LPN to ADN Bridge Week 4: Med-Surg Foundations Quiz 2026/2027
UPDATE
1. A nurse is caring for a patient who is 24 hours post-abdominal surgery. Which
assessment finding requires immediate intervention by the RN?
A. Serosanguinous drainage on the dressing
B. Hypoactive bowel sounds in all four quadrants
C. Urine output of 20 mL/hr for the last two hours
D. Pain level of 5 on a scale of 0-10
Answer: C
Rationale: The RN must prioritize the ABCs and organ perfusion. Urine output less than 30
mL/hr indicates potential renal failure or hypovolemia. Hypoactive bowel sounds are
expected post-op, as is serosanguinous drainage.
2. Which task is most appropriate for the RN to delegate to a Licensed Practical
Nurse (LPN)?
A. Developing the initial plan of care for a new admission
B. Performing the admission assessment on a complex patient
C. Administering a scheduled intramuscular injection
D. Evaluating the effectiveness of a new pain medication
Answer: C
Rationale: LPNs can administer medications via most routes. Assessment, planning, and
evaluation are the core responsibilities of the RN and cannot be delegated.
,3. A patient has a potassium level of 6.2 mEq/L. Which cardiac change should
the nurse monitor for on the ECG?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted T waves
Answer: C
Rationale: Hyperkalemia (potassium > 5.0) causes tall, peaked T waves. U waves and ST
depression are associated with hypokalemia.
4. In the nursing process, which action is specifically the responsibility of the RN
rather than the LPN?
A. Monitoring vital signs
B. Collecting data for the health history
C. Performing a focused physical exam
D. Analyzing data to identify nursing diagnoses
Answer: D
Rationale: The RN is responsible for the ‘Analyze’ or ‘Diagnosis’ phase of the nursing
process, whereas LPNs assist with data collection and implementation.
5. A patient with a history of COPD is at risk for which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Rationale: COPD causes CO2 retention due to alveolar hypoventilation, leading to an
increase in carbonic acid and respiratory acidosis.
, 6. Which clinical manifestation is a late sign of fluid volume deficit
(hypovolemia)?
A. Tachycardia
B. Flattened neck veins
C. Hypotension
D. Poor skin turgor
Answer: C
Rationale: Hypotension is often a late sign of hypovolemia as the body can no longer
compensate for the loss of volume. Tachycardia is an early compensatory sign.
7. When providing discharge teaching, the RN determines the patient needs
further instruction when they state:
A. ‘I will call the doctor if my temperature is over 101°F.’
B. ‘I can stop taking my blood pressure medicine once it’s normal.’
C. ‘I will finish all my antibiotics even if I feel better.’
D. ‘I will change my dressing using the technique shown.’
Answer: B
Rationale: Hypertension medication usually requires lifelong management; stopping it
abruptly can cause rebound hypertension. This indicates a need for more teaching.
8. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of hypocalcemia or hypomagnesemia.
UPDATE
1. A nurse is caring for a patient who is 24 hours post-abdominal surgery. Which
assessment finding requires immediate intervention by the RN?
A. Serosanguinous drainage on the dressing
B. Hypoactive bowel sounds in all four quadrants
C. Urine output of 20 mL/hr for the last two hours
D. Pain level of 5 on a scale of 0-10
Answer: C
Rationale: The RN must prioritize the ABCs and organ perfusion. Urine output less than 30
mL/hr indicates potential renal failure or hypovolemia. Hypoactive bowel sounds are
expected post-op, as is serosanguinous drainage.
2. Which task is most appropriate for the RN to delegate to a Licensed Practical
Nurse (LPN)?
A. Developing the initial plan of care for a new admission
B. Performing the admission assessment on a complex patient
C. Administering a scheduled intramuscular injection
D. Evaluating the effectiveness of a new pain medication
Answer: C
Rationale: LPNs can administer medications via most routes. Assessment, planning, and
evaluation are the core responsibilities of the RN and cannot be delegated.
,3. A patient has a potassium level of 6.2 mEq/L. Which cardiac change should
the nurse monitor for on the ECG?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted T waves
Answer: C
Rationale: Hyperkalemia (potassium > 5.0) causes tall, peaked T waves. U waves and ST
depression are associated with hypokalemia.
4. In the nursing process, which action is specifically the responsibility of the RN
rather than the LPN?
A. Monitoring vital signs
B. Collecting data for the health history
C. Performing a focused physical exam
D. Analyzing data to identify nursing diagnoses
Answer: D
Rationale: The RN is responsible for the ‘Analyze’ or ‘Diagnosis’ phase of the nursing
process, whereas LPNs assist with data collection and implementation.
5. A patient with a history of COPD is at risk for which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: B
Rationale: COPD causes CO2 retention due to alveolar hypoventilation, leading to an
increase in carbonic acid and respiratory acidosis.
, 6. Which clinical manifestation is a late sign of fluid volume deficit
(hypovolemia)?
A. Tachycardia
B. Flattened neck veins
C. Hypotension
D. Poor skin turgor
Answer: C
Rationale: Hypotension is often a late sign of hypovolemia as the body can no longer
compensate for the loss of volume. Tachycardia is an early compensatory sign.
7. When providing discharge teaching, the RN determines the patient needs
further instruction when they state:
A. ‘I will call the doctor if my temperature is over 101°F.’
B. ‘I can stop taking my blood pressure medicine once it’s normal.’
C. ‘I will finish all my antibiotics even if I feel better.’
D. ‘I will change my dressing using the technique shown.’
Answer: B
Rationale: Hypertension medication usually requires lifelong management; stopping it
abruptly can cause rebound hypertension. This indicates a need for more teaching.
8. Which electrolyte imbalance is most commonly associated with a positive
Chvostek’s sign?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of hypocalcemia or hypomagnesemia.
