Page 1 of 39
RN ADULT MEDICAL SURGICAL ONLINE PRACTICE
2019 B WITH NGN (REVISED 2025/2026) LATEST
QUESTIONS WITH COMPLETE SOLUTIONS GRADED A+
A nurse is providing postoperative teaching for a client who had
a total knee arthroplasty. Which of the following instructions
should the nurse include? ......ANSWER........Flex the foot every
hour when awake.
Rationale: The nurse should instruct the client to flex the foot
every hour to reduce the risk for thromboembolism and promote
venous return.
A nurse is caring for a client who has a pneumothorax and a
closed-chest drainage system. Which of the following findings is
an indication of lung re-expansion? ......ANSWER........Bubbling in
the water seal chamber has ceased.
Rationale: Bubbling in the water seal chamber ceases when the
lung re-expands.
A nurse is reviewing the medical record of a client who is taking
warfarin for chronic atrial fibrillation. Which of the following
values should the nurse identify as a desired outcome for this
therapy? ......ANSWER........INR 2.5
Rationale: Clients receive warfarin therapy to decrease the risk
of stroke, myocardial infarction (MI), or pulmonary emboli (PE)
from blood clots. Since warfarin is an anticoagulant, the
medication must be monitored to ensure the anticoagulation is
within the therapeutic range and prevent hemorrhage (high
levels of anticoagulation) or stroke, MI, or PE (low levels of
anticoagulation). An INR of 2.5 is within the targeted therapeutic
range of 2 to 3 for a client who has atrial fibrillation.
,Page 2 of 39
A home health nurse is providing teaching to a client who has a
stage 1 pressure injury on the greater trochanter of his left hip.
Which of the following instructions should the nurse include in the
teaching? ......ANSWER........Change position every hour
Rationale: Changing position every 1 to 2 hr decreases pressure
on bony prominences. The nurse should also instruct the client to
limit the angle of the hips when in a lateral position to no more
than 30°. This positioning prevents direct pressure on the
trochanter.
A nurse is assessing a client following the completion of
hemodialysis. Which of the following findings is the nurse's
priority to report to the provider? ......ANSWER........Restlessness
Rationale: Using the urgent vs. nonurgent approach to client care,
the nurse should determine that the priority finding to report to
the provider is restlessness, which can be an indication the client
is experiencing disequilibrium syndrome. Disequilibrium syndrome
is caused by the rapid removal of electrolytes from the client's
blood and can lead to dysrhythmias or seizures. Other
manifestations include nausea, vomiting, fatigue, and headache.
A nurse is caring for a client who is 8 hr postoperative following
a total hip arthroplasty. The client is unable to void on the
bedpan. Which of the following actions should the nurse take
first? ......ANSWER........Scan the bladder with a portable
ultrasound.
Rationale: The first action the nurse should take using the nursing
process is to assess the client. Scanning the bladder with a
portable ultrasound device will determine the amount of urine in
the bladder
,Page 3 of 39
A nurse is planning a health promotional presentation for a
group of African American clients at a community center. Which
of the following disorders presents the greatest risk to this group
of clients? ......ANSWER........Hypertension
Rationale: When using the safety/risk reduction approach to
client care, the nurse should determine that the disorder with the
greatest risk for this group of clients is hypertension. The
prevalence of hypertension is highest among African American
clients, followed by Caucasian clients, and then Hispanic clients.
A nurse is caring for a client who has DKA. Which of the
following findings should indicate to the nurse that the client's
condition is improving? ......ANSWER........Glucose 272 mg/dL
Rationale: A glucose reading less than 300 mg/dL indicates
improvement in the client's status.
A nurse is caring for a client following extubation of an
endotracheal tube 10 min. ago. Which of the following findings
should the nurse report to the provider immediately?
......ANSWER........Stridor
Rationale: Using the urgent vs. nonurgent approach to client care,
the nurse should determine that the priority finding is stridor.
Stridor can indicate a narrowing airway or possible obstruction
caused by edema or laryngeal spasms. The nurse should report
the finding immediately and implement an intervention.
A nurse is caring for a client who had a nephrostomy tube
inserted 112 hr ago. Which of the following findings should the
nurse report to the provider? ......ANSWER........The client reports
back pain
, Page 4 of 39
Rationale: The nurse should notify the provider if the client
reports back pain, which can indicate that the nephrostomy tube
is dislodged or clogged.
A nurse is admitting a client who has active TB. Which of the
following types of transmission precautions should the nurse
initiate? ......ANSWER........Airborne
Rationale: Airborne precautions are required for clients who
have infections due to micro-organisms that can remain
suspended in air for lengthy periods of time, such as tuberculosis,
measles, varicella, and disseminated varicella zoster.
A nurse is planning care for a client who has a sealed radiation
implant for cervical cancer. Which of the following interventions
should the nurse include in the plan of care?
......ANSWER........Keep a lead-lined container in the client's room
Rationale: The nurse should keep a lead-lined container and
forceps in the client's room in case of accidental dislodgement of
the implant.
A nurse is assessing a client who is postoperative following a
thyroidectomy. Which of the following findings is the nurse's
priority? ......ANSWER........Temperature 38.9° C (102° F)
Rationale: When using the urgent vs. nonurgent approach to
client care, the nurse should determine that the priority finding is
an elevated temperature. An elevated temperature is a
manifestation of excessive thyroid hormone release, or thyroid
storm, due to an increase in metabolic rate. The nurse should
report this finding immediately to the provider because it can
lead to seizures and coma.
RN ADULT MEDICAL SURGICAL ONLINE PRACTICE
2019 B WITH NGN (REVISED 2025/2026) LATEST
QUESTIONS WITH COMPLETE SOLUTIONS GRADED A+
A nurse is providing postoperative teaching for a client who had
a total knee arthroplasty. Which of the following instructions
should the nurse include? ......ANSWER........Flex the foot every
hour when awake.
Rationale: The nurse should instruct the client to flex the foot
every hour to reduce the risk for thromboembolism and promote
venous return.
A nurse is caring for a client who has a pneumothorax and a
closed-chest drainage system. Which of the following findings is
an indication of lung re-expansion? ......ANSWER........Bubbling in
the water seal chamber has ceased.
Rationale: Bubbling in the water seal chamber ceases when the
lung re-expands.
A nurse is reviewing the medical record of a client who is taking
warfarin for chronic atrial fibrillation. Which of the following
values should the nurse identify as a desired outcome for this
therapy? ......ANSWER........INR 2.5
Rationale: Clients receive warfarin therapy to decrease the risk
of stroke, myocardial infarction (MI), or pulmonary emboli (PE)
from blood clots. Since warfarin is an anticoagulant, the
medication must be monitored to ensure the anticoagulation is
within the therapeutic range and prevent hemorrhage (high
levels of anticoagulation) or stroke, MI, or PE (low levels of
anticoagulation). An INR of 2.5 is within the targeted therapeutic
range of 2 to 3 for a client who has atrial fibrillation.
,Page 2 of 39
A home health nurse is providing teaching to a client who has a
stage 1 pressure injury on the greater trochanter of his left hip.
Which of the following instructions should the nurse include in the
teaching? ......ANSWER........Change position every hour
Rationale: Changing position every 1 to 2 hr decreases pressure
on bony prominences. The nurse should also instruct the client to
limit the angle of the hips when in a lateral position to no more
than 30°. This positioning prevents direct pressure on the
trochanter.
A nurse is assessing a client following the completion of
hemodialysis. Which of the following findings is the nurse's
priority to report to the provider? ......ANSWER........Restlessness
Rationale: Using the urgent vs. nonurgent approach to client care,
the nurse should determine that the priority finding to report to
the provider is restlessness, which can be an indication the client
is experiencing disequilibrium syndrome. Disequilibrium syndrome
is caused by the rapid removal of electrolytes from the client's
blood and can lead to dysrhythmias or seizures. Other
manifestations include nausea, vomiting, fatigue, and headache.
A nurse is caring for a client who is 8 hr postoperative following
a total hip arthroplasty. The client is unable to void on the
bedpan. Which of the following actions should the nurse take
first? ......ANSWER........Scan the bladder with a portable
ultrasound.
Rationale: The first action the nurse should take using the nursing
process is to assess the client. Scanning the bladder with a
portable ultrasound device will determine the amount of urine in
the bladder
,Page 3 of 39
A nurse is planning a health promotional presentation for a
group of African American clients at a community center. Which
of the following disorders presents the greatest risk to this group
of clients? ......ANSWER........Hypertension
Rationale: When using the safety/risk reduction approach to
client care, the nurse should determine that the disorder with the
greatest risk for this group of clients is hypertension. The
prevalence of hypertension is highest among African American
clients, followed by Caucasian clients, and then Hispanic clients.
A nurse is caring for a client who has DKA. Which of the
following findings should indicate to the nurse that the client's
condition is improving? ......ANSWER........Glucose 272 mg/dL
Rationale: A glucose reading less than 300 mg/dL indicates
improvement in the client's status.
A nurse is caring for a client following extubation of an
endotracheal tube 10 min. ago. Which of the following findings
should the nurse report to the provider immediately?
......ANSWER........Stridor
Rationale: Using the urgent vs. nonurgent approach to client care,
the nurse should determine that the priority finding is stridor.
Stridor can indicate a narrowing airway or possible obstruction
caused by edema or laryngeal spasms. The nurse should report
the finding immediately and implement an intervention.
A nurse is caring for a client who had a nephrostomy tube
inserted 112 hr ago. Which of the following findings should the
nurse report to the provider? ......ANSWER........The client reports
back pain
, Page 4 of 39
Rationale: The nurse should notify the provider if the client
reports back pain, which can indicate that the nephrostomy tube
is dislodged or clogged.
A nurse is admitting a client who has active TB. Which of the
following types of transmission precautions should the nurse
initiate? ......ANSWER........Airborne
Rationale: Airborne precautions are required for clients who
have infections due to micro-organisms that can remain
suspended in air for lengthy periods of time, such as tuberculosis,
measles, varicella, and disseminated varicella zoster.
A nurse is planning care for a client who has a sealed radiation
implant for cervical cancer. Which of the following interventions
should the nurse include in the plan of care?
......ANSWER........Keep a lead-lined container in the client's room
Rationale: The nurse should keep a lead-lined container and
forceps in the client's room in case of accidental dislodgement of
the implant.
A nurse is assessing a client who is postoperative following a
thyroidectomy. Which of the following findings is the nurse's
priority? ......ANSWER........Temperature 38.9° C (102° F)
Rationale: When using the urgent vs. nonurgent approach to
client care, the nurse should determine that the priority finding is
an elevated temperature. An elevated temperature is a
manifestation of excessive thyroid hormone release, or thyroid
storm, due to an increase in metabolic rate. The nurse should
report this finding immediately to the provider because it can
lead to seizures and coma.
