Adult Medical-Surgical Nursing Test Bank
2026 | Med Surg Nursing Practice Questions
with Verified Answers & Detailed Rationales
• This test bank features 200 rigorously crafted Adult Med-Surg practice questions
with 5 options each (A–E), verified correct answers, and detailed clinical EXPERT
RATIONALE deepen your understanding.
• Use this material by attempting each question independently before checking the
answer — focus on the EXPERT RATIONALE to build clinical reasoning, not just
memorization.
ADULT MEDICAL-SURGICAL NURSING TEST BANK 2026
200 Practice Questions | Verified Answers & Detailed EXPERT RATIONALE
SECTION 1: CARDIOVASCULAR NURSING
1. A nurse is caring for a client with heart failure who has dependent edema,
dyspnea, and a third heart sound (S3). Which nursing diagnosis is the highest
priority?
A. Ineffective breathing pattern related to anxiety
B. Deficient knowledge related to medication regimen
C. Activity intolerance related to decreased cardiac output
D. Risk for impaired skin integrity related to edema
E. Imbalanced nutrition: less than body requirements
Correct Answer: C. Activity intolerance related to decreased cardiac
output
EXPERT RATIONALE: In heart failure, the heart cannot pump sufficient blood to
meet the body's metabolic demands, leading to fatigue and activity intolerance. The
S3 heart sound, dyspnea, and edema all reflect reduced cardiac output. This is the
,priority nursing diagnosis as it directly affects the client's ability to perform activities
of daily living and reflects the core pathophysiology.
2. A client is admitted with suspected myocardial infarction. Which initial
diagnostic test should the nurse anticipate?
A. Chest X-ray
B. Echocardiogram
C. Coronary angiography
D. 12-lead electrocardiogram (ECG)
E. Magnetic resonance imaging (MRI) of the chest
Correct Answer: D. 12-lead electrocardiogram (ECG)
EXPERT RATIONALE: A 12-lead ECG is the first and most immediate diagnostic test
performed when MI is suspected. It can rapidly identify ST-segment elevation, T-
wave changes, and new Q waves that indicate myocardial ischemia or infarction.
Time is critical in MI management, and the ECG guides immediate treatment
decisions.
3. A nurse is assessing a client with atrial fibrillation. Which finding requires
immediate intervention?
A. Heart rate of 88 beats per minute
B. Irregularly irregular pulse
C. Blood pressure of 118/76 mmHg
D. Sudden onset of left-sided weakness and facial drooping
E. Mild fatigue upon exertion
Correct Answer: D. Sudden onset of left-sided weakness and facial
drooping
,EXPERT RATIONALE: Atrial fibrillation predisposes clients to thrombus formation in
the atria, which can embolize to the brain causing a stroke. Sudden onset of
unilateral weakness and facial drooping are classic signs of a stroke, which is a
medical emergency requiring immediate intervention. The other findings are
expected in atrial fibrillation.
4. A client is receiving IV furosemide for acute pulmonary edema. Which
electrolyte imbalance should the nurse monitor for most closely?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
E. Hypermagnesemia
Correct Answer: C. Hypokalemia
EXPERT RATIONALE: Furosemide is a loop diuretic that promotes excretion of
sodium, water, and potassium. Hypokalemia is a common and dangerous side
effect because low potassium levels increase the risk of life-threatening cardiac
dysrhythmias. The nurse should monitor serum potassium levels closely and assess
for signs such as muscle weakness, cramps, and ECG changes.
5. A nurse is teaching a client newly diagnosed with hypertension. Which
lifestyle modification has the greatest impact on lowering blood pressure?
A. Reducing caffeine intake
B. Taking daily aspirin
C. Reducing dietary sodium intake
D. Increasing vitamin C supplementation
E. Sleeping at least 10 hours per night
, Correct Answer: C. Reducing dietary sodium intake
EXPERT RATIONALE: Sodium reduction is one of the most evidence-based lifestyle
modifications for lowering blood pressure. Excess sodium causes fluid retention,
which increases blood volume and vascular resistance. The DASH diet recommends
limiting sodium to less than 2,300 mg/day, which can reduce systolic BP by 2–8
mmHg.
6. A client who had a coronary artery bypass graft (CABG) 2 days ago develops
a temperature of 38.8°C, redness, and drainage at the sternal incision. Which
action should the nurse take first?
A. Administer prescribed antipyretic medication
B. Encourage increased oral fluid intake
C. Notify the physician immediately
D. Apply a warm compress to the incision
E. Document the findings and continue monitoring
Correct Answer: C. Notify the physician immediately
EXPERT RATIONALE: Sternal wound infection following CABG is a serious, life-
threatening complication that can lead to mediastinitis. Fever, redness, and
drainage from the sternal incision are early signs of wound infection and require
prompt medical evaluation and intervention, including possible wound cultures,
antibiotics, or surgical debridement.
7. A nurse is caring for a client in cardiogenic shock. Which hemodynamic
finding is expected?
A. Elevated cardiac output
B. Decreased systemic vascular resistance
C. Decreased pulmonary capillary wedge pressure
2026 | Med Surg Nursing Practice Questions
with Verified Answers & Detailed Rationales
• This test bank features 200 rigorously crafted Adult Med-Surg practice questions
with 5 options each (A–E), verified correct answers, and detailed clinical EXPERT
RATIONALE deepen your understanding.
• Use this material by attempting each question independently before checking the
answer — focus on the EXPERT RATIONALE to build clinical reasoning, not just
memorization.
ADULT MEDICAL-SURGICAL NURSING TEST BANK 2026
200 Practice Questions | Verified Answers & Detailed EXPERT RATIONALE
SECTION 1: CARDIOVASCULAR NURSING
1. A nurse is caring for a client with heart failure who has dependent edema,
dyspnea, and a third heart sound (S3). Which nursing diagnosis is the highest
priority?
A. Ineffective breathing pattern related to anxiety
B. Deficient knowledge related to medication regimen
C. Activity intolerance related to decreased cardiac output
D. Risk for impaired skin integrity related to edema
E. Imbalanced nutrition: less than body requirements
Correct Answer: C. Activity intolerance related to decreased cardiac
output
EXPERT RATIONALE: In heart failure, the heart cannot pump sufficient blood to
meet the body's metabolic demands, leading to fatigue and activity intolerance. The
S3 heart sound, dyspnea, and edema all reflect reduced cardiac output. This is the
,priority nursing diagnosis as it directly affects the client's ability to perform activities
of daily living and reflects the core pathophysiology.
2. A client is admitted with suspected myocardial infarction. Which initial
diagnostic test should the nurse anticipate?
A. Chest X-ray
B. Echocardiogram
C. Coronary angiography
D. 12-lead electrocardiogram (ECG)
E. Magnetic resonance imaging (MRI) of the chest
Correct Answer: D. 12-lead electrocardiogram (ECG)
EXPERT RATIONALE: A 12-lead ECG is the first and most immediate diagnostic test
performed when MI is suspected. It can rapidly identify ST-segment elevation, T-
wave changes, and new Q waves that indicate myocardial ischemia or infarction.
Time is critical in MI management, and the ECG guides immediate treatment
decisions.
3. A nurse is assessing a client with atrial fibrillation. Which finding requires
immediate intervention?
A. Heart rate of 88 beats per minute
B. Irregularly irregular pulse
C. Blood pressure of 118/76 mmHg
D. Sudden onset of left-sided weakness and facial drooping
E. Mild fatigue upon exertion
Correct Answer: D. Sudden onset of left-sided weakness and facial
drooping
,EXPERT RATIONALE: Atrial fibrillation predisposes clients to thrombus formation in
the atria, which can embolize to the brain causing a stroke. Sudden onset of
unilateral weakness and facial drooping are classic signs of a stroke, which is a
medical emergency requiring immediate intervention. The other findings are
expected in atrial fibrillation.
4. A client is receiving IV furosemide for acute pulmonary edema. Which
electrolyte imbalance should the nurse monitor for most closely?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
E. Hypermagnesemia
Correct Answer: C. Hypokalemia
EXPERT RATIONALE: Furosemide is a loop diuretic that promotes excretion of
sodium, water, and potassium. Hypokalemia is a common and dangerous side
effect because low potassium levels increase the risk of life-threatening cardiac
dysrhythmias. The nurse should monitor serum potassium levels closely and assess
for signs such as muscle weakness, cramps, and ECG changes.
5. A nurse is teaching a client newly diagnosed with hypertension. Which
lifestyle modification has the greatest impact on lowering blood pressure?
A. Reducing caffeine intake
B. Taking daily aspirin
C. Reducing dietary sodium intake
D. Increasing vitamin C supplementation
E. Sleeping at least 10 hours per night
, Correct Answer: C. Reducing dietary sodium intake
EXPERT RATIONALE: Sodium reduction is one of the most evidence-based lifestyle
modifications for lowering blood pressure. Excess sodium causes fluid retention,
which increases blood volume and vascular resistance. The DASH diet recommends
limiting sodium to less than 2,300 mg/day, which can reduce systolic BP by 2–8
mmHg.
6. A client who had a coronary artery bypass graft (CABG) 2 days ago develops
a temperature of 38.8°C, redness, and drainage at the sternal incision. Which
action should the nurse take first?
A. Administer prescribed antipyretic medication
B. Encourage increased oral fluid intake
C. Notify the physician immediately
D. Apply a warm compress to the incision
E. Document the findings and continue monitoring
Correct Answer: C. Notify the physician immediately
EXPERT RATIONALE: Sternal wound infection following CABG is a serious, life-
threatening complication that can lead to mediastinitis. Fever, redness, and
drainage from the sternal incision are early signs of wound infection and require
prompt medical evaluation and intervention, including possible wound cultures,
antibiotics, or surgical debridement.
7. A nurse is caring for a client in cardiogenic shock. Which hemodynamic
finding is expected?
A. Elevated cardiac output
B. Decreased systemic vascular resistance
C. Decreased pulmonary capillary wedge pressure
