ESTUDYR
MED SURG 2 FINAL UPDATED EXAM WITH MOST TESTED QUESTIONS
AND ANSWERS | GRADED A+ | ASSURED SUCCESS WITH DETAILED
RATIONALES
⃣ A patient admitted for shortness of breath is hooked to the cardiac monitor, showing new-onset
atrial fibrillation with rapid ventricular response. Which treatment is most appropriate?
A) Administer adenosine
B) Administer a thiazide diuretic
C) Administer an oral anticoagulant
D) Administer a beta blocker
Rationale: In new-onset AFib, anticoagulation reduces stroke risk; rate control follows once stabilized.
⃣ An AMI patient ambulated in the hallways. Which response indicates the exercise level should be
decreased?
A) O₂ saturation 100% → 98%
B) BP 118/60 → 126/26
C) RR 14 → 20
D) HR 66 → 0
Rationale: A >30-bpm increase in HR suggests overexertion; guidelines recommend limiting heart rate
rise.
⃣ A 70-year-old with suspected hearing loss nods through discharge teaching. To verify
understanding, the nurse should:
A) Ask the patient to repeat back instructions
B) Ask if he understood and have him sign
C) Have another nurse witness teaching
D) Call his wife to explain
Rationale: “Teach-back” confirms patient comprehension directly.
⃣ After an SIADH hospitalization, a client develops pontine myelinolysis and is confused. First
nursing intervention:
,ESTUDYR
A) Reorient the client to his room
B) Patch one eye
C) Evaluate swallowing
D) Perform ROM exercises
Rationale: Acute confusion from osmotic demyelination requires orientation and safety measures.
⃣ A nurse makes a serious medication error and reports it. To foster critical thinking, the manager
should:
A) Pair the nurse with experienced staff
B) Have the nurse present an in-service on the error’s cause
C) Send the nurse to a refresher course
D) Assign the nurse to write a paper on error avoidance
Rationale: Teaching peers promotes reflection, analysis, and shared solutions.
6 ⃣ An attorney with newly diagnosed CHF stays busy on calls in his hospital room. His stress pattern is
best described as:
A) Acute stress
B) Episodic stress
C) Chronic stress
D) Normal stress
Rationale: Episodic stress is recurring periods of high anxiety/tension in response to demands.
⃣ Which conditions put a patient at risk for ARDS? (Select all that apply)
A) Drug reaction
B) Head injury
C) Pancreatitis
D) Sepsis
E) High altitude
Rationale: ARDS is triggered by systemic inflammation from these insults; high altitude is not a risk.
⃣ On a cardiac monitor, peaked T waves suggest which lab finding?
,ESTUDYR
A) Hypercalcemia
B) Hyperkalemia
C) Hypokalemia
D) Hypocalcemia
Rationale: Tall, peaked T waves are classic in hyperkalemia.
⃣ A patient newly diagnosed with MI asks about support groups and info. This is what coping
strategy?
A) Problem-focused
B) Meaning-focused
C) Emotion-focused
D) Maladaptive
Rationale: Seeking information and solutions is a problem-focused strategy.
�A patient on digoxin reports nausea, vomiting, headaches; HR 58 bpm. What should the nurse do?
A) Hold the dose and notify the provider of possible toxicity
B) Request orders for antiemetic and analgesic
C) Reassure patient these are common, self-limiting
D) Administer the next dose as ordered
Rationale: GI symptoms plus bradycardia suggest digoxin toxicity; hold and report.
⃣ ⃣ To prepare for possible smallpox bioterrorism, the ED nurse-manager must stockpile:
A) Vaccine
B) Antibiotics
C) Blood products
D) Atropine
Rationale: Smallpox prevention relies on vaccination.
⃣ ⃣ Which finding is indicative of hypovolemia?
A) Fluid in intracellular space
B) Elevated systolic BP
, ESTUDYR
C) Elevated MAP
D) Fluid moving into extravascular space
Rationale: In hypovolemia, fluid shifts out of the vascular compartment into interstitial (extravascular)
spaces.
⃣ ⃣ For a burn patient (63% TBSA), wound-care interventions should include: (Select all)
A) Wear gown, mask, gloves, eye protection
B) Use sterile technique when applying dressings
C) Use scrub brush to debride wounds
D) Provide pain meds 2 hours before dressings
E) Provide pain meds 30 minutes before dressing changes
Rationale: Full PPE and sterile technique prevent infection; analgesia 30 min prior is optimal.
⃣ ⃣ Contraindications to stroke thrombolytic therapy include: (Select all)
A) Sudden symptom onset
B) INR > 1.0
C) Recent intracranial pathology
D) Current anticoagulation therapy
E) Symptom onset > hours ago
Rationale: These increase bleeding risk or fall outside the treatment window.
⃣ ⃣ A chest pain patient arrives in the ED. Which diagnostic test should be done first?
A) ECG
B) CXR
C) Troponin level
D) CT scan
Rationale: ECG must be obtained within 10 minutes to diagnose acute MI.
⃣ ⃣ A trauma patient with suspected internal bleeding shows early hypovolemic shock. Expected
6
initial finding:
MED SURG 2 FINAL UPDATED EXAM WITH MOST TESTED QUESTIONS
AND ANSWERS | GRADED A+ | ASSURED SUCCESS WITH DETAILED
RATIONALES
⃣ A patient admitted for shortness of breath is hooked to the cardiac monitor, showing new-onset
atrial fibrillation with rapid ventricular response. Which treatment is most appropriate?
A) Administer adenosine
B) Administer a thiazide diuretic
C) Administer an oral anticoagulant
D) Administer a beta blocker
Rationale: In new-onset AFib, anticoagulation reduces stroke risk; rate control follows once stabilized.
⃣ An AMI patient ambulated in the hallways. Which response indicates the exercise level should be
decreased?
A) O₂ saturation 100% → 98%
B) BP 118/60 → 126/26
C) RR 14 → 20
D) HR 66 → 0
Rationale: A >30-bpm increase in HR suggests overexertion; guidelines recommend limiting heart rate
rise.
⃣ A 70-year-old with suspected hearing loss nods through discharge teaching. To verify
understanding, the nurse should:
A) Ask the patient to repeat back instructions
B) Ask if he understood and have him sign
C) Have another nurse witness teaching
D) Call his wife to explain
Rationale: “Teach-back” confirms patient comprehension directly.
⃣ After an SIADH hospitalization, a client develops pontine myelinolysis and is confused. First
nursing intervention:
,ESTUDYR
A) Reorient the client to his room
B) Patch one eye
C) Evaluate swallowing
D) Perform ROM exercises
Rationale: Acute confusion from osmotic demyelination requires orientation and safety measures.
⃣ A nurse makes a serious medication error and reports it. To foster critical thinking, the manager
should:
A) Pair the nurse with experienced staff
B) Have the nurse present an in-service on the error’s cause
C) Send the nurse to a refresher course
D) Assign the nurse to write a paper on error avoidance
Rationale: Teaching peers promotes reflection, analysis, and shared solutions.
6 ⃣ An attorney with newly diagnosed CHF stays busy on calls in his hospital room. His stress pattern is
best described as:
A) Acute stress
B) Episodic stress
C) Chronic stress
D) Normal stress
Rationale: Episodic stress is recurring periods of high anxiety/tension in response to demands.
⃣ Which conditions put a patient at risk for ARDS? (Select all that apply)
A) Drug reaction
B) Head injury
C) Pancreatitis
D) Sepsis
E) High altitude
Rationale: ARDS is triggered by systemic inflammation from these insults; high altitude is not a risk.
⃣ On a cardiac monitor, peaked T waves suggest which lab finding?
,ESTUDYR
A) Hypercalcemia
B) Hyperkalemia
C) Hypokalemia
D) Hypocalcemia
Rationale: Tall, peaked T waves are classic in hyperkalemia.
⃣ A patient newly diagnosed with MI asks about support groups and info. This is what coping
strategy?
A) Problem-focused
B) Meaning-focused
C) Emotion-focused
D) Maladaptive
Rationale: Seeking information and solutions is a problem-focused strategy.
�A patient on digoxin reports nausea, vomiting, headaches; HR 58 bpm. What should the nurse do?
A) Hold the dose and notify the provider of possible toxicity
B) Request orders for antiemetic and analgesic
C) Reassure patient these are common, self-limiting
D) Administer the next dose as ordered
Rationale: GI symptoms plus bradycardia suggest digoxin toxicity; hold and report.
⃣ ⃣ To prepare for possible smallpox bioterrorism, the ED nurse-manager must stockpile:
A) Vaccine
B) Antibiotics
C) Blood products
D) Atropine
Rationale: Smallpox prevention relies on vaccination.
⃣ ⃣ Which finding is indicative of hypovolemia?
A) Fluid in intracellular space
B) Elevated systolic BP
, ESTUDYR
C) Elevated MAP
D) Fluid moving into extravascular space
Rationale: In hypovolemia, fluid shifts out of the vascular compartment into interstitial (extravascular)
spaces.
⃣ ⃣ For a burn patient (63% TBSA), wound-care interventions should include: (Select all)
A) Wear gown, mask, gloves, eye protection
B) Use sterile technique when applying dressings
C) Use scrub brush to debride wounds
D) Provide pain meds 2 hours before dressings
E) Provide pain meds 30 minutes before dressing changes
Rationale: Full PPE and sterile technique prevent infection; analgesia 30 min prior is optimal.
⃣ ⃣ Contraindications to stroke thrombolytic therapy include: (Select all)
A) Sudden symptom onset
B) INR > 1.0
C) Recent intracranial pathology
D) Current anticoagulation therapy
E) Symptom onset > hours ago
Rationale: These increase bleeding risk or fall outside the treatment window.
⃣ ⃣ A chest pain patient arrives in the ED. Which diagnostic test should be done first?
A) ECG
B) CXR
C) Troponin level
D) CT scan
Rationale: ECG must be obtained within 10 minutes to diagnose acute MI.
⃣ ⃣ A trauma patient with suspected internal bleeding shows early hypovolemic shock. Expected
6
initial finding:
