Comprehensive Medical-Surgical Nursing
Exam 2025 Questions and correct
answers
Topics: Cardiovascular, Neurological, Endocrine, Musculoskeletal, Respiratory, Gastrointestinal,
Hematologic, Renal, Infection Control, and more
1. Cardiovascular System
Question:
A 68-year-old patient with a history of hypertension and smoking presents to the
emergency department with chest pain radiating to the left arm. Which of the
following is the priority intervention for this patient?
A) Administer nitroglycerin as ordered
B) Obtain a 12-lead electrocardiogram (ECG)
C) Prepare for thrombolytic therapy
D) Administer morphine as ordered
Answer:
B) Obtain a 12-lead electrocardiogram (ECG)
Explanation: A 12-lead ECG is the priority intervention in a patient presenting with
chest pain, as it helps determine whether the pain is related to a myocardial
infarction (MI) or another cardiovascular issue. Once the ECG is obtained, further
interventions like administering nitroglycerin or morphine can be considered
based on the findings.
2. Respiratory System
Question:
A patient with chronic obstructive pulmonary disease (COPD) is admitted to the
hospital with increased shortness of breath. The nurse notes that the patient has
a barrel chest, diminished breath sounds, and an increased respiratory rate. What
,is the best nursing intervention?
A) Administer bronchodilators as prescribed
B) Instruct the patient to lie flat to reduce work of breathing
C) Encourage the patient to cough and deep-breathe every hour
D) Place the patient in a supine position for comfort
Answer:
A) Administer bronchodilators as prescribed
Explanation: Bronchodilators are a cornerstone of treatment for COPD and help
improve airflow by relaxing the muscles around the airways. This improves the
patient’s breathing, which is a priority in COPD exacerbations. Other options like
coughing or positioning may be beneficial but are secondary to medication.
3. Gastrointestinal System
Question:
A patient is admitted with a diagnosis of acute pancreatitis. Which of the
following interventions should the nurse implement?
A) Encourage oral intake of fluids
B) Prepare the patient for surgery
C) Administer IV fluids and electrolytes
D) Administer an antiemetic before meals
Answer:
C) Administer IV fluids and electrolytes
Explanation: Acute pancreatitis can lead to dehydration and electrolyte
imbalances, so the primary intervention is to administer IV fluids and electrolytes
to maintain hydration and support the patient’s cardiovascular status. Oral intake
should be avoided initially to rest the pancreas.
4. Renal System
Question:
A patient with chronic kidney disease (CKD) is receiving hemodialysis. Which of
the following lab values would the nurse most likely expect to find elevated?
,A) Sodium
B) Potassium
C) Calcium
D) Hemoglobin
Answer:
B) Potassium
Explanation: In patients with chronic kidney disease, especially those undergoing
hemodialysis, potassium levels are often elevated because the kidneys are unable
to excrete potassium effectively. This can lead to hyperkalemia, a serious
condition that can cause cardiac arrhythmias.
5. Endocrine System
Question:
A 50-year-old diabetic patient presents with confusion, sweating, and trembling.
The patient’s blood glucose is 50 mg/dL. What should the nurse do first?
A) Administer insulin as ordered
B) Provide the patient with 15 grams of fast-acting carbohydrates
C) Assess the patient for signs of diabetic ketoacidosis
D) Prepare the patient for intravenous glucose infusion
Answer:
B) Provide the patient with 15 grams of fast-acting carbohydrates
Explanation: The patient is experiencing signs of hypoglycemia, which requires
immediate treatment with a source of fast-acting carbohydrates (such as glucose
tablets, juice, or regular soda). This will raise the blood glucose level and relieve
the symptoms. Insulin and other options are not appropriate for hypoglycemia.
6. Neurological System
Question:
A nurse is caring for a patient who has had a stroke and is showing signs of
dysphagia. Which of the following interventions should the nurse implement to
prevent aspiration?
, A) Encourage the patient to drink liquids through a straw
B) Keep the head of the bed elevated at least 45 degrees
C) Administer the patient’s medications in liquid form
D) Place the patient on a clear liquid diet
Answer:
B) Keep the head of the bed elevated at least 45 degrees
Explanation: Elevating the head of the bed helps prevent aspiration by promoting
proper swallowing and reducing the likelihood of food or liquid entering the
airway. Dysphagia should be managed carefully with modifications to the
patient's diet and positioning.
7. Infection Control
Question:
A nurse is preparing to care for a patient with tuberculosis (TB). Which of the
following precautions is the nurse required to implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Answer:
A) Airborne precautions
Explanation: Tuberculosis is transmitted through airborne droplets. Therefore,
airborne precautions, including wearing an N95 mask and placing the patient in a
negative pressure room, are necessary to prevent the spread of TB.
8. Musculoskeletal System
Question:
A patient has a cast applied to the left arm after a fracture. The nurse assesses the
patient's neurovascular status and notices that the fingers are cold and pale with
diminished pulses. What is the most appropriate nursing action?
A) Elevate the arm above the level of the heart
Exam 2025 Questions and correct
answers
Topics: Cardiovascular, Neurological, Endocrine, Musculoskeletal, Respiratory, Gastrointestinal,
Hematologic, Renal, Infection Control, and more
1. Cardiovascular System
Question:
A 68-year-old patient with a history of hypertension and smoking presents to the
emergency department with chest pain radiating to the left arm. Which of the
following is the priority intervention for this patient?
A) Administer nitroglycerin as ordered
B) Obtain a 12-lead electrocardiogram (ECG)
C) Prepare for thrombolytic therapy
D) Administer morphine as ordered
Answer:
B) Obtain a 12-lead electrocardiogram (ECG)
Explanation: A 12-lead ECG is the priority intervention in a patient presenting with
chest pain, as it helps determine whether the pain is related to a myocardial
infarction (MI) or another cardiovascular issue. Once the ECG is obtained, further
interventions like administering nitroglycerin or morphine can be considered
based on the findings.
2. Respiratory System
Question:
A patient with chronic obstructive pulmonary disease (COPD) is admitted to the
hospital with increased shortness of breath. The nurse notes that the patient has
a barrel chest, diminished breath sounds, and an increased respiratory rate. What
,is the best nursing intervention?
A) Administer bronchodilators as prescribed
B) Instruct the patient to lie flat to reduce work of breathing
C) Encourage the patient to cough and deep-breathe every hour
D) Place the patient in a supine position for comfort
Answer:
A) Administer bronchodilators as prescribed
Explanation: Bronchodilators are a cornerstone of treatment for COPD and help
improve airflow by relaxing the muscles around the airways. This improves the
patient’s breathing, which is a priority in COPD exacerbations. Other options like
coughing or positioning may be beneficial but are secondary to medication.
3. Gastrointestinal System
Question:
A patient is admitted with a diagnosis of acute pancreatitis. Which of the
following interventions should the nurse implement?
A) Encourage oral intake of fluids
B) Prepare the patient for surgery
C) Administer IV fluids and electrolytes
D) Administer an antiemetic before meals
Answer:
C) Administer IV fluids and electrolytes
Explanation: Acute pancreatitis can lead to dehydration and electrolyte
imbalances, so the primary intervention is to administer IV fluids and electrolytes
to maintain hydration and support the patient’s cardiovascular status. Oral intake
should be avoided initially to rest the pancreas.
4. Renal System
Question:
A patient with chronic kidney disease (CKD) is receiving hemodialysis. Which of
the following lab values would the nurse most likely expect to find elevated?
,A) Sodium
B) Potassium
C) Calcium
D) Hemoglobin
Answer:
B) Potassium
Explanation: In patients with chronic kidney disease, especially those undergoing
hemodialysis, potassium levels are often elevated because the kidneys are unable
to excrete potassium effectively. This can lead to hyperkalemia, a serious
condition that can cause cardiac arrhythmias.
5. Endocrine System
Question:
A 50-year-old diabetic patient presents with confusion, sweating, and trembling.
The patient’s blood glucose is 50 mg/dL. What should the nurse do first?
A) Administer insulin as ordered
B) Provide the patient with 15 grams of fast-acting carbohydrates
C) Assess the patient for signs of diabetic ketoacidosis
D) Prepare the patient for intravenous glucose infusion
Answer:
B) Provide the patient with 15 grams of fast-acting carbohydrates
Explanation: The patient is experiencing signs of hypoglycemia, which requires
immediate treatment with a source of fast-acting carbohydrates (such as glucose
tablets, juice, or regular soda). This will raise the blood glucose level and relieve
the symptoms. Insulin and other options are not appropriate for hypoglycemia.
6. Neurological System
Question:
A nurse is caring for a patient who has had a stroke and is showing signs of
dysphagia. Which of the following interventions should the nurse implement to
prevent aspiration?
, A) Encourage the patient to drink liquids through a straw
B) Keep the head of the bed elevated at least 45 degrees
C) Administer the patient’s medications in liquid form
D) Place the patient on a clear liquid diet
Answer:
B) Keep the head of the bed elevated at least 45 degrees
Explanation: Elevating the head of the bed helps prevent aspiration by promoting
proper swallowing and reducing the likelihood of food or liquid entering the
airway. Dysphagia should be managed carefully with modifications to the
patient's diet and positioning.
7. Infection Control
Question:
A nurse is preparing to care for a patient with tuberculosis (TB). Which of the
following precautions is the nurse required to implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Standard precautions only
Answer:
A) Airborne precautions
Explanation: Tuberculosis is transmitted through airborne droplets. Therefore,
airborne precautions, including wearing an N95 mask and placing the patient in a
negative pressure room, are necessary to prevent the spread of TB.
8. Musculoskeletal System
Question:
A patient has a cast applied to the left arm after a fracture. The nurse assesses the
patient's neurovascular status and notices that the fingers are cold and pale with
diminished pulses. What is the most appropriate nursing action?
A) Elevate the arm above the level of the heart
