Test Bank Ignatavicius Medical Surgical 9th
2017 (Chapter 1-74 Complete Testbank)
Medical-Surgical Nursing Practice Questions (1–50)
1. Multiple Choice
A patient with chronic obstructive pulmonary disease (COPD) is admitted with increased
shortness of breath. Which intervention should the nurse implement first?
A. Encourage fluid restriction
B. Administer oxygen as prescribed
C. Teach pursed-lip breathing
D. Initiate chest physiotherapy
Answer: B. Administer oxygen as prescribed
Rationale: Oxygen administration is the priority to address hypoxemia in a patient with acute
respiratory distress. Teaching breathing techniques and chest physiotherapy are important but
secondary.
2. NCLEX-Style Scenario
A 65-year-old male with a history of hypertension reports a sudden severe headache and
blurred vision. His BP is 210/120 mmHg. What is the nurse’s priority action?
A. Administer antihypertensive medication as prescribed
B. Notify the healthcare provider immediately
C. Place the patient in Trendelenburg position
D. Obtain a blood glucose level
Answer: B. Notify the healthcare provider immediately
Rationale: Hypertensive crisis can cause stroke or organ damage. Immediate notification of the
provider is essential before administering medications.
3. Multiple Choice
,Which lab result indicates that a patient on heparin therapy is at risk for bleeding?
A. Platelet count 180,000/mm³
B. aPTT 80 seconds
C. INR 1.0
D. Hemoglobin 14 g/dL
Answer: B. aPTT 80 seconds
Rationale: Therapeutic aPTT is usually 60–80 seconds depending on protocol; higher values
indicate increased bleeding risk.
4. Multiple Choice
A patient is prescribed digoxin for heart failure. Which assessment finding requires immediate
intervention?
A. Pulse 70 bpm
B. K+ 3.2 mEq/L
C. BP 110/70 mmHg
D. Weight gain of 0.5 kg in 1 week
Answer: B. K+ 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium levels should be
corrected before continuing therapy.
5. Short Answer / Fill-in-the-Blank
A patient is diagnosed with iron-deficiency anemia. The nurse should instruct the patient to
increase intake of ________________.
Answer: Iron-rich foods (e.g., red meat, spinach, legumes)
Rationale: Dietary iron helps improve hemoglobin levels in iron-deficiency anemia.
6. NCLEX-Style Scenario
A post-op patient develops a temperature of 38.9°C, increased heart rate, and purulent wound
drainage. What is the nurse’s priority action?
A. Administer antipyretics
B. Apply sterile dressings
C. Notify the healthcare provider
D. Increase oral fluids
,Answer: C. Notify the healthcare provider
Rationale: These are signs of postoperative infection; early intervention prevents sepsis.
7. Multiple Choice
Which electrolyte imbalance is most likely in a patient with chronic kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B. Hyperkalemia
Rationale: Decreased renal excretion in CKD leads to potassium accumulation.
8. Multiple Choice
A patient with pneumonia is prescribed ceftriaxone. What is an important nursing action?
A. Administer oral medication with dairy
B. Monitor for diarrhea and superinfection
C. Check blood glucose before administration
D. Encourage low-protein diet
Answer: B. Monitor for diarrhea and superinfection
Rationale: Antibiotics can disrupt normal flora, causing diarrhea or C. difficile infection.
9. Short Answer
The nurse is caring for a patient with cirrhosis who has ascites. The nurse should monitor the
patient’s ______________ closely.
Answer: Fluid and electrolyte balance
Rationale: Ascites can cause fluid shifts, hyponatremia, and hypokalemia.
10. NCLEX-Style Scenario
A patient receiving IV potassium develops burning at the IV site. What should the nurse do first?
A. Slow the infusion rate
B. Stop the infusion and assess the site
C. Apply a warm compress
D. Increase the infusion rate
, Answer: B. Stop the infusion and assess the site
Rationale: IV potassium is irritating to veins. Stopping the infusion prevents tissue damage and
complications.
11. Multiple Choice
A patient with a history of myocardial infarction reports chest pain radiating to the left arm.
Which is the nurse’s priority?
A. Administer nitroglycerin
B. Assess vital signs and ECG
C. Encourage rest
D. Notify family
Answer: B. Assess vital signs and ECG
Rationale: Immediate assessment and monitoring help detect life-threatening cardiac events
before interventions.
12. NCLEX-Style Scenario
A patient with type 1 diabetes reports nausea, vomiting, and fruity breath. Blood glucose is 420
mg/dL. What is the priority action?
A. Administer oral antidiabetic medication
B. Provide a high-carbohydrate snack
C. Notify the healthcare provider for possible DKA
D. Encourage exercise
Answer: C. Notify the healthcare provider for possible DKA
Rationale: Symptoms indicate diabetic ketoacidosis, a medical emergency requiring prompt
treatment.
13. Multiple Choice
Which assessment finding indicates worsening heart failure?
A. Mild ankle edema
B. Crackles in the lungs
C. BP 120/80 mmHg
D. HR 72 bpm
2017 (Chapter 1-74 Complete Testbank)
Medical-Surgical Nursing Practice Questions (1–50)
1. Multiple Choice
A patient with chronic obstructive pulmonary disease (COPD) is admitted with increased
shortness of breath. Which intervention should the nurse implement first?
A. Encourage fluid restriction
B. Administer oxygen as prescribed
C. Teach pursed-lip breathing
D. Initiate chest physiotherapy
Answer: B. Administer oxygen as prescribed
Rationale: Oxygen administration is the priority to address hypoxemia in a patient with acute
respiratory distress. Teaching breathing techniques and chest physiotherapy are important but
secondary.
2. NCLEX-Style Scenario
A 65-year-old male with a history of hypertension reports a sudden severe headache and
blurred vision. His BP is 210/120 mmHg. What is the nurse’s priority action?
A. Administer antihypertensive medication as prescribed
B. Notify the healthcare provider immediately
C. Place the patient in Trendelenburg position
D. Obtain a blood glucose level
Answer: B. Notify the healthcare provider immediately
Rationale: Hypertensive crisis can cause stroke or organ damage. Immediate notification of the
provider is essential before administering medications.
3. Multiple Choice
,Which lab result indicates that a patient on heparin therapy is at risk for bleeding?
A. Platelet count 180,000/mm³
B. aPTT 80 seconds
C. INR 1.0
D. Hemoglobin 14 g/dL
Answer: B. aPTT 80 seconds
Rationale: Therapeutic aPTT is usually 60–80 seconds depending on protocol; higher values
indicate increased bleeding risk.
4. Multiple Choice
A patient is prescribed digoxin for heart failure. Which assessment finding requires immediate
intervention?
A. Pulse 70 bpm
B. K+ 3.2 mEq/L
C. BP 110/70 mmHg
D. Weight gain of 0.5 kg in 1 week
Answer: B. K+ 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium levels should be
corrected before continuing therapy.
5. Short Answer / Fill-in-the-Blank
A patient is diagnosed with iron-deficiency anemia. The nurse should instruct the patient to
increase intake of ________________.
Answer: Iron-rich foods (e.g., red meat, spinach, legumes)
Rationale: Dietary iron helps improve hemoglobin levels in iron-deficiency anemia.
6. NCLEX-Style Scenario
A post-op patient develops a temperature of 38.9°C, increased heart rate, and purulent wound
drainage. What is the nurse’s priority action?
A. Administer antipyretics
B. Apply sterile dressings
C. Notify the healthcare provider
D. Increase oral fluids
,Answer: C. Notify the healthcare provider
Rationale: These are signs of postoperative infection; early intervention prevents sepsis.
7. Multiple Choice
Which electrolyte imbalance is most likely in a patient with chronic kidney disease?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Answer: B. Hyperkalemia
Rationale: Decreased renal excretion in CKD leads to potassium accumulation.
8. Multiple Choice
A patient with pneumonia is prescribed ceftriaxone. What is an important nursing action?
A. Administer oral medication with dairy
B. Monitor for diarrhea and superinfection
C. Check blood glucose before administration
D. Encourage low-protein diet
Answer: B. Monitor for diarrhea and superinfection
Rationale: Antibiotics can disrupt normal flora, causing diarrhea or C. difficile infection.
9. Short Answer
The nurse is caring for a patient with cirrhosis who has ascites. The nurse should monitor the
patient’s ______________ closely.
Answer: Fluid and electrolyte balance
Rationale: Ascites can cause fluid shifts, hyponatremia, and hypokalemia.
10. NCLEX-Style Scenario
A patient receiving IV potassium develops burning at the IV site. What should the nurse do first?
A. Slow the infusion rate
B. Stop the infusion and assess the site
C. Apply a warm compress
D. Increase the infusion rate
, Answer: B. Stop the infusion and assess the site
Rationale: IV potassium is irritating to veins. Stopping the infusion prevents tissue damage and
complications.
11. Multiple Choice
A patient with a history of myocardial infarction reports chest pain radiating to the left arm.
Which is the nurse’s priority?
A. Administer nitroglycerin
B. Assess vital signs and ECG
C. Encourage rest
D. Notify family
Answer: B. Assess vital signs and ECG
Rationale: Immediate assessment and monitoring help detect life-threatening cardiac events
before interventions.
12. NCLEX-Style Scenario
A patient with type 1 diabetes reports nausea, vomiting, and fruity breath. Blood glucose is 420
mg/dL. What is the priority action?
A. Administer oral antidiabetic medication
B. Provide a high-carbohydrate snack
C. Notify the healthcare provider for possible DKA
D. Encourage exercise
Answer: C. Notify the healthcare provider for possible DKA
Rationale: Symptoms indicate diabetic ketoacidosis, a medical emergency requiring prompt
treatment.
13. Multiple Choice
Which assessment finding indicates worsening heart failure?
A. Mild ankle edema
B. Crackles in the lungs
C. BP 120/80 mmHg
D. HR 72 bpm
