Page 1 of 167
RN VATI ADULT MEDICAL SURGICAL
ASSESSMENT EXAM PREP GUIDE
2026-2027 ACADEMIC YEAR | 250+ PRACTICE
QUESTIONS WITH VERIFIED ANSWERS &
RATIONALES
# SECTION I: CARDIOVASCULAR DISORDERS
## Question 1
A nurse is assessing a client who has left-sided heart failure. Which of the following findings
should the nurse identify as a manifestation of left-sided heart failure?
A) Dependent edema in the lower extremities
B) Pink-tinged frothy sputum
C) Jugular vein distention
D) Hepatomegaly
**Correct Answer: B**
**Rationale:** Pink-tinged frothy sputum indicates pulmonary edema, a hallmark manifestation
of left-sided heart failure due to increased pressure in the pulmonary vasculature and fluid
accumulation in the alveoli. Left-sided heart failure causes blood to back up into the lungs,
leading to pulmonary congestion, dyspnea, orthopnea, and crackles on auscultation. Dependent
edema (A), jugular vein distention (C), and hepatomegaly (D) are manifestations of **right-
sided** heart failure, which results from systemic venous congestion.
,Page 2 of 167
## Question 2
A nurse is caring for a client with acute myocardial infarction who reports chest pain unrelieved
by sublingual nitroglycerin. Which of the following medications should the nurse anticipate
administering?
A) Aspirin
B) Morphine sulfate
C) Metoprolol
D) Heparin
**Correct Answer: B**
**Rationale:** Morphine sulfate is indicated for chest pain unrelieved by nitroglycerin in acute
myocardial infarction. It reduces pain, decreases myocardial oxygen demand, and promotes
venous pooling. Aspirin (A) is given for its antiplatelet effects but does not relieve pain.
Metoprolol (C) is a beta-blocker used to reduce heart rate and oxygen demand but is not the
primary agent for unrelieved pain. Heparin (D) is an anticoagulant and does not provide
analgesia.
---
## Question 3
A nurse is assessing a client who has atrial fibrillation. Which of the following findings is the
priority for the nurse to report to the provider?
A) Heart rate of 110/min
B) Irregularly irregular pulse
C) Sudden onset of slurred speech
D) Fatigue and shortness of breath
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**Correct Answer: C**
**Rationale:** Sudden onset of slurred speech is a manifestation of an acute ischemic stroke, the
most serious complication of atrial fibrillation due to the risk of emboli formation in the atria.
This finding requires immediate notification of the provider and rapid intervention. A heart rate
of 110/min (A) and irregularly irregular pulse (B) are expected findings in atrial fibrillation.
Fatigue and shortness of breath (D) are common but not as immediately life-threatening as signs
of stroke.
---
## Question 4
A client with heart failure is prescribed furosemide (Lasix). Which of the following laboratory
values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
**Correct Answer: B**
**Rationale:** Furosemide is a loop diuretic that causes significant potassium depletion through
increased urinary excretion. Hypokalemia can lead to cardiac dysrhythmias, especially in clients
taking digoxin. While sodium (A), calcium (C), and magnesium (D) may also be affected,
potassium monitoring is the highest priority due to the risk of life-threatening arrhythmias.
---
## Question 5
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A nurse is providing discharge teaching to a client who has a new diagnosis of hypertension.
Which of the following statements by the client indicates an understanding of the teaching?
A) "I will check my blood pressure only when I feel dizzy."
B) "I can stop my medication once my blood pressure is normal."
C) "I will limit my sodium intake to less than 2,000 mg per day."
D) "I should exercise vigorously for 30 minutes every day."
**Correct Answer: C**
**Rationale:** The client demonstrates understanding by stating they will limit sodium intake to
less than 2,000 mg per day, which is a key dietary modification for hypertension management.
Blood pressure should be monitored regularly, not only when symptomatic (A). Antihypertensive
medications must be taken consistently even when blood pressure is normal (B). Exercise should
be moderate and approved by the provider, not necessarily vigorous (D).
---
## Question 6
A nurse is caring for a client with peripheral arterial disease (PAD). Which of the following
assessment findings should the nurse expect?
A) Bounding pedal pulses
B) Warm, pink extremities
C) Thin, shiny skin with hair loss on the lower extremities
D) Edema and brown discoloration of the lower legs
**Correct Answer: C**
RN VATI ADULT MEDICAL SURGICAL
ASSESSMENT EXAM PREP GUIDE
2026-2027 ACADEMIC YEAR | 250+ PRACTICE
QUESTIONS WITH VERIFIED ANSWERS &
RATIONALES
# SECTION I: CARDIOVASCULAR DISORDERS
## Question 1
A nurse is assessing a client who has left-sided heart failure. Which of the following findings
should the nurse identify as a manifestation of left-sided heart failure?
A) Dependent edema in the lower extremities
B) Pink-tinged frothy sputum
C) Jugular vein distention
D) Hepatomegaly
**Correct Answer: B**
**Rationale:** Pink-tinged frothy sputum indicates pulmonary edema, a hallmark manifestation
of left-sided heart failure due to increased pressure in the pulmonary vasculature and fluid
accumulation in the alveoli. Left-sided heart failure causes blood to back up into the lungs,
leading to pulmonary congestion, dyspnea, orthopnea, and crackles on auscultation. Dependent
edema (A), jugular vein distention (C), and hepatomegaly (D) are manifestations of **right-
sided** heart failure, which results from systemic venous congestion.
,Page 2 of 167
## Question 2
A nurse is caring for a client with acute myocardial infarction who reports chest pain unrelieved
by sublingual nitroglycerin. Which of the following medications should the nurse anticipate
administering?
A) Aspirin
B) Morphine sulfate
C) Metoprolol
D) Heparin
**Correct Answer: B**
**Rationale:** Morphine sulfate is indicated for chest pain unrelieved by nitroglycerin in acute
myocardial infarction. It reduces pain, decreases myocardial oxygen demand, and promotes
venous pooling. Aspirin (A) is given for its antiplatelet effects but does not relieve pain.
Metoprolol (C) is a beta-blocker used to reduce heart rate and oxygen demand but is not the
primary agent for unrelieved pain. Heparin (D) is an anticoagulant and does not provide
analgesia.
---
## Question 3
A nurse is assessing a client who has atrial fibrillation. Which of the following findings is the
priority for the nurse to report to the provider?
A) Heart rate of 110/min
B) Irregularly irregular pulse
C) Sudden onset of slurred speech
D) Fatigue and shortness of breath
,Page 3 of 167
**Correct Answer: C**
**Rationale:** Sudden onset of slurred speech is a manifestation of an acute ischemic stroke, the
most serious complication of atrial fibrillation due to the risk of emboli formation in the atria.
This finding requires immediate notification of the provider and rapid intervention. A heart rate
of 110/min (A) and irregularly irregular pulse (B) are expected findings in atrial fibrillation.
Fatigue and shortness of breath (D) are common but not as immediately life-threatening as signs
of stroke.
---
## Question 4
A client with heart failure is prescribed furosemide (Lasix). Which of the following laboratory
values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
**Correct Answer: B**
**Rationale:** Furosemide is a loop diuretic that causes significant potassium depletion through
increased urinary excretion. Hypokalemia can lead to cardiac dysrhythmias, especially in clients
taking digoxin. While sodium (A), calcium (C), and magnesium (D) may also be affected,
potassium monitoring is the highest priority due to the risk of life-threatening arrhythmias.
---
## Question 5
, Page 4 of 167
A nurse is providing discharge teaching to a client who has a new diagnosis of hypertension.
Which of the following statements by the client indicates an understanding of the teaching?
A) "I will check my blood pressure only when I feel dizzy."
B) "I can stop my medication once my blood pressure is normal."
C) "I will limit my sodium intake to less than 2,000 mg per day."
D) "I should exercise vigorously for 30 minutes every day."
**Correct Answer: C**
**Rationale:** The client demonstrates understanding by stating they will limit sodium intake to
less than 2,000 mg per day, which is a key dietary modification for hypertension management.
Blood pressure should be monitored regularly, not only when symptomatic (A). Antihypertensive
medications must be taken consistently even when blood pressure is normal (B). Exercise should
be moderate and approved by the provider, not necessarily vigorous (D).
---
## Question 6
A nurse is caring for a client with peripheral arterial disease (PAD). Which of the following
assessment findings should the nurse expect?
A) Bounding pedal pulses
B) Warm, pink extremities
C) Thin, shiny skin with hair loss on the lower extremities
D) Edema and brown discoloration of the lower legs
**Correct Answer: C**
