VATI RN MED-SURG ASSESSMENT TEST – 250
QUESTIONS WITH ANSWERS (100% CORRECT
ANSWERS)
Complete A+ Guide for 2026
QUESTION 1
A client with end-stage renal disease is receiving peritoneal dialysis. The nurse notes
that the effluent is cloudy. Which action should the nurse take first?
A) Continue the dialysis as prescribed
B) Obtain a specimen of the effluent for culture and sensitivity
C) Add heparin to the dialysate
D) Increase the dwell time
Answer: B) Obtain a specimen of the effluent for culture and sensitivity
Rationale: Cloudy effluent is the earliest sign of peritonitis, a serious complication of
peritoneal dialysis. The nurse should obtain a specimen for culture and sensitivity to
identify the causative organism. Antibiotics may be started after the specimen is obtained .
QUESTION 2
A client with chronic pancreatitis is prescribed pancreatic enzyme supplements. Which
instruction should the nurse include in the teaching plan?
A) Take the enzymes with meals and snacks
B) Take the enzymes on an empty stomach
C) Crush the tablets before swallowing
D) Take the enzymes only when experiencing pain
,Answer: A) Take the enzymes with meals and snacks
Rationale: Pancreatic enzyme supplements should be taken with meals and snacks to aid
in digestion of fats, proteins, and carbohydrates. They should be swallowed whole without
crushing or chewing .
QUESTION 3
A client is admitted with a suspected bowel obstruction. Which assessment finding is
most consistent with this condition?
A) Diarrhea and hyperactive bowel sounds
B) Abdominal distention and absent bowel sounds
C) Flatulence and low-grade fever
D) Constipation and bradycardia
Answer: B) Abdominal distention and absent bowel sounds
Rationale: Bowel obstruction presents with abdominal distention, cramping pain, nausea,
vomiting, and absent or high-pitched bowel sounds. Early obstruction may have
hyperactive sounds, but late obstruction leads to absent sounds .
QUESTION 4
A client with a fractured tibia is in a long leg cast. The nurse notes that the client's toes
are pale, cool, and capillary refill is 5 seconds. Which action should the nurse take first?
A) Administer pain medication
B) Notify the provider
,C) Elevate the leg
D) Perform a neurovascular assessment and prepare for cast bivalving
Answer: D) Perform a neurovascular assessment and prepare for cast bivalving
Rationale: Pallor, coolness, and delayed capillary refill are signs of neurovascular
compromise and possible compartment syndrome. The nurse should perform a full
neurovascular assessment and prepare for cast bivalving if indicated .
QUESTION 5
A client is receiving IV potassium chloride. Which action is essential for safe
administration?
A) Administer the medication as a rapid IV push
B) Mix the medication in lactated Ringer's solution
C) Administer the medication via an IV pump
D) Administer the medication without diluting
Answer: C) Administer the medication via an IV pump
Rationale: IV potassium must be administered slowly via an infusion pump, never as an IV
push, to prevent cardiac arrest and hyperkalemia. The maximum infusion rate is typically
10-20 mEq/hr .
QUESTION 6
A client with a history of alcohol use disorder is admitted with acute pancreatitis. Which
intervention is a priority?
, A) Administer antibiotics
B) Withhold oral fluids
C) Provide nutritional support
D) Administer pain medication
Answer: D) Administer pain medication
Rationale: Pain is a hallmark of acute pancreatitis and is the priority intervention. While
all options may be part of the care plan, pain management is most urgent to promote
comfort and reduce stress .
QUESTION 7
A client is suspected of having a pulmonary embolism. Which diagnostic test is most
definitive?
A) Chest X-ray
B) D-dimer
C) Spiral CT scan
D) Pulmonary angiography
Answer: D) Pulmonary angiography
Rationale: Pulmonary angiography is considered the gold standard for diagnosing
pulmonary embolism, though spiral CT (CT angiography) is now more commonly used. D-
dimer is a screening test .
QUESTION 8
QUESTIONS WITH ANSWERS (100% CORRECT
ANSWERS)
Complete A+ Guide for 2026
QUESTION 1
A client with end-stage renal disease is receiving peritoneal dialysis. The nurse notes
that the effluent is cloudy. Which action should the nurse take first?
A) Continue the dialysis as prescribed
B) Obtain a specimen of the effluent for culture and sensitivity
C) Add heparin to the dialysate
D) Increase the dwell time
Answer: B) Obtain a specimen of the effluent for culture and sensitivity
Rationale: Cloudy effluent is the earliest sign of peritonitis, a serious complication of
peritoneal dialysis. The nurse should obtain a specimen for culture and sensitivity to
identify the causative organism. Antibiotics may be started after the specimen is obtained .
QUESTION 2
A client with chronic pancreatitis is prescribed pancreatic enzyme supplements. Which
instruction should the nurse include in the teaching plan?
A) Take the enzymes with meals and snacks
B) Take the enzymes on an empty stomach
C) Crush the tablets before swallowing
D) Take the enzymes only when experiencing pain
,Answer: A) Take the enzymes with meals and snacks
Rationale: Pancreatic enzyme supplements should be taken with meals and snacks to aid
in digestion of fats, proteins, and carbohydrates. They should be swallowed whole without
crushing or chewing .
QUESTION 3
A client is admitted with a suspected bowel obstruction. Which assessment finding is
most consistent with this condition?
A) Diarrhea and hyperactive bowel sounds
B) Abdominal distention and absent bowel sounds
C) Flatulence and low-grade fever
D) Constipation and bradycardia
Answer: B) Abdominal distention and absent bowel sounds
Rationale: Bowel obstruction presents with abdominal distention, cramping pain, nausea,
vomiting, and absent or high-pitched bowel sounds. Early obstruction may have
hyperactive sounds, but late obstruction leads to absent sounds .
QUESTION 4
A client with a fractured tibia is in a long leg cast. The nurse notes that the client's toes
are pale, cool, and capillary refill is 5 seconds. Which action should the nurse take first?
A) Administer pain medication
B) Notify the provider
,C) Elevate the leg
D) Perform a neurovascular assessment and prepare for cast bivalving
Answer: D) Perform a neurovascular assessment and prepare for cast bivalving
Rationale: Pallor, coolness, and delayed capillary refill are signs of neurovascular
compromise and possible compartment syndrome. The nurse should perform a full
neurovascular assessment and prepare for cast bivalving if indicated .
QUESTION 5
A client is receiving IV potassium chloride. Which action is essential for safe
administration?
A) Administer the medication as a rapid IV push
B) Mix the medication in lactated Ringer's solution
C) Administer the medication via an IV pump
D) Administer the medication without diluting
Answer: C) Administer the medication via an IV pump
Rationale: IV potassium must be administered slowly via an infusion pump, never as an IV
push, to prevent cardiac arrest and hyperkalemia. The maximum infusion rate is typically
10-20 mEq/hr .
QUESTION 6
A client with a history of alcohol use disorder is admitted with acute pancreatitis. Which
intervention is a priority?
, A) Administer antibiotics
B) Withhold oral fluids
C) Provide nutritional support
D) Administer pain medication
Answer: D) Administer pain medication
Rationale: Pain is a hallmark of acute pancreatitis and is the priority intervention. While
all options may be part of the care plan, pain management is most urgent to promote
comfort and reduce stress .
QUESTION 7
A client is suspected of having a pulmonary embolism. Which diagnostic test is most
definitive?
A) Chest X-ray
B) D-dimer
C) Spiral CT scan
D) Pulmonary angiography
Answer: D) Pulmonary angiography
Rationale: Pulmonary angiography is considered the gold standard for diagnosing
pulmonary embolism, though spiral CT (CT angiography) is now more commonly used. D-
dimer is a screening test .
QUESTION 8
