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CERTIFIED MEDICAL-SURGICAL REGISTERED
NURSE 2026-2027 BANK QUESTIONS WITH DETAILED
VERIFIED ANSWERS EXAM QUESTIONS WILL COME
FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a patient with chronic obstructive pulmonary
disease (COPD). Which finding is most indicative of carbon dioxide
retention?
A) Fine inspiratory crackles at the lung bases
B) An increase in respiratory rate from 20 to 26
C) Morning headache and confusion
D) Harsh, dry cough with scant sputum
Answer: C
Explanation: Carbon dioxide retention leads to cerebral vasodilation,
which can cause increased intracranial pressure manifesting as morning
headache, confusion, and drowsiness. Crackles indicate fluid, an
increased respiratory rate alone is a compensatory mechanism, and a
dry cough is a common symptom, not a specific sign of CO2 retention.
2. A patient is admitted with suspected pancreatitis. Which serum
laboratory value would the nurse expect to be elevated?
A) Amylase
B) Creatinine
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C) Potassium
D) Hemoglobin
Answer: A
Explanation: Serum amylase is a primary diagnostic marker for acute
pancreatitis, rising within 2-12 hours of onset. Creatinine reflects
kidney function, potassium is an electrolyte, and hemoglobin measures
red blood cell concentration, none of which are specific diagnostic
indicators for pancreatitis.
3. A nurse is caring for a patient after a thyroidectomy. Which
assessment finding requires the most immediate action?
A) Difficulty swallowing
B) Hoarse voice
C) Blood pressure of 150/90 mmHg
D) Frequent clearing of the throat with a subjective feeling of fullness in
the neck
Answer: D
Explanation: Frequent throat clearing and a sensation of neck fullness
can indicate a surgical site hematoma forming, which can rapidly
compress the trachea and cause airway compromise. While swallowing
difficulty and hoarseness require monitoring, and elevated blood
pressure needs management, airway obstruction is the priority.
4. A patient with chronic heart failure is prescribed lisinopril. The nurse
knows the primary mechanism of action of this medication is to:
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A) Increase cardiac contractility
B) Block beta-adrenergic receptors
C) Inhibit the conversion of angiotensin I to angiotensin II
D) Promote the excretion of sodium and water
Answer: C
Explanation: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It blocks the conversion of angiotensin I to the potent
vasoconstrictor angiotensin II, leading to vasodilation and decreased
blood pressure. Increased contractility is an effect of digoxin, beta-
blockers block receptors, and diuretics promote excretion.
5. A nurse is interpreting a patient's arterial blood gas (ABG): pH 7.48,
PaCO2 30 mmHg, HCO3- 24 mEq/L. This indicates:
A) Uncompensated metabolic alkalosis
B) Uncompensated respiratory alkalosis
C) Compensated respiratory acidosis
D) Compensated metabolic acidosis
Answer: B
Explanation: The pH is above 7.45, indicating alkalosis. The PaCO2 is
below 35 mmHg, which is alkalotic, while the HCO3- is normal. This
pattern of a high pH, a low PaCO2 (the respiratory component), and a
normal HCO3- (the metabolic component) defines uncompensated
respiratory alkalosis.
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6. A patient with a long leg cast reports severe, unrelenting pain and a
feeling that the cast is too tight. The nurse notes the toes are pale and
capillary refill is 6 seconds. The priority nursing action is to:
A) Elevate the leg on pillows
B) Administer prescribed pain medication
C) Notify the healthcare provider immediately
D) Apply ice packs to the area proximal to the cast
Answer: C
Explanation: These are classic signs of compartment syndrome, a
medical emergency requiring prompt surgical intervention
(fasciotomy). Elevation, pain medication, or ice are insufficient and
delay definitive treatment, risking permanent neurovascular damage.
7. Which finding indicates that a patient is experiencing a complication
of a central venous catheter?
A) The transparent dressing is dated 3 days ago
B) The insertion site is clean, dry, and intact
C) There is a crackling sensation palpated near the clavicle
D) The catheter is secured with a suture
Answer: C
Explanation: Subcutaneous emphysema, felt as crackling (crepitus)
under the skin, can indicate a pneumothorax or air leakage into the
tissues, a serious complication of central line insertion. An intact
dressing is a normal finding, and a suture is a common method of
securing the line initially.
CERTIFIED MEDICAL-SURGICAL REGISTERED
NURSE 2026-2027 BANK QUESTIONS WITH DETAILED
VERIFIED ANSWERS EXAM QUESTIONS WILL COME
FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a patient with chronic obstructive pulmonary
disease (COPD). Which finding is most indicative of carbon dioxide
retention?
A) Fine inspiratory crackles at the lung bases
B) An increase in respiratory rate from 20 to 26
C) Morning headache and confusion
D) Harsh, dry cough with scant sputum
Answer: C
Explanation: Carbon dioxide retention leads to cerebral vasodilation,
which can cause increased intracranial pressure manifesting as morning
headache, confusion, and drowsiness. Crackles indicate fluid, an
increased respiratory rate alone is a compensatory mechanism, and a
dry cough is a common symptom, not a specific sign of CO2 retention.
2. A patient is admitted with suspected pancreatitis. Which serum
laboratory value would the nurse expect to be elevated?
A) Amylase
B) Creatinine
,2|Page
C) Potassium
D) Hemoglobin
Answer: A
Explanation: Serum amylase is a primary diagnostic marker for acute
pancreatitis, rising within 2-12 hours of onset. Creatinine reflects
kidney function, potassium is an electrolyte, and hemoglobin measures
red blood cell concentration, none of which are specific diagnostic
indicators for pancreatitis.
3. A nurse is caring for a patient after a thyroidectomy. Which
assessment finding requires the most immediate action?
A) Difficulty swallowing
B) Hoarse voice
C) Blood pressure of 150/90 mmHg
D) Frequent clearing of the throat with a subjective feeling of fullness in
the neck
Answer: D
Explanation: Frequent throat clearing and a sensation of neck fullness
can indicate a surgical site hematoma forming, which can rapidly
compress the trachea and cause airway compromise. While swallowing
difficulty and hoarseness require monitoring, and elevated blood
pressure needs management, airway obstruction is the priority.
4. A patient with chronic heart failure is prescribed lisinopril. The nurse
knows the primary mechanism of action of this medication is to:
,3|Page
A) Increase cardiac contractility
B) Block beta-adrenergic receptors
C) Inhibit the conversion of angiotensin I to angiotensin II
D) Promote the excretion of sodium and water
Answer: C
Explanation: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It blocks the conversion of angiotensin I to the potent
vasoconstrictor angiotensin II, leading to vasodilation and decreased
blood pressure. Increased contractility is an effect of digoxin, beta-
blockers block receptors, and diuretics promote excretion.
5. A nurse is interpreting a patient's arterial blood gas (ABG): pH 7.48,
PaCO2 30 mmHg, HCO3- 24 mEq/L. This indicates:
A) Uncompensated metabolic alkalosis
B) Uncompensated respiratory alkalosis
C) Compensated respiratory acidosis
D) Compensated metabolic acidosis
Answer: B
Explanation: The pH is above 7.45, indicating alkalosis. The PaCO2 is
below 35 mmHg, which is alkalotic, while the HCO3- is normal. This
pattern of a high pH, a low PaCO2 (the respiratory component), and a
normal HCO3- (the metabolic component) defines uncompensated
respiratory alkalosis.
, 4|Page
6. A patient with a long leg cast reports severe, unrelenting pain and a
feeling that the cast is too tight. The nurse notes the toes are pale and
capillary refill is 6 seconds. The priority nursing action is to:
A) Elevate the leg on pillows
B) Administer prescribed pain medication
C) Notify the healthcare provider immediately
D) Apply ice packs to the area proximal to the cast
Answer: C
Explanation: These are classic signs of compartment syndrome, a
medical emergency requiring prompt surgical intervention
(fasciotomy). Elevation, pain medication, or ice are insufficient and
delay definitive treatment, risking permanent neurovascular damage.
7. Which finding indicates that a patient is experiencing a complication
of a central venous catheter?
A) The transparent dressing is dated 3 days ago
B) The insertion site is clean, dry, and intact
C) There is a crackling sensation palpated near the clavicle
D) The catheter is secured with a suture
Answer: C
Explanation: Subcutaneous emphysema, felt as crackling (crepitus)
under the skin, can indicate a pneumothorax or air leakage into the
tissues, a serious complication of central line insertion. An intact
dressing is a normal finding, and a suture is a common method of
securing the line initially.
