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Medical-Surgical Nursing 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is caring for a patient with heart failure who reports dyspnea
when lying flat. The nurse documents this as:
A) Tachypnea
B) Bradypnea
C) Orthopnea
D) Apnea
Answer: C) Orthopnea
Explanation: Orthopnea is the medical term for difficulty breathing
when lying flat, a classic symptom of left-sided heart failure due to
pulmonary congestion. It results from the redistribution of fluid from
the lower extremities to the central circulation when supine. This is
distinct from tachypnea (rapid breathing), bradypnea (slow breathing),
and apnea (cessation of breathing).
2. The primary purpose of the cuff on a tracheostomy tube is to:
A) Keep the tracheostomy tube in place
B) Prevent aspiration of secretions
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C) Allow the patient to speak
D) Clean the tracheostomy opening
Answer: B) Prevent aspiration of secretions
Explanation: When inflated, the cuff creates a seal between the tube
and the tracheal wall. This seal is crucial for positive pressure
ventilation and for preventing oropharyngeal secretions or gastric
contents from being aspirated into the lower airways. The flange or ties
hold the tube in place, a Passy-Muir valve allows speaking, and cleaning
is done with specific supplies.
3. A patient develops sudden chest pain, tachypnea, and hemoptysis 2
days after a total hip replacement. The nurse’s priority action is to:
A) Elevate the head of the bed and administer oxygen
B) Place the patient in Trendelenburg position
C) Massage the affected leg to break up the clot
D) Apply sequential compression devices to the legs
Answer: A) Elevate the head of the bed and administer oxygen
Explanation: The clinical picture is highly suggestive of a pulmonary
embolism. The immediate priorities are to improve gas exchange
(elevating the head of the bed, administering high-flow oxygen) and
notify the rapid response team. Trendelenburg position is
contraindicated. Massaging a leg with a potential deep vein thrombosis
could dislodge the clot. Applying SCDs is contraindicated if a DVT
already exists.
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4. A nurse is preparing to administer a unit of packed red blood cells.
Which IV solution is the only compatible option?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's solution
C) 0.9% Normal Saline
D) 0.45% Normal Saline (Half-normal saline)
Answer: C) 0.9% Normal Saline
Explanation: 0.9% Sodium Chloride (Normal Saline) is the only solution
compatible with blood products for routine transfusion. Hypotonic
solutions like 0.45% NaCl can cause hemolysis of red blood cells.
Calcium-containing solutions like Lactated Ringer's can reverse the
citrate anticoagulants in the stored blood, leading to clot formation.
Dextrose solutions (D5W) also cause hemolysis.
5. A patient with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which physician order should the nurse question?
A) Administer IV calcium gluconate
B) Administer sodium polystyrene sulfonate (Kayexalate)
C) Administer IV 0.9% normal saline with 40 mEq KCl
D) Prepare the patient for emergency hemodialysis
Answer: C) Administer IV 0.9% normal saline with 40 mEq KCl
Explanation: A potassium level of 6.8 mEq/L is severe, life-threatening
hyperkalemia. Administering any IV fluid with added potassium (KCl)
would dangerously worsen the hyperkalemia and could induce fatal
cardiac arrhythmias. Calcium gluconate protects the myocardium,
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Kayexalate removes potassium, and hemodialysis is a definitive
treatment for refractory hyperkalemia.
6. A nurse is assessing a patient with increased intracranial pressure
(ICP). Which of the following is an early sign of rising ICP?
A) Cushing's triad (hypertension, bradycardia, irregular respirations)
B) Fixed and dilated pupils
C) Change in level of consciousness
D) Decerebrate posturing
Answer: C) Change in level of consciousness
Explanation: A change in level of consciousness, such as restlessness,
confusion, or drowsiness, is the most sensitive and earliest indicator of
increasing ICP. Cushing's triad, fixed and dilated pupils, and decerebrate
posturing are all late, ominous signs of severe brain herniation.
7. Which patient should the nurse see first after receiving change-of-
shift report?
A) A patient with cirrhosis and a distended abdomen
B) A patient with acute kidney injury with a phosphorus level of 5.0
mg/dL
C) A patient with a chest tube who has continuous bubbling in the
water-seal chamber
D) A patient in a below-knee plaster cast who reports 8/10 pain
unrelieved by opioids
Medical-Surgical Nursing 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is caring for a patient with heart failure who reports dyspnea
when lying flat. The nurse documents this as:
A) Tachypnea
B) Bradypnea
C) Orthopnea
D) Apnea
Answer: C) Orthopnea
Explanation: Orthopnea is the medical term for difficulty breathing
when lying flat, a classic symptom of left-sided heart failure due to
pulmonary congestion. It results from the redistribution of fluid from
the lower extremities to the central circulation when supine. This is
distinct from tachypnea (rapid breathing), bradypnea (slow breathing),
and apnea (cessation of breathing).
2. The primary purpose of the cuff on a tracheostomy tube is to:
A) Keep the tracheostomy tube in place
B) Prevent aspiration of secretions
,2|Page
C) Allow the patient to speak
D) Clean the tracheostomy opening
Answer: B) Prevent aspiration of secretions
Explanation: When inflated, the cuff creates a seal between the tube
and the tracheal wall. This seal is crucial for positive pressure
ventilation and for preventing oropharyngeal secretions or gastric
contents from being aspirated into the lower airways. The flange or ties
hold the tube in place, a Passy-Muir valve allows speaking, and cleaning
is done with specific supplies.
3. A patient develops sudden chest pain, tachypnea, and hemoptysis 2
days after a total hip replacement. The nurse’s priority action is to:
A) Elevate the head of the bed and administer oxygen
B) Place the patient in Trendelenburg position
C) Massage the affected leg to break up the clot
D) Apply sequential compression devices to the legs
Answer: A) Elevate the head of the bed and administer oxygen
Explanation: The clinical picture is highly suggestive of a pulmonary
embolism. The immediate priorities are to improve gas exchange
(elevating the head of the bed, administering high-flow oxygen) and
notify the rapid response team. Trendelenburg position is
contraindicated. Massaging a leg with a potential deep vein thrombosis
could dislodge the clot. Applying SCDs is contraindicated if a DVT
already exists.
,3|Page
4. A nurse is preparing to administer a unit of packed red blood cells.
Which IV solution is the only compatible option?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's solution
C) 0.9% Normal Saline
D) 0.45% Normal Saline (Half-normal saline)
Answer: C) 0.9% Normal Saline
Explanation: 0.9% Sodium Chloride (Normal Saline) is the only solution
compatible with blood products for routine transfusion. Hypotonic
solutions like 0.45% NaCl can cause hemolysis of red blood cells.
Calcium-containing solutions like Lactated Ringer's can reverse the
citrate anticoagulants in the stored blood, leading to clot formation.
Dextrose solutions (D5W) also cause hemolysis.
5. A patient with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which physician order should the nurse question?
A) Administer IV calcium gluconate
B) Administer sodium polystyrene sulfonate (Kayexalate)
C) Administer IV 0.9% normal saline with 40 mEq KCl
D) Prepare the patient for emergency hemodialysis
Answer: C) Administer IV 0.9% normal saline with 40 mEq KCl
Explanation: A potassium level of 6.8 mEq/L is severe, life-threatening
hyperkalemia. Administering any IV fluid with added potassium (KCl)
would dangerously worsen the hyperkalemia and could induce fatal
cardiac arrhythmias. Calcium gluconate protects the myocardium,
, 4|Page
Kayexalate removes potassium, and hemodialysis is a definitive
treatment for refractory hyperkalemia.
6. A nurse is assessing a patient with increased intracranial pressure
(ICP). Which of the following is an early sign of rising ICP?
A) Cushing's triad (hypertension, bradycardia, irregular respirations)
B) Fixed and dilated pupils
C) Change in level of consciousness
D) Decerebrate posturing
Answer: C) Change in level of consciousness
Explanation: A change in level of consciousness, such as restlessness,
confusion, or drowsiness, is the most sensitive and earliest indicator of
increasing ICP. Cushing's triad, fixed and dilated pupils, and decerebrate
posturing are all late, ominous signs of severe brain herniation.
7. Which patient should the nurse see first after receiving change-of-
shift report?
A) A patient with cirrhosis and a distended abdomen
B) A patient with acute kidney injury with a phosphorus level of 5.0
mg/dL
C) A patient with a chest tube who has continuous bubbling in the
water-seal chamber
D) A patient in a below-knee plaster cast who reports 8/10 pain
unrelieved by opioids
