ANCC MEDICAL SURGICAL NURSING
COMBINED EXAMS ACTUAL QUESTIONS WITH
VERIFIED SOLUTIONS
◉ A nurse is caring for a client who has dilated cardiomyopathy. The
client reports increasing difficulty completing her daily 1-mile
walks. The nurse should recognize that this is a finding of which of
the following?a. left ventricular failureb. peripheral vasodilationc.
pericardial effusiond. dec vascular volume.
Answer: a
◉ A nurse is caring for a client who is scheduled for a coronary
artery bypass graft in 2 hr. Which of the following client statements
indicates a need for further clarification by the nurse?a. "My arthritis
is really bothering me because I haven't taken my aspiring in a
week."b. "My blood pressure shouldn't be high because I took my BP
medication this morning."c. "I took my warfarin last night according
to my usually schedule."d. "I will check my BP because I took a
reduced dose of insulin this morning.".
Answer: c
◉ A nurse is caring for a client who had an onset of chest pain 24 hr
ago. The nurse should recognize that an increase in which of the
following is diagnostic of a MI?a. myoglobinb. c-reactive proteinc.
creatine kinase- MBd. Homocysteine.
,Answer: c
◉ a nurse is caring for a client who has a history of DVT and is
receiving warfarin. Which of the following client findings provides
the nurse with the best evidence regarding the effectiveness of the
warfarin therapy?a. hemoglobin 14 g/dLb. minimal bruising of
extremitiesc. reduced circumference of affected extremityd. INR 2.5.
Answer: d
◉ A client who has a new diagnosis of hypertension has a
prescription for an ACE inhibitor. The nurse instructs the client
about adverse effects of the medication. The client demonstrates an
understanding of the teaching by stating that he will notify his
provider if he experiences which of the following?a. tendon painb.
persistent coughc. frequent urinationd. constipation.
Answer: b
◉ A client is being evaluated in the ED for a possible brain attack
(stroke). Assessment findings consistent with a brain attack include
which of the following? (select all that apply)a. facial droopb. slurred
speechc. weakness of affected extremityd. crackles in lungse.
decreased urine output.
Answer: a, b, c
,◉ A client is admitted with a diagnosis of acute stroke. The provider
orders "diet as tolerated." Before feeding this client, which nursing
action is priority?a. determine client's food preferencesb. elevate the
head of the bed 30 degreesc. assess client's swallowing reflexd.
review serum albumin level to determine appropriate diet.
Answer: c
◉ Which of the following recommendations is best for the nurse to
suggest to a client as a way to keep BP under control?a. follow a
regular exercise programb. attend a stress-reduction support
groupc. avoid use of tobacco and limit alcohol intaked. increase
intake of fruits and veggies.
Answer: a
◉ which of the following assessment findings indicate to the nurse
the client is experiencing left-sided HF?a. fatigue and dyspneab.
Cheyne-Stokes breathing and orthostatic hypotensionc. liver
tenderness and peripheral edemad. anorexia and dependent edema.
Answer: a
◉ the nurse is teaching a group of adult clients about risk for
coronary artery disease, especially MI. This nurse should instruct
this group of clients about which of the following as ways to
decrease incidence of CAD and MI? (select all that apply)a. "if you
smoke, quit"b. "be sure to consume at least 10% of your calories
from saturates fats."c. "Engage in moderate exercise for 20-30
, minutes 3-5 times a week."d. "jog at a mild pace for at least one hour
a day."e. "check BP regularly.".
Answer: a, c, e
◉ Which client response requires a focused GI assessment?a. "I take
ibuprofen 600 mg three times a day for arthritis pain."b. "I
experienced occasional constipation."c. "I have had dentures for 3
years."d. "spicy foods upset my stomach.".
Answer: a
◉ After abdominal surgery, what is the most reliable assessment
that suggests return of peristaltic movement?a. presence of normal
bowel soundsb. client report of passing flatusc. client report of
hungerd. absence of nausea.
Answer: b
◉ when administering a new medication to an older client, the
nurse understands that:a. the dose may need to be increased to
greater-than-normal levelsb. close monitoring is needed because
toxic levels may developc. the dose may need to be decreased to
lower-than-normal levelsd. nausea and vomiting may develop
rapidly and are common side effects in older adults.
Answer: c
COMBINED EXAMS ACTUAL QUESTIONS WITH
VERIFIED SOLUTIONS
◉ A nurse is caring for a client who has dilated cardiomyopathy. The
client reports increasing difficulty completing her daily 1-mile
walks. The nurse should recognize that this is a finding of which of
the following?a. left ventricular failureb. peripheral vasodilationc.
pericardial effusiond. dec vascular volume.
Answer: a
◉ A nurse is caring for a client who is scheduled for a coronary
artery bypass graft in 2 hr. Which of the following client statements
indicates a need for further clarification by the nurse?a. "My arthritis
is really bothering me because I haven't taken my aspiring in a
week."b. "My blood pressure shouldn't be high because I took my BP
medication this morning."c. "I took my warfarin last night according
to my usually schedule."d. "I will check my BP because I took a
reduced dose of insulin this morning.".
Answer: c
◉ A nurse is caring for a client who had an onset of chest pain 24 hr
ago. The nurse should recognize that an increase in which of the
following is diagnostic of a MI?a. myoglobinb. c-reactive proteinc.
creatine kinase- MBd. Homocysteine.
,Answer: c
◉ a nurse is caring for a client who has a history of DVT and is
receiving warfarin. Which of the following client findings provides
the nurse with the best evidence regarding the effectiveness of the
warfarin therapy?a. hemoglobin 14 g/dLb. minimal bruising of
extremitiesc. reduced circumference of affected extremityd. INR 2.5.
Answer: d
◉ A client who has a new diagnosis of hypertension has a
prescription for an ACE inhibitor. The nurse instructs the client
about adverse effects of the medication. The client demonstrates an
understanding of the teaching by stating that he will notify his
provider if he experiences which of the following?a. tendon painb.
persistent coughc. frequent urinationd. constipation.
Answer: b
◉ A client is being evaluated in the ED for a possible brain attack
(stroke). Assessment findings consistent with a brain attack include
which of the following? (select all that apply)a. facial droopb. slurred
speechc. weakness of affected extremityd. crackles in lungse.
decreased urine output.
Answer: a, b, c
,◉ A client is admitted with a diagnosis of acute stroke. The provider
orders "diet as tolerated." Before feeding this client, which nursing
action is priority?a. determine client's food preferencesb. elevate the
head of the bed 30 degreesc. assess client's swallowing reflexd.
review serum albumin level to determine appropriate diet.
Answer: c
◉ Which of the following recommendations is best for the nurse to
suggest to a client as a way to keep BP under control?a. follow a
regular exercise programb. attend a stress-reduction support
groupc. avoid use of tobacco and limit alcohol intaked. increase
intake of fruits and veggies.
Answer: a
◉ which of the following assessment findings indicate to the nurse
the client is experiencing left-sided HF?a. fatigue and dyspneab.
Cheyne-Stokes breathing and orthostatic hypotensionc. liver
tenderness and peripheral edemad. anorexia and dependent edema.
Answer: a
◉ the nurse is teaching a group of adult clients about risk for
coronary artery disease, especially MI. This nurse should instruct
this group of clients about which of the following as ways to
decrease incidence of CAD and MI? (select all that apply)a. "if you
smoke, quit"b. "be sure to consume at least 10% of your calories
from saturates fats."c. "Engage in moderate exercise for 20-30
, minutes 3-5 times a week."d. "jog at a mild pace for at least one hour
a day."e. "check BP regularly.".
Answer: a, c, e
◉ Which client response requires a focused GI assessment?a. "I take
ibuprofen 600 mg three times a day for arthritis pain."b. "I
experienced occasional constipation."c. "I have had dentures for 3
years."d. "spicy foods upset my stomach.".
Answer: a
◉ After abdominal surgery, what is the most reliable assessment
that suggests return of peristaltic movement?a. presence of normal
bowel soundsb. client report of passing flatusc. client report of
hungerd. absence of nausea.
Answer: b
◉ when administering a new medication to an older client, the
nurse understands that:a. the dose may need to be increased to
greater-than-normal levelsb. close monitoring is needed because
toxic levels may developc. the dose may need to be decreased to
lower-than-normal levelsd. nausea and vomiting may develop
rapidly and are common side effects in older adults.
Answer: c
