Medical-Surgical Nursing Test Bank 2026-
2027 | 110 Exam Questions & Rationales |
Ignatavicius 11th Edition | NCLEX-RN
Preparation
Description:
Download the complete Medical-Surgical Nursing Exam Bank 2026-2027 featuring 110
NCLEX-style questions with evidence-based rationales. Covers pharmacology, stroke care,
wound management, legal ethics, and prioritization. Perfect for nursing students, educators,
and NCLEX-RN candidates.
Download now, study smarter, and pass your med-surg exam on the first attempt!
, Medical-Surgical Nursing Test Bank 2026-2027 (110 Q&A)
Part 1: Clinical Judgment and Prioritization
1. The nurse receives stat orders for a patient with a right femoral-popliteal bypass graft
occlusion who is receiving a continuous IV heparin infusion. Which order should the nurse
question?
A. Oxygen per nasal cannula at 4 L per minute
B. Enoxaparin (Lovenox) 40 mg subcutaneously
C. Troponin level
D. Computed tomography (CT) angiogram
Answer: B
Explanation: The order for enoxaparin (Lovenox) should be questioned because the patient is
already receiving continuous IV heparin. Combining two anticoagulants significantly increases
the risk of bleeding complications, including hemorrhage at the surgical site or other locations.
The other orders are appropriate for a patient with possible graft occlusion and cardiac history.
2. A patient with a history of multiple myocardial infarctions and heavy smoking is
admitted following angioplasty of a failed femoral-popliteal bypass graft. He is receiving
continuous IV heparin. What is the priority nursing intervention?
A. Monitor prothrombin time daily
B. Observe for signs of pulmonary embolism
C. Limit intake of foods high in vitamin K
D. Check the femoral puncture site frequently for bleeding
Answer: D
Explanation: Bleeding is a common and potentially life-threatening side effect of heparin
therapy. The femoral puncture site from the angioplasty is a specific location where bleeding
,may occur, and frequent assessment allows for early detection and intervention. While
monitoring coagulation studies is important, direct inspection of the invasive site takes priority.
3. A patient twelve hours post-below-knee amputation (BKA) develops shortness of breath,
diaphoresis, chest pain, tachycardia (140/min), hypotension (105/60 mmHg), tachypnea
(32/min), and oxygen saturation of 85%. After calling for help, which question is most
important for the nurse to ask?
A. "Have you ever had this type of chest pain before?"
B. "How long have you had this pain?"
C. "What pain medication do you usually take?"
D. "What were you doing when the pain started?"
Answer: A
Explanation: Given the patient's history of multiple myocardial infarctions and the acute
presentation, it is critical to determine if this chest pain is similar to previous cardiac pain. This
information helps differentiate between a pulmonary embolism (common post-amputation) and
an acute myocardial infarction, guiding immediate treatment decisions.
Part 2: Postoperative and Stoma Care
4. A patient underwent total proctocolectomy with permanent ileostomy 12 hours ago.
Which finding requires immediate notification of the physician?
A. The stoma appears pale and dry
B. The stoma appears red and shiny
C. 200 mL of dark green output from the stoma
D. 50 mL of serosanguinous drainage from the stoma
Answer: A
Explanation: A pale, dry stoma indicates inadequate blood supply, suggesting ischemia or
necrosis of the bowel. This is a surgical emergency. A healthy stoma should be pink or red and
, moist. Dark green output and small amounts of serosanguinous drainage are normal findings in
the immediate postoperative period.
5. When changing an ileostomy appliance, the nurse notes irritated peristomal skin. Which
action is appropriate before reapplying the appliance?
A. Wash the area with antiseptic soap and water
B. Clean the site with Dakin's solution
C. Use a solid skin barrier
D. Obtain an order for a topical antibiotic
Answer: C
Explanation: A solid skin barrier with pectin base or karaya wafer provides a protective
hydrocolloid layer between the stoma drainage and the peristomal skin. This is the standard of
care for preventing and managing irritation. Antiseptic soaps and Dakin's solution can further
irritate the skin, and topical antibiotics require an order but do not address the underlying cause.
6. Before surgery, which comment by a patient indicates concern about body image related
to an ileostomy?
A. "I will have to stop my aerobics classes."
B. "I'm so afraid I may not survive the surgery."
C. "I need to go shopping for some loose, baggy clothes."
D. "I'm concerned that this may be only the first of many surgeries."
Answer: C
Explanation: Expressing a need for loose, baggy clothing reflects concern about how the body
will look and function with an ostomy. This is a body image concern. Fear of death relates to
anxiety about the procedure's outcome, and concern about future surgeries relates to illness
progression, not body perception.
2027 | 110 Exam Questions & Rationales |
Ignatavicius 11th Edition | NCLEX-RN
Preparation
Description:
Download the complete Medical-Surgical Nursing Exam Bank 2026-2027 featuring 110
NCLEX-style questions with evidence-based rationales. Covers pharmacology, stroke care,
wound management, legal ethics, and prioritization. Perfect for nursing students, educators,
and NCLEX-RN candidates.
Download now, study smarter, and pass your med-surg exam on the first attempt!
, Medical-Surgical Nursing Test Bank 2026-2027 (110 Q&A)
Part 1: Clinical Judgment and Prioritization
1. The nurse receives stat orders for a patient with a right femoral-popliteal bypass graft
occlusion who is receiving a continuous IV heparin infusion. Which order should the nurse
question?
A. Oxygen per nasal cannula at 4 L per minute
B. Enoxaparin (Lovenox) 40 mg subcutaneously
C. Troponin level
D. Computed tomography (CT) angiogram
Answer: B
Explanation: The order for enoxaparin (Lovenox) should be questioned because the patient is
already receiving continuous IV heparin. Combining two anticoagulants significantly increases
the risk of bleeding complications, including hemorrhage at the surgical site or other locations.
The other orders are appropriate for a patient with possible graft occlusion and cardiac history.
2. A patient with a history of multiple myocardial infarctions and heavy smoking is
admitted following angioplasty of a failed femoral-popliteal bypass graft. He is receiving
continuous IV heparin. What is the priority nursing intervention?
A. Monitor prothrombin time daily
B. Observe for signs of pulmonary embolism
C. Limit intake of foods high in vitamin K
D. Check the femoral puncture site frequently for bleeding
Answer: D
Explanation: Bleeding is a common and potentially life-threatening side effect of heparin
therapy. The femoral puncture site from the angioplasty is a specific location where bleeding
,may occur, and frequent assessment allows for early detection and intervention. While
monitoring coagulation studies is important, direct inspection of the invasive site takes priority.
3. A patient twelve hours post-below-knee amputation (BKA) develops shortness of breath,
diaphoresis, chest pain, tachycardia (140/min), hypotension (105/60 mmHg), tachypnea
(32/min), and oxygen saturation of 85%. After calling for help, which question is most
important for the nurse to ask?
A. "Have you ever had this type of chest pain before?"
B. "How long have you had this pain?"
C. "What pain medication do you usually take?"
D. "What were you doing when the pain started?"
Answer: A
Explanation: Given the patient's history of multiple myocardial infarctions and the acute
presentation, it is critical to determine if this chest pain is similar to previous cardiac pain. This
information helps differentiate between a pulmonary embolism (common post-amputation) and
an acute myocardial infarction, guiding immediate treatment decisions.
Part 2: Postoperative and Stoma Care
4. A patient underwent total proctocolectomy with permanent ileostomy 12 hours ago.
Which finding requires immediate notification of the physician?
A. The stoma appears pale and dry
B. The stoma appears red and shiny
C. 200 mL of dark green output from the stoma
D. 50 mL of serosanguinous drainage from the stoma
Answer: A
Explanation: A pale, dry stoma indicates inadequate blood supply, suggesting ischemia or
necrosis of the bowel. This is a surgical emergency. A healthy stoma should be pink or red and
, moist. Dark green output and small amounts of serosanguinous drainage are normal findings in
the immediate postoperative period.
5. When changing an ileostomy appliance, the nurse notes irritated peristomal skin. Which
action is appropriate before reapplying the appliance?
A. Wash the area with antiseptic soap and water
B. Clean the site with Dakin's solution
C. Use a solid skin barrier
D. Obtain an order for a topical antibiotic
Answer: C
Explanation: A solid skin barrier with pectin base or karaya wafer provides a protective
hydrocolloid layer between the stoma drainage and the peristomal skin. This is the standard of
care for preventing and managing irritation. Antiseptic soaps and Dakin's solution can further
irritate the skin, and topical antibiotics require an order but do not address the underlying cause.
6. Before surgery, which comment by a patient indicates concern about body image related
to an ileostomy?
A. "I will have to stop my aerobics classes."
B. "I'm so afraid I may not survive the surgery."
C. "I need to go shopping for some loose, baggy clothes."
D. "I'm concerned that this may be only the first of many surgeries."
Answer: C
Explanation: Expressing a need for loose, baggy clothing reflects concern about how the body
will look and function with an ostomy. This is a body image concern. Fear of death relates to
anxiety about the procedure's outcome, and concern about future surgeries relates to illness
progression, not body perception.
