RN Adult Medical-Surgical Nursing Online
Practice 2026 A – Comprehensive Review and
Clinical Practice Guide.
NGN The client is experiencing manifestations of pancreatitis as
*0900:Client presents with abdominal pain in evidenced by the amylase and lipase.
the upper left quadrant for the past 2 days.
States pain became worse this morning and
is radiating to the back. Rates pain as 8 on a Rational:
scale of 0 to 10.Hypoactive bowel sounds;
reports nausea, no vomiting; client is Drop Down 1:
passing flatus.Febrile, oriented to person, Pancreatitis is correct. The client's laboratory results
and place, and time.Tachypnea with diminished physical assessment indicate the client is
experiencing
breath sounds.Sinus tachycardia.Client voidsmanifestations of pancreatitis. Clients who have
pancreatitis 300 mL of clear, amber urine. experience an increase in pancreatic enzymes, amylase, and
*0930:Client vomited 100 mL brown liquid. lipase.
Paralytic ileus, adult respiratory distress syndrome (ARDS),
cardiogenic shock, and a cerebral vascular accident (CVA)
are incorrect. The client is not experiencing manifestations of
paralytic ileus because they have bowel sounds and are
passing flatus. The client is not experiencing manifestations
of ARDS because there is no indication the client is in
respiratory distress. The client is not experiencing
manifestations of
cardiogenic shock because there is no indication from the
client's medical record that there is a risk for cardiogenic
shock. The client is not experiencing manifestations of a CVA
because there is no indication from the client's medical record
that there is a risk for a CVA.
Drop Down 2:
Amylase and lipase is correct. The client's laboratory results
and physical assessment indicate the client is
experiencing manifestations of pancreatitis. Clients who
have pancreatitis experience an increase in pancreatic
enzymes, amylase, and lipase.
Oxygen saturation, urine output, platelet levels, and blood
pressure are incorrect. These findings do not indicate
pancreatitis.
,A nurse is caring for a client who is Complete the diagram by dragging from the choices below
postoperative. to specify what condition the client is most likely
experiencing, two actions the nurse should take to address
Client admitted to medical-surgical unit that condition, and two parameters the nurse should monitor
from PACU. Client reports incisional pain as to assess the client's progress.
2 on a scale of 0 to 10. Client appears
restless and frequently asks for water. Answer:
Bilateral lower extremities cool with +1 pedal *Insert a large-gauge
pulses. Urine output is 40 mL for the past 2 *IV.Initiate a fluid challenge.
hr. Moderate amount of bright red drainage *Hypovolemia
noted on surgical incision dressing. *Urine output
*Blood pressure
Rational:
The nurse should insert a large-gauge IV and initiate a fluid
challenge because the client is most likely experiencing
hypovolemia as evidenced by the client's restlessness,
tachycardia, hypotension, decreased pulses, cool extremities,
and decreased urine output. The nurse should monitor the
client's urine output and blood pressure to evaluate the
effectiveness of treatment.
A nurse on a medical-surgical unit is Answer:
reviewing the medical record of an older
adult client who is receiving IV fluid therapy. BUN
Which of the following client
information should indicate to the nurse Rational:
that the client requires re-evaluation of
the IV therapy The client's Hct and BUN levels indicate dehydration and
prescription? (Click on the "Exhibit" button require an increase in the IV fluid infusion rate.
for additional information about the
client. There are three tabs that contain
separate categories of data.)
A nurse is assessing a client while suctioning The client's heart rate increases.
the client's tracheostomy tube. Which of
the following findings should indicate to Rational:
the
nurse the client is experiencing hypoxia? Hypoxia related to suctioning can cause the client's heart
rate to increase. If this occurs, the nurse should discontinue
the
suctioning and manually oxygenate the client with 100%
oxygen. The nurse should instruct the client to take three or
four deep breaths prior to suctioning to reduce the risk for
hypoxia.
, A nurse is providing teaching to a client who "Ginkgo biloba can cause an increased risk for
takes ginkgo biloba as an herbal
supplement. Which of the following bleeding." Rational:
statements should the nurse make?
Ginkgo biloba increases blood flow and is effective in
decreasing the pain associated with peripheral artery
disease. The supplement also decreases platelet aggregation,
which in turn increases the risk for bleeding. Clients who
have been
prescribed antiplatelet medications, such as aspirin,
should avoid taking ginkgo biloba without first speaking
with their provider.
A nurse is teaching a class about client A client should sign an informed consent before receiving a
rights. Which of the following instructions placebo during a research trial.
should the nurse include?
Rational:
A nurse should ensure a client has provided informed consent
before administering a placebo. Placebos should not be used
outside of approved clinical research in which the client
has
consented to participate.
A nurse is caring for a client who is 12 hr Place a pillow between the client's legs.
postoperative following a total hip
arthroplasty. Which of the following actions Rational:
should the nurse take?
The nurse should place a pillow between the client's legs to
prevent hip dislocation.
A nurse is providing teaching to a client who Suppressing gastric acid production
has a gastric ulcer and a new
prescription for omeprazole. The nurse Rational:
should instruct the client that the Omeprazole is a proton pump inhibitor. It relieves
medication provides relief by which of the manifestations of gastric ulcers by suppressing gastric acid
following actions? production.
A nurse is assessing a client who is Temperature 38.9° C (102° F)
postoperative following a thyroidectomy.
Which of the following findings is the nurse's Rational:
priority? When using the urgent vs. nonurgent approach to client
care, the nurse should determine that the priority finding
is an
elevated temperature. An elevated temperature is a
manifestation of excessive thyroid hormone release, or
thyroid storm, due to an increase in metabolic rate. The nurse
should report this finding immediately to the provider
because it can lead to seizures and coma.
Practice 2026 A – Comprehensive Review and
Clinical Practice Guide.
NGN The client is experiencing manifestations of pancreatitis as
*0900:Client presents with abdominal pain in evidenced by the amylase and lipase.
the upper left quadrant for the past 2 days.
States pain became worse this morning and
is radiating to the back. Rates pain as 8 on a Rational:
scale of 0 to 10.Hypoactive bowel sounds;
reports nausea, no vomiting; client is Drop Down 1:
passing flatus.Febrile, oriented to person, Pancreatitis is correct. The client's laboratory results
and place, and time.Tachypnea with diminished physical assessment indicate the client is
experiencing
breath sounds.Sinus tachycardia.Client voidsmanifestations of pancreatitis. Clients who have
pancreatitis 300 mL of clear, amber urine. experience an increase in pancreatic enzymes, amylase, and
*0930:Client vomited 100 mL brown liquid. lipase.
Paralytic ileus, adult respiratory distress syndrome (ARDS),
cardiogenic shock, and a cerebral vascular accident (CVA)
are incorrect. The client is not experiencing manifestations of
paralytic ileus because they have bowel sounds and are
passing flatus. The client is not experiencing manifestations
of ARDS because there is no indication the client is in
respiratory distress. The client is not experiencing
manifestations of
cardiogenic shock because there is no indication from the
client's medical record that there is a risk for cardiogenic
shock. The client is not experiencing manifestations of a CVA
because there is no indication from the client's medical record
that there is a risk for a CVA.
Drop Down 2:
Amylase and lipase is correct. The client's laboratory results
and physical assessment indicate the client is
experiencing manifestations of pancreatitis. Clients who
have pancreatitis experience an increase in pancreatic
enzymes, amylase, and lipase.
Oxygen saturation, urine output, platelet levels, and blood
pressure are incorrect. These findings do not indicate
pancreatitis.
,A nurse is caring for a client who is Complete the diagram by dragging from the choices below
postoperative. to specify what condition the client is most likely
experiencing, two actions the nurse should take to address
Client admitted to medical-surgical unit that condition, and two parameters the nurse should monitor
from PACU. Client reports incisional pain as to assess the client's progress.
2 on a scale of 0 to 10. Client appears
restless and frequently asks for water. Answer:
Bilateral lower extremities cool with +1 pedal *Insert a large-gauge
pulses. Urine output is 40 mL for the past 2 *IV.Initiate a fluid challenge.
hr. Moderate amount of bright red drainage *Hypovolemia
noted on surgical incision dressing. *Urine output
*Blood pressure
Rational:
The nurse should insert a large-gauge IV and initiate a fluid
challenge because the client is most likely experiencing
hypovolemia as evidenced by the client's restlessness,
tachycardia, hypotension, decreased pulses, cool extremities,
and decreased urine output. The nurse should monitor the
client's urine output and blood pressure to evaluate the
effectiveness of treatment.
A nurse on a medical-surgical unit is Answer:
reviewing the medical record of an older
adult client who is receiving IV fluid therapy. BUN
Which of the following client
information should indicate to the nurse Rational:
that the client requires re-evaluation of
the IV therapy The client's Hct and BUN levels indicate dehydration and
prescription? (Click on the "Exhibit" button require an increase in the IV fluid infusion rate.
for additional information about the
client. There are three tabs that contain
separate categories of data.)
A nurse is assessing a client while suctioning The client's heart rate increases.
the client's tracheostomy tube. Which of
the following findings should indicate to Rational:
the
nurse the client is experiencing hypoxia? Hypoxia related to suctioning can cause the client's heart
rate to increase. If this occurs, the nurse should discontinue
the
suctioning and manually oxygenate the client with 100%
oxygen. The nurse should instruct the client to take three or
four deep breaths prior to suctioning to reduce the risk for
hypoxia.
, A nurse is providing teaching to a client who "Ginkgo biloba can cause an increased risk for
takes ginkgo biloba as an herbal
supplement. Which of the following bleeding." Rational:
statements should the nurse make?
Ginkgo biloba increases blood flow and is effective in
decreasing the pain associated with peripheral artery
disease. The supplement also decreases platelet aggregation,
which in turn increases the risk for bleeding. Clients who
have been
prescribed antiplatelet medications, such as aspirin,
should avoid taking ginkgo biloba without first speaking
with their provider.
A nurse is teaching a class about client A client should sign an informed consent before receiving a
rights. Which of the following instructions placebo during a research trial.
should the nurse include?
Rational:
A nurse should ensure a client has provided informed consent
before administering a placebo. Placebos should not be used
outside of approved clinical research in which the client
has
consented to participate.
A nurse is caring for a client who is 12 hr Place a pillow between the client's legs.
postoperative following a total hip
arthroplasty. Which of the following actions Rational:
should the nurse take?
The nurse should place a pillow between the client's legs to
prevent hip dislocation.
A nurse is providing teaching to a client who Suppressing gastric acid production
has a gastric ulcer and a new
prescription for omeprazole. The nurse Rational:
should instruct the client that the Omeprazole is a proton pump inhibitor. It relieves
medication provides relief by which of the manifestations of gastric ulcers by suppressing gastric acid
following actions? production.
A nurse is assessing a client who is Temperature 38.9° C (102° F)
postoperative following a thyroidectomy.
Which of the following findings is the nurse's Rational:
priority? When using the urgent vs. nonurgent approach to client
care, the nurse should determine that the priority finding
is an
elevated temperature. An elevated temperature is a
manifestation of excessive thyroid hormone release, or
thyroid storm, due to an increase in metabolic rate. The nurse
should report this finding immediately to the provider
because it can lead to seizures and coma.
