All Free Medical Surgical Nursing MCQs with Answers

Every Medical Surgical Nursing question in the bank, across all chapters, each with the correct answer and a written explanation. Free and unlimited, with no account needed.

600 questions · page 4 of 30

Hard
  • A. Administer the prescribed lisinopril dose
  • B. Report the potassium result promptly
  • C. Encourage the patient to eat bananas
  • D. Restrict the patient's oral fluid intake

Explanation: A potassium level of 5.8 mmol/L with weakness suggests clinically significant hyperkalaemia, which can cause dangerous dysrhythmias.

Correct answer: Report the potassium result promptly
Moderate
  • A. Place the patient in a high-Fowler position
  • B. Offer oral fluids to loosen secretions
  • C. Place the patient flat with the legs elevated
  • D. Encourage coughing while lying supine

Explanation: These findings indicate acute pulmonary oedema from left ventricular failure.

Correct answer: Place the patient in a high-Fowler position
  • A. Crackles at both lung bases
  • B. Pink frothy sputum
  • C. Distended neck veins
  • D. Paroxysmal nocturnal dyspnoea

Explanation: Right-sided heart failure causes systemic venous congestion, producing jugular venous distension, dependent oedema and hepatomegaly.

Correct answer: Distended neck veins
Easy
  • A. Irregularly irregular rhythm without P waves
  • B. Sawtooth flutter waves between QRS complexes
  • C. Progressively longer PR intervals before a dropped beat
  • D. Wide QRS complexes occurring without preceding P waves

Explanation: Atrial flutter produces rapid, regular atrial activity that appears as sawtooth flutter waves, often with a regular or variably conducted…

Correct answer: Sawtooth flutter waves between QRS complexes
Very hard
  • A. Reduced cerebral and coronary perfusion
  • B. Increased pulmonary surfactant production
  • C. Excessive venous return to the heart
  • D. Improved ventricular relaxation during exertion

Explanation: A narrowed aortic valve obstructs left ventricular outflow and limits cardiac output, especially during exertion.

Correct answer: Reduced cerebral and coronary perfusion
Moderate
  • A. Reassure the patient that this is expected
  • B. Report the symptoms promptly to the prescriber
  • C. Advise the patient to double the next dose
  • D. Encourage strenuous exercise to improve tolerance

Explanation: New cough and dyspnoea may indicate amiodarone-induced pulmonary toxicity, which can become serious.

Correct answer: Report the symptoms promptly to the prescriber
  • A. Blood pressure of 86/ fifty-four mmHg
  • B. Mild fatigue after bathing
  • C. Heart rate of 78 beats per minute
  • D. Warm hands after a blanket is applied

Explanation: A blood pressure of 86/54 mmHg with confusion, cool skin and a weak pulse suggests inadequate tissue perfusion and possible cardiogenic…

Correct answer: Blood pressure of 86/ fifty-four mmHg
Easy
  • A. Serum potassium of 2.9 mmol/L
  • B. Serum sodium of 140 mmol/L
  • C. Serum calcium of 2.3 mmol/L
  • D. Serum chloride of 102 mmol/L

Explanation: Furosemide increases urinary potassium loss, and hypokalaemia can cause muscle cramps and cardiac dysrhythmias.

Correct answer: Serum potassium of 2.9 mmol/L
Easy
  • A. The atrial impulses are not reaching the ventricles
  • B. The PR interval is prolonged but every beat conducts
  • C. The ventricles are depolarising before the atria
  • D. The atrial rhythm is chaotic and irregular

Explanation: First-degree AV block is defined by a prolonged PR interval, usually more than 0.20 seconds, with every P wave followed by a QRS complex.

Correct answer: The PR interval is prolonged but every beat conducts
  • A. Stop prescribed medicines when symptoms improve
  • B. Plan activity with rest periods and avoid heavy exertion
  • C. Exercise vigorously immediately after large meals
  • D. Use extra salt to maintain circulating volume

Explanation: Pacing activity with planned rest reduces myocardial oxygen demand and helps prevent exertional ischaemia.

Correct answer: Plan activity with rest periods and avoid heavy exertion
Moderate
  • A. Ask the patient to walk slowly in the corridor
  • B. Instruct the patient to take the next prescribed dose
  • C. Notify the emergency response team and provider
  • D. Offer oral fluids and reassess after 30 minutes

Explanation: Chest pain that persists after the first nitroglycerin dose may indicate myocardial infarction and requires urgent assessment.

Correct answer: Notify the emergency response team and provider
  • A. An early wide QRS complex without a preceding P wave
  • B. A delayed narrow QRS complex after every normal beat
  • C. A prolonged PR interval before each normal QRS complex
  • D. A regular saw-toothed baseline between each QRS complex

Explanation: A premature ventricular contraction arises in the ventricle, producing an early, wide and abnormal QRS complex that is usually not…

Correct answer: An early wide QRS complex without a preceding P wave
  • A. I will weigh myself once a week after breakfast
  • B. I will weigh myself daily after urinating
  • C. I will check my weight whenever my ankles swell
  • D. I will compare my weight before each evening meal

Explanation: Daily weighing under similar conditions, preferably after urination and before breakfast, helps detect fluid retention early.

Correct answer: I will weigh myself daily after urinating
Moderate
  • A. It suggests acute myocardial injury in a specific region
  • B. It confirms a harmless variation in ventricular recovery
  • C. It indicates delayed conduction through the atrioventricular node
  • D. It demonstrates chronic enlargement of the left atrium

Explanation: ST-segment elevation in contiguous leads supports acute myocardial injury affecting the area supplied by related coronary vessels.

Correct answer: It suggests acute myocardial injury in a specific region
Fairly easy
  • A. Heart rate of 52 beats per minute with dizziness
  • B. Respiratory rate of 18 breaths per minute without distress
  • C. Blood pressure of 138/82 mmHg with warm skin
  • D. Apical pulse of 76 beats per minute with mild fatigue

Explanation: Metoprolol slows the heart rate and can worsen symptomatic bradycardia.

Correct answer: Heart rate of 52 beats per minute with dizziness
  • A. International normalised ratio
  • B. Activated partial thromboplastin time
  • C. Serum creatinine concentration
  • D. Platelet aggregation time

Explanation: The activated partial thromboplastin time is commonly used to monitor unfractionated heparin therapy and guide dose adjustment.

Correct answer: Activated partial thromboplastin time
Moderate
  • A. Administer it slowly through a small peripheral vein
  • B. Give it as a rapid intravenous bolus followed by a flush
  • C. Mix it with dextrose and infuse it over 30 minutes
  • D. Ask the patient to take it orally with a full glass of water

Explanation: Adenosine has an extremely short half-life, so it is administered rapidly through an intravenous line followed immediately by a flush.

Correct answer: Give it as a rapid intravenous bolus followed by a flush
  • A. Atrial fibrillation with reduced cardiac output
  • B. Complete heart block with fixed ventricular rhythm
  • C. Acute aortic regurgitation with bounding pulses
  • D. Ventricular fibrillation with immediate cardiac arrest

Explanation: Mitral stenosis enlarges the left atrium and increases the risk of atrial fibrillation.

Correct answer: Atrial fibrillation with reduced cardiac output
  • A. Flat supine with the legs elevated
  • B. High Fowler position with the legs dependent
  • C. Prone position with the head turned sideways
  • D. Left lateral position with the knees flexed

Explanation: High Fowler position improves lung expansion, while dependent legs reduce venous return to the heart and may lessen pulmonary congestion.

Correct answer: High Fowler position with the legs dependent
Fairly easy
  • A. Administer the next dose with food
  • B. Assess the patient and notify the provider promptly
  • C. Encourage vigorous tooth brushing to remove blood
  • D. Give aspirin to reduce the risk of embolism

Explanation: Gum bleeding and melena suggest clinically important anticoagulant-related bleeding and require prompt assessment, including vital signs…

Correct answer: Assess the patient and notify the provider promptly