Med Surge Certification Practice Test 2026 with 330
Questions and Correct Answers with Rationales/ Medical
Surgical Nursing Certification Practice Test C Latest 2026
Albert Harrison, age 64, has been diagnosed with heart failure as a result of a
recent anterior wall myocardial infarction. He is being transferred from the critical
care area to the medical surgical unit. Current medication include lisinopril 20 mg
by mouth twice daily; digoxin 0.125 mg by mouth daily; furosemide 40 mg daily;
potassium chloride 20 meq by mouth twice daily.
In preparing him for discharge, the nurse's highest priority will be to reinforce the
importance of which of the following?
A. Fluid restrictions
B. Activity limitations
C. Daily weights
D. Carbohydrate elimination - ANSWER-C. Daily weights
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
Based on this patients diagnosis, the nurse caring for Ms. Pratt expects the patient
will:
A. Only experience chest pain with strenuous activity
B. Have unpredictable frequency or intensity of symptoms
C. Present with pathologic Q waves on her cardiac rhythm strip
pg. 1
,D. Exhibit altered contractility of her ventricles - ANSWER-B. Have
unpredictable frequency or intensity of symptoms
Unstable angina is characterized by unpredictable intensity, frequency, or duration
of chest pain. It often occurs with minimal activity or at rest. Unstable angina
neither alters ventricular contractility nor produces Q waves on the EKG
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
Ms. Pratt's rapid heart rate may be a problem primarily because it:
A. Places her at risk for pulmonary emboli
B. Often causes extreme SOB
C. Results in altered cardiac output
D. Further narrows her coronary arteries - ANSWER-C. Results in altered cardiac
output
Rapid ventricular rates result in short filling time for the ventricles. Less filling
time csausesd a reduction in ventricular preload and a decrease in cardiasc output.
This is more likely to occur in older patients who have decreased ventricular
compliance. Rapid heart rate does not cause narrowing of the coronary arteries and
does not cause pulmonary emboli. SOB can occur but this would be secondary to
the cardiac output
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
pg. 2
,place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
The nurse teaches Ms. Pratt about use of nitroglycerin. Following the teaching, it is
most important for the patient to:
A. Indicate she will call for help if three nitro tabs do not relieve her chest pain
B. Identify flushing and dizziness as common side effects of the drug
C. Verbalize understanding that nitro will prevent her from having an MI
D. Confirm she will not take the drug until she is experiencing chest pain -
ANSWER-A. Indicate she will call for help if three nitro tabs do not relieve her
chest pain
A 68 year old female is admitted with a diagnosis of heart failure and ischemic
cardiomyopathy. Her cardiac history includes three previous MI's and three
coronary artery bypass grafts. The patient's appetite is unchanged. Which dietary
restriction would be the highest priority for this patient?
A. Low cholesterol
B. Reduced calorie
C. Low fat
D. Restricted sodium - ANSWER-D. Restricted sodium
A compensatory mechanism in heart failure is the retention of sodium and water
along with the inability of the kidneys to excrete sodium. Sodium intake should be
restricted to 2-3 grams per day
pg. 3
, A 65 year old male is diagnosed with right sided heart failure and is admitted to the
medsurge floor. Based on this diagnosis the nurse will expect assessment to
include which of the following findings?
A. Dyspnea on exertion and bibasilar crackles
B. Dependent edema and hepatic engorgement
C. Distended veins and systolic murmur
D. Cool extremities and weak peripheral pulses - ANSWER-B. Dependent edema
and hepatic engorgement
Right sided heart failure can result from primary pulmonary hypertension.
Symptoms include distended neck veins, dependent edema, and hepatic
engorgement. Conversely symptoms of left sided heart failure include dyspnea,
crackles, cool extremities, and weak peripheral pulses
A patient is admitted to the hospital after experiencing substernal chest pain for
two hours. Which lab study does the nurse recognize as most useful in determining
if the patient has experienced an MI?
A. CBC w/diff
B. CRP
C. Trops
D. Homocysteine - ANSWER-C. Trops
Troponin level provide the important diagnostic criteria for MI
The priority nursing intervention for a patient with a suspected MI is:
pg. 4
Questions and Correct Answers with Rationales/ Medical
Surgical Nursing Certification Practice Test C Latest 2026
Albert Harrison, age 64, has been diagnosed with heart failure as a result of a
recent anterior wall myocardial infarction. He is being transferred from the critical
care area to the medical surgical unit. Current medication include lisinopril 20 mg
by mouth twice daily; digoxin 0.125 mg by mouth daily; furosemide 40 mg daily;
potassium chloride 20 meq by mouth twice daily.
In preparing him for discharge, the nurse's highest priority will be to reinforce the
importance of which of the following?
A. Fluid restrictions
B. Activity limitations
C. Daily weights
D. Carbohydrate elimination - ANSWER-C. Daily weights
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
Based on this patients diagnosis, the nurse caring for Ms. Pratt expects the patient
will:
A. Only experience chest pain with strenuous activity
B. Have unpredictable frequency or intensity of symptoms
C. Present with pathologic Q waves on her cardiac rhythm strip
pg. 1
,D. Exhibit altered contractility of her ventricles - ANSWER-B. Have
unpredictable frequency or intensity of symptoms
Unstable angina is characterized by unpredictable intensity, frequency, or duration
of chest pain. It often occurs with minimal activity or at rest. Unstable angina
neither alters ventricular contractility nor produces Q waves on the EKG
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
Ms. Pratt's rapid heart rate may be a problem primarily because it:
A. Places her at risk for pulmonary emboli
B. Often causes extreme SOB
C. Results in altered cardiac output
D. Further narrows her coronary arteries - ANSWER-C. Results in altered cardiac
output
Rapid ventricular rates result in short filling time for the ventricles. Less filling
time csausesd a reduction in ventricular preload and a decrease in cardiasc output.
This is more likely to occur in older patients who have decreased ventricular
compliance. Rapid heart rate does not cause narrowing of the coronary arteries and
does not cause pulmonary emboli. SOB can occur but this would be secondary to
the cardiac output
Teresa Pratt, age 72, has been admitted to the hospital with a diagnosis of unstable
angina. She is receiving oxygen at 3 lpm by nasal cannula and has a saline lock in
pg. 2
,place. Telemetry monitoring indicates sinus tachycardia with a heart rate of 112
bpm. Ms. Pratt also has sublingual nitroglycerin at the bedside for her use as
needed.
The nurse teaches Ms. Pratt about use of nitroglycerin. Following the teaching, it is
most important for the patient to:
A. Indicate she will call for help if three nitro tabs do not relieve her chest pain
B. Identify flushing and dizziness as common side effects of the drug
C. Verbalize understanding that nitro will prevent her from having an MI
D. Confirm she will not take the drug until she is experiencing chest pain -
ANSWER-A. Indicate she will call for help if three nitro tabs do not relieve her
chest pain
A 68 year old female is admitted with a diagnosis of heart failure and ischemic
cardiomyopathy. Her cardiac history includes three previous MI's and three
coronary artery bypass grafts. The patient's appetite is unchanged. Which dietary
restriction would be the highest priority for this patient?
A. Low cholesterol
B. Reduced calorie
C. Low fat
D. Restricted sodium - ANSWER-D. Restricted sodium
A compensatory mechanism in heart failure is the retention of sodium and water
along with the inability of the kidneys to excrete sodium. Sodium intake should be
restricted to 2-3 grams per day
pg. 3
, A 65 year old male is diagnosed with right sided heart failure and is admitted to the
medsurge floor. Based on this diagnosis the nurse will expect assessment to
include which of the following findings?
A. Dyspnea on exertion and bibasilar crackles
B. Dependent edema and hepatic engorgement
C. Distended veins and systolic murmur
D. Cool extremities and weak peripheral pulses - ANSWER-B. Dependent edema
and hepatic engorgement
Right sided heart failure can result from primary pulmonary hypertension.
Symptoms include distended neck veins, dependent edema, and hepatic
engorgement. Conversely symptoms of left sided heart failure include dyspnea,
crackles, cool extremities, and weak peripheral pulses
A patient is admitted to the hospital after experiencing substernal chest pain for
two hours. Which lab study does the nurse recognize as most useful in determining
if the patient has experienced an MI?
A. CBC w/diff
B. CRP
C. Trops
D. Homocysteine - ANSWER-C. Trops
Troponin level provide the important diagnostic criteria for MI
The priority nursing intervention for a patient with a suspected MI is:
pg. 4
