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Quizzes > Health & Medicine > Human Anatomy & Medicine

Medical Surgical Nursing Practice Test Part 2 - Test Your Skills

Think you can ace the medical surgical nursing quiz? Tackle 2 important questions now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art medical surgical nursing quiz with test sheets stethoscope on dark blue background

Hey future nursing pros! Ready to tackle the ultimate medical surgical nursing practice test? Our latest free quiz, Ace the Medical Surgical Nursing Practice Test Part 2, offers 60 essential questions designed to sharpen your skills in medical surgical nursing. Whether you're brushing up on med surg nursing practice test strategies or looking to review critical medical surgical nursing exam questions, this challenge will boost your confidence. Explore our Medical-Surgical Nursing Quiz for targeted scenarios, or dive into a full-length Medical Surgical Nursing Practice Test to see where you stand. Ready, set, learn - start now!

What is the normal respiratory rate for a healthy adult?
12 - 20 breaths per minute
28 - 34 breaths per minute
20 - 28 breaths per minute
8 - 12 breaths per minute
The normal respiratory rate for a healthy adult at rest ranges from 12 to 20 breaths per minute. Rates below or above this range can indicate respiratory depression or distress.NIH: Respiratory Rate Norms
At what heart rate is a patient considered tachycardic?
Greater than 100 beats per minute
Greater than 120 beats per minute
Greater than 60 beats per minute
Greater than 80 beats per minute
Tachycardia is defined as a heart rate exceeding 100 beats per minute in adults at rest. It can be caused by various factors such as fever, pain, hypovolemia, or anxiety.American Heart Association
What is the normal arterial blood pH range in adults?
7.15 - 7.25
7.25 - 7.35
7.35 - 7.45
7.45 - 7.55
Normal arterial blood pH in adults is tightly regulated between 7.35 and 7.45. Deviations indicate acidosis or alkalosis and require prompt assessment.NIH: Acid - Base Balance
What is the primary purpose of inserting a chest tube in a postoperative patient?
To provide long-term nutritional support
To measure central venous pressure
To reinflate the lung and remove air or fluid
To monitor intracranial pressure
Chest tubes are placed to evacuate air (pneumothorax) or fluid (hemothorax, pleural effusion) from the pleural space and allow the lung to re-expand. This restores negative intrapleural pressure and improves oxygenation.NIH: Chest Tube Drainage
Which fasting blood glucose level is considered within the normal range?
50 - 70 mg/dL
130 - 160 mg/dL
70 - 100 mg/dL
100 - 130 mg/dL
A normal fasting blood glucose level is 70 - 100 mg/dL. Levels above this range may indicate impaired glucose tolerance or diabetes mellitus.American Diabetes Association
In SBAR communication, what does the 'B' stand for?
Balance
Background
Baseline
Behavior
SBAR stands for Situation, Background, Assessment, Recommendation. The 'Background' section provides relevant history and context for the patient's current situation.Joint Commission: SBAR
Which position is most effective for relieving orthopnea in a patient with heart failure?
Trendelenburg
Prone
Supine with head flat
High Fowler's
High Fowler's position (sitting upright at 60 - 90 degrees) reduces venous return and diaphragmatic pressure, improving lung expansion and relieving orthopnea in heart failure patients.NCBI: Orthopnea Management
Which intravenous fluid is classified as isotonic?
3% Sodium chloride
5% Dextrose in water
0.45% Sodium chloride
0.9% Sodium chloride
0.9% Sodium chloride (normal saline) has the same osmolarity as plasma and is classified as isotonic. It is used for fluid volume replacement without causing fluid shifts.NIH: Intravenous Fluids
A patient is experiencing partial airway obstruction. What is the priority nursing action?
Perform a tracheostomy
Begin abdominal thrusts immediately
Encourage the patient to cough
Apply oxygen via face mask
For partial airway obstruction, encouraging the patient to cough can help dislodge the object. Abdominal thrusts are reserved for complete obstructions when the patient cannot speak or cough effectively.American Red Cross: Choking First Aid
How often should a bedridden patient be repositioned to prevent pressure ulcers?
Every two hours
Every hour
Every six hours
Every four hours
Repositioning every two hours is recommended to relieve pressure and promote circulation, reducing the risk of pressure ulcer formation.NPUAP Guidelines
What is the normal serum potassium range for an adult?
3.5 - 5.0 mEq/L
5.0 - 6.5 mEq/L
6.5 - 8.0 mEq/L
2.5 - 3.5 mEq/L
Normal serum potassium levels range between 3.5 and 5.0 mEq/L. Levels outside this range can cause cardiac dysrhythmias or muscular weakness.NIH: Potassium Homeostasis
Which of the following is a classic sign of hypoglycemia?
Blurred vision
Polydipsia
Polyuria
Diaphoresis and tremors
Hypoglycemia often presents with sympathetic activation symptoms such as diaphoresis, tremors, tachycardia, and anxiety. Early recognition is critical to prevent complications.American Diabetes Association
What is the preferred site for intramuscular injections in adults?
Deltoid
Vastus lateralis
Dorsogluteal
Ventrogluteal
The ventrogluteal site is preferred for IM injections due to its thick muscle mass, minimal overlying nerves, and low risk of complications.NIH: Injection Sites
What is the main purpose of using an incentive spirometer postoperatively?
Prevent atelectasis by encouraging deep inhalation
Measure peak expiratory flow
Administer aerosolized medications
Provide humidified oxygen
Incentive spirometry promotes deep inhalation, preventing alveolar collapse and reducing the risk of postoperative atelectasis and pneumonia.NIH: Incentive Spirometry
Which assessment is a priority after administering epidural analgesia?
Urine output
Respiratory rate and sedation level
Blood glucose level
Liver function tests
Epidural analgesia can cause respiratory depression and excessive sedation. Monitoring respiratory rate and sedation level ensures patient safety and timely intervention.NIH: Epidural Analgesia Care
Which statement best defines palliative care?
Acute interventions to shorten hospital stay
Rehabilitation to restore full function
Supportive care to improve quality of life for serious illness
Cure-focused treatment of chronic diseases
Palliative care focuses on symptom management, comfort, and quality of life for patients with serious or life-limiting illnesses, regardless of prognosis.WHO: Palliative Care
After inserting a nasogastric tube, what is the most appropriate initial nursing action?
Irrigate the tube with 30 mL of water
Check tube placement by aspirating gastric contents
Apply suction at high intermittent pressure
Begin enteral feeding immediately
Verification of nasogastric tube placement by aspirating gastric contents and checking pH or radiographically is essential before feeding or irrigation to prevent pulmonary placement.NIH: Nasogastric Tube Management
What is the primary mechanism of action of metformin in type 2 diabetes?
Increases renal glucose excretion
Stimulates insulin secretion
Delays carbohydrate absorption
Decreases hepatic gluconeogenesis
Metformin lowers blood glucose by decreasing hepatic glucose production (gluconeogenesis) and improving insulin sensitivity, making it a first-line therapy in type 2 diabetes.NIH: Metformin Pharmacology
Which ABG result is indicative of metabolic acidosis in a diabetic ketoacidosis patient?
pH 7.55, HCO?? 20 mEq/L
pH 7.50, HCO?? 30 mEq/L
pH 7.25, HCO?? 12 mEq/L
pH 7.40, HCO?? 24 mEq/L
In diabetic ketoacidosis, excessive ketone production leads to metabolic acidosis, characterized by a low pH (<7.35) and low bicarbonate (<22 mEq/L).NIH: Diabetic Ketoacidosis
What is the gold-standard diagnostic test for a suspected pulmonary embolism?
D-dimer assay
Ventilation-perfusion scan
CT pulmonary angiography
Chest X-ray
CT pulmonary angiography is the gold-standard imaging modality for diagnosing pulmonary embolism due to its high sensitivity and specificity for detecting clots in pulmonary arteries.NEJM: PE Diagnosis
Which breathing technique is recommended for patients with COPD to improve ventilation?
Rapid thoracic breathing
Diaphragmatic breathing
Shallow chest breathing
Pursed-lip breathing
Pursed-lip breathing helps slow exhalation and maintain positive airway pressure, preventing airway collapse and improving ventilation in COPD patients.NCBI: COPD Breathing Techniques
Which laboratory value should be monitored in a patient receiving warfarin therapy?
aPTT
Bleeding time
Platelet count
INR
The International Normalized Ratio (INR) is used to monitor warfarin therapy because it standardizes prothrombin time results, ensuring consistent anticoagulation management.NIH: Warfarin Monitoring
A patient's INR is 5.0. What is the appropriate nursing action?
Administer protamine sulfate
Continue current dose and recheck in one week
Administer a vitamin K injection
Increase the warfarin dose
An INR above the therapeutic range (>4.5) increases bleeding risk; administering vitamin K helps reverse warfarin's effects safely.NIH: Warfarin Reversal
Which isolation precaution is indicated for a patient with Clostridioides difficile infection?
Airborne precautions
Droplet precautions
Standard precautions only
Contact precautions
Contact precautions (gloves, gown) are required for C. difficile to prevent spore transmission via contaminated surfaces and patient contact.CDC: C. difficile Infection
Which clinical sign is most consistent with increased intracranial pressure?
Hypotension with tachycardia
Fever with bradypnea
Tachycardia
Bradycardia with hypertension
Cushing's triad - bradycardia, hypertension, and irregular respirations - is a hallmark of increased intracranial pressure and indicates impending herniation.NIH: Intracranial Pressure
Which electrolyte imbalance is expected in Addison's disease?
Hyperkalemia
Hypernatremia
Hypocalcemia
Hypokalemia
Addison's disease leads to decreased aldosterone, causing sodium loss and potassium retention, resulting in hyperkalemia.NIH: Addison's Disease
Which symptom is most characteristic of thyroid storm?
Hypothermia
High fever and tachycardia
Hypotension and lethargy
Bradycardia
Thyroid storm presents with exaggerated hyperthyroid symptoms including high fever, severe tachycardia, agitation, and delirium. It is a life-threatening emergency.NIH: Thyroid Storm
What is the best initial nursing intervention for suspected postoperative urinary retention?
Perform renal ultrasound
Insert a Foley catheter immediately
Administer diuretic medication
Encourage oral fluid intake and try to void
Encouraging the patient to void, providing privacy, and adequate fluid intake are first-line interventions. Catheterization is considered if noninvasive measures fail.NIH: Postoperative Urinary Retention
Which description best defines arteriosclerosis?
Formation of blood clots in veins
Inflammation of arterial walls
Vasospasm of coronary arteries
Hardening and loss of elasticity of arterial walls
Arteriosclerosis refers to the thickening, loss of elasticity, and hardening of arterial walls, contributing to hypertension and cardiovascular disease.NIH: Arteriosclerosis
Which intervention is recommended to reduce serum potassium in hyperkalemia?
Administer insulin with glucose
Restrict fluid intake
Administer sodium bicarbonate
Administer calcium gluconate
Insulin with glucose shifts potassium into cells, lowering serum levels temporarily. Calcium stabilizes cardiac membranes but does not lower K+ concentration.NIH: Hyperkalemia Management
What is the optimal time of day to administer a loop diuretic to a patient?
Evening
At bedtime
Morning
Afternoon
Administering loop diuretics in the morning minimizes nocturia and sleep disturbances while promoting daytime diuresis.NIH: Diuretic Therapy
Which clinical finding is most suggestive of peritonitis in an abdominal surgery patient?
Positive rebound tenderness
Hypoactive bowel sounds
Bradycardia
Elevated urine output
Rebound tenderness indicates peritoneal irritation and is a hallmark of peritonitis. It requires prompt evaluation and management.NIH: Peritonitis
Which IV fluid is most appropriate to correct hypernatremia with dehydration?
3% Sodium chloride
Lactated Ringer's
5% Dextrose in water
0.9% Sodium chloride
5% Dextrose in water is hypotonic once dextrose is metabolized, helping to move water into intracellular space and lower serum sodium. NS or LR can worsen hypernatremia.NIH: Fluid Therapy
What is the most common complication associated with total parenteral nutrition delivered via a central line?
Hypokalemia
Line infection
Hyperglycemia
Pulmonary edema
Central line - associated bloodstream infection is the most frequent and serious complication of TPN, requiring strict aseptic technique and line care.NIH: TPN Complications
A patient develops urticaria and itching during a blood transfusion. What type of transfusion reaction is this?
Allergic reaction
Transfusion-related acute lung injury
Acute hemolytic reaction
Febrile, nonhemolytic reaction
Urticaria and itching without fever or hemolysis suggest a mild allergic reaction to plasma proteins. It is managed by stopping the transfusion and giving antihistamines.NIH: Transfusion Reactions
Which lab finding distinguishes sepsis from systemic inflammatory response syndrome (SIRS)?
Positive blood cultures
Increased heart rate
Elevated respiratory rate
Elevated white blood cell count
Sepsis is defined as SIRS plus a confirmed or suspected infection. Positive blood cultures confirm infection, differentiating sepsis from noninfectious SIRS.NIH: Sepsis Definitions
What is the most effective nursing intervention to prevent ventilator-associated pneumonia?
Administer prophylactic antibiotics
Change circuits every 48 hours
Keep the head of bed elevated 30 - 45 degrees
Perform oral suctioning every 4 hours
Elevating the head of the bed reduces aspiration risk, a key factor in ventilator-associated pneumonia prevention. Oral care and suctioning are also important but head elevation is most effective.CDC VAP Guidelines
Which laboratory finding is most indicative of acute pancreatitis?
Decreased AST and ALT
Elevated creatinine
Increased serum bilirubin
Elevated amylase and lipase
Pancreatic inflammation releases enzymes into the bloodstream, leading to elevated serum amylase and lipase levels, with lipase being more specific.NIH: Acute Pancreatitis
An ABG in a patient with acute renal failure shows pH 7.28, PaCO? 40 mmHg, HCO?? 18 mEq/L. What does this indicate?
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
A low pH (<7.35) with normal PaCO? and decreased HCO?? indicates metabolic acidosis, commonly seen in acute renal failure due to impaired acid excretion.NIH: Acid - Base Disturbances in Kidney Disease
What is the priority nursing action for a patient with third-degree burns upon admission?
Obtain wound cultures
Initiate fluid resuscitation
Cover wounds with dry sterile dressings
Administer IV antibiotics
Fluid loss from extensive third-degree burns can lead to hypovolemic shock. Prompt fluid resuscitation following Parkland formula is the priority.NIH: Burn Management
What is the normal range for central venous pressure (CVP) in adults?
2 - 6 mmHg
10 - 15 mmHg
5 - 10 mmHg
0 - 2 mmHg
Normal CVP ranges from 5 to 10 mmHg and reflects right atrial pressure and intravascular volume status. Values outside this range guide fluid management.NIH: Hemodynamic Monitoring
Which medication is indicated to control ventricular rate in atrial fibrillation?
Metoprolol
Digoxin
Amiodarone
Lidocaine
Metoprolol, a beta-blocker, slows AV nodal conduction and helps control the ventricular rate in atrial fibrillation.AHA AF Management
What is the mechanism of action of mannitol in treating increased intracranial pressure?
Increases plasma osmolarity to draw fluid from brain tissue
Decreases CSF production
Vasodilates cerebral vessels
Blocks sodium channels in neurons
Mannitol is an osmotic diuretic that increases plasma osmolarity, drawing fluid from cerebral tissue into the vascular space, reducing intracranial pressure.NIH: Osmotic Diuretics
Which laboratory pattern is characteristic of disseminated intravascular coagulation (DIC)?
Low fibrinogen, prolonged PT and aPTT
High platelet count, prolonged aPTT
Normal fibrinogen, shortened PT
Elevated fibrinogen, prolonged PT
DIC features widespread clotting and consumption of clotting factors, leading to low fibrinogen, prolonged PT/aPTT, elevated D-dimer, and thrombocytopenia.NIH: DIC Pathophysiology
What irrigation pressure is recommended when performing wound irrigation to avoid tissue damage?
10 - 15 psi
Less than 4 psi
5 - 8 psi
Greater than 20 psi
An irrigation pressure below 4 psi effectively cleans wounds without damaging healthy tissue or driving bacteria deeper into the wound bed.NIH: Wound Care
Which ECG change is most indicative of acute myocardial injury?
Prolonged PR interval
ST-segment depression
T-wave inversion
ST-segment elevation
ST-segment elevation is the hallmark of acute myocardial injury (STEMI) indicating transmural ischemia and requires emergent reperfusion therapy.AHA STEMI Guidelines
What is the priority nursing action for a patient experiencing anaphylactic shock?
Obtain serum tryptase level
Administer intramuscular epinephrine
Start IV corticosteroids
Give IV diphenhydramine
Intramuscular epinephrine is the first-line treatment for anaphylaxis; it reverses bronchoconstriction, vasodilation, and angioedema quickly to stabilize the patient.NIH: Anaphylaxis Management
A patient on a heparin infusion has an aPTT of 100 seconds (therapeutic range 60 - 80 seconds). What is the appropriate nursing action?
Discontinue the heparin infusion
Increase the heparin infusion rate
Decrease the heparin infusion rate
Administer protamine sulfate
An aPTT above the therapeutic range increases bleeding risk. The appropriate action is to decrease the infusion rate and notify the provider for possible dose adjustment.NIH: Heparin Protocols
A ventilated patient has SpO? of 88% on FiO? 0.6 and PEEP 5 cm H?O. Which ventilator adjustment will most improve oxygenation?
Increase tidal volume
Decrease respiratory rate
Lower FiO? to 0.5
Increase PEEP to 10 cm H?O
Increasing PEEP improves alveolar recruitment and oxygenation without raising FiO?, reducing the risk of oxygen toxicity.NIH: Mechanical Ventilation
An arterial line waveform is dampened with falsely elevated pressures. What is the nurse's priority intervention?
Re-zero the transducer to atmosphere
Flush the line and check for air bubbles
Raise the transducer to the patient's heart level
Decrease the flush pressure
A dampened waveform often results from air bubbles or clots in the line. Flushing the line restores patency and accurate pressure readings.NIH: Arterial Line Monitoring
A patient with severe acute pancreatitis develops ARDS. What pathophysiological mechanism explains this complication?
Heart failure leading to pulmonary edema
Pulmonary microthrombi formation
Release of pancreatic enzymes causing increased capillary permeability
Aspiration pneumonia from ileus
Pancreatic enzymes and inflammatory mediators increase pulmonary capillary permeability, leading to noncardiogenic pulmonary edema and ARDS.NIH: ARDS Pathogenesis
A patient with chest pain has PCWP of 18 mmHg, CVP of 4 mmHg, and elevated SVR. Which condition is most likely?
Hypovolemic shock
Right ventricular infarction
Distributive shock
Cardiogenic shock
Elevated PCWP indicates left ventricular failure causing increased pulmonary pressures; normal CVP excludes right failure, and high SVR is compensatory in cardiogenic shock.NIH: Shock States
A patient on continuous renal replacement therapy becomes hypotensive. What is the nurse's best action?
Slow the blood flow rate
Increase the filtration rate
Raise the dialysate temperature
Administer heparin bolus
Slowing the blood flow rate reduces fluid removal and helps stabilize hemodynamics, minimizing hypotension during CRRT.NIH: CRRT Complications
In a patient experiencing myasthenic crisis, which intervention is most appropriate?
Withhold all cholinesterase inhibitors
Increase corticosteroid dose
Give intravenous immunoglobulin only
Administer neostigmine and prepare for intubation
Myasthenic crisis requires rapid improvement of neuromuscular transmission with neostigmine and airway management. Intubation is needed if respiratory muscles are compromised.NIH: Myasthenic Crisis
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Study Outcomes

  1. Apply Critical Thinking -

    Use clinical reasoning to tackle medical surgical nursing practice test questions with accuracy and confidence.

  2. Interpret Lab Values -

    Interpret laboratory and diagnostic findings to guide safe, effective patient care decisions in medical-surgical scenarios.

  3. Prioritize Patient Care -

    Rank nursing interventions according to urgency and patient safety in diverse medical-surgical situations.

  4. Demonstrate Pathophysiological Knowledge -

    Explain underlying disease processes relevant to medical-surgical nursing exam questions for deeper understanding.

  5. Identify Nursing Interventions -

    Recognize evidence-based interventions to manage common post-operative and medical complications.

  6. Enhance Exam Readiness -

    Assess strengths and address knowledge gaps to boost confidence before taking the medical-surgical nursing exam.

Cheat Sheet

  1. ABCDE Prioritization Framework -

    Use the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) to rapidly assess and prioritize patients in critical scenarios. This systematic method ensures you address life”threatening issues first and is a must”know for any medical surgical nursing practice test. Remember: "A Breath Can Die Eventually" can help cement the order.

  2. Electrolyte Imbalance Essentials -

    Memorize normal lab ranges (Na+ 135 - 145 mEq/L, K+ 3.5 - 5.0 mEq/L) and key signs like peaked T waves in hyperkalemia or muscle cramps in hypocalcemia. In your med surg nursing practice test prep, link each imbalance to interventions - e.g., Kayexalate for hyperkalemia, IV calcium gluconate for hypocalcemia. A quick mnemonic: "Salt, Pot, Cal, Mag" reminds you of the top four to monitor closely.

  3. Hemodynamic Monitoring & MAP Formula -

    Understand arterial line waveforms and calculate mean arterial pressure (MAP = [SBP + 2 × DBP]/3); aim for MAP ≥ 65 mm Hg to ensure organ perfusion. This formula is a staple in medical surgical nursing exam questions and guides titration of vasoactive drips. Visualize the waveform landmarks (dicrotic notch) to confirm accurate readings.

  4. Pain Assessment & WHO Analgesic Ladder -

    Use the SOCRATES mnemonic (Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating/relieving factors, Severity) for comprehensive pain assessment. Apply the WHO three”step ladder - nonopioids, mild opioids, strong opioids - and always watch for respiratory depression when administering narcotics. Mastering this sequence will boost your score on medical surgical nursing quiz sections.

  5. Infection Control & Precaution Standards -

    Adhere to the WHO's "Five Moments for Hand Hygiene" and select the proper precaution (standard, contact, droplet, airborne) based on mode of transmission. Consistent practice prevents HAIs and is frequently tested on med surg nursing quiz items. Remember the phrase "Clean Hands, Safe Patients" as a quick confidence”boost before any clinical scenario.

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