RN ADULT MEDICAL SURGICAL ONLINE PRACTICE
EXAM 90 QUESTIONS & CORRECT ANSWERS
LATEST 2026/2027
NGN
*0900:Client presents with abdominal pain in 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 scale of 0 to 10.Hypoactive bowel sounds; reports nausea, no
vomiting; client is passing flatus.Febrile, oriented to person, place, and
time.Tachypnea with diminished breath sounds.Sinus tachycardia.Client voids 300
mL of clear, amber urine.
*0930:Client vomited 100 mL brown liquid.
The client is experiencing manifestations of pancreatitis as evidenced by
the amylase and lipase.
Rational:
Drop Down 1:
Pancreatitis 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.
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 postoperative.
Client admitted to medical-surgical unit from PACU. Client reports incisional pain
as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water.
Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the
past 2 hr. Moderate amount of bright red drainage noted on surgical incision
dressing.
Complete the diagram by dragging from the choices below to specify what
condition the client is most likely experiencing, two actions the nurse should
take to address that condition, and two parameters the nurse should monitor
to assess the client's progress.
Answer:
*Insert a large-gauge
*IV.Initiate a fluid challenge.
*Hypovolemia
*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 reviewing the medical record of an older
adult client who is receiving IV fluid therapy. Which of the following client
,information should indicate to the nurse that the client requires re-evaluation of the
IV therapy prescription? (Click on the "Exhibit" button for additional information
about the client. There are three tabs that contain separate categories of data.)
Answer:
BUN
Rational:
The client's Hct and BUN levels indicate dehydration and require an increase in the
IV fluid infusion rate.
A nurse is assessing a client while suctioning the client's tracheostomy tube. Which
of the following findings should indicate to the nurse the client is experiencing
hypoxia?
The client's heart rate increases.
Rational:
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 takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?
"Ginkgo biloba can cause an increased risk for bleeding."
Rational:
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 rights. Which of the following instructions
should the nurse include?
, A client should sign an informed consent before receiving a placebo during a
research trial.
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 postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
Place a pillow between the client's legs.
Rational:
The nurse should place a pillow between the client's legs to prevent hip dislocation.
A nurse is providing teaching to a client who has a gastric ulcer and a new
prescription for omeprazole. The nurse should instruct the client that the
medication provides relief by which of the following actions?
Suppressing gastric acid production
Rational:
Omeprazole is a proton pump inhibitor. It relieves manifestations of gastric ulcers
by suppressing gastric acid production.
A nurse is assessing a client who is postoperative following a thyroidectomy.
Which of the following findings is the nurse's priority?
Temperature 38.9° C (102° F)
Rational:
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.
EXAM 90 QUESTIONS & CORRECT ANSWERS
LATEST 2026/2027
NGN
*0900:Client presents with abdominal pain in 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 scale of 0 to 10.Hypoactive bowel sounds; reports nausea, no
vomiting; client is passing flatus.Febrile, oriented to person, place, and
time.Tachypnea with diminished breath sounds.Sinus tachycardia.Client voids 300
mL of clear, amber urine.
*0930:Client vomited 100 mL brown liquid.
The client is experiencing manifestations of pancreatitis as evidenced by
the amylase and lipase.
Rational:
Drop Down 1:
Pancreatitis 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.
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 postoperative.
Client admitted to medical-surgical unit from PACU. Client reports incisional pain
as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water.
Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the
past 2 hr. Moderate amount of bright red drainage noted on surgical incision
dressing.
Complete the diagram by dragging from the choices below to specify what
condition the client is most likely experiencing, two actions the nurse should
take to address that condition, and two parameters the nurse should monitor
to assess the client's progress.
Answer:
*Insert a large-gauge
*IV.Initiate a fluid challenge.
*Hypovolemia
*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 reviewing the medical record of an older
adult client who is receiving IV fluid therapy. Which of the following client
,information should indicate to the nurse that the client requires re-evaluation of the
IV therapy prescription? (Click on the "Exhibit" button for additional information
about the client. There are three tabs that contain separate categories of data.)
Answer:
BUN
Rational:
The client's Hct and BUN levels indicate dehydration and require an increase in the
IV fluid infusion rate.
A nurse is assessing a client while suctioning the client's tracheostomy tube. Which
of the following findings should indicate to the nurse the client is experiencing
hypoxia?
The client's heart rate increases.
Rational:
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 takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?
"Ginkgo biloba can cause an increased risk for bleeding."
Rational:
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 rights. Which of the following instructions
should the nurse include?
, A client should sign an informed consent before receiving a placebo during a
research trial.
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 postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
Place a pillow between the client's legs.
Rational:
The nurse should place a pillow between the client's legs to prevent hip dislocation.
A nurse is providing teaching to a client who has a gastric ulcer and a new
prescription for omeprazole. The nurse should instruct the client that the
medication provides relief by which of the following actions?
Suppressing gastric acid production
Rational:
Omeprazole is a proton pump inhibitor. It relieves manifestations of gastric ulcers
by suppressing gastric acid production.
A nurse is assessing a client who is postoperative following a thyroidectomy.
Which of the following findings is the nurse's priority?
Temperature 38.9° C (102° F)
Rational:
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.
