Actual RN Medical-Surgical Retake Exam 2023 | 2026 NGN
Version | 100 Verified Questions & Answers for Level 3 Pass
Q1. A nurse is preparing a client who has supraventricular tachycardia for elective
cardioversion. Which medication should the client withhold for 48 hours prior?
• a. Enoxaparin
• b. Metformin
• c. Diazepam
• d. Digoxin
Rationale: Cardiac glycosides such as digoxin are withheld prior to cardioversion
because they can increase ventricular irritability and put the client at risk for ventricular
fibrillation after synchronized countershock .
,Q2. A nurse is caring for a client 1 hour following a cardiac catheterization via the
right femoral artery. A hematoma forms at the insertion site with decreased pulse
in the affected extremity. Which intervention is the priority?
• a. Initiate oxygen at 2 L/min via nasal cannula
• b. Apply firm pressure to the insertion site
• c. Take the client's vital signs
• d. Obtain a stat order for an aPTT
Rationale: The greatest risk to the client is bleeding. The priority intervention is
applying firm pressure to the hematoma to stop the bleeding. Ecchymosis is expected,
but hematoma with pulse changes indicates active bleeding .
,Q3. A nurse is assessing a client following a cardiac catheterization via the right
femoral artery. Which finding requires immediate intervention?
• a. 3 cm area of ecchymosis at the insertion site
• b. Client reports pain at the site rated 3/10
• c. Dorsalis pedis pulse is +2 bilaterally
• d. The right foot is cool to touch with capillary refill of 6 seconds
Rationale: Coolness and delayed capillary refill (normal is <3 seconds) in the affected
extremity indicate arterial insufficiency, which may be caused by thrombus formation or
arterial occlusion. This is a vascular emergency that can lead to limb loss if not treated
immediately .
, Q4. A nurse is caring for a client with acute decompensated heart failure. The
client has 3+ pitting edema in the lower extremities, crackles heard halfway up the
lung fields, and a weight gain of 5 lbs (2.3 kg) in 24 hours. Which intervention
should the nurse implement first?
• a. Restrict oral fluids to 1,500 mL per day
• b. Administer furosemide 40 mg IV push
• c. Elevate the lower extremities on pillows
• d. Apply sequential compression devices
Rationale: The client is displaying signs of fluid volume overload (edema, crackles, rapid
weight gain). Furosemide, a loop diuretic, rapidly reduces preload by promoting diuresis,
which decreases pulmonary congestion and improves oxygenation. This is the priority
intervention to address the immediate threat of pulmonary edema .
Version | 100 Verified Questions & Answers for Level 3 Pass
Q1. A nurse is preparing a client who has supraventricular tachycardia for elective
cardioversion. Which medication should the client withhold for 48 hours prior?
• a. Enoxaparin
• b. Metformin
• c. Diazepam
• d. Digoxin
Rationale: Cardiac glycosides such as digoxin are withheld prior to cardioversion
because they can increase ventricular irritability and put the client at risk for ventricular
fibrillation after synchronized countershock .
,Q2. A nurse is caring for a client 1 hour following a cardiac catheterization via the
right femoral artery. A hematoma forms at the insertion site with decreased pulse
in the affected extremity. Which intervention is the priority?
• a. Initiate oxygen at 2 L/min via nasal cannula
• b. Apply firm pressure to the insertion site
• c. Take the client's vital signs
• d. Obtain a stat order for an aPTT
Rationale: The greatest risk to the client is bleeding. The priority intervention is
applying firm pressure to the hematoma to stop the bleeding. Ecchymosis is expected,
but hematoma with pulse changes indicates active bleeding .
,Q3. A nurse is assessing a client following a cardiac catheterization via the right
femoral artery. Which finding requires immediate intervention?
• a. 3 cm area of ecchymosis at the insertion site
• b. Client reports pain at the site rated 3/10
• c. Dorsalis pedis pulse is +2 bilaterally
• d. The right foot is cool to touch with capillary refill of 6 seconds
Rationale: Coolness and delayed capillary refill (normal is <3 seconds) in the affected
extremity indicate arterial insufficiency, which may be caused by thrombus formation or
arterial occlusion. This is a vascular emergency that can lead to limb loss if not treated
immediately .
, Q4. A nurse is caring for a client with acute decompensated heart failure. The
client has 3+ pitting edema in the lower extremities, crackles heard halfway up the
lung fields, and a weight gain of 5 lbs (2.3 kg) in 24 hours. Which intervention
should the nurse implement first?
• a. Restrict oral fluids to 1,500 mL per day
• b. Administer furosemide 40 mg IV push
• c. Elevate the lower extremities on pillows
• d. Apply sequential compression devices
Rationale: The client is displaying signs of fluid volume overload (edema, crackles, rapid
weight gain). Furosemide, a loop diuretic, rapidly reduces preload by promoting diuresis,
which decreases pulmonary congestion and improves oxygenation. This is the priority
intervention to address the immediate threat of pulmonary edema .
