Medical-Surgical Nursing
Core concepts
Med-surg questions emphasize assessment of deteriorating clients, fluid and electrolyte balance, and postoperative care. Know signs of hypovolemic shock (tachycardia, hypotension, cool clammy skin, decreased urine output), hyperkalemia (peaked T waves, muscle weakness), and hypokalemia (U waves, dysrhythmias). Understand perioperative priorities: airway and breathing post-anesthesia, preventing atelectasis with incentive spirometry and early ambulation, and monitoring for DVT. Recognize acute complications such as chest pain (assume cardiac until proven otherwise), stroke signs (sudden facial droop, arm weakness, speech difficulty), and hypoglycemia (sweating, tremor, confusion).
Traps
Questions may present a client with multiple problems and ask which finding to report first. Report life-threatening findings (airway compromise, chest pain, new dysrhythmia, signs of shock) before chronic or expected findings. Do not be distracted by stable abnormal labs when a physiologic emergency is present.
Rule of thumb
For "which finding requires immediate follow-up," choose the one that signals airway, breathing, circulation, or neurologic compromise.
Worked example
Postoperative day 1 client reports sudden shortness of breath and chest pain, SpO2 88%. Priority: assess airway/breathing and apply oxygen, then notify the provider - this suggests pulmonary embolism, an emergency.