PRACTICE TEST WITH VERIFIED QUESTIONS
& CORRECT ANSWERS | UPDATED MEDICAL-
SURGICAL NURSING STUDY GUIDE 2026
• This practice test contains 200 verified multiple-choice questions covering all
major Med-Surg Exam 3 topics to help you master content through active recall and
self-assessment.
• Use this guide by attempting each question independently before checking the
highlighted correct answer and EXPERT RATIONALE below it — this method
reinforces clinical reasoning and long-term retention.
NUR 242 MED-SURG EXAM 3 – COMPLETE PRACTICE TEST 200 QUESTIONS |
UPDATED 2026
1. A nurse is caring for a client with heart failure who has dependent edema,
fatigue, and shortness of breath. Which finding is most indicative of left-sided
heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Hepatomegaly
D. Ascites
E. Pulmonary crackles
Correct Answer: E. Pulmonary crackles EXPERT RATIONALE: Left-sided
heart failure causes a backup of fluid into the pulmonary circulation, resulting in
pulmonary congestion and crackles on auscultation. Right-sided failure causes systemic
congestion (edema, JVD, hepatomegaly).
2. A client is prescribed furosemide (Lasix) for heart failure. Which laboratory
value should the nurse monitor most closely?
,A. Sodium
B. Calcium
C. Potassium
D. Phosphorus
E. Magnesium
Correct Answer: C. Potassium EXPERT RATIONALE: Furosemide is a loop
diuretic that causes significant potassium loss, placing clients at risk for hypokalemia,
which can lead to dangerous cardiac dysrhythmias.
3. A client with heart failure is prescribed digoxin. The nurse assesses the
client before administration. Which finding requires the nurse to withhold the
medication?
A. Blood pressure of 140/88 mmHg
B. Respiratory rate of 18 breaths/min
C. Apical pulse of 52 beats/min
D. Oxygen saturation of 95%
E. Temperature of 37.2°C
Correct Answer: C. Apical pulse of 52 beats/min EXPERT RATIONALE:
Digoxin slows the heart rate and is withheld if the apical pulse is below 60 beats/min in
adults. The nurse should notify the provider before administration.
4. A nurse is assessing a client with right-sided heart failure. Which of the
following findings is expected?
A. Pulmonary crackles
B. Pink frothy sputum
C. Pitting edema in the lower extremities
,D. Orthopnea
E. Paroxysmal nocturnal dyspnea
Correct Answer: C. Pitting edema in the lower extremities EXPERT
RATIONALE: Right-sided heart failure causes systemic venous congestion, leading to
dependent pitting edema, jugular vein distension, hepatomegaly, and ascites.
5. A client is admitted with acute decompensated heart failure. The nurse
anticipates which priority intervention?
A. Administer oral antihypertensives
B. Administer IV furosemide
C. Encourage increased oral fluid intake
D. Place the client in Trendelenburg position
E. Obtain a 12-lead ECG
Correct Answer: B. Administer IV furosemide EXPERT RATIONALE: IV
furosemide rapidly reduces preload through diuresis, relieving pulmonary congestion in
acute decompensated heart failure. This is the priority pharmacological intervention.
HYPERTENSION
6. A nurse is teaching a client newly diagnosed with hypertension about
lifestyle modifications. Which instruction is most important?
A. Take aspirin daily
B. Reduce sodium intake to less than 2,300 mg/day
C. Increase potassium supplement use
D. Avoid all physical activity
E. Increase dairy intake only
, Correct Answer: B. Reduce sodium intake to less than 2,300 mg/day
EXPERT RATIONALE: Sodium reduction is a primary lifestyle modification for
hypertension as it reduces fluid retention and decreases cardiac workload, lowering
blood pressure effectively.
7. A client with hypertension is prescribed a beta-blocker. The nurse should
teach the client to monitor for which side effect?
A. Tachycardia
B. Bradycardia
C. Hyponatremia
D. Hyperglycemia
E. Increased libido
Correct Answer: B. Bradycardia EXPERT RATIONALE: Beta-blockers block
beta-1 receptors in the heart, reducing heart rate and blood pressure. Bradycardia is a
common and important side effect to monitor.
8. A nurse is caring for a client in hypertensive crisis with a blood pressure of
220/130 mmHg. Which medication does the nurse anticipate administering?
A. Oral metoprolol
B. Oral amlodipine
C. IV labetalol
D. Sublingual nifedipine
E. Oral hydrochlorothiazide
Correct Answer: C. IV labetalol EXPERT RATIONALE: Hypertensive crisis
requires rapid blood pressure reduction using IV antihypertensives such as labetalol or
nicardipine in an ICU setting with continuous monitoring.