Medical-Surgical Nursing (NSG 233)
Exam With Actual Questions & Verified
Answers ,Plus Explained
Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A patient with chronic heart failure is experiencing dyspnea and
edema. Which intervention should the nurse implement first?
A. Encourage ambulation
B. Administer prescribed diuretics
C. Restrict fluid intake
D. Teach low-sodium diet
B. Administer prescribed diuretics
Rationale: Diuretics reduce fluid overload, relieving symptoms
like dyspnea and edema, which is the immediate concern.
2. A patient is diagnosed with pneumonia. Which assessment
finding is most concerning?
A. Mild cough with sputum
B. Temperature 101°F
C. Oxygen saturation 88%
D. Fatigue
C. Oxygen saturation 88%
Rationale: Low oxygen saturation indicates hypoxemia and
requires immediate intervention.
,3. Which lab value is most important to monitor in a patient
receiving heparin therapy?
A. Hemoglobin
B. Platelet count
C. Activated partial thromboplastin time (aPTT)
D. Prothrombin time (PT)
C. Activated partial thromboplastin time (aPTT)
Rationale: aPTT is used to monitor the therapeutic effect and
risk of bleeding with heparin therapy.
4. A patient with type 1 diabetes reports dizziness and sweating.
The nurse suspects hypoglycemia. Which action is priority?
A. Administer insulin
B. Give 15–20 g of fast-acting carbohydrate
C. Check hemoglobin A1c
D. Call the healthcare provider
B. Give 15–20 g of fast-acting carbohydrate
Rationale: Immediate treatment of hypoglycemia is essential
to prevent progression to loss of consciousness.
5. A patient with COPD is experiencing increased shortness of
breath. Which intervention should the nurse implement first?
A. Encourage coughing and deep breathing
B. Administer supplemental oxygen as prescribed
C. Teach pursed-lip breathing
D. Position patient upright
B. Administer supplemental oxygen as prescribed
Rationale: Hypoxemia is an immediate threat. Oxygen
administration should be prioritized while assessing and
implementing other interventions.
,6. A postoperative patient develops a temperature of 102°F and
redness around the incision. What is the nurse’s priority action?
A. Encourage fluid intake
B. Administer prescribed acetaminophen
C. Assess the incision for signs of infection
D. Change the dressing
C. Assess the incision for signs of infection
Rationale: Identifying infection is critical for timely
intervention and prevents further complications.
7. Which electrolyte imbalance is most concerning in a patient
taking furosemide?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
B. Hypokalemia
Rationale: Furosemide can cause potassium loss, which
increases the risk of cardiac arrhythmias.
8. A patient with renal failure has a potassium level of 6.2 mEq/L.
Which intervention should the nurse anticipate?
A. Administer potassium supplements
B. Encourage high-potassium foods
C. Prepare for dialysis or administer potassium-lowering
medications
D. Restrict fluids
C. Prepare for dialysis or administer potassium-lowering
medications
Rationale: Hyperkalemia is life-threatening and requires
urgent intervention to prevent cardiac complications.
, 9. A patient is receiving a blood transfusion and reports chills and
back pain. What is the nurse’s first action?
A. Slow the transfusion
B. Stop the transfusion and notify the provider
C. Administer antipyretic
D. Continue transfusion while monitoring
B. Stop the transfusion and notify the provider
Rationale: Symptoms indicate a potential hemolytic reaction,
which is a medical emergency.
10. A patient with asthma uses a short-acting bronchodilator.
What is the primary purpose?
A. Prevent asthma attacks
B. Reduce airway inflammation
C. Provide quick relief of acute bronchospasm
D. Treat chronic symptoms
C. Provide quick relief of acute bronchospasm
Rationale: Short-acting bronchodilators act rapidly to relieve
acute symptoms, not for long-term prevention.
11. A patient with heart failure is prescribed digoxin. Which
assessment finding would require holding the dose?
A. Heart rate 78 bpm
B. Heart rate 56 bpm
C. Blood pressure 120/80 mmHg
D. Peripheral edema
B. Heart rate 56 bpm
Rationale: Digoxin can cause bradycardia; a heart rate below
60 bpm in adults is a contraindication for administration.
Exam With Actual Questions & Verified
Answers ,Plus Explained
Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
1. A patient with chronic heart failure is experiencing dyspnea and
edema. Which intervention should the nurse implement first?
A. Encourage ambulation
B. Administer prescribed diuretics
C. Restrict fluid intake
D. Teach low-sodium diet
B. Administer prescribed diuretics
Rationale: Diuretics reduce fluid overload, relieving symptoms
like dyspnea and edema, which is the immediate concern.
2. A patient is diagnosed with pneumonia. Which assessment
finding is most concerning?
A. Mild cough with sputum
B. Temperature 101°F
C. Oxygen saturation 88%
D. Fatigue
C. Oxygen saturation 88%
Rationale: Low oxygen saturation indicates hypoxemia and
requires immediate intervention.
,3. Which lab value is most important to monitor in a patient
receiving heparin therapy?
A. Hemoglobin
B. Platelet count
C. Activated partial thromboplastin time (aPTT)
D. Prothrombin time (PT)
C. Activated partial thromboplastin time (aPTT)
Rationale: aPTT is used to monitor the therapeutic effect and
risk of bleeding with heparin therapy.
4. A patient with type 1 diabetes reports dizziness and sweating.
The nurse suspects hypoglycemia. Which action is priority?
A. Administer insulin
B. Give 15–20 g of fast-acting carbohydrate
C. Check hemoglobin A1c
D. Call the healthcare provider
B. Give 15–20 g of fast-acting carbohydrate
Rationale: Immediate treatment of hypoglycemia is essential
to prevent progression to loss of consciousness.
5. A patient with COPD is experiencing increased shortness of
breath. Which intervention should the nurse implement first?
A. Encourage coughing and deep breathing
B. Administer supplemental oxygen as prescribed
C. Teach pursed-lip breathing
D. Position patient upright
B. Administer supplemental oxygen as prescribed
Rationale: Hypoxemia is an immediate threat. Oxygen
administration should be prioritized while assessing and
implementing other interventions.
,6. A postoperative patient develops a temperature of 102°F and
redness around the incision. What is the nurse’s priority action?
A. Encourage fluid intake
B. Administer prescribed acetaminophen
C. Assess the incision for signs of infection
D. Change the dressing
C. Assess the incision for signs of infection
Rationale: Identifying infection is critical for timely
intervention and prevents further complications.
7. Which electrolyte imbalance is most concerning in a patient
taking furosemide?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
B. Hypokalemia
Rationale: Furosemide can cause potassium loss, which
increases the risk of cardiac arrhythmias.
8. A patient with renal failure has a potassium level of 6.2 mEq/L.
Which intervention should the nurse anticipate?
A. Administer potassium supplements
B. Encourage high-potassium foods
C. Prepare for dialysis or administer potassium-lowering
medications
D. Restrict fluids
C. Prepare for dialysis or administer potassium-lowering
medications
Rationale: Hyperkalemia is life-threatening and requires
urgent intervention to prevent cardiac complications.
, 9. A patient is receiving a blood transfusion and reports chills and
back pain. What is the nurse’s first action?
A. Slow the transfusion
B. Stop the transfusion and notify the provider
C. Administer antipyretic
D. Continue transfusion while monitoring
B. Stop the transfusion and notify the provider
Rationale: Symptoms indicate a potential hemolytic reaction,
which is a medical emergency.
10. A patient with asthma uses a short-acting bronchodilator.
What is the primary purpose?
A. Prevent asthma attacks
B. Reduce airway inflammation
C. Provide quick relief of acute bronchospasm
D. Treat chronic symptoms
C. Provide quick relief of acute bronchospasm
Rationale: Short-acting bronchodilators act rapidly to relieve
acute symptoms, not for long-term prevention.
11. A patient with heart failure is prescribed digoxin. Which
assessment finding would require holding the dose?
A. Heart rate 78 bpm
B. Heart rate 56 bpm
C. Blood pressure 120/80 mmHg
D. Peripheral edema
B. Heart rate 56 bpm
Rationale: Digoxin can cause bradycardia; a heart rate below
60 bpm in adults is a contraindication for administration.
