MEDSURG-BC Nurse Exam Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q21During a cardiac rehabilitation session, a patient walking on a treadmill reports a new sensation of pressure in the jaw. The heart rate is 112 beats/minute. What is the nurse's priority action?
✓ Correct answer: D. Stop the exercise immediately
Stopping exercise immediately is the priority because jaw pressure is a common anginal equivalent indicating potential myocardial ischemia. Cessation allows for stability assessment and infarction prevention. Continuing monitoring or slowing down are unsafe as they ignore instability signs. While nitroglycerin may be needed, stopping the activity is the immediate safety step to prevent cardiac injury.
Q22A nurse is teaching diaphragmatic breathing to a patient with anxiety. Which instruction ensures the correct mechanics to effectively increase vagal tone?
✓ Correct answer: A. Inhale slowly to expand abdomen
The correct answer is to inhale slowly to expand the abdomen. Effective diaphragmatic breathing requires slow rates (4–6 breaths/min) and abdominal engagement to stimulate the vagus nerve and reduce autonomic arousal. Distractor 1 promotes hyperventilation and arousal. Distractor 2 describes a paradoxical movement that inhibits diaphragm descent. Distractor 3 creates unnecessary tension. Distractor 4 describes chest breathing, which does not effectively engage the parasympathetic response.
Q23A pre-operative patient reports taking garlic and ginkgo biloba daily. Surgery is scheduled for 3 days from now. What is the nurse's best action?
✓ Correct answer: C. Stop taking the supplements immediately
The correct answer is to stop taking the supplements immediately. Garlic and ginkgo biloba inhibit platelet aggregation and increase bleeding risk; while stopping 1-2 weeks prior is ideal, stopping now is better than continuing. Distractor 1 increases bleeding risk during the procedure. Distractor 2 is unsafe given the upcoming surgery. Distractor 3 ignores the NPO status and the bleeding risk. Distractor 4 would dangerously potentiate bleeding effects.
Q24A patient reports painful neck muscle spasms three days after a whiplash injury. Which nonpharmacologic modality is most indicated for this subacute phase?
✓ Correct answer: E. Apply moist heat
The correct answer is to apply moist heat. In the subacute phase (>48 hours), heat helps relax muscle spasms and improve blood flow, whereas cold is primarily for acute inflammation. Distractor 1 is more appropriate for the immediate acute injury phase. Distractor 2 can lead to further stiffness and deconditioning. Distractor 3 is aggressive and may worsen the injury. Distractor 4 is contraindicated while spasms are present.
Q25A patient hospitalized with acute low back pain has rested for 24 hours. Which activity goal is most appropriate for the second day?
✓ Correct answer: B. Gentle ambulation as tolerated
The correct answer is gentle ambulation as tolerated. Graduated activity prevents deconditioning and stiffness associated with prolonged bed rest, which is no longer recommended for acute back pain. Distractor 1 promotes deconditioning and sick-role behavior. Distractor 2 is too aggressive for the acute pain phase. Distractor 3 risks complications like VTE and muscle atrophy. Distractor 4 is insufficient to maintain mobility.
Q26An older adult with chronic insomnia has not improved after 4 weeks of sleep hygiene education. What is the next evidence-based recommendation?
✓ Correct answer: D. Refer for cognitive behavioral therapy
The correct answer is referral for cognitive behavioral therapy for insomnia (CBT-I). CBT-I is the first-line treatment for chronic insomnia, addressing underlying maladaptive behaviors, unlike meds which carry risks. Distractor 1 presents safety risks (falls, confusion) in older adults. Distractor 2 (antihistamines) has anticholinergic side effects dangerous for elderly patients. Distractor 3 ignores the treatable condition. Distractor 4 is inappropriate due to high adverse event profiles.
Q27A 78-year-old patient is being discharged with a prescribed home walking program to improve conditioning. Which instruction should the nurse prioritize to ensure patient safety?
✓ Correct answer: A. Stop if dizziness or chest pain occurs
Stopping if dizziness or chest pain occurs is the priority. Recognizing warning signs of exercise intolerance prevents falls or cardiac events. Rapid walking, carrying weights, or ignoring pain encourages unsafe exertion levels. Walking on uneven terrain significantly increases fall risk for elderly patients initiating a new program.
Q28An inpatient receiving a continuous heparin infusion requests acupuncture therapy for management of chronic back pain. What is the nurse's best response regarding the safety of this intervention?
✓ Correct answer: C. Defer due to bleeding risk
Acupuncture is generally deferred due to bleeding risks. Therapeutic anticoagulation increases the risk of hematoma or bleeding at insertion sites. Allowing treatment, even by licensed providers, ignores this medical contraindication. Scheduling around dosing does not mitigate the continuous effect of a drip. Deep tissue massage is also often contraindicated due to bruising risks.
Q29A patient with an acute flare of rheumatoid arthritis presents with hot, swollen joints. Which provider order should the nurse question as inappropriate for this specific clinical presentation?
✓ Correct answer: E. Initiate heavy resistance training
Heavy resistance training is inappropriate during acute flares, as aggressive strengthening exacerbates joint damage and pain; treatment focuses on rest. Gentle range of motion maintains mobility without stress. Cold packs reduce inflammation. Anti-inflammatory medications are standard management. Energy conservation is essential during active disease.
Q30A patient recovering from a hip fracture is preparing for discharge. Which specific exercise intervention best promotes functional independence and safety within the home environment?
✓ Correct answer: B. Perform sit-to-stand repetitions
Sit-to-stand repetitions are function-specific, directly mimicking essential daily tasks like transferring from a chair or toilet. Isotonic quadriceps setting is a non-functional isolation exercise. Passive ankle range of motion does not address hip mobility. Upper body ergometer cycling improves cardiovascular endurance, not transfer skills. Gluteal squeezing is a non-weight-bearing isolation exercise.
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