Medical-
Surgical Assignment Exam Questions
] ] ] ]
with100% correct Answers and Rationa
] ] ] ]
les
When ]making ]morning ]assessments, ]the ]practical ]nurse ]finds ]a ]client ]who ]is ]exhibiting ]a ]new ]fin
ding ]of ]right-
sided ]facial ]drooping. ]Which ]assessment ]is ]most ]important ]for ]the ]PN ]to ]implement ]first? ]- ]corre
ct ]answer: ]Test ]all ]four ]extremities ]for ]movement ]and ]strength
Rationale
Unilateral ]facial ]droop ]may ]be ]a ]symptom ]of ]an ]acute ]brain ]attack ]
(stroke) ]or ]Bell's ]Palsy. ]Unilateral ]motor ]deficits ]are ]the ]most ]obvious ]effects ]of ]a ]stroke ]
(B) ]and ]should ]be ]assessed ]for ]first. ]If ]ruled ]out, ]other ]assessments ]can ]be ]performed ]for ]the ]po
ssibility ]of ]Bell's ]Palsy ](A, ]C ]and ]D).
An ]adult ]male ]presents ]in ]the ]Emergency ]Center ]with ]"tearing" ]chest ]pain ]that ]has ]moved ]into ]h
is ]back. ]Which ]finding ]by ]the ]practical ]nurse ]in ]the ]client's ]history ]is ]relevant ]to ]the ]client's ]chest
]pain? ]- ]correct ]answer: ]Smokes ]three ]packs ]of ]cigarettes ]a ]day
Rationale
Cigarette ]smoking ]
(A) ]is ]the ]common ]risk ]factor ]associated ]with ]hypertension ]that ]contributes ]to ]dissecting ]aneury
sms ]of ]the ]aortic ]arch, ]which ]is ]manifested ]by ]"tearing ]chest" ]that ]radiates ]to ]the ]back. ]Alcohol ]c
onsumption ](B) ]does ]not ]have ]a ]direct ]correlation ]with ]dissecting ]aneurysms. ]Although ]
,(C) ]increases ]the ]client's ]risk ]for ]diabetes, ]the ]most ]relevant ]client ]behavior ]that ]contributes ]to ]a
rterial ]disease ]is ]cigarette ]smoking. ](D) ]is ]not ]related ]to ]these ]symptoms.
A ]client ]who ]is ]positive ]for ]human ]immunodeficiency ]virus ](HIV) ]comes ]to ]the ]clinic ]for ]a ]routine
]check ]up. ]During ]the ]initial ]interview, ]the ]client's ]partner ]tells ]the ]practical ]nurse ]
(PN) ]that ]the ]client ]has ]had ]several ]occasions ]of ]mental ]confusion. ]The ]PN ]should ]focus ]questio
ns ]to ]determine ]if ]the ]client ]is ]developing ]which ]opportunistic ]infection? ]- ]correct ]answer: ]Toxop
lasmosis.
Rationale
Clients ]with ]HIV ]who ]have ]toxoplasmosis ]
(C) ]of ]the ]brain ]are ]most ]likely ]to ]manifest ]mental ]confusion, ]so ]questions ]should ]focus ]on ]this ]p
rotozoan ]infection ]that ]is ]hosted ]in ]cats ]and ]excreted ]in ]cat ]feces. ]Although ]Kaposi's ]sarcoma ]ha
s ]been ]associated ]as ]an ]AIDS-
defining ]opportunistic ]infection, ]it ]is ]a ]dermatological ]sarcoma ]associated ]with ]the ]herpes ]virus, ]
not ]a ]neurological ]complication. ]
(B ]and ]D) ]are ]respiratory ]acquired ]opportunistic ]infections ]in ]clients ]with ]acquired ]immunodefici
ency ]syndrome ](AIDS).
The ]practical ]nurse ]
(PN) ]is ]monitoring ]a ]client ]with ]a ]comminuted ]fracture ]of ]the ]left ]femur. ]Which ]finding ]should ]th
e ]PN ]report ]to ]the ]healthcare ]provider ]immediately? ]- ]correct ]answer: ]Leg ]pain ]of ]"10" ]unrelieve
d ]by ]opioids.
Rationale
Compartment ]syndrome, ]an ]emergency ]complication ]of ]circulatory ]impairment, ]is ]manifested ]b
y ]severe ]pain ]unaffected ]by ]opioid ]analgesics ](C), ]which ]should ]be ]reported ]immediately. ]
(A ]and ]B) ]are ]common ]findings ]consistent ]with ]trauma. ]Although ]
(D) ]should ]be ]reported, ]the ]presence ]of ]a ]pulse ]point ]provides ]some ]oxygenation ]to ]distal ]tissue
s.
,The ]practical ]nurse ]
(PN) ]is ]caring ]for ]a ]group ]of ]clients ]on ]a ]telemetry ]unit. ]Which ]client ]requires ]immediate ]follow-
up ]by ]the ]PN? ]- ]correct ]answer: ]A ]client ]with ]multiple ]premature ]ventricular ]contractions ]
(PVC)/minute ]after ]receiving ]atropine.
Rationale
A ]client ]who ]is ]experiencing ]multiple ]PVCs/minute ](C) ]is ]at ]risk ]for ]ventricular ]fibrillation ]
(VF) ]and ]requires ]immediate ]follow-
up ]and ]treatment. ]Digoxin ]slows ]the ]heart ]rate ]by ]decreasing ]the ]rate ]impulse ]conduction ]throu
gh ]the ]AV ]node, ]which ]is ]contraindicated ]in ]heart ]block ]
(A), ]but ]the ]client ]who ]is ]at ]risk ]for ]impending ]VF ]is ]the ]priority. ]The ]PN ]should ]continue ]monitor
ing ](B ]and ]D) ]for ]other ]side ]effects ]of ]glucocorticosteroids ]and ]epinephrine, ]such ]as ]trembling ]
(D), ]which ]are ]not ]life ]threatening.
The ]practical ]nurse ](PN) ]is ]transferring ]a ]client ]to ]the ]in-
patient ]dialysis ]unit ]for ]hemodialysis ]scheduled ]for ]today. ]Which ]information ]is ]essential ]for ]the ]
PN ]to ]report ]to ]the ]receiving ]nurse? ]- ]correct ]answer: ]Today's ]hemoglobin ]result ]of ]8.0 ]grams.
Rationale
The ]PN ]should ]report ]the ]client's ]recent ]hemoglobin ]level ]
(D), ]which ]is ]low ]and ]is ]essential ]information ]in ]planning ]the ]client's ]care ]for ]hemodialysis. ]
(A ]and ]B) ]are ]standards ]of ]care ]for ]a ]client ]who ]is ]receiving ]dialysis. ]Although ]routine ]antihypert
ensive ]drugs ]
(C) ]are ]withheld ]before ]hemodialysis, ]the ]priority ]is ]the ]client's ]need ]for ]possible ]blood ]transfusi
on ]during ]the ]next ]hemodialysis ]session.
The ]practical ]nurse ](PN) ]receives ]shift ]report ]about ]a ]client ]whose ]chest ]x-
ray ]reveals ]"free ]air ]under ]the ]right ]diaphragm." ]What ]action ]should ]the ]PN ]take? ]- ]correct ]answ
er: ]Maintain ]the ]client ]NPO.
, Rationale
"Free ]air ]under ]the ]diaphragm" ]on ]an ]upright ]chest ]x-
ray ]is ]most ]often ]indicative ]of ]a ]gastrointestinal ]perforation, ]and ]the ]client ]will ]probably ]need ]su
rgery, ]so ]the ]client ]should ]be ]kept ]NPO ]
(A) ]until ]that ]determination ]is ]made. ]Since ]the ]air ]is ]outside ]the ]colon, ]hence ]the ]term ]"free ]air,"
]it ]will ]not ]help ]to ]position ](B) ]or ]ambulate ](C) ]the ]client. ](D) ]is ]not ]indicated.
The ]practical ]nurse ](PN) ]performs ]a ]Glasgow ]Coma ]Scale ]
(GCS) ]assessment ]for ]a ]client ]who ]experienced ]an ]acute ]brain ]attack ]
(stroke) ]yesterday ]and ]obtains ]a ]score ]of ]"12." ]What ]assessment ]should ]the ]PN ]do ]next? ]- ]correc
t ]answer: ]Comparison ]of ]GCS ]score ]with ]previous ]checks.
Rationale
A ]key ]element ]in ]neurological ]assessments ]is ]the ]client's ]trends, ]which ]can ]be ]subtle ]changes, ]so
]the ]PN ]should ]compare ]the ]client's ]present ]score ]to ]previous ]scores ]to ]determine ]if ]the ]client ]is ]
better, ]worse, ]or ]the ]same ](D). ](A, ]B, ]and ]C) ]are ]components ]of ]the ]GCS.
The ]practical ]nurse ]
(PN) ]at ]an ]extended ]care ]facility ]is ]called ]to ]the ]unit's ]activity ]room ]where ]a ]client ]has ]"fainted." ]
Which ]finding ]indicates ]to ]the ]PN ]that ]the ]client ]experienced ]a ]syncopal ]episode? ]- ]correct ]answ
er: ]A ]sudden ]experience ]that ]everything ]went ]black.
Rationale
In ]syncope ]or ]"fainting", ]the ]client ]experiences ]a ]sudden ]loss ]of ]consciousness ]
(A). ]Incontinence ]of ]urine ]or ]stool ]
(B) ]is ]typical ]for ]a ]seizure ]disorder, ]not ]syncope. ]A ]sudden ]fall ]in ]blood ]pressure ]
Surgical Assignment Exam Questions
] ] ] ]
with100% correct Answers and Rationa
] ] ] ]
les
When ]making ]morning ]assessments, ]the ]practical ]nurse ]finds ]a ]client ]who ]is ]exhibiting ]a ]new ]fin
ding ]of ]right-
sided ]facial ]drooping. ]Which ]assessment ]is ]most ]important ]for ]the ]PN ]to ]implement ]first? ]- ]corre
ct ]answer: ]Test ]all ]four ]extremities ]for ]movement ]and ]strength
Rationale
Unilateral ]facial ]droop ]may ]be ]a ]symptom ]of ]an ]acute ]brain ]attack ]
(stroke) ]or ]Bell's ]Palsy. ]Unilateral ]motor ]deficits ]are ]the ]most ]obvious ]effects ]of ]a ]stroke ]
(B) ]and ]should ]be ]assessed ]for ]first. ]If ]ruled ]out, ]other ]assessments ]can ]be ]performed ]for ]the ]po
ssibility ]of ]Bell's ]Palsy ](A, ]C ]and ]D).
An ]adult ]male ]presents ]in ]the ]Emergency ]Center ]with ]"tearing" ]chest ]pain ]that ]has ]moved ]into ]h
is ]back. ]Which ]finding ]by ]the ]practical ]nurse ]in ]the ]client's ]history ]is ]relevant ]to ]the ]client's ]chest
]pain? ]- ]correct ]answer: ]Smokes ]three ]packs ]of ]cigarettes ]a ]day
Rationale
Cigarette ]smoking ]
(A) ]is ]the ]common ]risk ]factor ]associated ]with ]hypertension ]that ]contributes ]to ]dissecting ]aneury
sms ]of ]the ]aortic ]arch, ]which ]is ]manifested ]by ]"tearing ]chest" ]that ]radiates ]to ]the ]back. ]Alcohol ]c
onsumption ](B) ]does ]not ]have ]a ]direct ]correlation ]with ]dissecting ]aneurysms. ]Although ]
,(C) ]increases ]the ]client's ]risk ]for ]diabetes, ]the ]most ]relevant ]client ]behavior ]that ]contributes ]to ]a
rterial ]disease ]is ]cigarette ]smoking. ](D) ]is ]not ]related ]to ]these ]symptoms.
A ]client ]who ]is ]positive ]for ]human ]immunodeficiency ]virus ](HIV) ]comes ]to ]the ]clinic ]for ]a ]routine
]check ]up. ]During ]the ]initial ]interview, ]the ]client's ]partner ]tells ]the ]practical ]nurse ]
(PN) ]that ]the ]client ]has ]had ]several ]occasions ]of ]mental ]confusion. ]The ]PN ]should ]focus ]questio
ns ]to ]determine ]if ]the ]client ]is ]developing ]which ]opportunistic ]infection? ]- ]correct ]answer: ]Toxop
lasmosis.
Rationale
Clients ]with ]HIV ]who ]have ]toxoplasmosis ]
(C) ]of ]the ]brain ]are ]most ]likely ]to ]manifest ]mental ]confusion, ]so ]questions ]should ]focus ]on ]this ]p
rotozoan ]infection ]that ]is ]hosted ]in ]cats ]and ]excreted ]in ]cat ]feces. ]Although ]Kaposi's ]sarcoma ]ha
s ]been ]associated ]as ]an ]AIDS-
defining ]opportunistic ]infection, ]it ]is ]a ]dermatological ]sarcoma ]associated ]with ]the ]herpes ]virus, ]
not ]a ]neurological ]complication. ]
(B ]and ]D) ]are ]respiratory ]acquired ]opportunistic ]infections ]in ]clients ]with ]acquired ]immunodefici
ency ]syndrome ](AIDS).
The ]practical ]nurse ]
(PN) ]is ]monitoring ]a ]client ]with ]a ]comminuted ]fracture ]of ]the ]left ]femur. ]Which ]finding ]should ]th
e ]PN ]report ]to ]the ]healthcare ]provider ]immediately? ]- ]correct ]answer: ]Leg ]pain ]of ]"10" ]unrelieve
d ]by ]opioids.
Rationale
Compartment ]syndrome, ]an ]emergency ]complication ]of ]circulatory ]impairment, ]is ]manifested ]b
y ]severe ]pain ]unaffected ]by ]opioid ]analgesics ](C), ]which ]should ]be ]reported ]immediately. ]
(A ]and ]B) ]are ]common ]findings ]consistent ]with ]trauma. ]Although ]
(D) ]should ]be ]reported, ]the ]presence ]of ]a ]pulse ]point ]provides ]some ]oxygenation ]to ]distal ]tissue
s.
,The ]practical ]nurse ]
(PN) ]is ]caring ]for ]a ]group ]of ]clients ]on ]a ]telemetry ]unit. ]Which ]client ]requires ]immediate ]follow-
up ]by ]the ]PN? ]- ]correct ]answer: ]A ]client ]with ]multiple ]premature ]ventricular ]contractions ]
(PVC)/minute ]after ]receiving ]atropine.
Rationale
A ]client ]who ]is ]experiencing ]multiple ]PVCs/minute ](C) ]is ]at ]risk ]for ]ventricular ]fibrillation ]
(VF) ]and ]requires ]immediate ]follow-
up ]and ]treatment. ]Digoxin ]slows ]the ]heart ]rate ]by ]decreasing ]the ]rate ]impulse ]conduction ]throu
gh ]the ]AV ]node, ]which ]is ]contraindicated ]in ]heart ]block ]
(A), ]but ]the ]client ]who ]is ]at ]risk ]for ]impending ]VF ]is ]the ]priority. ]The ]PN ]should ]continue ]monitor
ing ](B ]and ]D) ]for ]other ]side ]effects ]of ]glucocorticosteroids ]and ]epinephrine, ]such ]as ]trembling ]
(D), ]which ]are ]not ]life ]threatening.
The ]practical ]nurse ](PN) ]is ]transferring ]a ]client ]to ]the ]in-
patient ]dialysis ]unit ]for ]hemodialysis ]scheduled ]for ]today. ]Which ]information ]is ]essential ]for ]the ]
PN ]to ]report ]to ]the ]receiving ]nurse? ]- ]correct ]answer: ]Today's ]hemoglobin ]result ]of ]8.0 ]grams.
Rationale
The ]PN ]should ]report ]the ]client's ]recent ]hemoglobin ]level ]
(D), ]which ]is ]low ]and ]is ]essential ]information ]in ]planning ]the ]client's ]care ]for ]hemodialysis. ]
(A ]and ]B) ]are ]standards ]of ]care ]for ]a ]client ]who ]is ]receiving ]dialysis. ]Although ]routine ]antihypert
ensive ]drugs ]
(C) ]are ]withheld ]before ]hemodialysis, ]the ]priority ]is ]the ]client's ]need ]for ]possible ]blood ]transfusi
on ]during ]the ]next ]hemodialysis ]session.
The ]practical ]nurse ](PN) ]receives ]shift ]report ]about ]a ]client ]whose ]chest ]x-
ray ]reveals ]"free ]air ]under ]the ]right ]diaphragm." ]What ]action ]should ]the ]PN ]take? ]- ]correct ]answ
er: ]Maintain ]the ]client ]NPO.
, Rationale
"Free ]air ]under ]the ]diaphragm" ]on ]an ]upright ]chest ]x-
ray ]is ]most ]often ]indicative ]of ]a ]gastrointestinal ]perforation, ]and ]the ]client ]will ]probably ]need ]su
rgery, ]so ]the ]client ]should ]be ]kept ]NPO ]
(A) ]until ]that ]determination ]is ]made. ]Since ]the ]air ]is ]outside ]the ]colon, ]hence ]the ]term ]"free ]air,"
]it ]will ]not ]help ]to ]position ](B) ]or ]ambulate ](C) ]the ]client. ](D) ]is ]not ]indicated.
The ]practical ]nurse ](PN) ]performs ]a ]Glasgow ]Coma ]Scale ]
(GCS) ]assessment ]for ]a ]client ]who ]experienced ]an ]acute ]brain ]attack ]
(stroke) ]yesterday ]and ]obtains ]a ]score ]of ]"12." ]What ]assessment ]should ]the ]PN ]do ]next? ]- ]correc
t ]answer: ]Comparison ]of ]GCS ]score ]with ]previous ]checks.
Rationale
A ]key ]element ]in ]neurological ]assessments ]is ]the ]client's ]trends, ]which ]can ]be ]subtle ]changes, ]so
]the ]PN ]should ]compare ]the ]client's ]present ]score ]to ]previous ]scores ]to ]determine ]if ]the ]client ]is ]
better, ]worse, ]or ]the ]same ](D). ](A, ]B, ]and ]C) ]are ]components ]of ]the ]GCS.
The ]practical ]nurse ]
(PN) ]at ]an ]extended ]care ]facility ]is ]called ]to ]the ]unit's ]activity ]room ]where ]a ]client ]has ]"fainted." ]
Which ]finding ]indicates ]to ]the ]PN ]that ]the ]client ]experienced ]a ]syncopal ]episode? ]- ]correct ]answ
er: ]A ]sudden ]experience ]that ]everything ]went ]black.
Rationale
In ]syncope ]or ]"fainting", ]the ]client ]experiences ]a ]sudden ]loss ]of ]consciousness ]
(A). ]Incontinence ]of ]urine ]or ]stool ]
(B) ]is ]typical ]for ]a ]seizure ]disorder, ]not ]syncope. ]A ]sudden ]fall ]in ]blood ]pressure ]
