“NURS 66 01N-48 Comprehensive Nursing Master Exam:
100 Mixed-Rotation Questions with answers &
Rationales”
MEDICAL–SURGICAL NURSING (1–25)
1. A client with chronic heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Total bilirubin
B. Potassium
C. Hemoglobin
D. Magnesium
- answer ;- : B
Rationale: Loop diuretics cause potassium loss leading to hypokalemia; monitor K⁺ closely.
2. A patient with COPD has an elevated PaCO₂ and decreased pH. Which acid–base disturbance
is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
- answer ;- : C
Rationale: Elevated PaCO₂ with decreased pH indicates respiratory acidosis from
hypoventilation/CO₂ retention.
3. A post-op client suddenly develops sharp chest pain and dyspnea. What is the nurse’s first
action?
A. Administer morphine
B. Assess vital signs and oxygen saturation
C. Elevate the head of bed and call family
D. Obtain an ECG after notifying the physician
- answer ;- : B
,Rationale: Immediate assessment (vitals, SpO₂) is priority to identify life-threatening causes
(e.g., PE, MI).
4. Which diet is recommended for a client with hypertension?
A. High sodium, low potassium
B. DASH diet (low sodium, high fruits/vegetables)
C. High saturated fat, low fiber
D. High carbohydrate, low protein
- answer ;- : B
Rationale: DASH reduces BP by lowering sodium and increasing potassium, fiber, and
magnesium.
5. A client taking digoxin reports blurred yellow vision and nausea. What should the nurse
suspect?
A. Hypothyroidism
B. Digoxin toxicity
C. Hyperkalemia
D. Early heart failure
- answer ;- : B
Rationale: Visual disturbances and GI symptoms are classic signs of digoxin toxicity.
6. A client with acute pancreatitis should be placed on which initial diet?
A. High-fiber solids
B. NPO with IV fluids and pain control
C. High-fat clear liquids
D. Regular oral diet with pancreatic enzymes
- answer ;- : B
Rationale: Bowel rest (NPO), fluids, and pain control reduce pancreatic stimulation.
7. Which finding indicates worsening renal function in a client with acute tubular necrosis?
A. Increased urine output
B. Decreased BUN and creatinine
C. Hyperkalemia
D. Metabolic alkalosis
- answer ;- : C
Rationale: Decreased renal excretion causes hyperkalemia; rising BUN/creatinine also occur.
8. A client with deep vein thrombosis is started on heparin infusion. Which lab test does the
nurse monitor?
A. INR
, B. aPTT
C. Platelet count only
D. Serum fibrinogen
- answer ;- : B
Rationale: aPTT monitors heparin therapeutic effect; platelets monitored for HIT risk.
9. A patient with peptic ulcer disease is prescribed omeprazole. Primary purpose of this
medication is to:
A. Neutralize existing acid in stomach
B. Increase gastric motility
C. Decrease gastric acid secretion by inhibiting proton pump
D. Coat the ulcer base for protection
- answer ;- : C
Rationale: Proton pump inhibitors reduce acid secretion by blocking H⁺/K⁺-ATPase.
10. Which sign suggests hypovolemia in a postoperative client?
A. Bounding pulses
B. Increased urine output
C. Decreased blood pressure and tachycardia
D. Warm, flushed skin
- answer ;- : C
Rationale: Hypovolemia causes hypotension and compensatory tachycardia.
11. A client on warfarin therapy has an INR of 5.2 and minor bleeding. What is the nurse’s
priority?
A. Administer vitamin K as ordered and hold warfarin
B. Continue warfarin and recheck INR in one week
C. Give aspirin for clot prevention
D. Increase dietary vitamin K intake immediately
- answer ;- : A
Rationale: High INR with bleeding warrants holding warfarin and administering vitamin K per
protocol.
12. A client with COPD uses pursed-lip breathing to:
A. Increase inspiratory volume
B. Reduce oxygen saturation
C. Decrease air trapping and improve expiration
D. Encourage deeper inhalation quickly
- answer ;- : C
100 Mixed-Rotation Questions with answers &
Rationales”
MEDICAL–SURGICAL NURSING (1–25)
1. A client with chronic heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Total bilirubin
B. Potassium
C. Hemoglobin
D. Magnesium
- answer ;- : B
Rationale: Loop diuretics cause potassium loss leading to hypokalemia; monitor K⁺ closely.
2. A patient with COPD has an elevated PaCO₂ and decreased pH. Which acid–base disturbance
is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic alkalosis
- answer ;- : C
Rationale: Elevated PaCO₂ with decreased pH indicates respiratory acidosis from
hypoventilation/CO₂ retention.
3. A post-op client suddenly develops sharp chest pain and dyspnea. What is the nurse’s first
action?
A. Administer morphine
B. Assess vital signs and oxygen saturation
C. Elevate the head of bed and call family
D. Obtain an ECG after notifying the physician
- answer ;- : B
,Rationale: Immediate assessment (vitals, SpO₂) is priority to identify life-threatening causes
(e.g., PE, MI).
4. Which diet is recommended for a client with hypertension?
A. High sodium, low potassium
B. DASH diet (low sodium, high fruits/vegetables)
C. High saturated fat, low fiber
D. High carbohydrate, low protein
- answer ;- : B
Rationale: DASH reduces BP by lowering sodium and increasing potassium, fiber, and
magnesium.
5. A client taking digoxin reports blurred yellow vision and nausea. What should the nurse
suspect?
A. Hypothyroidism
B. Digoxin toxicity
C. Hyperkalemia
D. Early heart failure
- answer ;- : B
Rationale: Visual disturbances and GI symptoms are classic signs of digoxin toxicity.
6. A client with acute pancreatitis should be placed on which initial diet?
A. High-fiber solids
B. NPO with IV fluids and pain control
C. High-fat clear liquids
D. Regular oral diet with pancreatic enzymes
- answer ;- : B
Rationale: Bowel rest (NPO), fluids, and pain control reduce pancreatic stimulation.
7. Which finding indicates worsening renal function in a client with acute tubular necrosis?
A. Increased urine output
B. Decreased BUN and creatinine
C. Hyperkalemia
D. Metabolic alkalosis
- answer ;- : C
Rationale: Decreased renal excretion causes hyperkalemia; rising BUN/creatinine also occur.
8. A client with deep vein thrombosis is started on heparin infusion. Which lab test does the
nurse monitor?
A. INR
, B. aPTT
C. Platelet count only
D. Serum fibrinogen
- answer ;- : B
Rationale: aPTT monitors heparin therapeutic effect; platelets monitored for HIT risk.
9. A patient with peptic ulcer disease is prescribed omeprazole. Primary purpose of this
medication is to:
A. Neutralize existing acid in stomach
B. Increase gastric motility
C. Decrease gastric acid secretion by inhibiting proton pump
D. Coat the ulcer base for protection
- answer ;- : C
Rationale: Proton pump inhibitors reduce acid secretion by blocking H⁺/K⁺-ATPase.
10. Which sign suggests hypovolemia in a postoperative client?
A. Bounding pulses
B. Increased urine output
C. Decreased blood pressure and tachycardia
D. Warm, flushed skin
- answer ;- : C
Rationale: Hypovolemia causes hypotension and compensatory tachycardia.
11. A client on warfarin therapy has an INR of 5.2 and minor bleeding. What is the nurse’s
priority?
A. Administer vitamin K as ordered and hold warfarin
B. Continue warfarin and recheck INR in one week
C. Give aspirin for clot prevention
D. Increase dietary vitamin K intake immediately
- answer ;- : A
Rationale: High INR with bleeding warrants holding warfarin and administering vitamin K per
protocol.
12. A client with COPD uses pursed-lip breathing to:
A. Increase inspiratory volume
B. Reduce oxygen saturation
C. Decrease air trapping and improve expiration
D. Encourage deeper inhalation quickly
- answer ;- : C
