CERTIFIED MEDICAL-SURGICAL
Med-Surge Certification Practice Study Guide
Exam Questions and Answers 2025 GRADED A+
A newly diabetic patient will receive instructions from his nurse. Which of the following
actions should the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer. -Correct Answer ✔B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
The post hysterectomy patient with calls the clinic stating that she has been having
difficulty with incontinence. Which of the following statements if made by the patient,
indicates that further teaching is needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void -Correct Answer ✔C.
A patient saying that he or she will only drink fluids when eating meals indicates that
they don't know what to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The
patient states to the RN that he is short of breath, has no appetite and hurts
everywhere. Which of the following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication -Correct Answer ✔C
A clinical nurse returns to the desk to find 4 phone messages. Which of the following
messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
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D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling
toes. -Correct Answer ✔A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D
is less critical than A. Best answer is A.
A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping.
Which of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement. -Correct Answer ✔A
B and C are recommendations that the RN can share after he/she determines the
patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is
concerned about the past (when the person retired). Remove D. A is the best answer.
The nurse cares for a patient several hours after a thyroidectomy. The RN observes that
the patient is diaphoretic and confused. The vital signs are:
Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects
the physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po
qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
ciprofloxacin (cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. -Correct Answer ✔B
A 63 year old female patient contacts the clinic to report that she is has been extremely
fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of
the following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. -Correct Answer ✔C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
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,CERTIFIED MEDICAL-SURGICAL
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. -Correct Answer ✔C
For the patient with a new tracheostomy, the nurse must be alert to which early
complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia -Correct Answer ✔C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING.
Infection comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to
85% over 4 hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe -Correct Answer ✔4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation,
nail polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an
asthma attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. -Correct Answer ✔D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a
calm environment. Helping the patient breathe with pursed lips will facilitate the
expiration of trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
cancer. She states that she doesn't want anyone to see her in this condition, even her
husband. This nurse's best response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
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, CERTIFIED MEDICAL-SURGICAL
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?" -Correct Answer ✔D
The nurse should allow the patient to share her concerns and express her feelings in a
nonjudgmental environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery -Correct Answer ✔C
Tricuspid valve is located between right atrium and right ventricle
MITRAL VALVE- left atrium and left ventricle
If the Purkinje system is damaged, conduction of the electrical impulse is impaired
through the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His -Correct Answer ✔C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently
eject blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje
fibers
The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization -Correct Answer ✔B. Atrial depolarization
CERTIFIED MEDICAL-SURGICAL
Med-Surge Certification Practice Study Guide
Exam Questions and Answers 2025 GRADED A+
A newly diabetic patient will receive instructions from his nurse. Which of the following
actions should the nurse take first?
A. Provide the patient with brochures for making smart choices for cooking/baking.
B. Ask the patient what they know about diabetes.
C. Instruct the patient on exercise or activities that will increase their metabolism.
D. Teach them how to use the glucometer. -Correct Answer ✔B.
First ask the patient what they know about diabetes.
*ACTION questions ask for intervention, NOT assessment
The post hysterectomy patient with calls the clinic stating that she has been having
difficulty with incontinence. Which of the following statements if made by the patient,
indicates that further teaching is needed?
A. I drink 8 oz. of fluid on the even hours while awake.
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
C. I will only drink fluid when I eat my meals
D. I will set the timer to remind me when to void -Correct Answer ✔C.
A patient saying that he or she will only drink fluids when eating meals indicates that
they don't know what to do in case of incontinence.
FURTHER TEACHING indicates that the patient needs more information
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The
patient states to the RN that he is short of breath, has no appetite and hurts
everywhere. Which of the following statements by the nurse is best?
A. Tell me how your family is coping
B. Show me where it does not hurt
C. I'll teach you relaxation techniques
D. Your physician should increase your pain medication -Correct Answer ✔C
A clinical nurse returns to the desk to find 4 phone messages. Which of the following
messages should the nurse respond to first?
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of change in peripheral vision.
C. A patient with a herniated disc complaining of consistent back pain.
CERTIFIED MEDICAL-SURGICAL
,CERTIFIED MEDICAL-SURGICAL
D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling
toes. -Correct Answer ✔A
B and C are expected symptoms of the patient's condition. A and D are unexpected. D
is less critical than A. Best answer is A.
A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping.
Which of the following actions by the nurse is most appropriate?
A. Determine the patient's usual sleeping and waking patterns.
B. Suggest that the client abstain from alcohol and caffeine before bed time.
C. Recommend that client establish a bedtime routine.
D. Ask how much sleep the client required before retirement. -Correct Answer ✔A
B and C are recommendations that the RN can share after he/she determines the
patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is
concerned about the past (when the person retired). Remove D. A is the best answer.
The nurse cares for a patient several hours after a thyroidectomy. The RN observes that
the patient is diaphoretic and confused. The vital signs are:
Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects
the physician to order which of the following?
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po
qld.
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
ciprofloxacin (cipro) 500 mg. po bid.
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. -Correct Answer ✔B
A 63 year old female patient contacts the clinic to report that she is has been extremely
fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of
the following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. -Correct Answer ✔C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
CERTIFIED MEDICAL-SURGICAL
,CERTIFIED MEDICAL-SURGICAL
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. -Correct Answer ✔C
For the patient with a new tracheostomy, the nurse must be alert to which early
complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia -Correct Answer ✔C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING.
Infection comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to
85% over 4 hours, the nurse will first:
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe -Correct Answer ✔4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation,
nail polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an
asthma attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. -Correct Answer ✔D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a
calm environment. Helping the patient breathe with pursed lips will facilitate the
expiration of trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
cancer. She states that she doesn't want anyone to see her in this condition, even her
husband. This nurse's best response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
CERTIFIED MEDICAL-SURGICAL
, CERTIFIED MEDICAL-SURGICAL
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?" -Correct Answer ✔D
The nurse should allow the patient to share her concerns and express her feelings in a
nonjudgmental environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery -Correct Answer ✔C
Tricuspid valve is located between right atrium and right ventricle
MITRAL VALVE- left atrium and left ventricle
If the Purkinje system is damaged, conduction of the electrical impulse is impaired
through the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His -Correct Answer ✔C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently
eject blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje
fibers
The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization -Correct Answer ✔B. Atrial depolarization
CERTIFIED MEDICAL-SURGICAL
