Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
A newly diabetic patient will receive instructions with a diagnosis of terminal cancer. The patient
from his nurse. Which of the following actions states to the RN that he is short of breath, has no
should the nurse take first? appetite and hurts everywhere. Which of the
following statements by the nurse is best?
A. Provide the patient with brochures for making
smart choices for cooking/baking. A. Tell me how your family is coping
B. Ask the patient what they know about B. Show me where it does not hurt
diabetes. C. I'll teach you relaxation techniques
C. Instruct the patient on exercise or activities D. Your physician should increase your pain
that will increase their metabolism. medication - ANSWER -C
D. Teach them how to use the glucometer. -
ANSWER -B.
First ask the patient what they know about A clinical nurse returns to the desk to find 4
diabetes. phone messages. Which of the following
messages should the nurse respond to first?
*ACTION questions ask for intervention, NOT
assessment A. A post cervical laminectomy patient
complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of
change in peripheral vision.
The post hysterectomy patient with calls the C. A patient with a herniated disc complaining of
clinic stating that she has been having difficulty consistent back pain.
with incontinence. Which of the following D. A patient with a cast due to a fracture of the
statements if made by the patient, indicates that right tibial bone complaining of tingling toes. -
further teaching is needed? ANSWER -A
A. I drink 8 oz. of fluid on the even hours while B and C are expected symptoms of the patient's
awake. condition. A and D are unexpected. D is less
B. I will attempt to void 30 minutes after drinking critical than A. Best answer is A.
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 -
ANSWER -C. A 75 year old patient complains to the clinical
nurse that he is having difficulty sleeping. Which
A patient saying that he or she will only drink of the following actions by the nurse is most
fluids when eating meals indicates that they don't appropriate?
know what to do in case of incontinence.
A. Determine the patient's usual sleeping and
FURTHER TEACHING indicates that the patient waking patterns.
needs more information B. Suggest that the client abstain from alcohol
and caffeine before bed time.
C. Recommend that client establish a bedtime
routine.
An RN assesses a patient in the Cancer Center D. Ask how much sleep the client required before
,Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
retirement. - ANSWER -A Need more info
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 The RN performs blood pressure screening at the
C. D is an inquiry, but is concerned about the local community center. Which of the following
past (when the person retired). Remove D. A is individuals is most likely to suffer from a
the best answer. cerebrovascular accident?
A. A 30 year old man who is an account
executive
The nurse cares for a patient several hours after B. A 40 year old man who jogs four times a week.
a thyroidectomy. The RN observes that the C. A 60 year old man whose father had a stroke.
patient is diaphoretic and confused. The vital D. A 75 year old man who takes multi-vitamins. -
signs are: ANSWER -C
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?
For the patient with a new tracheostomy, the
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min. nurse must be alert to which early complication?
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr
IV, propylthiaouracil (PTU) 200 mg po qld. a) Decannulation
C. Levothyroxine Sodium (Synthroid) 100 mcg b) Infection
IV, Lactated Ringer's 125 cc/hr IV, and c) Bleeding
ciprofloxacin (cipro) 500 mg. po bid. d) Tracheomalacia - ANSWER -C
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn,
0.9% NACl. - ANSWER -B Common acute risks of tracheostomy include
bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to
achieve successful airway
A 63 year old female patient contacts the clinic to
report that she is has been extremely fatigued, is EVERYTHING 24 HR POST SURGERY, FIRST
sleeping 12 hours a night, is always cold and her COMPLICATION IS BLEEDING. Infection comes
hair is falling out. Which of the following 2-3 days later.
responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min
every day. When a pulse oximetry monitor indicates that a
B. You don't need to worry. Sleeping a lot is patient has a drop in SpO2 from 96% to 85%
good for you. over 4 hours, the nurse will first:
C. Come in and see your health care provider
today. 1. Request an order for stat ABGs
D. You should eat more green leafy vegetables. - 2. Start the patient on oxygen by NC at 2L/minute
ANSWER -C 3. Notify the physician of the change
4. Check the position of the probe on patient's
,Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
finger or earlobe - ANSWER -4
D."What about your condition worries you?" -
Pulse oximetry is inaccurate if the probe is loose, ANSWER -D
or in the presence of poor circulation, nail polish,
or dark skin pigmentation. The nurse should allow the patient to share her
concerns and express her feelings in a
nonjudgmental environment.
To decrease a patient's shortness of breath and If there is psych/behavioral component- AFFIRM
a sense of impending doom during an asthma AND VALIDATE, NO PROBING
attack, the nurse will:
A. Place the patient on a cardiac monitor and
observe from the nurses' station. A patient with a tricuspid valve disorder will have
B. Let the patient rest alone in a quiet, calm impaired blood flow between the:
environment.
C. Reassure the patient that the doctor will arrive A. Vena cava and right atrium
soon B. Left atrium and left ventricle
D. Stay with the patient and encourage pursed- C. Right atrium and right ventricle
lip breathing. - ANSWER -D D. Right ventricle and pulmonary artery -
ANSWER -C
The patient experiencing an acute asthma
exacerbation will be fearful and anxious. It is Tricuspid valve is located between right atrium
important for the nurse to stay with the patient for and right ventricle
ongoing assessment and to provide a calm
environment. Helping the patient breathe with MITRAL VALVE- left atrium and left ventricle
pursed lips will facilitate the expiration of trapped
air and help the patient regain control of his or
her breathing.
If the Purkinje system is damaged, conduction of
the electrical impulse is impaired through the:
A 68 year old woman is admitted to the surgical A. Atria
unit after a gastric resection for gastric cancer. B. AV node
She states that she doesn't want anyone to see C. Ventricles
her in this condition, even her husband. This D. Bundle of His - ANSWER -C
nurse's best response is:
Purkinje fibers provide a high-speed distribution
A."Patients' rights protect your privacy. I won't of excitation throughout the ventricular
allow anyone in." myocardium; if the pattern of contraction is
disrupted, the ventricles will not efficiently eject
B."I've seen gastric cancer patients who look blood
much worse. Don't worry."
Order of impulse is SA node to AV node to
C."Would you like to talk to a social worker?" Bundle of His to bundle branch to purkinje fibers
, Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
D. Systolic BP of 150 mmHg - ANSWER -B
UO should be greater or equal to .5ml per kg per
The P-wave on an EKG is representative of: hour.
MAPs should be between 65-85
A. Ventricular depolarization Lactate levels should be less than 2.3
B. Atrial depolarization SBP of 150 is high but does not indicate poor
C. Atrial repolarization perfusion
D. Ventricular repolarization - ANSWER -B.
Atrial depolarization
Ventricular repolarization is represented by the When performing discharge teaching with a
QRS There is no distinctly visible wave patient who is taking warfarin sodium
representing atrial repolarization in the ECG (Coumadin), the nurse learns that patient used
because it occurs during ventricular complementary therapies at home. Which of the
depolarization, ventricular repolarization is shown following substances is most concerning?
as the interval between the start of the QRS
complex and the end of the T wave A. Echinacea
B. Vitamin B12
C. Vitamin D
D. Garlic - ANSWER -D. Garlic
A patient admitted with an abscess in her left
thigh undergoes incision and drainage. 3 days When taking warfarin, caution with - garlic,
later, she develops fever (temperature of 103°F), ginseng, ginkgo, ibuprofen, pain drugs, vitamin E
chills, lethargy, and shortness of breath. Garlic may increase bleeding, so supplemental
Infectious endocarditis is suspected. In addition garlic may cause a synergic effect when
to blood cultures, the nurse would expect which combined with coumadin
of these tests?
A. Transesophageal echocardiogram
B. Computed tomography of the chest For the same patient - who is being discharged
C. Cardiac stress test and is taking warfarin (Coumadin), the nurse
D. Cardiac enzymes - ANSWER -A. should also emphasize that:
Echocardiogram to visualize cardiac structures. A. Regular follow-up with healthcare provider is
essential
B. Aspirin would be recommended for headache
therapy
Which of the following is a sign of poor C. The medication can be taken any time of the
perfusion? day
D. Diet should be high in iron content -
A. Mean arterial pressure <80 mmHg ANSWER -A
B. Urine output <0.5 ml/kg/hr for 2 consecutive
hours Discuss INR. High INR is a risk for bleeding (GI,
C. Lactate levels > 1mmol/L hemorrhagic stroke, etc)
Answers Graded A+
A newly diabetic patient will receive instructions with a diagnosis of terminal cancer. The patient
from his nurse. Which of the following actions states to the RN that he is short of breath, has no
should the nurse take first? appetite and hurts everywhere. Which of the
following statements by the nurse is best?
A. Provide the patient with brochures for making
smart choices for cooking/baking. A. Tell me how your family is coping
B. Ask the patient what they know about B. Show me where it does not hurt
diabetes. C. I'll teach you relaxation techniques
C. Instruct the patient on exercise or activities D. Your physician should increase your pain
that will increase their metabolism. medication - ANSWER -C
D. Teach them how to use the glucometer. -
ANSWER -B.
First ask the patient what they know about A clinical nurse returns to the desk to find 4
diabetes. phone messages. Which of the following
messages should the nurse respond to first?
*ACTION questions ask for intervention, NOT
assessment A. A post cervical laminectomy patient
complaining of sudden difficulty talking.
B. A patient with multiple sclerosis complaining of
change in peripheral vision.
The post hysterectomy patient with calls the C. A patient with a herniated disc complaining of
clinic stating that she has been having difficulty consistent back pain.
with incontinence. Which of the following D. A patient with a cast due to a fracture of the
statements if made by the patient, indicates that right tibial bone complaining of tingling toes. -
further teaching is needed? ANSWER -A
A. I drink 8 oz. of fluid on the even hours while B and C are expected symptoms of the patient's
awake. condition. A and D are unexpected. D is less
B. I will attempt to void 30 minutes after drinking critical than A. Best answer is A.
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 -
ANSWER -C. A 75 year old patient complains to the clinical
nurse that he is having difficulty sleeping. Which
A patient saying that he or she will only drink of the following actions by the nurse is most
fluids when eating meals indicates that they don't appropriate?
know what to do in case of incontinence.
A. Determine the patient's usual sleeping and
FURTHER TEACHING indicates that the patient waking patterns.
needs more information B. Suggest that the client abstain from alcohol
and caffeine before bed time.
C. Recommend that client establish a bedtime
routine.
An RN assesses a patient in the Cancer Center D. Ask how much sleep the client required before
,Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
retirement. - ANSWER -A Need more info
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 The RN performs blood pressure screening at the
C. D is an inquiry, but is concerned about the local community center. Which of the following
past (when the person retired). Remove D. A is individuals is most likely to suffer from a
the best answer. cerebrovascular accident?
A. A 30 year old man who is an account
executive
The nurse cares for a patient several hours after B. A 40 year old man who jogs four times a week.
a thyroidectomy. The RN observes that the C. A 60 year old man whose father had a stroke.
patient is diaphoretic and confused. The vital D. A 75 year old man who takes multi-vitamins. -
signs are: ANSWER -C
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?
For the patient with a new tracheostomy, the
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min. nurse must be alert to which early complication?
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr
IV, propylthiaouracil (PTU) 200 mg po qld. a) Decannulation
C. Levothyroxine Sodium (Synthroid) 100 mcg b) Infection
IV, Lactated Ringer's 125 cc/hr IV, and c) Bleeding
ciprofloxacin (cipro) 500 mg. po bid. d) Tracheomalacia - ANSWER -C
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn,
0.9% NACl. - ANSWER -B Common acute risks of tracheostomy include
bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to
achieve successful airway
A 63 year old female patient contacts the clinic to
report that she is has been extremely fatigued, is EVERYTHING 24 HR POST SURGERY, FIRST
sleeping 12 hours a night, is always cold and her COMPLICATION IS BLEEDING. Infection comes
hair is falling out. Which of the following 2-3 days later.
responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min
every day. When a pulse oximetry monitor indicates that a
B. You don't need to worry. Sleeping a lot is patient has a drop in SpO2 from 96% to 85%
good for you. over 4 hours, the nurse will first:
C. Come in and see your health care provider
today. 1. Request an order for stat ABGs
D. You should eat more green leafy vegetables. - 2. Start the patient on oxygen by NC at 2L/minute
ANSWER -C 3. Notify the physician of the change
4. Check the position of the probe on patient's
,Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
finger or earlobe - ANSWER -4
D."What about your condition worries you?" -
Pulse oximetry is inaccurate if the probe is loose, ANSWER -D
or in the presence of poor circulation, nail polish,
or dark skin pigmentation. The nurse should allow the patient to share her
concerns and express her feelings in a
nonjudgmental environment.
To decrease a patient's shortness of breath and If there is psych/behavioral component- AFFIRM
a sense of impending doom during an asthma AND VALIDATE, NO PROBING
attack, the nurse will:
A. Place the patient on a cardiac monitor and
observe from the nurses' station. A patient with a tricuspid valve disorder will have
B. Let the patient rest alone in a quiet, calm impaired blood flow between the:
environment.
C. Reassure the patient that the doctor will arrive A. Vena cava and right atrium
soon B. Left atrium and left ventricle
D. Stay with the patient and encourage pursed- C. Right atrium and right ventricle
lip breathing. - ANSWER -D D. Right ventricle and pulmonary artery -
ANSWER -C
The patient experiencing an acute asthma
exacerbation will be fearful and anxious. It is Tricuspid valve is located between right atrium
important for the nurse to stay with the patient for and right ventricle
ongoing assessment and to provide a calm
environment. Helping the patient breathe with MITRAL VALVE- left atrium and left ventricle
pursed lips will facilitate the expiration of trapped
air and help the patient regain control of his or
her breathing.
If the Purkinje system is damaged, conduction of
the electrical impulse is impaired through the:
A 68 year old woman is admitted to the surgical A. Atria
unit after a gastric resection for gastric cancer. B. AV node
She states that she doesn't want anyone to see C. Ventricles
her in this condition, even her husband. This D. Bundle of His - ANSWER -C
nurse's best response is:
Purkinje fibers provide a high-speed distribution
A."Patients' rights protect your privacy. I won't of excitation throughout the ventricular
allow anyone in." myocardium; if the pattern of contraction is
disrupted, the ventricles will not efficiently eject
B."I've seen gastric cancer patients who look blood
much worse. Don't worry."
Order of impulse is SA node to AV node to
C."Would you like to talk to a social worker?" Bundle of His to bundle branch to purkinje fibers
, Med-Surg Certification Practice Questions with 100% Verified
Answers Graded A+
D. Systolic BP of 150 mmHg - ANSWER -B
UO should be greater or equal to .5ml per kg per
The P-wave on an EKG is representative of: hour.
MAPs should be between 65-85
A. Ventricular depolarization Lactate levels should be less than 2.3
B. Atrial depolarization SBP of 150 is high but does not indicate poor
C. Atrial repolarization perfusion
D. Ventricular repolarization - ANSWER -B.
Atrial depolarization
Ventricular repolarization is represented by the When performing discharge teaching with a
QRS There is no distinctly visible wave patient who is taking warfarin sodium
representing atrial repolarization in the ECG (Coumadin), the nurse learns that patient used
because it occurs during ventricular complementary therapies at home. Which of the
depolarization, ventricular repolarization is shown following substances is most concerning?
as the interval between the start of the QRS
complex and the end of the T wave A. Echinacea
B. Vitamin B12
C. Vitamin D
D. Garlic - ANSWER -D. Garlic
A patient admitted with an abscess in her left
thigh undergoes incision and drainage. 3 days When taking warfarin, caution with - garlic,
later, she develops fever (temperature of 103°F), ginseng, ginkgo, ibuprofen, pain drugs, vitamin E
chills, lethargy, and shortness of breath. Garlic may increase bleeding, so supplemental
Infectious endocarditis is suspected. In addition garlic may cause a synergic effect when
to blood cultures, the nurse would expect which combined with coumadin
of these tests?
A. Transesophageal echocardiogram
B. Computed tomography of the chest For the same patient - who is being discharged
C. Cardiac stress test and is taking warfarin (Coumadin), the nurse
D. Cardiac enzymes - ANSWER -A. should also emphasize that:
Echocardiogram to visualize cardiac structures. A. Regular follow-up with healthcare provider is
essential
B. Aspirin would be recommended for headache
therapy
Which of the following is a sign of poor C. The medication can be taken any time of the
perfusion? day
D. Diet should be high in iron content -
A. Mean arterial pressure <80 mmHg ANSWER -A
B. Urine output <0.5 ml/kg/hr for 2 consecutive
hours Discuss INR. High INR is a risk for bleeding (GI,
C. Lactate levels > 1mmol/L hemorrhagic stroke, etc)
