Comprehensive Medical-Surgical Nursing
Review for First Proctor Exam Questions
and Answers [Verified Answers] Plus
Rationales
Question 1
A nurse is caring for a client with heart failure. Which assessment finding
indicates fluid overload?
A. Dry mucous membranes
B. Crackles in the lungs
C. Weight loss
D. Bradycardia
Answer: B. Crackles in the lungs
Rationale: Crackles indicate pulmonary fluid accumulation associated with
heart failure.
Question 2
A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which oxygen flow rate is most appropriate?
A. 10 L/min via nonrebreather
B. 1–2 L/min via nasal cannula
,C. 15 L/min via simple mask
D. 8 L/min via face tent
Answer: B. 1–2 L/min via nasal cannula
Rationale: Low-flow oxygen helps prevent suppression of respiratory drive in
COPD.
Question 3
A nurse is assessing a client with hypoglycemia. Which manifestation should
the nurse expect?
A. Fruity breath odor
B. Warm dry skin
C. Tremors and diaphoresis
D. Kussmaul respirations
Answer: C. Tremors and diaphoresis
Rationale: Adrenergic symptoms commonly occur during hypoglycemia.
Question 4
A nurse is caring for a client with a potassium level of 6.1 mEq/L. Which
complication is most concerning?
A. Constipation
B. Cardiac dysrhythmias
,C. Dry skin
D. Polyuria
Answer: B. Cardiac dysrhythmias
Rationale: Hyperkalemia can cause life-threatening ECG changes.
Question 5
A nurse is caring for a client after thyroidectomy. Which finding requires
immediate intervention?
A. Mild hoarseness
B. Neck swelling
C. Pain rating 4/10
D. Heart rate 88/min
Answer: B. Neck swelling
Rationale: Swelling may indicate hemorrhage and airway compromise.
Question 6
A nurse is caring for a client with pneumonia. Which assessment finding is
expected?
A. Clear lung sounds
B. Productive cough with crackles
C. Bradycardia
D. Hypothermia
, Answer: B. Productive cough with crackles
Rationale: Pneumonia causes secretions and inflammation in the lungs.
Question 7
A nurse is caring for a client with diabetic ketoacidosis (DKA). Which
intervention should the nurse implement first?
A. Administer insulin
B. Start IV fluids
C. Give potassium supplements
D. Restrict fluids
Answer: B. Start IV fluids
Rationale: Fluid replacement is the first priority in DKA management.
Question 8
A nurse is caring for a client with cirrhosis. Which finding indicates ascites?
A. Flat abdomen
B. Increased abdominal girth
C. Weight loss
D. Hypotension
Answer: B. Increased abdominal girth
Rationale: Ascites is fluid accumulation within the abdomen.
Review for First Proctor Exam Questions
and Answers [Verified Answers] Plus
Rationales
Question 1
A nurse is caring for a client with heart failure. Which assessment finding
indicates fluid overload?
A. Dry mucous membranes
B. Crackles in the lungs
C. Weight loss
D. Bradycardia
Answer: B. Crackles in the lungs
Rationale: Crackles indicate pulmonary fluid accumulation associated with
heart failure.
Question 2
A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which oxygen flow rate is most appropriate?
A. 10 L/min via nonrebreather
B. 1–2 L/min via nasal cannula
,C. 15 L/min via simple mask
D. 8 L/min via face tent
Answer: B. 1–2 L/min via nasal cannula
Rationale: Low-flow oxygen helps prevent suppression of respiratory drive in
COPD.
Question 3
A nurse is assessing a client with hypoglycemia. Which manifestation should
the nurse expect?
A. Fruity breath odor
B. Warm dry skin
C. Tremors and diaphoresis
D. Kussmaul respirations
Answer: C. Tremors and diaphoresis
Rationale: Adrenergic symptoms commonly occur during hypoglycemia.
Question 4
A nurse is caring for a client with a potassium level of 6.1 mEq/L. Which
complication is most concerning?
A. Constipation
B. Cardiac dysrhythmias
,C. Dry skin
D. Polyuria
Answer: B. Cardiac dysrhythmias
Rationale: Hyperkalemia can cause life-threatening ECG changes.
Question 5
A nurse is caring for a client after thyroidectomy. Which finding requires
immediate intervention?
A. Mild hoarseness
B. Neck swelling
C. Pain rating 4/10
D. Heart rate 88/min
Answer: B. Neck swelling
Rationale: Swelling may indicate hemorrhage and airway compromise.
Question 6
A nurse is caring for a client with pneumonia. Which assessment finding is
expected?
A. Clear lung sounds
B. Productive cough with crackles
C. Bradycardia
D. Hypothermia
, Answer: B. Productive cough with crackles
Rationale: Pneumonia causes secretions and inflammation in the lungs.
Question 7
A nurse is caring for a client with diabetic ketoacidosis (DKA). Which
intervention should the nurse implement first?
A. Administer insulin
B. Start IV fluids
C. Give potassium supplements
D. Restrict fluids
Answer: B. Start IV fluids
Rationale: Fluid replacement is the first priority in DKA management.
Question 8
A nurse is caring for a client with cirrhosis. Which finding indicates ascites?
A. Flat abdomen
B. Increased abdominal girth
C. Weight loss
D. Hypotension
Answer: B. Increased abdominal girth
Rationale: Ascites is fluid accumulation within the abdomen.
