2026 EDITION Adult Medical-Surgical
Practice Assessment B Adult Medical-
Surgical Nursing Competency
Examination Questions, Bold Answers,
and Rationales
1. A nurse is caring for a client admitted with acute pancreatitis.
Which laboratory value is expected to be significantly elevated?
A. Hemoglobin
B. Serum amylase
C. Platelet count
D. Albumin
Answer: B. Serum amylase
Rationale: Acute pancreatitis causes inflammation of pancreatic
tissue, resulting in elevated serum amylase and lipase levels.
,2. A client with heart failure develops crackles in both lung
bases. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Restrict protein intake
D. Obtain a urine specimen
Answer: B. Place the client in high-Fowler's position
Rationale: Upright positioning decreases venous return and
improves lung expansion, reducing respiratory distress.
3. Which assessment finding indicates worsening hypoxia?
A. Warm extremities
B. Bradycardia
C. Restlessness
D. Increased appetite
Answer: C. Restlessness
Rationale: Restlessness is an early neurological manifestation of
inadequate oxygen delivery.
4. A client with chronic kidney disease should limit intake of
which nutrient?
,A. Vitamin C
B. Potassium
C. Calcium
D. Fiber
Answer: B. Potassium
Rationale: Reduced renal excretion increases the risk of
hyperkalemia.
5. Which finding is most consistent with left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Pulmonary crackles
D. Jugular vein distention
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion
leading to crackles.
6. Which intervention helps prevent deep vein thrombosis
following surgery?
A. Limiting fluid intake
B. Bed rest for 48 hours
, C. Early ambulation
D. Applying warm compresses continuously
Answer: C. Early ambulation
Rationale: Walking improves venous return and decreases clot
formation.
7. A client reports crushing chest pain. Which medication is
commonly administered first if not contraindicated?
A. Acetaminophen
B. Nitroglycerin
C. Diphenhydramine
D. Famotidine
Answer: B. Nitroglycerin
Rationale: Nitroglycerin dilates coronary arteries and reduces
myocardial oxygen demand.
8. Which electrolyte imbalance commonly causes peaked T
waves on an ECG?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypomagnesemia
Practice Assessment B Adult Medical-
Surgical Nursing Competency
Examination Questions, Bold Answers,
and Rationales
1. A nurse is caring for a client admitted with acute pancreatitis.
Which laboratory value is expected to be significantly elevated?
A. Hemoglobin
B. Serum amylase
C. Platelet count
D. Albumin
Answer: B. Serum amylase
Rationale: Acute pancreatitis causes inflammation of pancreatic
tissue, resulting in elevated serum amylase and lipase levels.
,2. A client with heart failure develops crackles in both lung
bases. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client in high-Fowler's position
C. Restrict protein intake
D. Obtain a urine specimen
Answer: B. Place the client in high-Fowler's position
Rationale: Upright positioning decreases venous return and
improves lung expansion, reducing respiratory distress.
3. Which assessment finding indicates worsening hypoxia?
A. Warm extremities
B. Bradycardia
C. Restlessness
D. Increased appetite
Answer: C. Restlessness
Rationale: Restlessness is an early neurological manifestation of
inadequate oxygen delivery.
4. A client with chronic kidney disease should limit intake of
which nutrient?
,A. Vitamin C
B. Potassium
C. Calcium
D. Fiber
Answer: B. Potassium
Rationale: Reduced renal excretion increases the risk of
hyperkalemia.
5. Which finding is most consistent with left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Pulmonary crackles
D. Jugular vein distention
Answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes pulmonary congestion
leading to crackles.
6. Which intervention helps prevent deep vein thrombosis
following surgery?
A. Limiting fluid intake
B. Bed rest for 48 hours
, C. Early ambulation
D. Applying warm compresses continuously
Answer: C. Early ambulation
Rationale: Walking improves venous return and decreases clot
formation.
7. A client reports crushing chest pain. Which medication is
commonly administered first if not contraindicated?
A. Acetaminophen
B. Nitroglycerin
C. Diphenhydramine
D. Famotidine
Answer: B. Nitroglycerin
Rationale: Nitroglycerin dilates coronary arteries and reduces
myocardial oxygen demand.
8. Which electrolyte imbalance commonly causes peaked T
waves on an ECG?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypomagnesemia
