Medical-Surgical Nursing Final Practice Exam – All Correct Answers
1. A patient with chronic kidney disease is experiencing hyperkalemia. Which intervention is most appropriate?
A) Administer IV potassium
B) Encourage high-potassium foods
C) Administer sodium polystyrene sulfonate (Kayexalate) ✅
D) Restrict fluids
Answer: C) Administer sodium polystyrene sulfonate (Kayexalate)
Explanation: Kayexalate helps remove excess potassium from the body, which is critical in hyperkalemia management.
2. A patient with heart failure is prescribed furosemide. Which lab value should the nurse monitor closely?
A) Sodium
B) Potassium ✅
C) Hemoglobin
D) Glucose
Answer: B) Potassium
Explanation: Furosemide is a loop diuretic that can cause hypokalemia, which must be monitored to prevent cardiac complications.
3. Which assessment finding indicates fluid overload in a patient with heart failure?
A) Dry mucous membranes
B) Peripheral edema ✅
C) Hypotension
D) Bradycardia
Answer: B) Peripheral edema
Explanation: Fluid retention often presents as peripheral edema in patients with heart failure.
, 4. A patient post-thyroidectomy reports tingling around the lips and fingers. What is the priority action?
A) Assess respiratory status
B) Administer calcium gluconate ✅
C) Encourage oral fluids
D) Apply a warm blanket
Answer: B) Administer calcium gluconate
Explanation: Tingling may indicate hypocalcemia from accidental parathyroid removal. Calcium supplementation is urgent.
5. Which nursing intervention is appropriate for a patient with COPD experiencing shortness of breath?
A) Place patient in supine position
B) Encourage pursed-lip breathing ✅
C) Limit oxygen therapy
D) Administer sedatives
Answer: B) Encourage pursed-lip breathing
Explanation: Pursed-lip breathing helps reduce dyspnea and improves ventilation in COPD patients.
6. A patient with diabetes presents with fruity-smelling breath, rapid respirations, and confusion. Which condition is suspected?
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA) ✅
C) Hyperosmolar hyperglycemic state
D) Insulin shock
Answer: B) Diabetic ketoacidosis (DKA)
Explanation: Fruity breath and Kussmaul respirations are classic signs of DKA.
7. Which lab result indicates anemia in a patient?
A) Hemoglobin 8 g/dL ✅
B) WBC 7,000/mm³
1. A patient with chronic kidney disease is experiencing hyperkalemia. Which intervention is most appropriate?
A) Administer IV potassium
B) Encourage high-potassium foods
C) Administer sodium polystyrene sulfonate (Kayexalate) ✅
D) Restrict fluids
Answer: C) Administer sodium polystyrene sulfonate (Kayexalate)
Explanation: Kayexalate helps remove excess potassium from the body, which is critical in hyperkalemia management.
2. A patient with heart failure is prescribed furosemide. Which lab value should the nurse monitor closely?
A) Sodium
B) Potassium ✅
C) Hemoglobin
D) Glucose
Answer: B) Potassium
Explanation: Furosemide is a loop diuretic that can cause hypokalemia, which must be monitored to prevent cardiac complications.
3. Which assessment finding indicates fluid overload in a patient with heart failure?
A) Dry mucous membranes
B) Peripheral edema ✅
C) Hypotension
D) Bradycardia
Answer: B) Peripheral edema
Explanation: Fluid retention often presents as peripheral edema in patients with heart failure.
, 4. A patient post-thyroidectomy reports tingling around the lips and fingers. What is the priority action?
A) Assess respiratory status
B) Administer calcium gluconate ✅
C) Encourage oral fluids
D) Apply a warm blanket
Answer: B) Administer calcium gluconate
Explanation: Tingling may indicate hypocalcemia from accidental parathyroid removal. Calcium supplementation is urgent.
5. Which nursing intervention is appropriate for a patient with COPD experiencing shortness of breath?
A) Place patient in supine position
B) Encourage pursed-lip breathing ✅
C) Limit oxygen therapy
D) Administer sedatives
Answer: B) Encourage pursed-lip breathing
Explanation: Pursed-lip breathing helps reduce dyspnea and improves ventilation in COPD patients.
6. A patient with diabetes presents with fruity-smelling breath, rapid respirations, and confusion. Which condition is suspected?
A) Hypoglycemia
B) Diabetic ketoacidosis (DKA) ✅
C) Hyperosmolar hyperglycemic state
D) Insulin shock
Answer: B) Diabetic ketoacidosis (DKA)
Explanation: Fruity breath and Kussmaul respirations are classic signs of DKA.
7. Which lab result indicates anemia in a patient?
A) Hemoglobin 8 g/dL ✅
B) WBC 7,000/mm³
