not expected; decreased urine output is a hallmark due to
decreased renal perfusion.
4. A nurse is assessing a client who is 24 hours post-operative from a
total hip arthroplasty. Which finding requires immediate intervention?
A. Pain at the surgical site.
B. A dry, intact surgical dressing.
C. Sudden shortness of breath and chest pain.
,D. Temperature of 37.8 C (100.0 F).
Correct Answer: C
Rationale: Sudden shortness of breath and chest pain in a post-
operative orthopedic client are classic signs of a pulmonary embolism, a
life-threatening complication requiring immediate intervention. Pain at
the surgical site (A) is expected. A dry dressing (B) is a normal finding. A
low-grade fever (D) is common post-operatively due to inflammation or
atelectasis.
5. A nurse is providing teaching to a client who is scheduled for
surgery. Which of the following statements indicates a need for
further teaching?
A. "I will stop taking my aspirin 7 days before surgery."
B. "I can have a glass of water with my morning medications on the day
of surgery."
C. "I will eat a heavy breakfast the morning of my surgery to keep my
strength up."
D. "I will shower with an antimicrobial soap the night before surgery."
Correct Answer: C
Rationale: Clients are typically NPO after midnight or at least 6-8 hours
before surgery to prevent aspiration during anesthesia. Eating a heavy
breakfast (C) is contraindicated. Stopping aspirin (A) is standard to
reduce bleeding risk. Taking medications with a sip of water (B) is often
allowed. Antimicrobial showers (D) reduce the risk of surgical site
infections.
6. A nurse is caring for a client who has a new prescription for
furosemide. Which of the following findings should the nurse monitor
as an adverse effect?
A. Hypertension
, B. Hypokalemia
C. Hypernatremia
D. Bradycardia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of
potassium, putting the client at risk for hypokalemia. It is used to treat
hypertension (A), so hypertension is not an adverse effect. It can cause
hyponatremia, not hypernatremia (C). It does not typically cause
bradycardia (D).
7. A nurse is assessing a client with a suspected peptic ulcer. Which of
the following findings is the priority?
A. Nausea after eating.
B. A sudden onset of severe, sharp abdominal pain.
C. Dark, tarry stools.
D. Heartburn relieved by antacids.
Correct Answer: B
Rationale: A sudden onset of severe, sharp abdominal pain indicates a
perforation, a life-threatening emergency requiring immediate surgical
intervention. Nausea (A) and heartburn (C, D) are common symptoms
of peptic ulcers but are not immediately life-threatening.
8. A nurse is evaluating a client who has just returned from the PACU.
Which of the following is the priority assessment?
A. Urine output.
B. Patency of the airway.
C. Surgical site dressing.
D. Level of consciousness.
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) framework,
WITH DETAILED RATIONALES
1. A nurse is caring for a client who is receiving morphine via a PCA
infusion device after abdominal surgery. Which statement shows the
patient understands the device?
A. "I will wait to use the device until the pain is absolutely unbearable."
B. "I will ask my son to push the device when I am sleeping."
C. "I should call the nurse if the pain doesn't stop after using the
device."
D. "I will be careful when pushing the button so I don't overdose."
Correct Answer: C
Rationale: If the patient's pain is not relieved after using the PCA, it
could indicate a complication or that the current medication is not
effective, requiring the nurse to assess the situation. Waiting until pain
is unbearable (A) delays pain control. Having a family member push the
button (B) is dangerous and is known as PCA by proxy. The PCA device
has a lockout interval to prevent overdose (D), so the patient does not
need to worry about overdosing by pushing the button.
2. A nurse in a cardiac unit is assisting with the admission of a client
who is to undergo hemodynamic monitoring. Which of the following
actions should the nurse anticipate performing?
A. Administer large IV volumes of IV fluids.
B. Assist with insertion of a pulmonary artery catheter.
C. Position the client laterally to calculate the phlebostatic axis.
,D. Gather supplies to insert a peripheral IV catheter.
Correct Answer: B
Rationale: Hemodynamic monitoring typically involves the insertion of a
pulmonary artery catheter to measure pressures within the heart and
pulmonary arteries. Administering large IV fluids (A) is a treatment, not
a preparatory action for monitoring. The phlebostatic axis is used for
transducer leveling, and the client should be supine, not lateral (C). A
peripheral IV (D) is not sufficient for hemodynamic monitoring.
3. A nurse in an ER is completing an assessment on a client who is in
shock. Which findings should the nurse expect?
A. Heart rate 60/min
B. Seizure activity
C. Respiratory rate 42/min
D. Increased urine output
Correct Answer: C
Rationale: In shock, the body attempts to compensate for decreased
tissue perfusion, leading to an increased respiratory rate to maximize
oxygen intake. A heart rate of 60/min (A) is bradycardic and not
expected in early shock (tachycardia is expected). Seizure activity (B) is
not a primary finding of general shock unless it is late-stage
hypoperfusion or specific toxin-induced shock. Increased urine output
(D) is not expected; decreased urine output is a hallmark due to
decreased renal perfusion.
4. A nurse is assessing a client who is 24 hours post-operative from a
total hip arthroplasty. Which finding requires immediate intervention?
A. Pain at the surgical site.
B. A dry, intact surgical dressing.
C. Sudden shortness of breath and chest pain.
,D. Temperature of 37.8 C (100.0 F).
Correct Answer: C
Rationale: Sudden shortness of breath and chest pain in a post-
operative orthopedic client are classic signs of a pulmonary embolism, a
life-threatening complication requiring immediate intervention. Pain at
the surgical site (A) is expected. A dry dressing (B) is a normal finding. A
low-grade fever (D) is common post-operatively due to inflammation or
atelectasis.
5. A nurse is providing teaching to a client who is scheduled for
surgery. Which of the following statements indicates a need for
further teaching?
A. "I will stop taking my aspirin 7 days before surgery."
B. "I can have a glass of water with my morning medications on the day
of surgery."
C. "I will eat a heavy breakfast the morning of my surgery to keep my
strength up."
D. "I will shower with an antimicrobial soap the night before surgery."
Correct Answer: C
Rationale: Clients are typically NPO after midnight or at least 6-8 hours
before surgery to prevent aspiration during anesthesia. Eating a heavy
breakfast (C) is contraindicated. Stopping aspirin (A) is standard to
reduce bleeding risk. Taking medications with a sip of water (B) is often
allowed. Antimicrobial showers (D) reduce the risk of surgical site
infections.
6. A nurse is caring for a client who has a new prescription for
furosemide. Which of the following findings should the nurse monitor
as an adverse effect?
A. Hypertension
, B. Hypokalemia
C. Hypernatremia
D. Bradycardia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of
potassium, putting the client at risk for hypokalemia. It is used to treat
hypertension (A), so hypertension is not an adverse effect. It can cause
hyponatremia, not hypernatremia (C). It does not typically cause
bradycardia (D).
7. A nurse is assessing a client with a suspected peptic ulcer. Which of
the following findings is the priority?
A. Nausea after eating.
B. A sudden onset of severe, sharp abdominal pain.
C. Dark, tarry stools.
D. Heartburn relieved by antacids.
Correct Answer: B
Rationale: A sudden onset of severe, sharp abdominal pain indicates a
perforation, a life-threatening emergency requiring immediate surgical
intervention. Nausea (A) and heartburn (C, D) are common symptoms
of peptic ulcers but are not immediately life-threatening.
8. A nurse is evaluating a client who has just returned from the PACU.
Which of the following is the priority assessment?
A. Urine output.
B. Patency of the airway.
C. Surgical site dressing.
D. Level of consciousness.
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) framework,
