ASSESSMENT | PRIORITIZATION | PHARMACOLOGY | CLINICAL JUDGMENT
BRUNNER & SUDDARTH'S
TEXTBOOK OF MEDICAL-SURGICAL NURSING
16th Edition
S-TIER UNIVERSAL MASTERY TEST BANK
60 Questions | Detailed Rationales | Distractor Analysis
NURSING EDUCATION | NCLEX-RN-STYLE PREPARATION
,Table of Contents
1. Part I: The Preview
• The Intro
• The Critical Axioms Cheat Sheet
2. Part II: The Elite Test Bank
• Tier 1: Foundational Syntax and Application (Questions 1–20)
• Tier 2: Complex Application and Simulation (Questions 21–40)
• Tier 3: Grandmaster Synthesis (Questions 41–60)
Medical-Surgical Nursing Elite Test Bank | Page 2
, Part I: The Preview
Mastering this test bank builds the clinical judgment that safe medical-surgical nursing requires:
recognizing what is unstable, deciding what to do first, and delegating appropriately. Each question links a
pathophysiologic principle to a nursing action, so you can defend your priorities at the bedside and on the
NCLEX.
The Critical Axioms Cheat Sheet
• Prioritize: Airway, breathing, circulation first; then unstable or acute changes; then safety; then chronic
and teaching needs. Assess before you intervene, and never delegate assessment, teaching, or
evaluation.
• Infection control: Airborne (N95, negative pressure) for TB, measles, and varicella; droplet (surgical
mask) for influenza and pertussis; contact (gown and gloves) for MRSA and C. difficile, with soap and
water for C. difficile.
• Fluids, electrolytes, and acid-base: High potassium gives peaked T waves; low calcium gives
Trousseau and Chvostek signs; severe low sodium risks seizures. In ABGs, match the pH to the gas
that moves opposite it (respiratory) or with it (metabolic).
• Medication safety: Hold digoxin if the apical pulse is below 60. INR (2 to 3) guides warfarin; aPTT
guides heparin. Antidotes: protamine for heparin, vitamin K for warfarin, naloxone for opioids. Verify
dosage calculations: drops/min = (volume x drop factor) / minutes.
• Emergencies: Anaphylaxis needs IM epinephrine first. For sepsis, give cultures, antibiotics within an
hour, and 30 mL/kg fluids. Treat sudden stridor, an expanding hematoma with hypotension,
compartment syndrome, and autonomic dysreflexia as time-critical.
The nursing process (ADPIE)
Diagnosis Planning Implementation Evaluation
Assessment
analyze, identify goals and act, delegate, outcomes met?
collect data
problems priorities teach revise
Assess before you act: assessment is a nursing responsibility that cannot be delegated.
Figure 1. The nursing process
Medical-Surgical Nursing Elite Test Bank | Page 3
BRUNNER & SUDDARTH'S
TEXTBOOK OF MEDICAL-SURGICAL NURSING
16th Edition
S-TIER UNIVERSAL MASTERY TEST BANK
60 Questions | Detailed Rationales | Distractor Analysis
NURSING EDUCATION | NCLEX-RN-STYLE PREPARATION
,Table of Contents
1. Part I: The Preview
• The Intro
• The Critical Axioms Cheat Sheet
2. Part II: The Elite Test Bank
• Tier 1: Foundational Syntax and Application (Questions 1–20)
• Tier 2: Complex Application and Simulation (Questions 21–40)
• Tier 3: Grandmaster Synthesis (Questions 41–60)
Medical-Surgical Nursing Elite Test Bank | Page 2
, Part I: The Preview
Mastering this test bank builds the clinical judgment that safe medical-surgical nursing requires:
recognizing what is unstable, deciding what to do first, and delegating appropriately. Each question links a
pathophysiologic principle to a nursing action, so you can defend your priorities at the bedside and on the
NCLEX.
The Critical Axioms Cheat Sheet
• Prioritize: Airway, breathing, circulation first; then unstable or acute changes; then safety; then chronic
and teaching needs. Assess before you intervene, and never delegate assessment, teaching, or
evaluation.
• Infection control: Airborne (N95, negative pressure) for TB, measles, and varicella; droplet (surgical
mask) for influenza and pertussis; contact (gown and gloves) for MRSA and C. difficile, with soap and
water for C. difficile.
• Fluids, electrolytes, and acid-base: High potassium gives peaked T waves; low calcium gives
Trousseau and Chvostek signs; severe low sodium risks seizures. In ABGs, match the pH to the gas
that moves opposite it (respiratory) or with it (metabolic).
• Medication safety: Hold digoxin if the apical pulse is below 60. INR (2 to 3) guides warfarin; aPTT
guides heparin. Antidotes: protamine for heparin, vitamin K for warfarin, naloxone for opioids. Verify
dosage calculations: drops/min = (volume x drop factor) / minutes.
• Emergencies: Anaphylaxis needs IM epinephrine first. For sepsis, give cultures, antibiotics within an
hour, and 30 mL/kg fluids. Treat sudden stridor, an expanding hematoma with hypotension,
compartment syndrome, and autonomic dysreflexia as time-critical.
The nursing process (ADPIE)
Diagnosis Planning Implementation Evaluation
Assessment
analyze, identify goals and act, delegate, outcomes met?
collect data
problems priorities teach revise
Assess before you act: assessment is a nursing responsibility that cannot be delegated.
Figure 1. The nursing process
Medical-Surgical Nursing Elite Test Bank | Page 3
