50 Medical Surgical Nursing Exam Questions with Answers – Recently Asked

Medical-Surgical Nursing MCQs

Practice the latest 50 Medical Surgical Nursing exam questions with answers, recently asked in competitive exams. Strengthen your preparation with important MCQs on medical and surgical nursing topics.

1. Which electrolyte imbalance is most likely to cause cardiac arrhythmias in a postoperative patient?
   a) Hypernatremia
   b) Hypercalcemia
   c) Hypokalemia
   d) Hypomagnesemia
   Answer: c

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1. A patient with chronic obstructive pulmonary disease (COPD) is at risk for:
   a) Respiratory alkalosis
   b) Respiratory acidosis
   c) Metabolic acidosis
   d) Metabolic alkalosis
   Answer: b

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1. In managing a patient with heart failure, which drug is considered first-line for reducing mortality?
   a) Loop diuretic
   b) Calcium channel blocker
   c) ACE inhibitor
   d) Beta-agonist
   Answer: c

2. A patient with peptic ulcer disease complains of burning epigastric pain relieved by eating. This is characteristic of:
   a) Gastric ulcer
   b) Stress ulcer
   c) Duodenal ulcer
   d) Mallory–Weiss tear
   Answer: c

3. Which sign is characteristic of peritonitis?
   a) Hyperactive bowel sounds
   b) Soft, non-tender abdomen
   c) Guarding and rebound tenderness
   d) Loud gurgling noises
   Answer: c

4. The primary purpose of a chest tube after thoracic surgery is to:
   a) Deliver medications
   b) Prevent infection
   c) Re-expand the lung and remove air/fluid
   d) Maintain sedation
   Answer: c

5. In a patient with diabetes, foot care is important because:
   a) They have stronger skin
   b) They are less prone to injury
   c) Neuropathy and poor circulation increase risk of ulcers
   d) Neuropathy and poor circulation increase risk of ulcers
   Answer: c

6. Which of the following is an early sign of hypoxia?
   a) Cyanosis
   b) Restlessness and agitation
   c) Bradycardia
   d) Hypotension
   Answer: b

7. What is the priority nursing intervention for a patient experiencing shock?
   a) Monitor laboratory values
   b) Administer opioids
   c) Ensure airway, breathing, and circulation (ABC)
   d) Provide patient education
   Answer: c

8. A patient with acute pancreatitis should be on which diet initially?
   a) High fat
   b) High protein
   c) NPO (nothing by mouth)
   d) Full liquid
   Answer: c

9. In clients with chronic kidney disease, what change is expected in the laboratory values?
   a) Decreased BUN
   b) Increased creatinine
   c) Increased creatinine
   d) Decreased potassium
   Answer: b

10. Which finding is characteristic of right-sided heart failure?
    a) Pulmonary edema
    b) Crackles in lung fields
    c) Peripheral edema and jugular venous distention
    d) Crackles over upper lobes
    Answer: c

11. A patient with a total hip replacement should avoid which action?
    a) Using a raised toilet seat
    b) Keeping pillows between knees
    c) Crossing the legs at the hip
    d) Using a walker
    Answer: c

12. The most common cause of acute pancreatitis in many countries is:
    a) Viral infection
    b) Gallstones
    c) Gallstones
    d) Trauma
    Answer: b

13. Which assessment finding is expected in a patient with left-sided heart failure?
    a) Jugular venous distention
    b) Dependent edema
    c) Crackles in the lungs and dyspnea
    d) Hepatomegaly
    Answer: c

14. A patient post-op develops sudden chest pain, shortness of breath, and anxiety. You suspect a pulmonary embolism. What is your first action?
    a) Draw blood for D-dimer
    b) Administer oxygen and notify physician
    c) Prepare for CT scan
    d) Mobilize patient
    Answer: b

15. What is the primary rationale for using incentive spirometry post-operatively?
    a) Administer medications
    b) Promote expectoration
    c) Prevent atelectasis and improve lung expansion
    d) Measure oxygen saturation
    Answer: c

16. Which lab finding is most indicative of myocardial infarction (MI)?
    a) Elevated BUN
    b) Elevated amylase
    c) Elevated troponin I or T
    d) Elevated bilirubin
    Answer: c

17. A patient with COPD is retaining CO₂. The expected acid-base imbalance is:
    a) Metabolic acidosis
    b) Respiratory acidosis with metabolic compensation
    c) Metabolic alkalosis
    d) Respiratory alkalosis
    Answer: b

18. In cirrhosis, the nurse expects to find which of the following?
    a) Splenomegaly, jaundice, ascites
    b) Increased albumin
    c) Decreased prothrombin time
    d) Splenomegaly, jaundice, ascites
    Answer: a

19. What is the priority nursing action for a patient with suspected acute hemorrhage?
    a) Administer antibiotics
    b) Control bleeding and restore circulating volume
    c) Provide nutrition
    d) Begin physical therapy
    Answer: b

20. For a patient with a colostomy, best initial advice is to:
    a) Restrict fluids
    b) Empty the pouch when it is one-third full
    c) Change pouch daily always
    d) Use tight clothing
    Answer: b

21. Which electrolyte imbalance may lead to muscle weakness and cardiac disturbances?
    a) Hypernatremia
    b) Hyperkalemia
    c) Hypermagnesemia
    d) Hypocalcemia
    Answer: b

22. A patient with a peptic ulcer is prescribed proton pump inhibitors. The nurse should teach:
    a) Take with milk
    b) Take before meals
    c) Avoid water
    d) Take only once a week
    Answer: b

23. In a patient with congestive heart failure, which diet recommendation is vital?
    a) High sodium diet
    b) Low salt (sodium) diet
    c) High potassium diet
    d) Low protein diet
    Answer: b

24. The nurse recognizes that Addison’s disease is characterized by:
    a) Hyperglycemia
    b) Hyponatremia and hyperkalemia
    c) Hypokalemia
    d) Hypernatremia
    Answer: b

25. A patient on mechanical ventilation suddenly develops high peak airway pressures. What might be the cause?
    a) Decreased airway resistance
    b) Kinked tubing, mucus plug, bronchospasm
    c) Improved lung compliance
    d) Reduced tidal volume
    Answer: b

26. In the case of diabetic ketoacidosis (DKA), which blood sugar level is typical?
    a) 80–120 mg/dL
    b) > 250 mg/dL
    c) 100–150 mg/dL
    d) < 70 mg/dL
    Answer: b

27. Which sign is characteristic of acute pericarditis?
    a) Lower back pain
    b) Sharp chest pain relieved by leaning forward
    c) Leg swelling
    d) Hematuria
    Answer: b

28. A patient with chronic liver disease should avoid:
    a) Proteins
    b) Excessive alcohol and hepatotoxic drugs
    c) Carbohydrates
    d) Water
    Answer: b

29. The nurse assesses for Chvostek’s sign in patients with:
    a) Hyperkalemia
    b) Hypocalcemia
    c) Hypermagnesemia
    d) Hyponatremia
    Answer: b

30. Which symptom is typical in hypoglycemia?
    a) Dry skin
    b) Sweating, tremors, confusion
    c) Polyuria
    d) Weight gain
    Answer: b

31. Which drug is commonly used in the management of atrial fibrillation to control ventricular rate?
    a) Digoxin
    b) Beta-blockers (e.g., metoprolol)
    c) Insulin
    d) Diuretics
    Answer: b

32. What is the best nursing intervention for a patient with a nasogastric tube and risk of aspiration?
    a) Keep head flat
    b) Keep head of bed elevated (30–45°)
    c) Turn off suction continuously
    d) Feed rapidly
    Answer: b

33. A patient develops signs of hypovolemia. Which lab finding is expected?
    a) Decreased hematocrit
    b) Increased blood pressure
    c) Elevated hematocrit and BUN/creatinine ratio
    d) Decreased BUN/creatinine ratio
    Answer: c

34. Which condition is characterized by an inflammatory response in lung alveoli leading to fluid-filled air spaces?
    a) Asthma
    b) Pneumonia
    c) COPD
    d) Emphysema
    Answer: b

35. For a patient with suspected stroke, what is the priority nursing action?
    a) Give oral glucose
    b) Check airway, breathing, circulation, and call stroke team
    c) Begin exercise
    d) Wait for lab results
    Answer: b

36. What is the main purpose of giving IV fluids in shock?
    a) Give nutrition
    b) Restore circulating volume and tissue perfusion
    c) Provide electrolytes only
    d) Sedate patient
    Answer: b

37. Which drug is used to reverse warfarin (Coumadin) overdose?
    a) Heparin
    b) Aspirin
    c) Vitamin K
    d) Furosemide
    Answer: c

38. In patients with hypertension, which organ is most at risk of damage over time?
    a) Skin
    b) Kidneys
    c) Ear
    d) Gallbladder
    Answer: b

39. Which of the following is characteristic of hypovolemic shock?
    a) Warm, flushed skin
    b) Cold, clammy skin with rapid pulse
    c) Flushed cheeks
    d) Bradycardia
    Answer: b

40. The priority nursing intervention for an upper GI bleed is:
    a) Administer insulin
    b) Stabilize airway, breathing, circulation, and prepare for endoscopy
    c) Apply cold compress
    d) Assess skin turgor only
    Answer: b

41. A client with hyperthyroidism may present with:
    a) Weight gain
    b) Cold intolerance
    c) Tachycardia, heat intolerance, weight loss
    d) Bradycardia
    Answer: c

42. Which lab test is used to monitor warfarin therapy?
    a) aPTT
    b) INR / PT (Prothrombin Time / International Normalized Ratio)
    c) Blood sugar
    d) BUN
    Answer: b

43. The primary purpose of a lymph node biopsy is to:
    a) Administer medications
    b) Diagnose malignancy or infections
    c) Provide nutrition
    d) Remove fluid
    Answer: b

44. A patient with chronic heart failure is prescribed furosemide. What should the nurse monitor?
    a) Hyperglycemia
    b) Hypercalcemia
    c) Hypokalemia and dehydration
    d) Hypernatremia
    Answer: c

45. Which acid-base disturbance occurs in prolonged vomiting?
    a) Respiratory acidosis
    b) Metabolic alkalosis
    c) Metabolic acidosis
    d) Respiratory alkalosis
    Answer: b

46. The best indicator of fluid balance is:
    a) Heart rate
    b) Daily weight
    c) Skin color
    d) Temperature
    Answer: b

47. What is the expected symptom in a patient with hypermagnesemia?
    a) Tremors
    b) Lethargy, decreased deep tendon reflexes, bradycardia
    c) Hyperactivity
    d) Insomnia
    Answer: b

48. In a patient with meningitis, which nursing action is priority?
    a) Provide diet education
    b) Maintain airway, administer prescribed antibiotics, monitor neurologic status
    c) Provide ambulation
    d) Teach hand hygiene
    Answer: b