TheoryMEDSURG-BC Nurse Exam Prep Practice Questions
Free MEDSURG-BC Nurse Exam Prep practice questions with answers and plain-English explanations. Browse the PDF, video and online mock test.
MEDSURG-BC Nurse Exam Prep Questions
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Q1A patient hospitalized for cellulitis has a history of heart failure. The provider orders "ambulate in hall three times daily." Before the morning walk, the patient reports new-onset chest heaviness rated 4/10 and telemetry shows frequent premature ventricular contractions. Which action is appropriate?
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✓ Correct answer: Immediately defer the activity and notify the provider
New-onset chest heaviness and PVCs indicate cardiac instability. Safety guidelines mandate deferring activity during acute symptoms. Proceeding with ambulation or performing bed exercises risks exacerbating the potential cardiac event.
Q2A 78-year-old patient deconditioned from prolonged bed rest is preparing for discharge. Using the FITT (Frequency, Intensity, Type, Time) framework, which exercise prescription ensures safety while promoting functional recovery?
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✓ Correct answer: Walking 10 minutes daily at a conversation pace
The correct answer is walking 10 minutes daily at a conversation pace. For deconditioned patients, the FITT framework prioritizes low intensity (permitting conversation) and manageable duration to build tolerance without exceeding pain thresholds or cardiac reserves. High-intensity interval training or working to the point of fatigue (distractors) increases injury risk in this population. Focusing solely on bed rest fails to reverse deconditioning. The prescription must balance activity with the patient's low baseline tolerance.
Q3A patient is 24 hours post-operative from a total knee replacement and also reports a flare-up of chronic lower back pain. Which combination of thermal modalities is indicated?
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✓ Correct answer: Ice packs to the knee; heating pad to the back
Cold therapy reduces inflammation and bleeding in acute surgical sites (first 48–72 hours). Heat promotes blood flow and relaxation for chronic muscle tension. Applying heat to fresh wounds increases bleeding risk, while ice is less effective than heat for chronic tension.
Q4A patient with chronic insomnia has had limited success with general sleep hygiene advice. The nurse plans to introduce stimulus control as part of Cognitive Behavioral Therapy for Insomnia (CBT-I). Which instruction aligns with this specific intervention?
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✓ Correct answer: Leaving the bedroom if awake for more than 20 minutes
Stimulus control aims to re-associate the bed with rapid sleep onset. Patients must leave the bedroom if unable to sleep after 20 minutes to break conditioned arousal. Sleep hygiene tips (limiting fluids or caffeine) do not address the behavioral conditioning specific to this intervention.
Q5A patient prescribed warfarin for atrial fibrillation asks about adding herbal supplements to their daily routine. Which product identified by the nurse requires immediate intervention due to a high risk of drug-drug interaction?
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✓ Correct answer: Garlic extract
The correct answer is garlic extract. Several herbal supplements, notably the "4 Gs" (Garlic, Ginkgo, Ginger, Ginseng), possess antiplatelet properties that can significantly potentiate the anticoagulant effect of warfarin, increasing the risk of spontaneous bleeding. While other supplements like Vitamin C, zinc, or probiotics (distractors) may have minor interactions or lack evidence of harm, garlic extract presents a well-documented safety hazard that necessitates counseling to prevent adverse hemorrhagic events.
Q6A patient recovering from pneumonia currently walks 10 minutes per session without dyspnea. Following the standard "10% rule" for safe progression, what is the maximum appropriate duration for the next week's sessions?
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✓ Correct answer: 11 minutes
The correct answer is 11 minutes. Safe exercise progression guidelines generally recommend increasing the frequency, intensity, or duration by no more than 10% per week to prevent injury and relapse. 10% of 10 minutes is 1 minute, making the new target 11 minutes ($$$10\times 1.10 = 11$$$). Distractors suggesting 15 or 20 minutes represent aggressive increases (50-100%) that risk overexertion, while maintaining 10 minutes does not facilitate progressive reconditioning.
Q7A patient with COPD is experiencing acute anxiety and tachypnea (respiratory rate 28/min) but has stable oxygen saturation. Which breathing technique is most appropriate to reduce autonomic arousal and work of breathing?
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✓ Correct answer: Diaphragmatic breathing at 6 breaths/minute
Diaphragmatic breathing (6 breaths/minute) stimulates the vagus nerve, reducing autonomic arousal and improving efficiency. This is a first-line intervention for respiratory anxiety. Rapid breathing worsens gas exchange, and breath holding causes hypoxia. Progressive muscle relaxation is often too complex during acute distress.
Q8A patient requests a referral for acupuncture to manage chronic pain. During the safety screening, which finding in the patient's medical record represents a contraindication requiring provider consultation?
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✓ Correct answer: Daily warfarin therapy
The correct answer is daily warfarin therapy. Acupuncture involves the insertion of needles, which carries a risk of bleeding and hematoma formation. Patients on anticoagulants (like warfarin) or antiplatelet agents are at increased risk, and this therapy is often contraindicated or requires specialized modification. Hypertension, age, or a history of surgery (distractors) are not absolute contraindications for acupuncture. The nurse must identify the bleeding risk as the priority safety concern.
Q9A nurse is teaching a patient with chronic insomnia about stimulus control. Which instruction correctly reinforces the association between the bed and sleep to reduce conditioned arousal?
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✓ Correct answer: Go to another room if unable to sleep
Stimulus control prevents negative associations between the bed and wakefulness. Patients should go to another room if unable to sleep. Activities like reading, watching TV, or lying awake in bed reinforce wakefulness in the sleep environment and should be avoided.
Q10A post-operative patient is refusing to mobilize due to pain and has shown a decline in functional status over the last 3 days. What is the most appropriate nursing intervention to address the immobility?
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✓ Correct answer: Request a physical therapy referral
Requesting a physical therapy referral is best when patients show functional decline or reluctance. PT provides specialized mobilization and progressive loading to prevent deconditioning. Enforcing bed rest worsens outcomes and increases complication risks like DVT. Increasing opioids or teaching passive ROM fails to address the functional mechanics and safety assessments required to reverse the patient's decline.
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