MED-SURG II PRACTICE EXAM ADULT HEALTH COMPLEX CARE
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Cardiovascular and Peripheral Vascular Disorders
Respiratory and Ventilatory Support
Neurological and Sensory Disorders
Endocrine and Metabolic Emergencies
Renal and Genitourinary Disorders
Gastrointestinal and Hepatobiliary Disorders
Musculoskeletal and Integumentary Care
Oncology, Hematology, and Immunology
Perioperative, Emergency, and Critical Care
Ethics, Legal Compliance, and Professional Standards
Introduction
The Med-Surg II Practice Exam Adult Health Complex Care assesses
the candidate's ability to manage adults with complex, multisystem
health problems. It evaluates foundational medical-surgical theory,
applied clinical judgment, regulatory and legal compliance, ethical
decision-making, and real-world prioritization. The exam uses
multiple-choice and scenario-based items to emphasize safe,
evidence-based nursing practice. Candidates must demonstrate
critical thinking, effective delegation, patient advocacy, and the
,ability to respond to rapidly changing conditions across acute,
critical, and transitional care settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse assesses a patient with an acute exacerbation of
COPD. Which finding requires immediate intervention?
A. Oxygen saturation 88% on 2 L nasal cannula
B. Barrel chest and clubbed fingers
C. PaCO2 55 mm Hg with drowsiness
D. Respiratory rate 28/min with accessory muscle use
🟢 C. PaCO2 55 mm Hg with drowsiness
🔴 RATIONALE: Drowsiness with elevated PaCO2 indicates carbon
dioxide narcosis and impending respiratory failure. This finding
requires immediate intervention to support ventilation.
2. A patient with heart failure is receiving furosemide. Which
laboratory value requires follow-up?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. BNP 400 pg/mL
D. Digoxin level 1.0 ng/mL
🟢 A. Potassium 3.1 mEq/L
🔴 RATIONALE: Furosemide is a loop diuretic that can cause
hypokalemia. A potassium level of 3.1 mEq/L is below normal and
,increases the risk for dysrhythmias.
3. After abdominal surgery, a patient reports sudden shortness
of breath and chest pain. Vital signs are HR 120, BP 90/60, and
O2 saturation 88%. What is the priority action?
A. Administer prescribed pain medication
B. Encourage incentive spirometry
C. Obtain a chest x-ray
D. Raise the head of the bed and call rapid response
🟢 D. Raise the head of the bed and call rapid response
🔴 RATIONALE: Sudden dyspnea, chest pain, hypotension, and
hypoxemia after surgery suggest pulmonary embolism. The nurse
must immediately improve oxygenation and activate emergency
support.
4. A patient with acute pancreatitis is NPO. Which nursing
intervention is the priority?
A. Monitor serum lipase levels
B. Administer IV morphine for severe pain
C. Assess bowel sounds every shift
D. Maintain nasogastric suction if ordered
🟢 B. Administer IV morphine for severe pain
🔴 RATIONALE: Acute pancreatitis causes severe pain, which
increases metabolic demand and sympathetic response. IV opioid
, analgesia is a priority while maintaining NPO status and fluid
resuscitation.
5. Which patient is at highest risk for developing a pressure
injury?
A. A patient with COPD on 2 L oxygen
B. A patient with controlled hypertension
C. A patient with a spinal cord injury and incontinence
D. A patient with diet-controlled diabetes
🟢 C. A patient with a spinal cord injury and incontinence
🔴 RATIONALE: Immobility, sensory loss, and moisture from
incontinence significantly increase pressure injury risk. Spinal cord
injury impairs mobility and sensation, making this patient highest
risk.
6. A nurse is teaching a patient about warfarin. Which statement
indicates understanding?
A. "I will use a soft toothbrush and an electric razor."
B. "I will increase leafy greens in my diet."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I bruise."
🟢 A. "I will use a soft toothbrush and an electric razor."
🔴 RATIONALE: Warfarin increases bleeding risk. Using a soft
toothbrush and electric razor reduces trauma-related bleeding.
Leafy greens and aspirin interact with warfarin.
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Cardiovascular and Peripheral Vascular Disorders
Respiratory and Ventilatory Support
Neurological and Sensory Disorders
Endocrine and Metabolic Emergencies
Renal and Genitourinary Disorders
Gastrointestinal and Hepatobiliary Disorders
Musculoskeletal and Integumentary Care
Oncology, Hematology, and Immunology
Perioperative, Emergency, and Critical Care
Ethics, Legal Compliance, and Professional Standards
Introduction
The Med-Surg II Practice Exam Adult Health Complex Care assesses
the candidate's ability to manage adults with complex, multisystem
health problems. It evaluates foundational medical-surgical theory,
applied clinical judgment, regulatory and legal compliance, ethical
decision-making, and real-world prioritization. The exam uses
multiple-choice and scenario-based items to emphasize safe,
evidence-based nursing practice. Candidates must demonstrate
critical thinking, effective delegation, patient advocacy, and the
,ability to respond to rapidly changing conditions across acute,
critical, and transitional care settings.
SECTION ONE: QUESTIONS 1–100
1. A nurse assesses a patient with an acute exacerbation of
COPD. Which finding requires immediate intervention?
A. Oxygen saturation 88% on 2 L nasal cannula
B. Barrel chest and clubbed fingers
C. PaCO2 55 mm Hg with drowsiness
D. Respiratory rate 28/min with accessory muscle use
🟢 C. PaCO2 55 mm Hg with drowsiness
🔴 RATIONALE: Drowsiness with elevated PaCO2 indicates carbon
dioxide narcosis and impending respiratory failure. This finding
requires immediate intervention to support ventilation.
2. A patient with heart failure is receiving furosemide. Which
laboratory value requires follow-up?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. BNP 400 pg/mL
D. Digoxin level 1.0 ng/mL
🟢 A. Potassium 3.1 mEq/L
🔴 RATIONALE: Furosemide is a loop diuretic that can cause
hypokalemia. A potassium level of 3.1 mEq/L is below normal and
,increases the risk for dysrhythmias.
3. After abdominal surgery, a patient reports sudden shortness
of breath and chest pain. Vital signs are HR 120, BP 90/60, and
O2 saturation 88%. What is the priority action?
A. Administer prescribed pain medication
B. Encourage incentive spirometry
C. Obtain a chest x-ray
D. Raise the head of the bed and call rapid response
🟢 D. Raise the head of the bed and call rapid response
🔴 RATIONALE: Sudden dyspnea, chest pain, hypotension, and
hypoxemia after surgery suggest pulmonary embolism. The nurse
must immediately improve oxygenation and activate emergency
support.
4. A patient with acute pancreatitis is NPO. Which nursing
intervention is the priority?
A. Monitor serum lipase levels
B. Administer IV morphine for severe pain
C. Assess bowel sounds every shift
D. Maintain nasogastric suction if ordered
🟢 B. Administer IV morphine for severe pain
🔴 RATIONALE: Acute pancreatitis causes severe pain, which
increases metabolic demand and sympathetic response. IV opioid
, analgesia is a priority while maintaining NPO status and fluid
resuscitation.
5. Which patient is at highest risk for developing a pressure
injury?
A. A patient with COPD on 2 L oxygen
B. A patient with controlled hypertension
C. A patient with a spinal cord injury and incontinence
D. A patient with diet-controlled diabetes
🟢 C. A patient with a spinal cord injury and incontinence
🔴 RATIONALE: Immobility, sensory loss, and moisture from
incontinence significantly increase pressure injury risk. Spinal cord
injury impairs mobility and sensation, making this patient highest
risk.
6. A nurse is teaching a patient about warfarin. Which statement
indicates understanding?
A. "I will use a soft toothbrush and an electric razor."
B. "I will increase leafy greens in my diet."
C. "I will take aspirin for headaches."
D. "I will stop the medication if I bruise."
🟢 A. "I will use a soft toothbrush and an electric razor."
🔴 RATIONALE: Warfarin increases bleeding risk. Using a soft
toothbrush and electric razor reduces trauma-related bleeding.
Leafy greens and aspirin interact with warfarin.
