Swift River Med-Surg Test Bank 2026 – 140
NCLEX-Style Questions & Answers
Description:
Master Med-Surg nursing concepts with this updated 140-question Swift River test bank,
crafted to 2026 standards. Each question mirrors real NCLEX-style scenarios, with clear answers
and detailed explanations to boost your exam readiness. Topics span emergency care, patient
safety, pharmacology, and clinical decision-making — all refined from real Swift River cases.
Get the competitive edge — download now and pass with confidence!
, Swift River Med-Surg Test Bank 2025/2026 – 140 NCLEX-Style
Questions with Answers & Explanations
1. You enter a patient’s room and find them unresponsive. What is your first action?
A. Check for a pulse
B. Call for help and activate the code team
C. Begin chest compressions
D. Place the patient on a cardiac monitor
Answer: B
Explanation: In 2026 ACLS guidelines, the immediate priority for an unresponsive patient is to
activate the emergency response system and call for help while assessing responsiveness. This
ensures timely initiation of CPR and advanced interventions.
2. A patient in the ED presents with symptomatic bradycardia at 38 bpm and hypotension.
According to the 2025 ACLS algorithm, which medication should be given first?
A. Epinephrine 1 mg IV
B. Atropine 1 mg IV
C. Dopamine infusion
D. Amiodarone 300 mg IV push
Answer: B
Explanation: The updated ACLS bradycardia protocol recommends atropine 1 mg IV as the
first-line treatment, repeated every 3–5 minutes up to a total of 3 mg, before progressing to
pacing or infusion therapy.
3. A patient’s IV site is red, swollen, and painful. What is the nurse’s best first action?
A. Apply warm compresses
B. Stop the infusion and remove the IV
C. Flush the IV with saline
D. Notify the healthcare provider
,Answer: B
Explanation: Signs of phlebitis or infiltration require immediate discontinuation of the IV to
prevent further tissue damage. Updated guidelines emphasize early removal to prevent
complications.
4. You find a patient on the floor next to their bed. What is the priority nursing action?
A. Call the provider immediately
B. Assist the patient back to bed
C. Assess for injury before moving the patient
D. Complete an incident report
Answer: C
Explanation: Fall assessment must be done before moving the patient to avoid worsening
potential injuries. Incident reports are completed afterward.
5. During a rapid response, the patient becomes pulseless. What is the next immediate step after
initiating CPR?
A. Check for reversible causes
B. Defibrillate if shockable rhythm is confirmed
C. Administer epinephrine
D. Intubate the patient
Answer: B
Explanation: For pulseless VT/VF, defibrillation is the first intervention after starting CPR, per
2025 ACLS guidelines. Epinephrine follows after the first shock.
6. A patient states, “I feel the worst headache of my life.” What should the nurse do first?
A. Give acetaminophen
B. Assess neurological status and vital signs
C. Notify the healthcare provider immediately
D. Offer a cool cloth and dim lights
, Answer: C
Explanation: A sudden, severe headache may indicate subarachnoid hemorrhage or other
neurological emergency. Immediate provider notification is critical.
7. A patient receiving IV antibiotics develops shortness of breath, rash, and hypotension. What is
the nurse’s first action?
A. Call the rapid response team
B. Stop the infusion
C. Administer diphenhydramine
D. Start oxygen therapy
Answer: B
Explanation: Anaphylaxis management begins with stopping the suspected causative agent
immediately before other interventions.
8. The nurse notes a patient’s blood pressure is 82/50 mmHg with new confusion. What is the
priority intervention?
A. Place the patient in Trendelenburg position
B. Call for rapid response
C. Administer an antihypertensive
D. Encourage oral fluids
Answer: B
Explanation: Hypotension with altered mental status indicates shock. Rapid response activation
allows for urgent evaluation and treatment.
9. While passing medications, you hear a patient say, “My IV bandage is oozing blood.” What
should the nurse do?
A. Apply firm pressure and notify the provider
B. Remove the IV and place a dressing
C. Document and continue medication pass
D. Elevate the extremity and recheck later
NCLEX-Style Questions & Answers
Description:
Master Med-Surg nursing concepts with this updated 140-question Swift River test bank,
crafted to 2026 standards. Each question mirrors real NCLEX-style scenarios, with clear answers
and detailed explanations to boost your exam readiness. Topics span emergency care, patient
safety, pharmacology, and clinical decision-making — all refined from real Swift River cases.
Get the competitive edge — download now and pass with confidence!
, Swift River Med-Surg Test Bank 2025/2026 – 140 NCLEX-Style
Questions with Answers & Explanations
1. You enter a patient’s room and find them unresponsive. What is your first action?
A. Check for a pulse
B. Call for help and activate the code team
C. Begin chest compressions
D. Place the patient on a cardiac monitor
Answer: B
Explanation: In 2026 ACLS guidelines, the immediate priority for an unresponsive patient is to
activate the emergency response system and call for help while assessing responsiveness. This
ensures timely initiation of CPR and advanced interventions.
2. A patient in the ED presents with symptomatic bradycardia at 38 bpm and hypotension.
According to the 2025 ACLS algorithm, which medication should be given first?
A. Epinephrine 1 mg IV
B. Atropine 1 mg IV
C. Dopamine infusion
D. Amiodarone 300 mg IV push
Answer: B
Explanation: The updated ACLS bradycardia protocol recommends atropine 1 mg IV as the
first-line treatment, repeated every 3–5 minutes up to a total of 3 mg, before progressing to
pacing or infusion therapy.
3. A patient’s IV site is red, swollen, and painful. What is the nurse’s best first action?
A. Apply warm compresses
B. Stop the infusion and remove the IV
C. Flush the IV with saline
D. Notify the healthcare provider
,Answer: B
Explanation: Signs of phlebitis or infiltration require immediate discontinuation of the IV to
prevent further tissue damage. Updated guidelines emphasize early removal to prevent
complications.
4. You find a patient on the floor next to their bed. What is the priority nursing action?
A. Call the provider immediately
B. Assist the patient back to bed
C. Assess for injury before moving the patient
D. Complete an incident report
Answer: C
Explanation: Fall assessment must be done before moving the patient to avoid worsening
potential injuries. Incident reports are completed afterward.
5. During a rapid response, the patient becomes pulseless. What is the next immediate step after
initiating CPR?
A. Check for reversible causes
B. Defibrillate if shockable rhythm is confirmed
C. Administer epinephrine
D. Intubate the patient
Answer: B
Explanation: For pulseless VT/VF, defibrillation is the first intervention after starting CPR, per
2025 ACLS guidelines. Epinephrine follows after the first shock.
6. A patient states, “I feel the worst headache of my life.” What should the nurse do first?
A. Give acetaminophen
B. Assess neurological status and vital signs
C. Notify the healthcare provider immediately
D. Offer a cool cloth and dim lights
, Answer: C
Explanation: A sudden, severe headache may indicate subarachnoid hemorrhage or other
neurological emergency. Immediate provider notification is critical.
7. A patient receiving IV antibiotics develops shortness of breath, rash, and hypotension. What is
the nurse’s first action?
A. Call the rapid response team
B. Stop the infusion
C. Administer diphenhydramine
D. Start oxygen therapy
Answer: B
Explanation: Anaphylaxis management begins with stopping the suspected causative agent
immediately before other interventions.
8. The nurse notes a patient’s blood pressure is 82/50 mmHg with new confusion. What is the
priority intervention?
A. Place the patient in Trendelenburg position
B. Call for rapid response
C. Administer an antihypertensive
D. Encourage oral fluids
Answer: B
Explanation: Hypotension with altered mental status indicates shock. Rapid response activation
allows for urgent evaluation and treatment.
9. While passing medications, you hear a patient say, “My IV bandage is oozing blood.” What
should the nurse do?
A. Apply firm pressure and notify the provider
B. Remove the IV and place a dressing
C. Document and continue medication pass
D. Elevate the extremity and recheck later
