, Table of Contents: Medical-Surgical Nursing
Unit / Chapter Topic Subtopics
Unit I:
Essential Quality & Safety Education for Nurses (QSEN),
Concepts of 1. Overview of Professional Patient-Centered Care, Safety, Teamwork, EBP,
Medical- Nursing Concepts QI, Informatics, Clinical Judgment, Health
Surgical Equity, Ethics
Nursing
2. Clinical Judgment and Critical Thinking, Clinical Reasoning,
Systems Thinking Interprofessional Team, Systems Thinking
Acid-Base, Cellular Regulation, Cognition,
Clotting, Comfort, Elimination, F&E Balance,
3. Overview of Health Gas Exchange, Glucose Regulation, Immunity,
Concepts Infection, Inflammation, Mobility, Nutrition,
Pain, Perfusion, Sensory Perception, Sexuality,
Tissue Integrity
4. Care for Older Adults Community & Hospital Health Issues
5. Care for
Transgender/Nonbinary Terminology, Health Needs
Patients
6. Pain Assessment &
Pain Concepts Overview
Management
7. Rehabilitation Concepts Chronic & Disabling Conditions
8. End-of-Life Care Death & Dying, Ethics, Comfort
9. Perioperative Patient
Pre-op, Intra-op, Post-op
Care
| Unit II: Emergency & Disaster Preparedness | 10. Emergency and Trauma Nursing | ED
Environment, Safety, Emergency Principles |
| | 11. Environmental Emergencies | Heat/Cold Injuries, Bites, Lightning, Altitude, Drowning |
| | 12. Disaster Preparedness | Disaster Types, Nursing Role, Psychosocial Impact |
| Unit III: Fluid, Electrolyte, & Acid-Base Balance | 13. Fluid & Electrolyte Balance |
Dehydration, Fluid Overload, Electrolyte Imbalances |
| | 14. Acid-Base Balance | pH Regulation, Acidosis, Alkalosis |
| | 15. Infusion Therapy | IV Types, Complications, Older Adults |
| Unit IV: Immunity Conditions | 16. Inflammation & Immunity Concepts | Innate &
Adaptive Immunity |
| | 17. Allergy and Immune Disorders | Hypersensitivity, Anaphylaxis, Autoimmunity, HIV,
SLE, Lyme, Transplants |
,| | 18. Cancer Care | Patho, Management, Side Effects, Emergencies, Survivorship |
| | 19. Infection Care | Resistance, Exposure, Collaboration, Bioterrorism |
| Unit V: Integumentary Conditions | 20. Skin, Hair, and Nails Assessment | Anatomy,
Physical Cues |
| | 21. Skin Disorders | Pressure Injuries, Infections, Burns, Skin Cancers, Psoriasis |
| Unit VI: Respiratory Conditions | 22. Respiratory System Assessment | A&P, Health
Promotion, Oxygen Therapy |
| | 23. Upper Respiratory Conditions | Obstructive Sleep Apnea, Trauma, Cancer |
| | 24. Lower Respiratory Conditions | Asthma, COPD, CF, PAH, Lung Cancer |
| | 25. Infectious Respiratory Conditions | Influenza, COVID-19, TB, Pneumonia |
| | 26. Respiratory Emergencies | PE, ARDS, Intubation, Chest Trauma |
| Unit VII: Cardiovascular Conditions | 27. Cardiovascular Assessment | Anatomy, Physical
Exam |
| | 28. Dysrhythmias | ECG, Atrial/Ventricular Dysrhythmias |
| | 29. Cardiac Conditions | Heart Failure, Endocarditis, Pericarditis |
| | 30. Vascular Conditions | Hypertension, Aneurysms, PAD, DVT |
| | 31. Shock Management | Hypovolemic Shock, Sepsis |
| | 32. Acute Coronary Syndromes | Angina, Myocardial Infarction |
| Unit VIII: Hematologic Conditions | 33. Hematologic Assessment | Anatomy, Cues |
| | 34. Blood Disorders | Anemia, Sickle Cell, Leukemia, Lymphomas, Transfusions |
| Unit IX: Nervous System Conditions | 35. Nervous System Assessment | Anatomy,
Neurological Exam |
| | 36. Brain Conditions | Alzheimer’s, Parkinson’s, Seizures, Meningitis |
| | 37. Spinal Cord Conditions | MS, SCI, Back & Neck Pain |
| | 38. Neurologic Emergencies | Stroke, TBI, Brain Tumors |
| Unit X: Sensory System Conditions | 39. Eye and Vision Care | Cataracts, Glaucoma,
Corneal/Retinal Disorders |
| | 40. Ear and Hearing Care | Hearing Loss, Otitis, Tinnitus, Vertigo |
| Unit XI: Musculoskeletal Conditions | 41. Musculoskeletal Assessment | Anatomy, Cues |
| | 42. Bone and Joint Disorders | Osteoporosis, Bone Tumors, Hand/Foot Disorders |
| | 43. Arthritis and Arthroplasty | OA, RA, Gout |
| | 44. Musculoskeletal Trauma | Fractures, Amputations, Injuries |
| Unit XII: Gastrointestinal Conditions | 45. GI System Assessment | Anatomy, Cues |
| | 46. Oral & Esophageal Disorders | Cancer, Sialadenitis, GERD |
| | 47. Stomach Disorders | Gastritis, PUD, Cancer |
| | 48. Noninflammatory Intestinal Disorders | Obstruction, IBS, Hernias |
| | 49. Inflammatory Intestinal Disorders | Peritonitis, UC, Crohn’s, Diverticulitis |
| | 50. Liver Disorders | Cirrhosis, Hepatitis, Transplant |
,| | 51. Biliary & Pancreatic Disorders | Cholecystitis, Pancreatitis, Cancer |
| | 52. Malnutrition | Undernutrition, Obesity |
| Unit XIII: Endocrine Conditions | 53. Endocrine Assessment | Anatomy, Cues |
| | 54. Pituitary & Adrenal Disorders | Cushing's, SIADH, Diabetes Insipidus |
| | 55. Thyroid & Parathyroid Disorders | Hypo-/Hyperthyroidism, Thyroid Cancer |
| | 56. Diabetes Mellitus | Type 1 & 2, Complications |
| Unit XIV: Renal and Urinary Conditions | 57. Renal/Urinary Assessment | A&P,
Assessment |
| | 58. Urinary Disorders | Incontinence, UTI, Stones, Cancer |
| | 59. Kidney Disorders | Pyelonephritis, CKD, Trauma |
| | 60. Kidney Injury & Failure | AKI, CKD |
| Unit XV: Reproductive Conditions | 61. Reproductive Assessment | A&P, Sexual Health |
| | 62. Breast Conditions | Benign & Malignant Disorders |
| | 63. Female Reproductive Disorders | Fibroids, Cancers, Vaginitis |
| | 64. Male Reproductive Disorders | BPH, Prostate Cancer, ED |
| | 65. Sexually Transmitted Infections | Herpes, HPV, Chlamydia, Gonorrhea, PID |
,CHAPTER 1
Question 1:
A nurse is planning care for a newly admitted patient with
multiple chronic conditions. To demonstrate the QSEN
competency of patient-centered care, which action should the
nurse prioritize?
A. Administer medications on schedule regardless of patient
preferences
B. Teach the patient health-literacy–level discharge instructions
without family involvement
C. Elicit the patient’s personal goals and incorporate them into
the plan of care
D. Focus on correcting the patient’s lifestyle choices to
evidence-based standards
Correct Answer: C
Rationale: Eliciting and integrating the patient’s own goals
exemplifies patient-centered care. Options A and B ignore
patient preferences and family support, and D imposes
standards without collaboration.
Question 2:
A hospitalized postoperative patient’s blood pressure suddenly
drops. Applying the clinical judgment model, what should the
nurse do first?
A. Notify the surgeon for orders
B. Assess the patient’s level of consciousness and peripheral
pulses
,C. Prepare to administer a vasopressor as ordered PRN
D. Document the vital signs in the electronic record
Correct Answer: B
Rationale: Gathering data (assessment) is the first step in
clinical judgment before interpreting data, making decisions,
and acting. Notifying or treating pre-assessment may lead to
inappropriate interventions.
Question 3:
During a team handoff, a nurse observes that critical lab values
were not communicated. This breach most directly
compromises which QSEN safety competency?
A. Evidence-Based Practice
B. Informatics
C. Quality Improvement
D. Safety
Correct Answer: D
Rationale: Failing to communicate critical data threatens
patient safety. Informatics (B) supports documentation but the
primary issue is safety. EBP and QI are not directly breached
here.
Question 4:
Which example best demonstrates the informatics
competency?
A. Using a standardized fall-risk scale
,B. Consulting the hospital’s online policy database before a new
procedure
C. Engaging a patient in shared decision-making about pain
management
D. Participating in root cause analysis after a medication error
Correct Answer: B
Rationale: Accessing evidence-based policies through
electronic databases exemplifies informatics. A is quality
improvement tool, C is patient-centered care, D is QI process.
Question 5:
A nurse uses PICO to frame a clinical question about pressure
ulcer prevention. Which element represents “O” in PICO?
A. “Does repositioning every 2 hours …?”
B. “… adult ICU patients …”
C. “… compare foam vs. gel mattresses …”
D. “… reduction in incidence of pressure ulcers?”
Correct Answer: D
Rationale: “O” stands for outcome—in this case, reduction in
pressure ulcer incidence. A is the intervention, B the
population, C the comparison.
Question 6:
To meet the QSEN competency of quality improvement, a nurse
identifies delays in pain assessment. Which is the best QI
strategy?
,A. Educate staff on pain scales once annually
B. Implement hourly rounding that includes pain assessment
C. Document pain scores only when the patient complains
D. Compare each nurse’s pain-assessment frequency privately
Correct Answer: B
Rationale: System redesign—hourly rounding with pain
checks—targets process improvement. Annual education alone
(A) is insufficient; C perpetuates delays; D may foster blame
rather than system change.
Question 7:
A patient with limited English proficiency expresses confusion
about discharge teaching. To uphold health equity, what should
the nurse do?
A. Continue teaching using family members as interpreters
B. Use a professional medical interpreter via phone or video
C. Provide written materials in English and hope for the best
D. Simplify English explanations further and proceed
Correct Answer: B
Rationale: Health equity requires access to culturally and
linguistically appropriate services. Professional interpreters
ensure accurate understanding; family members can introduce
errors.
Question 8:
During medication administration, a nurse double-checks
,insulin dose calculations with another nurse. This action aligns
best with which QSEN competency?
A. Teamwork and Collaboration
B. Evidence-Based Practice
C. Informatics
D. Ethics
Correct Answer: A
Rationale: Collaborating to verify high-risk medication dosing is
teamwork. EBP refers to using research evidence; informatics
to technology; ethics to moral principles.
Question 9:
A nurse leader observes recurring catheter-associated urinary
tract infections and uses Plan-Do-Study-Act (PDSA). Which step
corresponds to “Study”?
A. Implementing a new catheter-care protocol
B. Monitoring infection rates after protocol implementation
C. Identifying best-practice recommendations for catheter care
D. Revising the protocol based on outcome data
Correct Answer: B
Rationale: “Study” involves assessing data
post-implementation. A is “Do”; C is part of “Plan”; D is “Act.”
Question 10:
A patient refuses an evidence-based intervention. The nurse
respects this decision and documents it. Which ethical principle
, is primarily demonstrated?
A. Beneficence
B. Justice
C. Autonomy
D. Nonmaleficence
Correct Answer: C
Rationale: Respecting patient’s right to make their own
decisions is autonomy. Beneficence is doing good,
nonmaleficence avoiding harm, justice fairness in distribution.
Question 11:
A nurse notices that a colleague is fatigued and made a
documentation error. Which action reflects the ANA Code of
Ethics?
A. Report the colleague’s error to the manager anonymously
B. Offer to assist the colleague in correcting the chart in real
time
C. Ignore the error to preserve workplace harmony
D. Reprimand the colleague for unprofessional behavior
Correct Answer: B
Rationale: The Code supports collegiality and constructive
assistance to ensure safe care. Anonymous reporting delays
correction; ignoring is unethical; reprimand may not address
patient safety immediately.
Unit / Chapter Topic Subtopics
Unit I:
Essential Quality & Safety Education for Nurses (QSEN),
Concepts of 1. Overview of Professional Patient-Centered Care, Safety, Teamwork, EBP,
Medical- Nursing Concepts QI, Informatics, Clinical Judgment, Health
Surgical Equity, Ethics
Nursing
2. Clinical Judgment and Critical Thinking, Clinical Reasoning,
Systems Thinking Interprofessional Team, Systems Thinking
Acid-Base, Cellular Regulation, Cognition,
Clotting, Comfort, Elimination, F&E Balance,
3. Overview of Health Gas Exchange, Glucose Regulation, Immunity,
Concepts Infection, Inflammation, Mobility, Nutrition,
Pain, Perfusion, Sensory Perception, Sexuality,
Tissue Integrity
4. Care for Older Adults Community & Hospital Health Issues
5. Care for
Transgender/Nonbinary Terminology, Health Needs
Patients
6. Pain Assessment &
Pain Concepts Overview
Management
7. Rehabilitation Concepts Chronic & Disabling Conditions
8. End-of-Life Care Death & Dying, Ethics, Comfort
9. Perioperative Patient
Pre-op, Intra-op, Post-op
Care
| Unit II: Emergency & Disaster Preparedness | 10. Emergency and Trauma Nursing | ED
Environment, Safety, Emergency Principles |
| | 11. Environmental Emergencies | Heat/Cold Injuries, Bites, Lightning, Altitude, Drowning |
| | 12. Disaster Preparedness | Disaster Types, Nursing Role, Psychosocial Impact |
| Unit III: Fluid, Electrolyte, & Acid-Base Balance | 13. Fluid & Electrolyte Balance |
Dehydration, Fluid Overload, Electrolyte Imbalances |
| | 14. Acid-Base Balance | pH Regulation, Acidosis, Alkalosis |
| | 15. Infusion Therapy | IV Types, Complications, Older Adults |
| Unit IV: Immunity Conditions | 16. Inflammation & Immunity Concepts | Innate &
Adaptive Immunity |
| | 17. Allergy and Immune Disorders | Hypersensitivity, Anaphylaxis, Autoimmunity, HIV,
SLE, Lyme, Transplants |
,| | 18. Cancer Care | Patho, Management, Side Effects, Emergencies, Survivorship |
| | 19. Infection Care | Resistance, Exposure, Collaboration, Bioterrorism |
| Unit V: Integumentary Conditions | 20. Skin, Hair, and Nails Assessment | Anatomy,
Physical Cues |
| | 21. Skin Disorders | Pressure Injuries, Infections, Burns, Skin Cancers, Psoriasis |
| Unit VI: Respiratory Conditions | 22. Respiratory System Assessment | A&P, Health
Promotion, Oxygen Therapy |
| | 23. Upper Respiratory Conditions | Obstructive Sleep Apnea, Trauma, Cancer |
| | 24. Lower Respiratory Conditions | Asthma, COPD, CF, PAH, Lung Cancer |
| | 25. Infectious Respiratory Conditions | Influenza, COVID-19, TB, Pneumonia |
| | 26. Respiratory Emergencies | PE, ARDS, Intubation, Chest Trauma |
| Unit VII: Cardiovascular Conditions | 27. Cardiovascular Assessment | Anatomy, Physical
Exam |
| | 28. Dysrhythmias | ECG, Atrial/Ventricular Dysrhythmias |
| | 29. Cardiac Conditions | Heart Failure, Endocarditis, Pericarditis |
| | 30. Vascular Conditions | Hypertension, Aneurysms, PAD, DVT |
| | 31. Shock Management | Hypovolemic Shock, Sepsis |
| | 32. Acute Coronary Syndromes | Angina, Myocardial Infarction |
| Unit VIII: Hematologic Conditions | 33. Hematologic Assessment | Anatomy, Cues |
| | 34. Blood Disorders | Anemia, Sickle Cell, Leukemia, Lymphomas, Transfusions |
| Unit IX: Nervous System Conditions | 35. Nervous System Assessment | Anatomy,
Neurological Exam |
| | 36. Brain Conditions | Alzheimer’s, Parkinson’s, Seizures, Meningitis |
| | 37. Spinal Cord Conditions | MS, SCI, Back & Neck Pain |
| | 38. Neurologic Emergencies | Stroke, TBI, Brain Tumors |
| Unit X: Sensory System Conditions | 39. Eye and Vision Care | Cataracts, Glaucoma,
Corneal/Retinal Disorders |
| | 40. Ear and Hearing Care | Hearing Loss, Otitis, Tinnitus, Vertigo |
| Unit XI: Musculoskeletal Conditions | 41. Musculoskeletal Assessment | Anatomy, Cues |
| | 42. Bone and Joint Disorders | Osteoporosis, Bone Tumors, Hand/Foot Disorders |
| | 43. Arthritis and Arthroplasty | OA, RA, Gout |
| | 44. Musculoskeletal Trauma | Fractures, Amputations, Injuries |
| Unit XII: Gastrointestinal Conditions | 45. GI System Assessment | Anatomy, Cues |
| | 46. Oral & Esophageal Disorders | Cancer, Sialadenitis, GERD |
| | 47. Stomach Disorders | Gastritis, PUD, Cancer |
| | 48. Noninflammatory Intestinal Disorders | Obstruction, IBS, Hernias |
| | 49. Inflammatory Intestinal Disorders | Peritonitis, UC, Crohn’s, Diverticulitis |
| | 50. Liver Disorders | Cirrhosis, Hepatitis, Transplant |
,| | 51. Biliary & Pancreatic Disorders | Cholecystitis, Pancreatitis, Cancer |
| | 52. Malnutrition | Undernutrition, Obesity |
| Unit XIII: Endocrine Conditions | 53. Endocrine Assessment | Anatomy, Cues |
| | 54. Pituitary & Adrenal Disorders | Cushing's, SIADH, Diabetes Insipidus |
| | 55. Thyroid & Parathyroid Disorders | Hypo-/Hyperthyroidism, Thyroid Cancer |
| | 56. Diabetes Mellitus | Type 1 & 2, Complications |
| Unit XIV: Renal and Urinary Conditions | 57. Renal/Urinary Assessment | A&P,
Assessment |
| | 58. Urinary Disorders | Incontinence, UTI, Stones, Cancer |
| | 59. Kidney Disorders | Pyelonephritis, CKD, Trauma |
| | 60. Kidney Injury & Failure | AKI, CKD |
| Unit XV: Reproductive Conditions | 61. Reproductive Assessment | A&P, Sexual Health |
| | 62. Breast Conditions | Benign & Malignant Disorders |
| | 63. Female Reproductive Disorders | Fibroids, Cancers, Vaginitis |
| | 64. Male Reproductive Disorders | BPH, Prostate Cancer, ED |
| | 65. Sexually Transmitted Infections | Herpes, HPV, Chlamydia, Gonorrhea, PID |
,CHAPTER 1
Question 1:
A nurse is planning care for a newly admitted patient with
multiple chronic conditions. To demonstrate the QSEN
competency of patient-centered care, which action should the
nurse prioritize?
A. Administer medications on schedule regardless of patient
preferences
B. Teach the patient health-literacy–level discharge instructions
without family involvement
C. Elicit the patient’s personal goals and incorporate them into
the plan of care
D. Focus on correcting the patient’s lifestyle choices to
evidence-based standards
Correct Answer: C
Rationale: Eliciting and integrating the patient’s own goals
exemplifies patient-centered care. Options A and B ignore
patient preferences and family support, and D imposes
standards without collaboration.
Question 2:
A hospitalized postoperative patient’s blood pressure suddenly
drops. Applying the clinical judgment model, what should the
nurse do first?
A. Notify the surgeon for orders
B. Assess the patient’s level of consciousness and peripheral
pulses
,C. Prepare to administer a vasopressor as ordered PRN
D. Document the vital signs in the electronic record
Correct Answer: B
Rationale: Gathering data (assessment) is the first step in
clinical judgment before interpreting data, making decisions,
and acting. Notifying or treating pre-assessment may lead to
inappropriate interventions.
Question 3:
During a team handoff, a nurse observes that critical lab values
were not communicated. This breach most directly
compromises which QSEN safety competency?
A. Evidence-Based Practice
B. Informatics
C. Quality Improvement
D. Safety
Correct Answer: D
Rationale: Failing to communicate critical data threatens
patient safety. Informatics (B) supports documentation but the
primary issue is safety. EBP and QI are not directly breached
here.
Question 4:
Which example best demonstrates the informatics
competency?
A. Using a standardized fall-risk scale
,B. Consulting the hospital’s online policy database before a new
procedure
C. Engaging a patient in shared decision-making about pain
management
D. Participating in root cause analysis after a medication error
Correct Answer: B
Rationale: Accessing evidence-based policies through
electronic databases exemplifies informatics. A is quality
improvement tool, C is patient-centered care, D is QI process.
Question 5:
A nurse uses PICO to frame a clinical question about pressure
ulcer prevention. Which element represents “O” in PICO?
A. “Does repositioning every 2 hours …?”
B. “… adult ICU patients …”
C. “… compare foam vs. gel mattresses …”
D. “… reduction in incidence of pressure ulcers?”
Correct Answer: D
Rationale: “O” stands for outcome—in this case, reduction in
pressure ulcer incidence. A is the intervention, B the
population, C the comparison.
Question 6:
To meet the QSEN competency of quality improvement, a nurse
identifies delays in pain assessment. Which is the best QI
strategy?
,A. Educate staff on pain scales once annually
B. Implement hourly rounding that includes pain assessment
C. Document pain scores only when the patient complains
D. Compare each nurse’s pain-assessment frequency privately
Correct Answer: B
Rationale: System redesign—hourly rounding with pain
checks—targets process improvement. Annual education alone
(A) is insufficient; C perpetuates delays; D may foster blame
rather than system change.
Question 7:
A patient with limited English proficiency expresses confusion
about discharge teaching. To uphold health equity, what should
the nurse do?
A. Continue teaching using family members as interpreters
B. Use a professional medical interpreter via phone or video
C. Provide written materials in English and hope for the best
D. Simplify English explanations further and proceed
Correct Answer: B
Rationale: Health equity requires access to culturally and
linguistically appropriate services. Professional interpreters
ensure accurate understanding; family members can introduce
errors.
Question 8:
During medication administration, a nurse double-checks
,insulin dose calculations with another nurse. This action aligns
best with which QSEN competency?
A. Teamwork and Collaboration
B. Evidence-Based Practice
C. Informatics
D. Ethics
Correct Answer: A
Rationale: Collaborating to verify high-risk medication dosing is
teamwork. EBP refers to using research evidence; informatics
to technology; ethics to moral principles.
Question 9:
A nurse leader observes recurring catheter-associated urinary
tract infections and uses Plan-Do-Study-Act (PDSA). Which step
corresponds to “Study”?
A. Implementing a new catheter-care protocol
B. Monitoring infection rates after protocol implementation
C. Identifying best-practice recommendations for catheter care
D. Revising the protocol based on outcome data
Correct Answer: B
Rationale: “Study” involves assessing data
post-implementation. A is “Do”; C is part of “Plan”; D is “Act.”
Question 10:
A patient refuses an evidence-based intervention. The nurse
respects this decision and documents it. Which ethical principle
, is primarily demonstrated?
A. Beneficence
B. Justice
C. Autonomy
D. Nonmaleficence
Correct Answer: C
Rationale: Respecting patient’s right to make their own
decisions is autonomy. Beneficence is doing good,
nonmaleficence avoiding harm, justice fairness in distribution.
Question 11:
A nurse notices that a colleague is fatigued and made a
documentation error. Which action reflects the ANA Code of
Ethics?
A. Report the colleague’s error to the manager anonymously
B. Offer to assist the colleague in correcting the chart in real
time
C. Ignore the error to preserve workplace harmony
D. Reprimand the colleague for unprofessional behavior
Correct Answer: B
Rationale: The Code supports collegiality and constructive
assistance to ensure safe care. Anonymous reporting delays
correction; ignoring is unethical; reprimand may not address
patient safety immediately.
