ADULT MEDICAL SURGICAL NURSING
EXAM QUESTIONS AND ANSWERS
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Maintain the client’s legs in an adducted position.
B. Perform passive range-of-motion exercises for the hip.
C. Instruct the client to lean forward when sitting in a chair.
D. Place a pillow between the client’s legs when turning.
Answer: D
Conceptual Explanation: Following a total hip arthroplasty, the nurse should place an
abduction pillow between the client’s legs to prevent dislocation of the new joint.
Adduction and leaning forward past 90 degrees are contraindicated.
2. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. Which of the following findings indicates a tension pneumothorax?
A. Tracheal deviation to the unaffected side
B. Tidaling in the water-seal chamber
,C. Continuous bubbling in the water-seal chamber
D. Serosanguineous drainage in the collection chamber
Answer: A
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and classic
sign of a tension pneumothorax. Continuous bubbling indicates an air leak, and tidaling is
an expected finding.
3. A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of
the following findings should the nurse expect?
A. Increased serum lipase
B. Decreased serum amylase
C. Increased serum calcium
D. Decreased white blood cell count
Answer: A
Conceptual Explanation: In acute pancreatitis, serum lipase and amylase levels increase
significantly. Calcium levels typically decrease (hypocalcemia), and the WBC count
increases due to inflammation.
4. A nurse is providing discharge teaching for a client who has a new prescription for warfarin.
Which of the following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
, B. Use a hard-bristle toothbrush.
C. Report any black, tarry stools to the provider.
D. Take aspirin for minor headaches.
Answer: C
Conceptual Explanation: Black, tarry stools can indicate gastrointestinal bleeding, a
serious adverse effect of warfarin. Dark green vegetables contain Vitamin K, which
antagonizes warfarin, and should be kept consistent, not increased. Aspirin increases
bleeding risk.
5. A nurse is monitoring a client who is receiving a blood transfusion. Which of the following
findings should the nurse identify as an indication of a hemolytic transfusion reaction?
A. Distended neck veins
B. Hypertension
C. Bradycardia
D. Low back pain
Answer: D
Conceptual Explanation: Hemolytic transfusion reactions are characterized by low back
pain, hypotension, tachycardia, and apprehension due to the destruction of RBCs.
EXAM QUESTIONS AND ANSWERS
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Maintain the client’s legs in an adducted position.
B. Perform passive range-of-motion exercises for the hip.
C. Instruct the client to lean forward when sitting in a chair.
D. Place a pillow between the client’s legs when turning.
Answer: D
Conceptual Explanation: Following a total hip arthroplasty, the nurse should place an
abduction pillow between the client’s legs to prevent dislocation of the new joint.
Adduction and leaning forward past 90 degrees are contraindicated.
2. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. Which of the following findings indicates a tension pneumothorax?
A. Tracheal deviation to the unaffected side
B. Tidaling in the water-seal chamber
,C. Continuous bubbling in the water-seal chamber
D. Serosanguineous drainage in the collection chamber
Answer: A
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and classic
sign of a tension pneumothorax. Continuous bubbling indicates an air leak, and tidaling is
an expected finding.
3. A nurse is reviewing the laboratory results of a client who has acute pancreatitis. Which of
the following findings should the nurse expect?
A. Increased serum lipase
B. Decreased serum amylase
C. Increased serum calcium
D. Decreased white blood cell count
Answer: A
Conceptual Explanation: In acute pancreatitis, serum lipase and amylase levels increase
significantly. Calcium levels typically decrease (hypocalcemia), and the WBC count
increases due to inflammation.
4. A nurse is providing discharge teaching for a client who has a new prescription for warfarin.
Which of the following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
, B. Use a hard-bristle toothbrush.
C. Report any black, tarry stools to the provider.
D. Take aspirin for minor headaches.
Answer: C
Conceptual Explanation: Black, tarry stools can indicate gastrointestinal bleeding, a
serious adverse effect of warfarin. Dark green vegetables contain Vitamin K, which
antagonizes warfarin, and should be kept consistent, not increased. Aspirin increases
bleeding risk.
5. A nurse is monitoring a client who is receiving a blood transfusion. Which of the following
findings should the nurse identify as an indication of a hemolytic transfusion reaction?
A. Distended neck veins
B. Hypertension
C. Bradycardia
D. Low back pain
Answer: D
Conceptual Explanation: Hemolytic transfusion reactions are characterized by low back
pain, hypotension, tachycardia, and apprehension due to the destruction of RBCs.
