MEDICAL-SURGICAL NURSING: CONCEPTS AND
PRACTICE, 6TH EDITION — ORIGINAL PRACTICE
QUESTIONS: FUNDAMENTALS OF PATIENT CARE AND
SAFETY ACTUAL EXAM [QUESTION 1- 200] AND ANSWERS
UPDATED 2026/2027| 100% VERIFIED|DETAILED
RATIONALES –PASS GUARANTEED A+ GRADED |INSTANT
DOWNLOAD
INTRODUCTION
Medical-Surgical Nursing: Concepts and Practice, 6th Edition is a medical-surgical nursing
textbook by Holly K. Stromberg, published by Saunders/Elsevier. The sixth edition was
published in 2025 and is designed primarily for LPN/LVN students, emphasizing clinical
judgment, evidence-based practice, patient safety, and preparation for Next-Generation NCLEX-
PN–style assessment. (Elsevier Shop)
Because this is a textbook rather than a certification examination, there is no single official
"actual exam," official 200-question test, or standardized exam duration associated with the
book. The following are original practice questions, not reproduced questions from a
proprietary instructor test bank. They focus on fundamentals of medical-surgical patient care and
safety and are designed to emphasize application and clinical judgment.
The sixth edition covers medical-surgical nursing settings, clinical judgment and the nursing
process, fluids and electrolytes, perioperative care, infection prevention, pain, cancer, chronic
illness, emergency care, and multiple body-system disorders. The publisher specifically
emphasizes application of nursing knowledge and NGN-style clinical judgment. (Elsevier Shop)
Certification and nursing education can support professional development, but the value of a
particular credential depends on the nurse's role, jurisdiction, employer, and career goals. These
practice questions should therefore be used as supplemental study material rather than as a
guarantee of examination performance.
Core Domains Tested in Medical-Surgical Nursing:
Fundamentals of Patient Care and Safety
Clinical judgment and prioritization
Nursing process and patient assessment
Patient safety and fall prevention
Infection prevention and standard precautions
Medication safety
Communication and documentation
Mobility, positioning, and pressure-injury prevention
Fluid, electrolyte, and acid-base management
, Perioperative and postoperative safety
Emergency recognition and response
CONTENT AREA TABLE
% of Approx. # of
Content Domain Key Topics Covered
Practice Set Questions
Clinical Judgment & Assessment, prioritization,
15% 30
Nursing Process implementation, evaluation
Patient Safety & Risk Falls, restraints, environmental
15% 30
Reduction hazards, rapid deterioration
Infection Prevention & Standard precautions, transmission-
15% 30
Control based precautions, asepsis
Verification, administration,
Medication Safety 10% 20
adverse effects, reconciliation
Handoffs, therapeutic
Communication &
10% 20 communication, legal
Documentation
documentation
Transfers, positioning, pressure
Mobility & Skin Integrity 10% 20
injury prevention
Fluids, Electrolytes & IV IV complications, electrolyte
10% 20
Therapy abnormalities, fluid balance
Perioperative & Surgical preparation, recovery,
10% 20
Postoperative Care complications
Emergency & Basic
5% 10 ABCs, deterioration, rapid response
Patient-Care Priorities
Fundamentals of patient care and
Total 100% 200
safety
QUESTIONS 1–200
Q1: A hospitalized patient suddenly becomes restless, tachypneic, and confused. The
oxygen saturation has fallen from 96% to 88%. Which action should the nurse take first?
A) Document the change and reassess in 30 minutes
B) Assess airway and breathing while applying appropriate oxygen support
C) Administer the patient's prescribed oral analgesic
D) Call the family to obtain additional history
Correct Answer: B
Rationale: The acute change suggests possible hypoxemia. Airway and breathing take priority
under the ABC framework. Documentation and additional history are important but should not
delay stabilization. Analgesia does not address the immediate threat.
,Q2: A patient at high risk for falls attempts to get out of bed without assistance. Which
intervention best reduces immediate risk?
A) Apply a vest restraint
B) Keep all four side rails raised
C) Place the bed in the lowest position and activate the call-light system
D) Ask the patient to remain in bed without further explanation
Correct Answer: C
Rationale: A low bed and accessible call light reduce fall risk while preserving mobility and
autonomy. Restraints and all four side rails can create additional hazards and are not routine
fall-prevention measures.
Q3: A nurse discovers that a patient's identification band is missing immediately before
medication administration. What should the nurse do?
A) Ask the patient to state the name and date of birth and proceed
B) Ask another nurse to identify the patient
C) Replace or verify the identification according to facility policy before administering the
medication
D) Administer the medication because the nurse recognizes the patient
Correct Answer: C
Rationale: Positive patient identification is a fundamental medication-safety requirement.
Recognition or verbal confirmation alone does not substitute for the facility's required
identification process.
Q4: A postoperative patient reports increasing abdominal pain despite prescribed
analgesia. The abdomen is becoming firm and distended, and the blood pressure has
decreased. Which finding is most concerning?
A) Pain rated 7/10
B) Mild nausea
C) Abdominal distention accompanied by hypotension
D) Request for additional pain medication
Correct Answer: C
Rationale: Distention with hypotension may indicate internal bleeding or another serious
postoperative complication. The nurse should urgently assess the patient and notify the
appropriate provider or rapid-response team according to severity.
Q5: A nurse is preparing to enter the room of a patient with suspected Clostridioides
difficile infection. Which practice is most appropriate?
A) Wear an N95 respirator only
B) Use contact precautions and perform appropriate hand hygiene after care
C) Use sterile gloves for every interaction
D) Place the patient under airborne precautions
Correct Answer: B
Rationale: C. difficile requires contact precautions in addition to standard precautions. Soap-
and-water handwashing is particularly important because alcohol-based hand rubs do not
reliably eliminate spores.
, Q6: A nurse receives a handoff for four patients. Which patient should the nurse assess
first?
A) Patient requesting assistance with bathing
B) Patient with chronic arthritis reporting pain of 5/10
C) Patient awaiting routine discharge instructions
D) Patient with new-onset stridor after neck surgery
Correct Answer: D
Rationale: Stridor indicates possible upper-airway obstruction and is an immediate airway
threat. The other needs are important but do not take precedence over an unstable airway.
Q7: A nurse is documenting an assessment after a patient falls. Which documentation is
most appropriate?
A) "Patient fell because he was careless."
B) "Patient had an accident due to poor judgment."
C) "Patient found sitting on floor beside bed; states, 'I was trying to reach the bathroom.'"
D) "Patient experienced an apparently preventable fall."
Correct Answer: C
Rationale: Documentation should be objective, factual, and free of blame or unsupported
conclusions. The patient's direct statement may appropriately be documented as a quotation.
Q8: A patient receiving an IV infusion develops swelling, coolness, and pallor around the
IV site. What should the nurse do first?
A) Increase the infusion rate
B) Apply pressure over the catheter
C) Stop the infusion and assess the IV site
D) Flush the catheter forcefully
Correct Answer: C
Rationale: These findings are consistent with infiltration. The infusion should be stopped
promptly to prevent further tissue exposure. Forceful flushing can worsen tissue injury.
Q9: A patient with limited mobility is at increased risk for pressure injury. Which
intervention is most appropriate?
A) Massage reddened bony prominences
B) Keep the head of bed elevated continuously
C) Reposition regularly and inspect pressure-prone areas
D) Place a donut-shaped ring under the sacrum
Correct Answer: C
Rationale: Regular repositioning and skin assessment reduce prolonged pressure. Massage of
reddened tissue and donut devices can damage tissue or impair circulation.
Q10: During medication reconciliation, the nurse notices that the patient reports taking
two medications from different providers that have the same active ingredient. What is the
nurse's priority action?
A) Tell the patient to discontinue both medications
B) Document the medications but take no further action
C) Identify the potential duplication and communicate it to the appropriate
PRACTICE, 6TH EDITION — ORIGINAL PRACTICE
QUESTIONS: FUNDAMENTALS OF PATIENT CARE AND
SAFETY ACTUAL EXAM [QUESTION 1- 200] AND ANSWERS
UPDATED 2026/2027| 100% VERIFIED|DETAILED
RATIONALES –PASS GUARANTEED A+ GRADED |INSTANT
DOWNLOAD
INTRODUCTION
Medical-Surgical Nursing: Concepts and Practice, 6th Edition is a medical-surgical nursing
textbook by Holly K. Stromberg, published by Saunders/Elsevier. The sixth edition was
published in 2025 and is designed primarily for LPN/LVN students, emphasizing clinical
judgment, evidence-based practice, patient safety, and preparation for Next-Generation NCLEX-
PN–style assessment. (Elsevier Shop)
Because this is a textbook rather than a certification examination, there is no single official
"actual exam," official 200-question test, or standardized exam duration associated with the
book. The following are original practice questions, not reproduced questions from a
proprietary instructor test bank. They focus on fundamentals of medical-surgical patient care and
safety and are designed to emphasize application and clinical judgment.
The sixth edition covers medical-surgical nursing settings, clinical judgment and the nursing
process, fluids and electrolytes, perioperative care, infection prevention, pain, cancer, chronic
illness, emergency care, and multiple body-system disorders. The publisher specifically
emphasizes application of nursing knowledge and NGN-style clinical judgment. (Elsevier Shop)
Certification and nursing education can support professional development, but the value of a
particular credential depends on the nurse's role, jurisdiction, employer, and career goals. These
practice questions should therefore be used as supplemental study material rather than as a
guarantee of examination performance.
Core Domains Tested in Medical-Surgical Nursing:
Fundamentals of Patient Care and Safety
Clinical judgment and prioritization
Nursing process and patient assessment
Patient safety and fall prevention
Infection prevention and standard precautions
Medication safety
Communication and documentation
Mobility, positioning, and pressure-injury prevention
Fluid, electrolyte, and acid-base management
, Perioperative and postoperative safety
Emergency recognition and response
CONTENT AREA TABLE
% of Approx. # of
Content Domain Key Topics Covered
Practice Set Questions
Clinical Judgment & Assessment, prioritization,
15% 30
Nursing Process implementation, evaluation
Patient Safety & Risk Falls, restraints, environmental
15% 30
Reduction hazards, rapid deterioration
Infection Prevention & Standard precautions, transmission-
15% 30
Control based precautions, asepsis
Verification, administration,
Medication Safety 10% 20
adverse effects, reconciliation
Handoffs, therapeutic
Communication &
10% 20 communication, legal
Documentation
documentation
Transfers, positioning, pressure
Mobility & Skin Integrity 10% 20
injury prevention
Fluids, Electrolytes & IV IV complications, electrolyte
10% 20
Therapy abnormalities, fluid balance
Perioperative & Surgical preparation, recovery,
10% 20
Postoperative Care complications
Emergency & Basic
5% 10 ABCs, deterioration, rapid response
Patient-Care Priorities
Fundamentals of patient care and
Total 100% 200
safety
QUESTIONS 1–200
Q1: A hospitalized patient suddenly becomes restless, tachypneic, and confused. The
oxygen saturation has fallen from 96% to 88%. Which action should the nurse take first?
A) Document the change and reassess in 30 minutes
B) Assess airway and breathing while applying appropriate oxygen support
C) Administer the patient's prescribed oral analgesic
D) Call the family to obtain additional history
Correct Answer: B
Rationale: The acute change suggests possible hypoxemia. Airway and breathing take priority
under the ABC framework. Documentation and additional history are important but should not
delay stabilization. Analgesia does not address the immediate threat.
,Q2: A patient at high risk for falls attempts to get out of bed without assistance. Which
intervention best reduces immediate risk?
A) Apply a vest restraint
B) Keep all four side rails raised
C) Place the bed in the lowest position and activate the call-light system
D) Ask the patient to remain in bed without further explanation
Correct Answer: C
Rationale: A low bed and accessible call light reduce fall risk while preserving mobility and
autonomy. Restraints and all four side rails can create additional hazards and are not routine
fall-prevention measures.
Q3: A nurse discovers that a patient's identification band is missing immediately before
medication administration. What should the nurse do?
A) Ask the patient to state the name and date of birth and proceed
B) Ask another nurse to identify the patient
C) Replace or verify the identification according to facility policy before administering the
medication
D) Administer the medication because the nurse recognizes the patient
Correct Answer: C
Rationale: Positive patient identification is a fundamental medication-safety requirement.
Recognition or verbal confirmation alone does not substitute for the facility's required
identification process.
Q4: A postoperative patient reports increasing abdominal pain despite prescribed
analgesia. The abdomen is becoming firm and distended, and the blood pressure has
decreased. Which finding is most concerning?
A) Pain rated 7/10
B) Mild nausea
C) Abdominal distention accompanied by hypotension
D) Request for additional pain medication
Correct Answer: C
Rationale: Distention with hypotension may indicate internal bleeding or another serious
postoperative complication. The nurse should urgently assess the patient and notify the
appropriate provider or rapid-response team according to severity.
Q5: A nurse is preparing to enter the room of a patient with suspected Clostridioides
difficile infection. Which practice is most appropriate?
A) Wear an N95 respirator only
B) Use contact precautions and perform appropriate hand hygiene after care
C) Use sterile gloves for every interaction
D) Place the patient under airborne precautions
Correct Answer: B
Rationale: C. difficile requires contact precautions in addition to standard precautions. Soap-
and-water handwashing is particularly important because alcohol-based hand rubs do not
reliably eliminate spores.
, Q6: A nurse receives a handoff for four patients. Which patient should the nurse assess
first?
A) Patient requesting assistance with bathing
B) Patient with chronic arthritis reporting pain of 5/10
C) Patient awaiting routine discharge instructions
D) Patient with new-onset stridor after neck surgery
Correct Answer: D
Rationale: Stridor indicates possible upper-airway obstruction and is an immediate airway
threat. The other needs are important but do not take precedence over an unstable airway.
Q7: A nurse is documenting an assessment after a patient falls. Which documentation is
most appropriate?
A) "Patient fell because he was careless."
B) "Patient had an accident due to poor judgment."
C) "Patient found sitting on floor beside bed; states, 'I was trying to reach the bathroom.'"
D) "Patient experienced an apparently preventable fall."
Correct Answer: C
Rationale: Documentation should be objective, factual, and free of blame or unsupported
conclusions. The patient's direct statement may appropriately be documented as a quotation.
Q8: A patient receiving an IV infusion develops swelling, coolness, and pallor around the
IV site. What should the nurse do first?
A) Increase the infusion rate
B) Apply pressure over the catheter
C) Stop the infusion and assess the IV site
D) Flush the catheter forcefully
Correct Answer: C
Rationale: These findings are consistent with infiltration. The infusion should be stopped
promptly to prevent further tissue exposure. Forceful flushing can worsen tissue injury.
Q9: A patient with limited mobility is at increased risk for pressure injury. Which
intervention is most appropriate?
A) Massage reddened bony prominences
B) Keep the head of bed elevated continuously
C) Reposition regularly and inspect pressure-prone areas
D) Place a donut-shaped ring under the sacrum
Correct Answer: C
Rationale: Regular repositioning and skin assessment reduce prolonged pressure. Massage of
reddened tissue and donut devices can damage tissue or impair circulation.
Q10: During medication reconciliation, the nurse notices that the patient reports taking
two medications from different providers that have the same active ingredient. What is the
nurse's priority action?
A) Tell the patient to discontinue both medications
B) Document the medications but take no further action
C) Identify the potential duplication and communicate it to the appropriate
