PN Adult Medical Surgical Online Practice 2023 A
1. A nurse is preparing to administer furosemide to a client who has heart
failure. Which of the following findings should the nurse report before
administering the medication?: Decreased potassium
2. A nurse is reviewing the chart of a client who is experiencing an
adrenal crisis, which was precipitated by the client not taking their
medication for several days. The nurse should identify that withdrawal from
which of the following medications potentiated the adrenal crisis?:
Prednisone
3. A nurse is assisting with the care for a client who has a prescription for
digoxin 0.25 mg PO daily. While taking the client's apical pulse, the nurse
notes a rate of 58/min. Which of the following actions should the nurse
take?: Withhold the dose.
4. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c)
testing with a client who has diabetes mellitus. Which of the following
statements indicates that the client understands the teaching?: "I will have
my
HbA1c checked twice per year."
5. A nurse is providing information regarding transmission-based
precautions for a client who has Clostridium difficile to an assistive
personnel (AP). Which of the following instructions should the nurse
include? (Select all that
apply.): "Provide the client with disposable utensils and dishes for meals."
"Leave blood pressure equipment in the client's room."
"Clean contaminated surfaces with a bleach solution."
6. A nurse is reinforcing teaching with a client who has coronary artery
disease. Which of the following instructions should the nurse include in the
teaching?: "Add oily fish to your diet twice weekly."
7. A nurse in an oncology clinic is reinforcing teaching about Mohs
surgery with a client who has skin cancer. Which of the following
information should the nurse include in the teaching?: Mohs surgery is a
horizontal shaving of thin layers of the tumor.
8. A nurse is collecting data from an older adult client who has several
concerns. Which of the following concerns should the nurse recognize as
an expected change associated with aging?: "My food tastes bland even after I
add seasoning."
9. A nurse is reinforcing dietary teaching with a client about increasing
the intake of foods containing vitamin C to enhance absorption of oral iron
, PN Adult Medical Surgical Online Practice 2023 A
supplements. Which of the following food choices should the nurse include
in the teaching?: 1 cup of boiled broccoli
10. A nurse is assisting with the care for a client who is 2 hr postoperative
following the amputation of a foot. Which of the following actions should the
nurse take first?: Check the incisional dressing.
11. A nurse is assisting with the care of a client who is postoperative
following abdominal surgery.
Exhibit 1
Nurses' Notes
1100:
Client received from PACU; initial vital signs recorded. Client is drowsy but
arouses to verbal stimuli. Oriented to person, place, and time. Client is able
to move all extremities. Normal sinus rhythm noted. Breath sounds are clear
upon auscultation. Dressing to abdomen is intact with a small amount of
serosanguinous drainage noted and marked. No bowel sounds in all four
quadrants. Indwelling urinary catheter is in place and draining clear, yellow
urine. Lactated Ringer's is infusing at 100 mL/hr via IV catheter in the right
forearm.1200:
Client reports nausea and pain as an 8 on a scale of 0 to 10. Abdominal
dressing is intact with no further drainage noted. Urine output of 15 mL
noted since arrival from PACU. Analgesic and antiemetic were administered
as prescribed.1230:
Client reports relief from nausea, and pain as a 4 on a scale of 0 to 10. Oxygen
saturation is 96%. Client was repositioned for comfort and encouraged to
turn, cough, and deep breathe.1300:
No additional urine output noted since 1200.: Which of the following actions
should the nurse take?
Select all that apply.
Instruct the client to splint their abdomen with a pillow when coughing.
Report the client's urinary output to the charge nurse.
Monitor the client's pain level.
12. A nurse is assisting with monitoring a client who is receiving dialysis
treatment.
Exhibit 1
Nurses' Notes
0530:Client is awake and alert. Arteriovenous fistula (AVF) to right forearm
with thrill palpated and auscultated for bruit. Breath sounds are clear upon
, PN Adult Medical Surgical Online Practice 2023 A
auscultation; client denies shortness of breath. No peripheral edema noted;
capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses.AVF
access prepared and cannulated twice with no difficulty. Lines are taped and
secured; treatment is initiated.0600:Client is reading a book. Access is visible,
and lines are secure. Client reports no discomfort or pain.0630:Client reports
feeling warm, nauseated, and lightheaded; appears restless and slightly
confused.
Exhibit 2
Vital Signs
0530:Current weight 88 kg (194 lb)Temperature 37° C (98.6° F)Blood
pressure• Lying - 152/92 mm Hg• Sitting - 148/90 mm Hg• Standing - 144/88
mm HgHeart rate 90/minRespiratory rate 20/minOxygen saturation 98% on
room air0600:Temperature 36.9° C (98.4° F)Blood pressure 120/80 mm
HgHeart rate 96/minRespiratory rate 20/minOxygen saturation 97% on room
air0630:Temperature 36.2° C (97.1° F)Blood pressure 88/50 mm HgHeart rate
110/minRes-
piratory ra: For each potential nursing intervention, click to specify if the
intervention is indicated or not indicated.
Nursing Intervention
Request a chest x-ray - not indicated
Place the client in reverse Trendelenburg position - indicated
Assist with administering a 0.9% sodium chloride 200 mL IV bolus - indicated
Apply oxygen at 2 L/min via nasal cannula - indicated
Notify the charge nurse immediately - indicated
Obtain the client's blood glucose level - not indicated
13. A nurse is contributing to the plan of care for a client who has a new
prescription for nystatin suspension for oral candidiasis. Which of the
following interventions should the nurse include in the plan?: Remind the
client to swish the medication in their mouth.
14. A nurse is reinforcing teaching with the caregiver of a client who has a
cervical injury and has a halo vest in place. Which of the following safety
precautions should the nurse include in the teaching?: Change the sheepskin
liner weekly.
15. A nurse is assisting in the care of a client who is receiving a continuous
tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client
1. A nurse is preparing to administer furosemide to a client who has heart
failure. Which of the following findings should the nurse report before
administering the medication?: Decreased potassium
2. A nurse is reviewing the chart of a client who is experiencing an
adrenal crisis, which was precipitated by the client not taking their
medication for several days. The nurse should identify that withdrawal from
which of the following medications potentiated the adrenal crisis?:
Prednisone
3. A nurse is assisting with the care for a client who has a prescription for
digoxin 0.25 mg PO daily. While taking the client's apical pulse, the nurse
notes a rate of 58/min. Which of the following actions should the nurse
take?: Withhold the dose.
4. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c)
testing with a client who has diabetes mellitus. Which of the following
statements indicates that the client understands the teaching?: "I will have
my
HbA1c checked twice per year."
5. A nurse is providing information regarding transmission-based
precautions for a client who has Clostridium difficile to an assistive
personnel (AP). Which of the following instructions should the nurse
include? (Select all that
apply.): "Provide the client with disposable utensils and dishes for meals."
"Leave blood pressure equipment in the client's room."
"Clean contaminated surfaces with a bleach solution."
6. A nurse is reinforcing teaching with a client who has coronary artery
disease. Which of the following instructions should the nurse include in the
teaching?: "Add oily fish to your diet twice weekly."
7. A nurse in an oncology clinic is reinforcing teaching about Mohs
surgery with a client who has skin cancer. Which of the following
information should the nurse include in the teaching?: Mohs surgery is a
horizontal shaving of thin layers of the tumor.
8. A nurse is collecting data from an older adult client who has several
concerns. Which of the following concerns should the nurse recognize as
an expected change associated with aging?: "My food tastes bland even after I
add seasoning."
9. A nurse is reinforcing dietary teaching with a client about increasing
the intake of foods containing vitamin C to enhance absorption of oral iron
, PN Adult Medical Surgical Online Practice 2023 A
supplements. Which of the following food choices should the nurse include
in the teaching?: 1 cup of boiled broccoli
10. A nurse is assisting with the care for a client who is 2 hr postoperative
following the amputation of a foot. Which of the following actions should the
nurse take first?: Check the incisional dressing.
11. A nurse is assisting with the care of a client who is postoperative
following abdominal surgery.
Exhibit 1
Nurses' Notes
1100:
Client received from PACU; initial vital signs recorded. Client is drowsy but
arouses to verbal stimuli. Oriented to person, place, and time. Client is able
to move all extremities. Normal sinus rhythm noted. Breath sounds are clear
upon auscultation. Dressing to abdomen is intact with a small amount of
serosanguinous drainage noted and marked. No bowel sounds in all four
quadrants. Indwelling urinary catheter is in place and draining clear, yellow
urine. Lactated Ringer's is infusing at 100 mL/hr via IV catheter in the right
forearm.1200:
Client reports nausea and pain as an 8 on a scale of 0 to 10. Abdominal
dressing is intact with no further drainage noted. Urine output of 15 mL
noted since arrival from PACU. Analgesic and antiemetic were administered
as prescribed.1230:
Client reports relief from nausea, and pain as a 4 on a scale of 0 to 10. Oxygen
saturation is 96%. Client was repositioned for comfort and encouraged to
turn, cough, and deep breathe.1300:
No additional urine output noted since 1200.: Which of the following actions
should the nurse take?
Select all that apply.
Instruct the client to splint their abdomen with a pillow when coughing.
Report the client's urinary output to the charge nurse.
Monitor the client's pain level.
12. A nurse is assisting with monitoring a client who is receiving dialysis
treatment.
Exhibit 1
Nurses' Notes
0530:Client is awake and alert. Arteriovenous fistula (AVF) to right forearm
with thrill palpated and auscultated for bruit. Breath sounds are clear upon
, PN Adult Medical Surgical Online Practice 2023 A
auscultation; client denies shortness of breath. No peripheral edema noted;
capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses.AVF
access prepared and cannulated twice with no difficulty. Lines are taped and
secured; treatment is initiated.0600:Client is reading a book. Access is visible,
and lines are secure. Client reports no discomfort or pain.0630:Client reports
feeling warm, nauseated, and lightheaded; appears restless and slightly
confused.
Exhibit 2
Vital Signs
0530:Current weight 88 kg (194 lb)Temperature 37° C (98.6° F)Blood
pressure• Lying - 152/92 mm Hg• Sitting - 148/90 mm Hg• Standing - 144/88
mm HgHeart rate 90/minRespiratory rate 20/minOxygen saturation 98% on
room air0600:Temperature 36.9° C (98.4° F)Blood pressure 120/80 mm
HgHeart rate 96/minRespiratory rate 20/minOxygen saturation 97% on room
air0630:Temperature 36.2° C (97.1° F)Blood pressure 88/50 mm HgHeart rate
110/minRes-
piratory ra: For each potential nursing intervention, click to specify if the
intervention is indicated or not indicated.
Nursing Intervention
Request a chest x-ray - not indicated
Place the client in reverse Trendelenburg position - indicated
Assist with administering a 0.9% sodium chloride 200 mL IV bolus - indicated
Apply oxygen at 2 L/min via nasal cannula - indicated
Notify the charge nurse immediately - indicated
Obtain the client's blood glucose level - not indicated
13. A nurse is contributing to the plan of care for a client who has a new
prescription for nystatin suspension for oral candidiasis. Which of the
following interventions should the nurse include in the plan?: Remind the
client to swish the medication in their mouth.
14. A nurse is reinforcing teaching with the caregiver of a client who has a
cervical injury and has a halo vest in place. Which of the following safety
precautions should the nurse include in the teaching?: Change the sheepskin
liner weekly.
15. A nurse is assisting in the care of a client who is receiving a continuous
tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client
