✅ Medical-Surgical Nursing Practice
Questions (Set 1 – 20)
1. A client with heart failure is receiving furosemide. Which finding requires
immediate intervention?
A. +1 edema in ankles
B. Serum potassium 2.9 mEq/L
C. Urine output 1500 mL/day
D. Mild dizziness on standing
Answer: B. Serum potassium 2.9 mEq/L
Rationale: Severe hypokalemia (<3.5) can cause arrhythmias and must be treated
immediately.
2. A postoperative client reports sudden chest pain and shortness of breath.
What is the priority action?
A. Apply oxygen
B. Call the provider
C. Administer morphine
D. Assess incision site
Answer: A. Apply oxygen
Rationale: Sudden chest pain + dyspnea suggests pulmonary embolism; oxygen is the first
intervention.
3. Which diet is appropriate for a client with chronic kidney disease?
A. High-protein
B. High-sodium
C. Low-potassium
D. High-phosphorus
Answer: C. Low-potassium
Rationale: CKD causes impaired potassium excretion → risk of hyperkalemia.
4. A client with COPD is on 2 L/min O₂. Which finding indicates CO₂
retention?
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,A. Restlessness
B. Pink, warm skin
C. Drowsiness and confusion
D. Productive cough
Answer: C. Drowsiness and confusion
Rationale: Classic signs of CO₂ narcosis.
5. A client with diabetes is diaphoretic, shaky, and confused. What should the
nurse give?
A. Glargine insulin
B. Orange juice
C. Metformin
D. Sliding-scale insulin
Answer: B. Orange juice
Rationale: These are signs of hypoglycemia → give fast-acting sugar.
6. The nurse hears a high-pitched bowel sound in a client with abdominal
pain. This suggests:
A. Normal function
B. Peritonitis
C. Early small bowel obstruction
D. Ascites
Answer: C. Early small bowel obstruction
7. Which lab value is critical in a client taking warfarin?
A. aPTT
B. INR
C. Platelets
D. Hemoglobin
Answer: B. INR
Rationale: INR monitors warfarin effectiveness.
8. A client with pneumonia has thick secretions. The best intervention is:
A. Restrict fluids
B. Encourage coughing and deep breathing
C. Give antidiarrheal medication
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, D. Increase protein intake
Answer: B. Encourage coughing and deep breathing
9. A patient with C. diff must be placed in:
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Neutropenic precautions
Answer: C. Contact precautions
10. Which assessment finding in a client with Graves’ disease indicates a
thyroid storm?
A. Weight gain
B. Bradycardia
C. Fever and hypertension
D. Lethargy
Answer: C. Fever and hypertension
11. A client on digoxin reports nausea and blurred yellow vision. Priority
action?
A. Hold digoxin
B. Give antiemetic
C. Encourage extra fluids
D. Give oxygen
Answer: A. Hold digoxin
Rationale: Signs of digoxin toxicity.
12. A client with cirrhosis has a distended abdomen. This is likely due to:
A. Hypoglycemia
B. Ascites
C. Kidney retention
D. Dehydration
Answer: B. Ascites
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Questions (Set 1 – 20)
1. A client with heart failure is receiving furosemide. Which finding requires
immediate intervention?
A. +1 edema in ankles
B. Serum potassium 2.9 mEq/L
C. Urine output 1500 mL/day
D. Mild dizziness on standing
Answer: B. Serum potassium 2.9 mEq/L
Rationale: Severe hypokalemia (<3.5) can cause arrhythmias and must be treated
immediately.
2. A postoperative client reports sudden chest pain and shortness of breath.
What is the priority action?
A. Apply oxygen
B. Call the provider
C. Administer morphine
D. Assess incision site
Answer: A. Apply oxygen
Rationale: Sudden chest pain + dyspnea suggests pulmonary embolism; oxygen is the first
intervention.
3. Which diet is appropriate for a client with chronic kidney disease?
A. High-protein
B. High-sodium
C. Low-potassium
D. High-phosphorus
Answer: C. Low-potassium
Rationale: CKD causes impaired potassium excretion → risk of hyperkalemia.
4. A client with COPD is on 2 L/min O₂. Which finding indicates CO₂
retention?
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,A. Restlessness
B. Pink, warm skin
C. Drowsiness and confusion
D. Productive cough
Answer: C. Drowsiness and confusion
Rationale: Classic signs of CO₂ narcosis.
5. A client with diabetes is diaphoretic, shaky, and confused. What should the
nurse give?
A. Glargine insulin
B. Orange juice
C. Metformin
D. Sliding-scale insulin
Answer: B. Orange juice
Rationale: These are signs of hypoglycemia → give fast-acting sugar.
6. The nurse hears a high-pitched bowel sound in a client with abdominal
pain. This suggests:
A. Normal function
B. Peritonitis
C. Early small bowel obstruction
D. Ascites
Answer: C. Early small bowel obstruction
7. Which lab value is critical in a client taking warfarin?
A. aPTT
B. INR
C. Platelets
D. Hemoglobin
Answer: B. INR
Rationale: INR monitors warfarin effectiveness.
8. A client with pneumonia has thick secretions. The best intervention is:
A. Restrict fluids
B. Encourage coughing and deep breathing
C. Give antidiarrheal medication
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, D. Increase protein intake
Answer: B. Encourage coughing and deep breathing
9. A patient with C. diff must be placed in:
A. Airborne precautions
B. Droplet precautions
C. Contact precautions
D. Neutropenic precautions
Answer: C. Contact precautions
10. Which assessment finding in a client with Graves’ disease indicates a
thyroid storm?
A. Weight gain
B. Bradycardia
C. Fever and hypertension
D. Lethargy
Answer: C. Fever and hypertension
11. A client on digoxin reports nausea and blurred yellow vision. Priority
action?
A. Hold digoxin
B. Give antiemetic
C. Encourage extra fluids
D. Give oxygen
Answer: A. Hold digoxin
Rationale: Signs of digoxin toxicity.
12. A client with cirrhosis has a distended abdomen. This is likely due to:
A. Hypoglycemia
B. Ascites
C. Kidney retention
D. Dehydration
Answer: B. Ascites
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