Medical-Surgical Nursing Exam Questions

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Sample questions from Medical-Surgical Nursing Exam Questions

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a 56-year-old client reports crushing chest pressure radiating to the jaw that began 30 minutes ago. The client is diaphoretic, and the ECG shows ST-segment elevation in leads II, III, and aVF. Which action should the nurse prioritize?

   • A.Obtain a fasting lipid panel before administering any medication.
   • B.Activate the facility's STEMI response and prepare for immediate reperfusion therapy.
   • C.Encourage the client to walk to assess the effect of activity on the pain.
   • D.Schedule an exercise stress test for later that day.

   Rationale: Activating the STEMI response supports rapid reperfusion, which limits myocardial damage in a client with acute ST-elevation myocardial infarction. A lipid panel can be obtained later, and walking or stress testing is unsafe during an acute infarction. The exam takeaway is to prioritize reperfusion for STEMI rather than delay care for diagnostic tests that are not immediately life-saving.

2. 2.Which statement by a client newly prescribed warfarin for atrial fibrillation indicates correct understanding of the teaching?

   • A.I do not need blood tests once my dose has been established.
   • B.I can stop taking this medication when my heartbeat feels regular.
   • C.I will keep my intake of foods high in vitamin K consistent from week to week.
   • D.I should take aspirin whenever I notice unusual bruising.

   Rationale: Keeping vitamin K intake consistent helps prevent avoidable fluctuations in the anticoagulant effect of warfarin. A regular-feeling heartbeat does not eliminate stroke risk, and aspirin should not be added without guidance because it can increase bleeding. INR monitoring remains necessary because the therapeutic response and bleeding risk can change over time.

3. 3.Refer to the client's chart. Which findings require the nurse to take immediate action for this client with suspected acute coronary syndrome? Select all that apply.

   • A.The client's heart rate decreased from 96/min to 88/min between assessments.
   • B.The client's oxygen saturation is 95% on room air at 1000.
   • C.The ECG shows new ST-segment elevation in leads II, III, and aVF.
   • D.The client is diaphoretic and reports nausea at 1000.
   • E.The client reports chest pressure increasing from 4/10 to 8/10 despite rest.

   Rationale: Worsening chest pressure, new ST elevation, and diaphoresis with nausea are concerning for ongoing myocardial ischemia and require immediate escalation of care. An SpO2 of 95% on room air and a heart rate decrease from 96/min to 88/min do not independently indicate acute deterioration in this chart. The exam takeaway is to act on evolving ischemic symptoms and ECG changes rather than be reassured by one relatively stable vital sign.

4. 4.A client with chronic heart failure calls the clinic to report a 2.3-kg (5-lb) weight gain over 3 days and new ankle swelling. Which instruction should the nurse give?

   • A.Wait a week and reweigh before reporting the change.
   • B.Increase fluid intake to help the kidneys remove excess sodium.
   • C.Skip the prescribed diuretic until the swelling resolves.
   • D.Contact the heart failure provider today to report the weight gain and swelling.

   Answer and rationale are in the full material.

5. 5.A client taking lisinopril for hypertension reports swelling of the lips and tongue and difficulty swallowing. What is the nurse's priority instruction?

   • A.Call emergency services now because the symptoms may indicate angioedema.
   • B.Take an over-the-counter antihistamine and continue the medication as prescribed.
   • C.Take the next dose with food and report the symptoms at the next appointment.
   • D.Drink water and lie flat until the swelling decreases.

   Answer and rationale are in the full material.