Kaplan Med Surg 1 Exam – 200 Practice Questions with
Verified Answers & Rationales
Section 1: Cardiovascular Disorders (Q1–35)
1. A patient with heart failure has bilateral crackles and oxygen saturation of 88%. Which action should
the nurse take FIRST?
A) Increase oral fluids
B) Place patient in high Fowler’s position
C) Encourage walking
D) Restrict oxygen
Correct Answer: B
Explanation: Upright positioning improves lung expansion and oxygenation.
> Source: Integrated Exam 2026 Q1
2. A patient with chest pain receives nitroglycerin. Which assessment is a PRIORITY afterward?
A) Temperature
B) Blood pressure
C) Reflexes
D) Bowel sounds
Correct Answer: B
Explanation: Nitroglycerin may cause hypotension; monitor BP closely.
> Source: Integrated Exam 2026 Q16
,3. A client’s BP is 168/98 on two separate visits. Which complication is the priority to assess for first?
A) Retinopathy
B) Stroke symptoms
C) Erectile dysfunction
D) Hypokalemia
Correct Answer: B
Explanation: Hypertension increases the risk for cerebrovascular accident.
> Source: Med Surg Exam 1 Q1
4. Which finding most suggests secondary hypertension?
A) Onset at age 52
B) BMI 32
C) Renal artery bruit
D) Family history of HTN
Correct Answer: C
Explanation: Renal artery stenosis is a cause of secondary hypertension.
> Source: Med Surg Exam 1 Q2
5. The provider prescribes a beta-blocker. What is the priority assessment before the first dose?
A) Respiratory rate
B) Heart rate and BP
C) Temperature
,D) Pain score
Correct Answer: B
Explanation: Beta-blockers lower heart rate and blood pressure; assess baseline.
6. Which feature is characteristic of left-sided heart failure?
A) Jugular venous distention
B) Hepatosplenomegaly
C) Crackles and orthopnea
D) Dependent edema only
Correct Answer: C
Explanation: Left heart failure → pulmonary congestion → crackles, orthopnea.
> Source: Med Surg Exam 1 Q9
7. Which is a compensatory mechanism that initially helps cardiac output but later worsens HF?
A) Natriuresis
B) Ventricular dilation and hypertrophy
C) Decreased SNS tone
D) Increased diuresis
Correct Answer: B
Explanation: Ventricular dilation and hypertrophy are compensatory but lead to remodeling and
worsening failure.
, > Source: Med Surg Exam 1 Q12
8. When caring for a client receiving a beta-blocker, the nurse understands that it works primarily by:
A) Blocking calcium influx into cardiac cells
B) Blocking beta-1 receptors, reducing heart rate and contractility
C) Inhibiting angiotensin-converting enzyme
D) Reducing RAAS activation
Correct Answer: B
Explanation: Beta-1 blockade decreases HR, contractility, and conduction velocity.
9. In the management of hypertension, the DASH diet focuses on which key change?
A) Reduce caffeine
B) Sodium restriction
C) Vitamin supplements
D) Compression stockings
Correct Answer: B
Explanation: The DASH diet emphasizes low sodium, high potassium, and high fiber.
10. The nurse notes an S3 gallop on auscultation. This finding is most classically associated with:
A) Pericarditis
B) Heart failure
C) Aortic stenosis
D) Mitral regurgitation
Correct Answer: B
Verified Answers & Rationales
Section 1: Cardiovascular Disorders (Q1–35)
1. A patient with heart failure has bilateral crackles and oxygen saturation of 88%. Which action should
the nurse take FIRST?
A) Increase oral fluids
B) Place patient in high Fowler’s position
C) Encourage walking
D) Restrict oxygen
Correct Answer: B
Explanation: Upright positioning improves lung expansion and oxygenation.
> Source: Integrated Exam 2026 Q1
2. A patient with chest pain receives nitroglycerin. Which assessment is a PRIORITY afterward?
A) Temperature
B) Blood pressure
C) Reflexes
D) Bowel sounds
Correct Answer: B
Explanation: Nitroglycerin may cause hypotension; monitor BP closely.
> Source: Integrated Exam 2026 Q16
,3. A client’s BP is 168/98 on two separate visits. Which complication is the priority to assess for first?
A) Retinopathy
B) Stroke symptoms
C) Erectile dysfunction
D) Hypokalemia
Correct Answer: B
Explanation: Hypertension increases the risk for cerebrovascular accident.
> Source: Med Surg Exam 1 Q1
4. Which finding most suggests secondary hypertension?
A) Onset at age 52
B) BMI 32
C) Renal artery bruit
D) Family history of HTN
Correct Answer: C
Explanation: Renal artery stenosis is a cause of secondary hypertension.
> Source: Med Surg Exam 1 Q2
5. The provider prescribes a beta-blocker. What is the priority assessment before the first dose?
A) Respiratory rate
B) Heart rate and BP
C) Temperature
,D) Pain score
Correct Answer: B
Explanation: Beta-blockers lower heart rate and blood pressure; assess baseline.
6. Which feature is characteristic of left-sided heart failure?
A) Jugular venous distention
B) Hepatosplenomegaly
C) Crackles and orthopnea
D) Dependent edema only
Correct Answer: C
Explanation: Left heart failure → pulmonary congestion → crackles, orthopnea.
> Source: Med Surg Exam 1 Q9
7. Which is a compensatory mechanism that initially helps cardiac output but later worsens HF?
A) Natriuresis
B) Ventricular dilation and hypertrophy
C) Decreased SNS tone
D) Increased diuresis
Correct Answer: B
Explanation: Ventricular dilation and hypertrophy are compensatory but lead to remodeling and
worsening failure.
, > Source: Med Surg Exam 1 Q12
8. When caring for a client receiving a beta-blocker, the nurse understands that it works primarily by:
A) Blocking calcium influx into cardiac cells
B) Blocking beta-1 receptors, reducing heart rate and contractility
C) Inhibiting angiotensin-converting enzyme
D) Reducing RAAS activation
Correct Answer: B
Explanation: Beta-1 blockade decreases HR, contractility, and conduction velocity.
9. In the management of hypertension, the DASH diet focuses on which key change?
A) Reduce caffeine
B) Sodium restriction
C) Vitamin supplements
D) Compression stockings
Correct Answer: B
Explanation: The DASH diet emphasizes low sodium, high potassium, and high fiber.
10. The nurse notes an S3 gallop on auscultation. This finding is most classically associated with:
A) Pericarditis
B) Heart failure
C) Aortic stenosis
D) Mitral regurgitation
Correct Answer: B
