Medical-Surgical Nursing (Lewis, Brunner &
Suddarth) – Essential Concepts Study Guide
2025/2026
Cardiovascular System
1. What is the primary function of the coronary arteries?
A. To carry deoxygenated blood to the lungs
B. To pump blood to the body
C. ✓ To supply oxygenated blood to the heart muscle itself
D. To regulate heart rate
2. A patient with acute coronary syndrome (ACS) is most likely to report which symptom?
A. Sharp, stabbing chest pain that worsens with breathing
B. ✓ Substernal chest pressure or pain, often described as "crushing"
C. Pleuritic chest pain relieved by sitting forward
D. Pain that is reproducible with palpation
3. The "5 P's" of a neurovascular assessment are:
A. Pain, Pallor, Pressure, Paresthesia, Paralysis
B. Pain, Pulse, Pallor, Paresthesia, Posturing
C. ✓ Pain, Pulse, Pallor, Paresthesia, Paralysis
D. Pain, Pressure, Pallor, Paresthesia, Pulse
4. What is the primary goal during the initial management of a patient with a suspected
myocardial infarction (MI)?
A. Administer IV fluids to maintain blood pressure
B. Begin a beta-blocker to slow the heart rate
C. ✓ Restore blood flow to the infarct-related artery (e.g., with PCI or thrombolytics)
D. Provide supplemental oxygen via nasal cannula
5. Which lab value is the most specific and sensitive biomarker for myocardial injury?
A. Creatine Kinase (CK)
B. Myoglobin
C. ✓ Troponin I or T
D. C-Reactive Protein (CRP)
,6. Heart failure is characterized by the heart's inability to pump sufficient blood to meet the
body's metabolic demands. Left-sided heart failure most commonly leads to:
A. ✓ Pulmonary congestion and edema
B. Jugular venous distension (JVD) and hepatic congestion
C. Peripheral edema and ascites
D. Bradycardia and hypotension
7. The nurse administers furosemide (Lasix) to a patient with heart failure. What is the
primary intended outcome?
A. Reduce afterload
B. Increase contractility
C. ✓ Reduce preload through diuresis
D. Slow the heart rate
8. What is a critical nursing intervention for a patient with deep vein thrombosis (DVT)?
A. Apply warm, moist packs to the affected limb
B. Massage the limb to promote circulation
C. ✓ Elevate the limb and apply moist heat (as ordered)
D. Ambulate the patient frequently
9. A patient with an abdominal aortic aneurysm (AAA) reports sudden, severe back pain and a
"tearing" sensation. The nurse's priority action is to:
A. Administer pain medication
B. Place the patient in a knee-chest position
C. ✓ Notify the physician immediately and prepare for possible rupture
D. Assess the patient's blood pressure in both arms
10. Which rhythm is considered a medical emergency requiring immediate defibrillation?
A. Atrial Fibrillation
B. Sinus Tachycardia
C. ✓ Pulseless Ventricular Tachycardia (V-tach) or Ventricular Fibrillation (V-fib)
D. First-Degree Heart Block
Pulmonary System
11. The most common early sign of hypoxia is:
A. Cyanosis
B. Bradycardia
,C. ✓ Restlessness and anxiety
D. Use of accessory muscles
12. A patient is admitted with a diagnosis of COPD exacerbation. What type of oxygen therapy
is most critical to monitor?
A. ✓ Low-flow oxygen (e.g., 2-3 L/min via nasal cannula) to avoid suppressing the hypoxic drive
B. High-flow oxygen to maintain SpO2 > 98%
C. Oxygen via non-rebreather mask at 15 L/min
D. Hyperbaric oxygen therapy
13. What is the primary pathophysiologic problem in asthma?
A. Destruction of alveolar walls
B. ✓ Reversible inflammation and bronchospasm
C. Permanent, irreversible dilation of the bronchi
D. Consolidation of lung tissue
14. A patient with a chest tube has continuous bubbling in the water seal chamber. The nurse
should:
A. This is a normal finding
B. ✓ Assess for an air leak in the system
C. Clamp the chest tube immediately
D. Increase the suction pressure
15. The most significant risk factor for developing lung cancer is:
A. Family history
B. Exposure to radon gas
C. ✓ Cigarette smoking
D. Occupational asbestos exposure
16. For a patient with pneumonia, the nurse should prioritize which intervention to prevent
atelectasis and improve oxygenation?
A. Encouraging fluid restriction
B. ✓ Encouraging deep breathing and coughing/incentive spirometry
C. Maintaining bed rest
D. Administering antibiotics on time
17. A patient develops sudden dyspnea, tachycardia, and pleuritic chest pain after surgery.
The nurse suspects a pulmonary embolism. What other finding is commonly associated with
this condition?
A. ✓ Hypoxia that does not improve with oxygen
, B. Productive cough with yellow sputum
C. Bradycardia and hypertension
D. Barrel-shaped chest
18. What is the primary diagnostic test for pulmonary embolism?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Arterial Blood Gas (ABG)
D. ✓ CT Pulmonary Angiogram (CTPA)
19. In which position should a patient with respiratory distress be placed to maximize lung
expansion?
A. Supine
B. Trendelenburg
C. ✓ High Fowler's
D. Left Lateral Recumbent
20. The nurse is suctioning a patient with a tracheostomy. What is the maximum time for each
suctioning pass?
A. 5 seconds
B. ✓ 10-15 seconds
C. 20-25 seconds
D. 30 seconds
Neurological System
21. The Glasgow Coma Scale (GCS) assesses which three functions?
A. Pupil reaction, motor response, verbal response
B. Orientation, memory, calculation
C. ✓ Eye opening, verbal response, motor response
D. Cranial nerves, sensation, reflexes
22. A patient with a head injury has a dilated pupil that is sluggish to react. The nurse
interprets this as:
A. A normal variant
B. ✓ A neurological emergency indicating increased intracranial pressure (ICP)
C. An expected finding with concussion
D. A side effect of opioid pain medication
Suddarth) – Essential Concepts Study Guide
2025/2026
Cardiovascular System
1. What is the primary function of the coronary arteries?
A. To carry deoxygenated blood to the lungs
B. To pump blood to the body
C. ✓ To supply oxygenated blood to the heart muscle itself
D. To regulate heart rate
2. A patient with acute coronary syndrome (ACS) is most likely to report which symptom?
A. Sharp, stabbing chest pain that worsens with breathing
B. ✓ Substernal chest pressure or pain, often described as "crushing"
C. Pleuritic chest pain relieved by sitting forward
D. Pain that is reproducible with palpation
3. The "5 P's" of a neurovascular assessment are:
A. Pain, Pallor, Pressure, Paresthesia, Paralysis
B. Pain, Pulse, Pallor, Paresthesia, Posturing
C. ✓ Pain, Pulse, Pallor, Paresthesia, Paralysis
D. Pain, Pressure, Pallor, Paresthesia, Pulse
4. What is the primary goal during the initial management of a patient with a suspected
myocardial infarction (MI)?
A. Administer IV fluids to maintain blood pressure
B. Begin a beta-blocker to slow the heart rate
C. ✓ Restore blood flow to the infarct-related artery (e.g., with PCI or thrombolytics)
D. Provide supplemental oxygen via nasal cannula
5. Which lab value is the most specific and sensitive biomarker for myocardial injury?
A. Creatine Kinase (CK)
B. Myoglobin
C. ✓ Troponin I or T
D. C-Reactive Protein (CRP)
,6. Heart failure is characterized by the heart's inability to pump sufficient blood to meet the
body's metabolic demands. Left-sided heart failure most commonly leads to:
A. ✓ Pulmonary congestion and edema
B. Jugular venous distension (JVD) and hepatic congestion
C. Peripheral edema and ascites
D. Bradycardia and hypotension
7. The nurse administers furosemide (Lasix) to a patient with heart failure. What is the
primary intended outcome?
A. Reduce afterload
B. Increase contractility
C. ✓ Reduce preload through diuresis
D. Slow the heart rate
8. What is a critical nursing intervention for a patient with deep vein thrombosis (DVT)?
A. Apply warm, moist packs to the affected limb
B. Massage the limb to promote circulation
C. ✓ Elevate the limb and apply moist heat (as ordered)
D. Ambulate the patient frequently
9. A patient with an abdominal aortic aneurysm (AAA) reports sudden, severe back pain and a
"tearing" sensation. The nurse's priority action is to:
A. Administer pain medication
B. Place the patient in a knee-chest position
C. ✓ Notify the physician immediately and prepare for possible rupture
D. Assess the patient's blood pressure in both arms
10. Which rhythm is considered a medical emergency requiring immediate defibrillation?
A. Atrial Fibrillation
B. Sinus Tachycardia
C. ✓ Pulseless Ventricular Tachycardia (V-tach) or Ventricular Fibrillation (V-fib)
D. First-Degree Heart Block
Pulmonary System
11. The most common early sign of hypoxia is:
A. Cyanosis
B. Bradycardia
,C. ✓ Restlessness and anxiety
D. Use of accessory muscles
12. A patient is admitted with a diagnosis of COPD exacerbation. What type of oxygen therapy
is most critical to monitor?
A. ✓ Low-flow oxygen (e.g., 2-3 L/min via nasal cannula) to avoid suppressing the hypoxic drive
B. High-flow oxygen to maintain SpO2 > 98%
C. Oxygen via non-rebreather mask at 15 L/min
D. Hyperbaric oxygen therapy
13. What is the primary pathophysiologic problem in asthma?
A. Destruction of alveolar walls
B. ✓ Reversible inflammation and bronchospasm
C. Permanent, irreversible dilation of the bronchi
D. Consolidation of lung tissue
14. A patient with a chest tube has continuous bubbling in the water seal chamber. The nurse
should:
A. This is a normal finding
B. ✓ Assess for an air leak in the system
C. Clamp the chest tube immediately
D. Increase the suction pressure
15. The most significant risk factor for developing lung cancer is:
A. Family history
B. Exposure to radon gas
C. ✓ Cigarette smoking
D. Occupational asbestos exposure
16. For a patient with pneumonia, the nurse should prioritize which intervention to prevent
atelectasis and improve oxygenation?
A. Encouraging fluid restriction
B. ✓ Encouraging deep breathing and coughing/incentive spirometry
C. Maintaining bed rest
D. Administering antibiotics on time
17. A patient develops sudden dyspnea, tachycardia, and pleuritic chest pain after surgery.
The nurse suspects a pulmonary embolism. What other finding is commonly associated with
this condition?
A. ✓ Hypoxia that does not improve with oxygen
, B. Productive cough with yellow sputum
C. Bradycardia and hypertension
D. Barrel-shaped chest
18. What is the primary diagnostic test for pulmonary embolism?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Arterial Blood Gas (ABG)
D. ✓ CT Pulmonary Angiogram (CTPA)
19. In which position should a patient with respiratory distress be placed to maximize lung
expansion?
A. Supine
B. Trendelenburg
C. ✓ High Fowler's
D. Left Lateral Recumbent
20. The nurse is suctioning a patient with a tracheostomy. What is the maximum time for each
suctioning pass?
A. 5 seconds
B. ✓ 10-15 seconds
C. 20-25 seconds
D. 30 seconds
Neurological System
21. The Glasgow Coma Scale (GCS) assesses which three functions?
A. Pupil reaction, motor response, verbal response
B. Orientation, memory, calculation
C. ✓ Eye opening, verbal response, motor response
D. Cranial nerves, sensation, reflexes
22. A patient with a head injury has a dilated pupil that is sluggish to react. The nurse
interprets this as:
A. A normal variant
B. ✓ A neurological emergency indicating increased intracranial pressure (ICP)
C. An expected finding with concussion
D. A side effect of opioid pain medication
