BKAT Med-Surg Complete Exam Questions &
Answers 2026/2027 | Basic Knowledge
Assessment Tool for Medical-Surgical
Nursing | Verified Q&A Study Guide PDF
BKAT Med-Surg Complete Exam Questions & Answers 2026/2027
• This study guide contains 200 verified multiple-choice questions covering all core
Medical-Surgical Nursing topics tested in the BKAT, with correct answers
highlighted and EXPERT RATIONALE provided for deep conceptual understanding.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE, reinforcing both knowledge recall and
clinical reasoning skills.
QUESTION 1 Which electrolyte imbalance is most commonly associated with
the use of loop diuretics such as furosemide?
A. Hypernatremia
B. Hyperkalemia
C. Hypercalcemia
D. Hypermagnesemia
== E. Hypokalemia== (Correct Answer)
EXPERT RATIONALE: Loop diuretics act on the ascending limb of the loop of Henle,
blocking sodium, chloride, and potassium reabsorption. This results in increased urinary
excretion of potassium, leading to hypokalemia. Nurses must monitor serum potassium
levels and educate patients on potassium-rich foods.
QUESTION 2 A patient is admitted with a serum sodium level of 125 mEq/L.
Which clinical manifestation would the nurse expect to find?
A. Extreme thirst
B. Dry mucous membranes
,C. Hypertension
D. Decreased deep tendon reflexes
== E. Confusion and headache== (Correct Answer)
EXPERT RATIONALE: A sodium level of 125 mEq/L indicates hyponatremia. Sodium is
critical for neurological function. When sodium falls below 135 mEq/L, cerebral edema
develops, manifesting as confusion, headache, nausea, and in severe cases, seizures and
coma.
QUESTION 3 The nurse is caring for a patient post-thyroidectomy. Which
finding requires immediate intervention?
A. Mild hoarseness
B. Serum calcium of 9.0 mg/dL
C. Blood pressure 130/80 mmHg
D. Pain at incision site
== E. Positive Chvostek's sign== (Correct Answer)
EXPERT RATIONALE: A positive Chvostek's sign indicates hypocalcemia, a life-
threatening complication after thyroidectomy due to accidental removal or damage to
the parathyroid glands. Hypocalcemia can lead to tetany, laryngospasm, and cardiac
dysrhythmias, requiring immediate calcium gluconate administration.
QUESTION 4 Which ABG result indicates fully compensated respiratory
acidosis?
A. pH 7.30, PaCO₂ 55, HCO₃ 24
B. pH 7.50, PaCO₂ 28, HCO₃ 22
C. pH 7.48, PaCO₂ 30, HCO₃ 20
D. pH 7.35, PaCO₂ 50, HCO₃ 29
,== E. pH 7.38, PaCO₂ 52, HCO₃ 31== (Correct Answer)
EXPERT RATIONALE: In fully compensated respiratory acidosis, the pH is within normal
range (7.35–7.45), PaCO₂ is elevated (primary problem), and HCO₃ is elevated (renal
compensation). The kidneys retain bicarbonate to buffer the excess acid, normalizing the
pH.
QUESTION 5 A patient with COPD is receiving oxygen therapy. What is the
maximum safe oxygen flow rate to avoid suppressing the hypoxic drive?
A. 6–8 L/min
B. 4–6 L/min
C. 10–12 L/min
D. 8–10 L/min
== E. 1–2 L/min== (Correct Answer)
EXPERT RATIONALE: Patients with COPD chronically retain CO₂ and rely on low oxygen
levels (hypoxic drive) to stimulate breathing. Administering high-flow oxygen removes
this stimulus, leading to respiratory depression. Oxygen should be given at 1–2 L/min via
nasal cannula.
QUESTION 6 A nurse is assessing a patient with left-sided heart failure. Which
finding is most expected?
A. Peripheral edema
B. Jugular vein distension
C. Hepatomegaly
D. Ascites
== E. Pulmonary crackles== (Correct Answer)
, EXPERT RATIONALE: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary edema. The nurse would auscultate
crackles (rales) in the lung bases due to fluid accumulation in the alveoli.
QUESTION 7 Which nursing action is the priority when a patient develops a
tension pneumothorax?
A. Administer morphine IV
B. Apply oxygen via non-rebreather mask and document
C. Place the patient in Trendelenburg position
D. Prepare for chest tube insertion immediately
== E. Notify the physician immediately for needle decompression== (Correct
Answer)
EXPERT RATIONALE: Tension pneumothorax is a life-threatening emergency where air
accumulates under pressure, collapsing the lung and shifting the mediastinum.
Immediate needle decompression at the second intercostal space, midclavicular line, is
required to release the pressure.
QUESTION 8 What is the priority assessment for a patient receiving a blood
transfusion who develops chills, fever, and low back pain 15 minutes after
initiation?
A. Slow the transfusion and monitor vital signs
B. Administer acetaminophen for fever
C. Continue the transfusion but notify the physician
D. Apply warm blankets for chills
== E. Stop the transfusion immediately and maintain IV access with normal
saline== (Correct Answer)
Answers 2026/2027 | Basic Knowledge
Assessment Tool for Medical-Surgical
Nursing | Verified Q&A Study Guide PDF
BKAT Med-Surg Complete Exam Questions & Answers 2026/2027
• This study guide contains 200 verified multiple-choice questions covering all core
Medical-Surgical Nursing topics tested in the BKAT, with correct answers
highlighted and EXPERT RATIONALE provided for deep conceptual understanding.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE, reinforcing both knowledge recall and
clinical reasoning skills.
QUESTION 1 Which electrolyte imbalance is most commonly associated with
the use of loop diuretics such as furosemide?
A. Hypernatremia
B. Hyperkalemia
C. Hypercalcemia
D. Hypermagnesemia
== E. Hypokalemia== (Correct Answer)
EXPERT RATIONALE: Loop diuretics act on the ascending limb of the loop of Henle,
blocking sodium, chloride, and potassium reabsorption. This results in increased urinary
excretion of potassium, leading to hypokalemia. Nurses must monitor serum potassium
levels and educate patients on potassium-rich foods.
QUESTION 2 A patient is admitted with a serum sodium level of 125 mEq/L.
Which clinical manifestation would the nurse expect to find?
A. Extreme thirst
B. Dry mucous membranes
,C. Hypertension
D. Decreased deep tendon reflexes
== E. Confusion and headache== (Correct Answer)
EXPERT RATIONALE: A sodium level of 125 mEq/L indicates hyponatremia. Sodium is
critical for neurological function. When sodium falls below 135 mEq/L, cerebral edema
develops, manifesting as confusion, headache, nausea, and in severe cases, seizures and
coma.
QUESTION 3 The nurse is caring for a patient post-thyroidectomy. Which
finding requires immediate intervention?
A. Mild hoarseness
B. Serum calcium of 9.0 mg/dL
C. Blood pressure 130/80 mmHg
D. Pain at incision site
== E. Positive Chvostek's sign== (Correct Answer)
EXPERT RATIONALE: A positive Chvostek's sign indicates hypocalcemia, a life-
threatening complication after thyroidectomy due to accidental removal or damage to
the parathyroid glands. Hypocalcemia can lead to tetany, laryngospasm, and cardiac
dysrhythmias, requiring immediate calcium gluconate administration.
QUESTION 4 Which ABG result indicates fully compensated respiratory
acidosis?
A. pH 7.30, PaCO₂ 55, HCO₃ 24
B. pH 7.50, PaCO₂ 28, HCO₃ 22
C. pH 7.48, PaCO₂ 30, HCO₃ 20
D. pH 7.35, PaCO₂ 50, HCO₃ 29
,== E. pH 7.38, PaCO₂ 52, HCO₃ 31== (Correct Answer)
EXPERT RATIONALE: In fully compensated respiratory acidosis, the pH is within normal
range (7.35–7.45), PaCO₂ is elevated (primary problem), and HCO₃ is elevated (renal
compensation). The kidneys retain bicarbonate to buffer the excess acid, normalizing the
pH.
QUESTION 5 A patient with COPD is receiving oxygen therapy. What is the
maximum safe oxygen flow rate to avoid suppressing the hypoxic drive?
A. 6–8 L/min
B. 4–6 L/min
C. 10–12 L/min
D. 8–10 L/min
== E. 1–2 L/min== (Correct Answer)
EXPERT RATIONALE: Patients with COPD chronically retain CO₂ and rely on low oxygen
levels (hypoxic drive) to stimulate breathing. Administering high-flow oxygen removes
this stimulus, leading to respiratory depression. Oxygen should be given at 1–2 L/min via
nasal cannula.
QUESTION 6 A nurse is assessing a patient with left-sided heart failure. Which
finding is most expected?
A. Peripheral edema
B. Jugular vein distension
C. Hepatomegaly
D. Ascites
== E. Pulmonary crackles== (Correct Answer)
, EXPERT RATIONALE: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary edema. The nurse would auscultate
crackles (rales) in the lung bases due to fluid accumulation in the alveoli.
QUESTION 7 Which nursing action is the priority when a patient develops a
tension pneumothorax?
A. Administer morphine IV
B. Apply oxygen via non-rebreather mask and document
C. Place the patient in Trendelenburg position
D. Prepare for chest tube insertion immediately
== E. Notify the physician immediately for needle decompression== (Correct
Answer)
EXPERT RATIONALE: Tension pneumothorax is a life-threatening emergency where air
accumulates under pressure, collapsing the lung and shifting the mediastinum.
Immediate needle decompression at the second intercostal space, midclavicular line, is
required to release the pressure.
QUESTION 8 What is the priority assessment for a patient receiving a blood
transfusion who develops chills, fever, and low back pain 15 minutes after
initiation?
A. Slow the transfusion and monitor vital signs
B. Administer acetaminophen for fever
C. Continue the transfusion but notify the physician
D. Apply warm blankets for chills
== E. Stop the transfusion immediately and maintain IV access with normal
saline== (Correct Answer)
