Approved RN Medical-Surgical Retake Exam 2023 | 2026 NGN
Version | 100 Verified Questions & Answers for Level 3 Pass
Question 1
A nurse is assessing a client who is 12 hours postoperative following a colon resection.
Which finding should the nurse report to the surgeon?
• A) Heart rate 90/min
• B) Absent bowel sounds
• C) Hgb 8.2 g/dL
• D) Gastric pH of 3.0
Correct Answer: C) Hgb 8.2 g/dL
Rationale: Normal hemoglobin is 13-18 g/dL for males and 12-16 g/dL for females. A
level of 8.2 g/dL is significantly low and may indicate postoperative hemorrhage
requiring immediate reporting. Absent bowel sounds are expected after major bowel
surgery and can take several days to return to normal.
,Question 2
A nurse is caring for a client receiving a blood transfusion. The client has bounding
peripheral pulses, hypertension, and distended jugular veins. Which medication should
the nurse anticipate administering?
• A) Diphenhydramine
• B) Acetaminophen
• C) Pantoprazole
• D) Furosemide
Correct Answer: D) Furosemide
Rationale: These signs indicate fluid overload or possible heart failure as a complication
of blood transfusion. Furosemide (Lasix) is a diuretic that helps remove excess fluid and
prevent cardiovascular and respiratory distress.
,Question 3
A nurse is caring for a client with heart failure who reports sudden weight gain of 2 kg
(4.4 lb) in 2 days. What is the nurse's priority action?
• A) Encourage ambulation
• B) Restrict fluids
• C) Notify the provider
• D) Administer potassium
Correct Answer: C) Notify the provider
Rationale: Rapid weight gain indicates fluid overload and possible exacerbation of heart
failure, requiring immediate provider intervention for diuretic adjustment or other
medical management.
, Question 4
A client with heart failure has 3+ pitting edema in the lower extremities, crackles heard
halfway up the lung fields, and weight gain of 5 lbs (2.3 kg) in 24 hours. Which
intervention should the nurse implement first?
• A) Restrict oral fluids to 1,500 mL per day
• B) Administer furosemide 40 mg IV push
• C) Elevate the lower extremities on pillows
• D) Apply sequential compression devices
Correct Answer: B) Administer furosemide 40 mg IV push
Rationale: The client shows signs of fluid volume overload (edema, crackles, rapid
weight gain). Furosemide, a loop diuretic, rapidly reduces preload by promoting diuresis,
Version | 100 Verified Questions & Answers for Level 3 Pass
Question 1
A nurse is assessing a client who is 12 hours postoperative following a colon resection.
Which finding should the nurse report to the surgeon?
• A) Heart rate 90/min
• B) Absent bowel sounds
• C) Hgb 8.2 g/dL
• D) Gastric pH of 3.0
Correct Answer: C) Hgb 8.2 g/dL
Rationale: Normal hemoglobin is 13-18 g/dL for males and 12-16 g/dL for females. A
level of 8.2 g/dL is significantly low and may indicate postoperative hemorrhage
requiring immediate reporting. Absent bowel sounds are expected after major bowel
surgery and can take several days to return to normal.
,Question 2
A nurse is caring for a client receiving a blood transfusion. The client has bounding
peripheral pulses, hypertension, and distended jugular veins. Which medication should
the nurse anticipate administering?
• A) Diphenhydramine
• B) Acetaminophen
• C) Pantoprazole
• D) Furosemide
Correct Answer: D) Furosemide
Rationale: These signs indicate fluid overload or possible heart failure as a complication
of blood transfusion. Furosemide (Lasix) is a diuretic that helps remove excess fluid and
prevent cardiovascular and respiratory distress.
,Question 3
A nurse is caring for a client with heart failure who reports sudden weight gain of 2 kg
(4.4 lb) in 2 days. What is the nurse's priority action?
• A) Encourage ambulation
• B) Restrict fluids
• C) Notify the provider
• D) Administer potassium
Correct Answer: C) Notify the provider
Rationale: Rapid weight gain indicates fluid overload and possible exacerbation of heart
failure, requiring immediate provider intervention for diuretic adjustment or other
medical management.
, Question 4
A client with heart failure has 3+ pitting edema in the lower extremities, crackles heard
halfway up the lung fields, and weight gain of 5 lbs (2.3 kg) in 24 hours. Which
intervention should the nurse implement first?
• A) Restrict oral fluids to 1,500 mL per day
• B) Administer furosemide 40 mg IV push
• C) Elevate the lower extremities on pillows
• D) Apply sequential compression devices
Correct Answer: B) Administer furosemide 40 mg IV push
Rationale: The client shows signs of fluid volume overload (edema, crackles, rapid
weight gain). Furosemide, a loop diuretic, rapidly reduces preload by promoting diuresis,
