MED SURG 1
OBJECTIVE ASSESSMENT - EXAM
MED SURG 1 FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS ALREADY
GRADED A+
Certification Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Dysrhythmias Liver Failure & Pancreatitis
ARDS & Mechanical Ventilation Fractures & Joint Replacement
Stroke & Increased ICP Burns & Wound Management
COVER PAGE - 1
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 1 of 51
,SECTION 1 | Cardiovascular Disorders | Q1-Q25 | MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GR
Q1 Question 1 of 100
A 68-year-old male with a history of hypertension and coronary artery disease is admitted with
progressive dyspnea on exertion, bilateral ankle edema, and a weight gain of 6 pounds over the
past week. His blood pressure is 158/94 mmHg, heart rate is 102 bpm, and respirations are 24/min.
Bibasilar crackles are heard on auscultation. Which pathophysiological process best explains his
presenting symptoms?
A. Decreased left ventricular preload leading to reduced cardiac output
B. Increased left ventricular afterload causing backward pressure into pulmonary circulation
C. Right ventricular hypertrophy resulting in decreased pulmonary blood flow
D. Systemic vasodilation causing pooling of blood in the extremities
Correct Answer: B
Rationale:
This patient presents with classic left-sided heart failure. Increased afterload from hypertension forces the left
ventricle to work harder, leading to decreased ejection and backward pressure into the pulmonary vasculature,
causing pulmonary congestion. Choice A is incorrect because preload is typically increased, not decreased, in
heart failure as the ventricle fails to pump effectively.
Q2 Question 2 of 100
A 72-year-old female is diagnosed with acute decompensated heart failure and started on
intravenous furosemide. Twelve hours after the infusion begins, she reports muscle weakness and
palpitations. Her telemetry shows frequent premature ventricular contractions. Which electrolyte
imbalance is most likely responsible for these findings?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale:
Loop diuretics like furosemide cause significant potassium loss through the kidneys, leading to hypokalemia. Low
potassium increases myocardial excitability, causing palpitations and PVCs, and produces skeletal muscle
weakness. Hypernatremia would cause neurological symptoms rather than arrhythmias, and hypercalcemia
shortens the QT interval rather than causing PVCs.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 1 of 51
,Q3 Question 3 of 100
A 55-year-old male presents to the emergency department with crushing substernal chest pain
radiating to the left arm that began 45 minutes ago. An ECG reveals ST-segment elevation in leads
II, III, and aVF. The nurse anticipates which immediate collaborative intervention?
A. Administration of a beta-blocker and observation for symptom resolution
B. Emergent percutaneous coronary intervention or thrombolytic therapy
C. Serial cardiac enzyme monitoring with discharge if enzymes are negative
D. Administration of digoxin to increase myocardial contractility
Correct Answer: B
Rationale:
ST-elevation in leads II, III, and aVF indicates an inferior wall STEMI, which requires immediate reperfusion
therapy through PCI or thrombolytics. Time is muscle - the goal is to open the occluded artery. Choice A delays
definitive treatment, and choice C ignores the clear ST-elevation requiring emergent intervention.
Q4 Question 4 of 100
A 64-year-old patient with a mechanical mitral valve replacement is being discharged. The nurse
provides education about long-term anticoagulation therapy with warfarin. Which patient statement
indicates a need for further teaching?
A. I will have my INR checked regularly to make sure my blood is not too thin.
B. I should eat consistent amounts of green leafy vegetables each week.
C. If I miss a dose, I should take two tablets the next day to catch up.
D. I will use a soft-bristle toothbrush and an electric razor for shaving.
Correct Answer: C
Rationale:
Doubling a missed warfarin dose can dangerously elevate the INR and cause serious bleeding. Patients should
never double up on anticoagulant doses. Choices A, B, and D all reflect correct understanding of warfarin therapy,
including consistent vitamin K intake to maintain stable INR levels.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 2 of 51
, Q5 Question 5 of 100
A 49-year-old female is admitted with acute onset of severe dyspnea, tachycardia, and pleuritic
chest pain one week after a total abdominal hysterectomy. A ventilation-perfusion scan reveals a
high-probability result. The nurse understands that which factor most likely contributed to this
patient's condition?
A. Increased mobility and physical activity during the postoperative period
B. Venous stasis from immobility and surgical trauma activating the clotting cascade
C. Excessive fluid intake leading to volume overload in the pulmonary vasculature
D. Elevated hematocrit from postoperative dehydration causing polycythemia
Correct Answer: B
Rationale:
This patient has a pulmonary embolism, a classic postoperative complication. Virchow's triad (venous stasis,
endothelial injury, and hypercoagulability) explains the pathogenesis. Postoperative immobility causes venous
stasis, and surgical trauma triggers the clotting cascade. Choice A is incorrect because immobility, not increased
mobility, is the risk factor.
Q6 Question 6 of 100
A 73-year-old male with chronic atrial fibrillation is taking apixaban 5 mg twice daily. He is now
admitted with a GI bleed from a duodenal ulcer. The nurse expects which reversal agent to be
ordered?
A. Vitamin K
B. Protamine sulfate
C. Andexanet alfa
D. Idarucizumab
Correct Answer: C
Rationale:
Andexanet alfa is the specific reversal agent for factor Xa inhibitors like apixaban. Vitamin K reverses warfarin,
protamine sulfate reverses heparin, and idarucizumab reverses dabigatran. Each anticoagulant has a specific
reversal agent, and using the wrong one would be ineffective.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 3 of 51
OBJECTIVE ASSESSMENT - EXAM
MED SURG 1 FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS ALREADY
GRADED A+
Certification Exam
100 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Dysrhythmias Liver Failure & Pancreatitis
ARDS & Mechanical Ventilation Fractures & Joint Replacement
Stroke & Increased ICP Burns & Wound Management
COVER PAGE - 1
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 1 of 51
,SECTION 1 | Cardiovascular Disorders | Q1-Q25 | MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GR
Q1 Question 1 of 100
A 68-year-old male with a history of hypertension and coronary artery disease is admitted with
progressive dyspnea on exertion, bilateral ankle edema, and a weight gain of 6 pounds over the
past week. His blood pressure is 158/94 mmHg, heart rate is 102 bpm, and respirations are 24/min.
Bibasilar crackles are heard on auscultation. Which pathophysiological process best explains his
presenting symptoms?
A. Decreased left ventricular preload leading to reduced cardiac output
B. Increased left ventricular afterload causing backward pressure into pulmonary circulation
C. Right ventricular hypertrophy resulting in decreased pulmonary blood flow
D. Systemic vasodilation causing pooling of blood in the extremities
Correct Answer: B
Rationale:
This patient presents with classic left-sided heart failure. Increased afterload from hypertension forces the left
ventricle to work harder, leading to decreased ejection and backward pressure into the pulmonary vasculature,
causing pulmonary congestion. Choice A is incorrect because preload is typically increased, not decreased, in
heart failure as the ventricle fails to pump effectively.
Q2 Question 2 of 100
A 72-year-old female is diagnosed with acute decompensated heart failure and started on
intravenous furosemide. Twelve hours after the infusion begins, she reports muscle weakness and
palpitations. Her telemetry shows frequent premature ventricular contractions. Which electrolyte
imbalance is most likely responsible for these findings?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale:
Loop diuretics like furosemide cause significant potassium loss through the kidneys, leading to hypokalemia. Low
potassium increases myocardial excitability, causing palpitations and PVCs, and produces skeletal muscle
weakness. Hypernatremia would cause neurological symptoms rather than arrhythmias, and hypercalcemia
shortens the QT interval rather than causing PVCs.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 1 of 51
,Q3 Question 3 of 100
A 55-year-old male presents to the emergency department with crushing substernal chest pain
radiating to the left arm that began 45 minutes ago. An ECG reveals ST-segment elevation in leads
II, III, and aVF. The nurse anticipates which immediate collaborative intervention?
A. Administration of a beta-blocker and observation for symptom resolution
B. Emergent percutaneous coronary intervention or thrombolytic therapy
C. Serial cardiac enzyme monitoring with discharge if enzymes are negative
D. Administration of digoxin to increase myocardial contractility
Correct Answer: B
Rationale:
ST-elevation in leads II, III, and aVF indicates an inferior wall STEMI, which requires immediate reperfusion
therapy through PCI or thrombolytics. Time is muscle - the goal is to open the occluded artery. Choice A delays
definitive treatment, and choice C ignores the clear ST-elevation requiring emergent intervention.
Q4 Question 4 of 100
A 64-year-old patient with a mechanical mitral valve replacement is being discharged. The nurse
provides education about long-term anticoagulation therapy with warfarin. Which patient statement
indicates a need for further teaching?
A. I will have my INR checked regularly to make sure my blood is not too thin.
B. I should eat consistent amounts of green leafy vegetables each week.
C. If I miss a dose, I should take two tablets the next day to catch up.
D. I will use a soft-bristle toothbrush and an electric razor for shaving.
Correct Answer: C
Rationale:
Doubling a missed warfarin dose can dangerously elevate the INR and cause serious bleeding. Patients should
never double up on anticoagulant doses. Choices A, B, and D all reflect correct understanding of warfarin therapy,
including consistent vitamin K intake to maintain stable INR levels.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 2 of 51
, Q5 Question 5 of 100
A 49-year-old female is admitted with acute onset of severe dyspnea, tachycardia, and pleuritic
chest pain one week after a total abdominal hysterectomy. A ventilation-perfusion scan reveals a
high-probability result. The nurse understands that which factor most likely contributed to this
patient's condition?
A. Increased mobility and physical activity during the postoperative period
B. Venous stasis from immobility and surgical trauma activating the clotting cascade
C. Excessive fluid intake leading to volume overload in the pulmonary vasculature
D. Elevated hematocrit from postoperative dehydration causing polycythemia
Correct Answer: B
Rationale:
This patient has a pulmonary embolism, a classic postoperative complication. Virchow's triad (venous stasis,
endothelial injury, and hypercoagulability) explains the pathogenesis. Postoperative immobility causes venous
stasis, and surgical trauma triggers the clotting cascade. Choice A is incorrect because immobility, not increased
mobility, is the risk factor.
Q6 Question 6 of 100
A 73-year-old male with chronic atrial fibrillation is taking apixaban 5 mg twice daily. He is now
admitted with a GI bleed from a duodenal ulcer. The nurse expects which reversal agent to be
ordered?
A. Vitamin K
B. Protamine sulfate
C. Andexanet alfa
D. Idarucizumab
Correct Answer: C
Rationale:
Andexanet alfa is the specific reversal agent for factor Xa inhibitors like apixaban. Vitamin K reverses warfarin,
protamine sulfate reverses heparin, and idarucizumab reverses dabigatran. Each anticoagulant has a specific
reversal agent, and using the wrong one would be ineffective.
MED SURG 1 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS ALREADY GRADED A+ - 2026/2027 | Passing Score: 80% | Page 3 of 51
