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Medical-Surgical Nursing, 7th Edition –
Comprehensive 95-Question Advanced
Test Bank (2025/2026 Academic Year)
Part 1: Questions 1-50
Foundations of Medical-Surgical Nursing (Ch. 1-10)
1. [ MCQ]The charge nurse is making assignments for theday shift. Which client should be
assigned to the most experienced registered nurse (RN)?
A. A client 2 days post-cholecystectomy who is ambulating independently.
B. A client newly diagnosed with type 2 diabetes mellitus who needs discharge teaching.
. A client with heart failure who has a new onset of dyspnea and an oxygen saturation
C
of 89% on room air.
D. A client with a history of alcohol dependence who is experiencing mild tremors.
orrect Answer: CRationale:This client is exhibitingsigns of acute decompensation
C
(dyspnea, hypoxia), which requires rapid assessment, critical thinking, and potentially
life-saving interventions. This situation is unstable and demands the expertise of the
most experienced nurse. The other clients have more stable or predictable needs.
2. [ Multiple-Response]The nurse manager is implementingevidence-based practice
(EBP) on the unit. Which actions are essential components of the EBP process?(Select
all that apply.)
A. Integrating clinical expertise with the best available external evidence.
B. Relying primarily on traditional nursing practices that have been used for years.
C. Considering individual patient preferences and values.
D. Using the most current research studies regardless of the clinical setting.
, E. Posing a clinical question in a structured format (e.g., PICO).
orrect Answer: A, C, ERationale:EBP is a problem-solving approach to clinical
C
practice that integrates the best available evidence, clinical expertise, and patient values
and preferences. PICO (Patient/Problem, Intervention, Comparison, Outcome) is a
standard framework for formulating clinical questions. Relying solely on tradition (B) or
using research without considering its applicability (D) are not components of EBP.
3. [ Ordered-Response]The nurse is preparing to administer a blood transfusion to a
client. Place the following nursing actions in the correct order, from first to last.
1. Document the transfusion in the client's medical record.
2. Verify the blood product with another RN against the client's armband and
medical record.
3. Obtain the client's baseline vital signs.
4. Stay with the client for the first 15 to 30 minutes of the infusion.
5. Instruct the client to report any chills, itching, or shortness of breath.
orrect Answer: 3, 2, 5, 4, 1Rationale:The correctsequence prioritizes safety.
C
Baseline vitals (3) are needed to compare for reactions. Verification (2) is the most
critical step to prevent a hemolytic reaction. Informing the client (5) empowers them
to report early signs of a reaction. Close monitoring (4) during the initial phase is
crucial as most severe reactions occur early. Documentation (1) occurs after the
procedure is safely initiated.
4. [ MCQ]A client is scheduled for surgery and expressesanxiety about the procedure.
Which communication technique by the nurse is most therapeutic?
A. "Don't worry, the surgeon is excellent."
B. "You shouldn't be anxious; this is a very common surgery."
C. "Can you tell me more about what is making you feel anxious?"
D. "I felt anxious before my surgery too, and it was fine."
orrect Answer: CRationale:This open-ended questionuses a therapeutic
C
communication technique to encourage the client to express feelings and concerns. It
validates the client's anxiety without offering false reassurance (A, B) or shifting the
focus to the nurse (D). Understanding the specific fear is the first step in providing
effective support and education.
5. [ MCQ]The nurse is caring for a client who refusesa blood transfusion based on
religious beliefs. What is the nurse's most appropriate action?
A. Administer the blood transfusion quickly to save the client's life.
, B. Respect the client's decision and inform the health care provider.
C. Have the client's family sign a consent form to override the client's refusal.
D. Explain that the client is not competent to make this decision.
orrect Answer: BRationale:A competent adult has the right to refuse treatment,
C
even life-saving treatment. The nurse must respect this autonomy, document the refusal
thoroughly, and ensure the health care provider is aware to explore alternative
treatments. Administering the blood (A) violates the client's rights and constitutes battery.
Involving family to override a competent client's decision (C) is inappropriate.
Questioning competency (D) without cause is also inappropriate.
Immune System (Ch. 11-15)
6. [ MCQ]A client is admitted with systemic lupus erythematosus(SLE). The nurse should
prioritize assessment for which potential complication?
A. Joint deformity
B. Fluctuating blood glucose levels
C. Renal dysfunction
D. Peripheral neuropathy
orrect Answer: CRationale:Lupus nephritis is acommon and potentially
C
life-threatening complication of SLE. Early detection through monitoring for proteinuria,
elevated BUN/creatinine, and hypertension is critical. While joint pain (A) is common,
deformity is more characteristic of rheumatoid arthritis. Fluctuating glucose (B) and
neuropathy (D) are not primary complications of SLE.
7. [ Multiple-Response]The nurse is caring for a client48 hours post-kidney
transplantation. Which findings indicate the client may be experiencing acute organ
rejection?(Select all that apply.)
A. Sudden decrease in urine output.
B. Temperature of 99.2°F (37.3°C).
C. Tenderness over the graft site.
D. Elevated serum creatinine.
E. Sudden weight loss.
, orrect Answer: A, C, DRationale:The classic signs of acute rejection are the "3 D's":
C
Decreased urine output, Decreased renal function (elevated creatinine), and
pain/tenderness over the graft site (Dolor). A low-grade fever (B) can be a sign but is
less specific. Sudden weight loss (E) is not associated; weight gain from fluid retention is
more likely.
8. [ MCQ]A client with HIV is prescribed antiretroviral therapy (ART). What is the most
important instruction for the nurse to provide to promote adherence?
A. "Take the medication on an empty stomach."
B. "It is acceptable to miss a dose occasionally if you feel well."
C. "Set a consistent daily routine and use a pillbox to help you remember."
D. "You can expect to feel better within a few days of starting the medication."
orrect Answer: CRationale:Adherence is paramountin HIV management to prevent
C
viral resistance and treatment failure. Strategies like establishing a routine and using
pillboxes are highly effective. Dietary instructions (A) vary by drug. Missing doses (B) is
strongly discouraged. Therapeutic effects (D) may take weeks to manifest as the CD4
count recovers.
9. [ Ordered-Response]A client arrives in the emergencydepartment with anaphylaxis
after a bee sting. Place the nurse's interventions in the correct priority order.
1. Administer epinephrine intramuscularly.
2. Assess airway, breathing, and circulation (ABCs).
3. Initiate IV fluids for volume resuscitation.
4. Administer diphenhydramine and corticosteroids.
5. Place the client in a supine position with legs elevated.
orrect Answer: 2, 1, 5, 3, 4Rationale:The ABCsframework guides priority. First,
C
assess the ABCs (2). The immediate life-saving intervention is administering
epinephrine (1) to reverse bronchospasm and vasodilation. Positioning (5) helps
improve blood pressure. IV fluids (3) address the distributive shock. Antihistamines
and corticopers (4) are secondary treatments that help prevent a biphasic reaction
but are not the initial priority.
10.[MCQ]The nurse is teaching a group of nursing studentsabout infection control. Which
statement by a student indicates a need for further teaching?
A. "Hand hygiene is the single most effective way to prevent infection."
B. "I should wear a mask for any client who is on contact precautions."
C. "Used needles should be disposed of in a puncture-proof sharps container."
D
Medical-Surgical Nursing, 7th Edition –
Comprehensive 95-Question Advanced
Test Bank (2025/2026 Academic Year)
Part 1: Questions 1-50
Foundations of Medical-Surgical Nursing (Ch. 1-10)
1. [ MCQ]The charge nurse is making assignments for theday shift. Which client should be
assigned to the most experienced registered nurse (RN)?
A. A client 2 days post-cholecystectomy who is ambulating independently.
B. A client newly diagnosed with type 2 diabetes mellitus who needs discharge teaching.
. A client with heart failure who has a new onset of dyspnea and an oxygen saturation
C
of 89% on room air.
D. A client with a history of alcohol dependence who is experiencing mild tremors.
orrect Answer: CRationale:This client is exhibitingsigns of acute decompensation
C
(dyspnea, hypoxia), which requires rapid assessment, critical thinking, and potentially
life-saving interventions. This situation is unstable and demands the expertise of the
most experienced nurse. The other clients have more stable or predictable needs.
2. [ Multiple-Response]The nurse manager is implementingevidence-based practice
(EBP) on the unit. Which actions are essential components of the EBP process?(Select
all that apply.)
A. Integrating clinical expertise with the best available external evidence.
B. Relying primarily on traditional nursing practices that have been used for years.
C. Considering individual patient preferences and values.
D. Using the most current research studies regardless of the clinical setting.
, E. Posing a clinical question in a structured format (e.g., PICO).
orrect Answer: A, C, ERationale:EBP is a problem-solving approach to clinical
C
practice that integrates the best available evidence, clinical expertise, and patient values
and preferences. PICO (Patient/Problem, Intervention, Comparison, Outcome) is a
standard framework for formulating clinical questions. Relying solely on tradition (B) or
using research without considering its applicability (D) are not components of EBP.
3. [ Ordered-Response]The nurse is preparing to administer a blood transfusion to a
client. Place the following nursing actions in the correct order, from first to last.
1. Document the transfusion in the client's medical record.
2. Verify the blood product with another RN against the client's armband and
medical record.
3. Obtain the client's baseline vital signs.
4. Stay with the client for the first 15 to 30 minutes of the infusion.
5. Instruct the client to report any chills, itching, or shortness of breath.
orrect Answer: 3, 2, 5, 4, 1Rationale:The correctsequence prioritizes safety.
C
Baseline vitals (3) are needed to compare for reactions. Verification (2) is the most
critical step to prevent a hemolytic reaction. Informing the client (5) empowers them
to report early signs of a reaction. Close monitoring (4) during the initial phase is
crucial as most severe reactions occur early. Documentation (1) occurs after the
procedure is safely initiated.
4. [ MCQ]A client is scheduled for surgery and expressesanxiety about the procedure.
Which communication technique by the nurse is most therapeutic?
A. "Don't worry, the surgeon is excellent."
B. "You shouldn't be anxious; this is a very common surgery."
C. "Can you tell me more about what is making you feel anxious?"
D. "I felt anxious before my surgery too, and it was fine."
orrect Answer: CRationale:This open-ended questionuses a therapeutic
C
communication technique to encourage the client to express feelings and concerns. It
validates the client's anxiety without offering false reassurance (A, B) or shifting the
focus to the nurse (D). Understanding the specific fear is the first step in providing
effective support and education.
5. [ MCQ]The nurse is caring for a client who refusesa blood transfusion based on
religious beliefs. What is the nurse's most appropriate action?
A. Administer the blood transfusion quickly to save the client's life.
, B. Respect the client's decision and inform the health care provider.
C. Have the client's family sign a consent form to override the client's refusal.
D. Explain that the client is not competent to make this decision.
orrect Answer: BRationale:A competent adult has the right to refuse treatment,
C
even life-saving treatment. The nurse must respect this autonomy, document the refusal
thoroughly, and ensure the health care provider is aware to explore alternative
treatments. Administering the blood (A) violates the client's rights and constitutes battery.
Involving family to override a competent client's decision (C) is inappropriate.
Questioning competency (D) without cause is also inappropriate.
Immune System (Ch. 11-15)
6. [ MCQ]A client is admitted with systemic lupus erythematosus(SLE). The nurse should
prioritize assessment for which potential complication?
A. Joint deformity
B. Fluctuating blood glucose levels
C. Renal dysfunction
D. Peripheral neuropathy
orrect Answer: CRationale:Lupus nephritis is acommon and potentially
C
life-threatening complication of SLE. Early detection through monitoring for proteinuria,
elevated BUN/creatinine, and hypertension is critical. While joint pain (A) is common,
deformity is more characteristic of rheumatoid arthritis. Fluctuating glucose (B) and
neuropathy (D) are not primary complications of SLE.
7. [ Multiple-Response]The nurse is caring for a client48 hours post-kidney
transplantation. Which findings indicate the client may be experiencing acute organ
rejection?(Select all that apply.)
A. Sudden decrease in urine output.
B. Temperature of 99.2°F (37.3°C).
C. Tenderness over the graft site.
D. Elevated serum creatinine.
E. Sudden weight loss.
, orrect Answer: A, C, DRationale:The classic signs of acute rejection are the "3 D's":
C
Decreased urine output, Decreased renal function (elevated creatinine), and
pain/tenderness over the graft site (Dolor). A low-grade fever (B) can be a sign but is
less specific. Sudden weight loss (E) is not associated; weight gain from fluid retention is
more likely.
8. [ MCQ]A client with HIV is prescribed antiretroviral therapy (ART). What is the most
important instruction for the nurse to provide to promote adherence?
A. "Take the medication on an empty stomach."
B. "It is acceptable to miss a dose occasionally if you feel well."
C. "Set a consistent daily routine and use a pillbox to help you remember."
D. "You can expect to feel better within a few days of starting the medication."
orrect Answer: CRationale:Adherence is paramountin HIV management to prevent
C
viral resistance and treatment failure. Strategies like establishing a routine and using
pillboxes are highly effective. Dietary instructions (A) vary by drug. Missing doses (B) is
strongly discouraged. Therapeutic effects (D) may take weeks to manifest as the CD4
count recovers.
9. [ Ordered-Response]A client arrives in the emergencydepartment with anaphylaxis
after a bee sting. Place the nurse's interventions in the correct priority order.
1. Administer epinephrine intramuscularly.
2. Assess airway, breathing, and circulation (ABCs).
3. Initiate IV fluids for volume resuscitation.
4. Administer diphenhydramine and corticosteroids.
5. Place the client in a supine position with legs elevated.
orrect Answer: 2, 1, 5, 3, 4Rationale:The ABCsframework guides priority. First,
C
assess the ABCs (2). The immediate life-saving intervention is administering
epinephrine (1) to reverse bronchospasm and vasodilation. Positioning (5) helps
improve blood pressure. IV fluids (3) address the distributive shock. Antihistamines
and corticopers (4) are secondary treatments that help prevent a biphasic reaction
but are not the initial priority.
10.[MCQ]The nurse is teaching a group of nursing studentsabout infection control. Which
statement by a student indicates a need for further teaching?
A. "Hand hygiene is the single most effective way to prevent infection."
B. "I should wear a mask for any client who is on contact precautions."
C. "Used needles should be disposed of in a puncture-proof sharps container."
