1|Page
266 BSN MEDICAL SURGICAL EXAM/BSN 266
MEDICAL SURGICAL Final Exam Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales | Already Graded A+||Brand
New Version!!
QUESTION 1
A nurse is caring for a client with heart failure who is receiving digoxin.
Which assessment finding indicates digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Serum potassium level of 4.0 mEq/L
C) Visual disturbances such as yellow halos around lights
D) Blood pressure of 120/80 mmHg
Answer: C) Visual disturbances such as yellow halos around lights
Rationale: Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting), cardiac dysrhythmias, and neurologic
manifestations including visual disturbances such as yellow-green halos
or blurred vision. A heart rate of 72 is within normal limits, potassium
4.0 is normal, and blood pressure 120/80 is normal. Hypokalemia
,2|Page
predisposes patients to digoxin toxicity, but a potassium of 4.0 does not
indicate toxicity.
QUESTION 2
The nurse is assessing a patient with chronic obstructive pulmonary
disease. Which arterial blood gas finding is consistent with this
diagnosis?
A) pH 7.38, PaCO2 48 mmHg, HCO3 30 mEq/L
B) pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
C) pH 7.42, PaCO2 38 mmHg, HCO3 24 mEq/L
D) pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
Answer: A) pH 7.38, PaCO2 48 mmHg, HCO3 30 mEq/L
Rationale: Chronic COPD leads to chronic hypercapnia and
compensatory metabolic alkalosis. The ABG shows a slightly low pH
(compensated respiratory acidosis), elevated PaCO2, and elevated
HCO3 indicating renal compensation. Options B shows metabolic
acidosis, C is normal, and D shows respiratory alkalosis.
QUESTION 3
The nurse is preparing to administer insulin to a patient with type 1
diabetes mellitus. Which action is essential prior to administration?
A) Shake the insulin vial vigorously
,3|Page
B) Check the blood glucose level
C) Administer insulin regardless of blood glucose
D) Warm the insulin to room temperature by placing it in warm water
Answer: B) Check the blood glucose level
Rationale: Blood glucose must be assessed prior to insulin
administration to determine the appropriate dose and to prevent
hypoglycemia. Insulin vials should be gently rolled, not shaken.
Warming insulin is unnecessary and can degrade it.
QUESTION 4
A patient is diagnosed with pneumonia. Which clinical manifestation
would the nurse expect to find?
A) Bradypnea and bradycardia
B) Fever, productive cough, and crackles
C) Hypotension and bradycardia
D) Wheezing and stridor
Answer: B) Fever, productive cough, and crackles
Rationale: Classic manifestations of pneumonia include fever,
productive cough, and adventitious breath sounds such as crackles or
, 4|Page
rhonchi. Tachycardia and tachypnea are more common. Wheezing is
more characteristic of asthma or bronchospasm.
QUESTION 5
The nurse is caring for a patient after a thyroidectomy. Which
complication requires immediate intervention?
A) Hoarseness
B) Difficulty swallowing
C) Laryngeal stridor
D) Neck pain
Answer: C) Laryngeal stridor
Rationale: Laryngeal stridor indicates airway obstruction from laryngeal
edema or tracheal compression, which can be life-threatening.
Hoarseness and difficulty swallowing are expected postoperatively.
Neck pain is managed with analgesics.
QUESTION 6
A patient with cirrhosis is exhibiting signs of hepatic encephalopathy.
Which dietary modification is most appropriate?
A) High protein diet
B) Low sodium diet
C) Low protein diet
266 BSN MEDICAL SURGICAL EXAM/BSN 266
MEDICAL SURGICAL Final Exam Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales | Already Graded A+||Brand
New Version!!
QUESTION 1
A nurse is caring for a client with heart failure who is receiving digoxin.
Which assessment finding indicates digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Serum potassium level of 4.0 mEq/L
C) Visual disturbances such as yellow halos around lights
D) Blood pressure of 120/80 mmHg
Answer: C) Visual disturbances such as yellow halos around lights
Rationale: Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting), cardiac dysrhythmias, and neurologic
manifestations including visual disturbances such as yellow-green halos
or blurred vision. A heart rate of 72 is within normal limits, potassium
4.0 is normal, and blood pressure 120/80 is normal. Hypokalemia
,2|Page
predisposes patients to digoxin toxicity, but a potassium of 4.0 does not
indicate toxicity.
QUESTION 2
The nurse is assessing a patient with chronic obstructive pulmonary
disease. Which arterial blood gas finding is consistent with this
diagnosis?
A) pH 7.38, PaCO2 48 mmHg, HCO3 30 mEq/L
B) pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
C) pH 7.42, PaCO2 38 mmHg, HCO3 24 mEq/L
D) pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
Answer: A) pH 7.38, PaCO2 48 mmHg, HCO3 30 mEq/L
Rationale: Chronic COPD leads to chronic hypercapnia and
compensatory metabolic alkalosis. The ABG shows a slightly low pH
(compensated respiratory acidosis), elevated PaCO2, and elevated
HCO3 indicating renal compensation. Options B shows metabolic
acidosis, C is normal, and D shows respiratory alkalosis.
QUESTION 3
The nurse is preparing to administer insulin to a patient with type 1
diabetes mellitus. Which action is essential prior to administration?
A) Shake the insulin vial vigorously
,3|Page
B) Check the blood glucose level
C) Administer insulin regardless of blood glucose
D) Warm the insulin to room temperature by placing it in warm water
Answer: B) Check the blood glucose level
Rationale: Blood glucose must be assessed prior to insulin
administration to determine the appropriate dose and to prevent
hypoglycemia. Insulin vials should be gently rolled, not shaken.
Warming insulin is unnecessary and can degrade it.
QUESTION 4
A patient is diagnosed with pneumonia. Which clinical manifestation
would the nurse expect to find?
A) Bradypnea and bradycardia
B) Fever, productive cough, and crackles
C) Hypotension and bradycardia
D) Wheezing and stridor
Answer: B) Fever, productive cough, and crackles
Rationale: Classic manifestations of pneumonia include fever,
productive cough, and adventitious breath sounds such as crackles or
, 4|Page
rhonchi. Tachycardia and tachypnea are more common. Wheezing is
more characteristic of asthma or bronchospasm.
QUESTION 5
The nurse is caring for a patient after a thyroidectomy. Which
complication requires immediate intervention?
A) Hoarseness
B) Difficulty swallowing
C) Laryngeal stridor
D) Neck pain
Answer: C) Laryngeal stridor
Rationale: Laryngeal stridor indicates airway obstruction from laryngeal
edema or tracheal compression, which can be life-threatening.
Hoarseness and difficulty swallowing are expected postoperatively.
Neck pain is managed with analgesics.
QUESTION 6
A patient with cirrhosis is exhibiting signs of hepatic encephalopathy.
Which dietary modification is most appropriate?
A) High protein diet
B) Low sodium diet
C) Low protein diet
