GNRS 558, Intermediate Medical-Surgical Care of the Adult
GNRS 558 ACTUAL Final Exam 2025 Azusa
Pacific University COMPLETE EXAM WITH
DETAILED ANSWERS/RATIONALE SOLVED
THIS EXAM CONTAINS REAL EXAM INSIGHT QUESTIONS 200 QUESTIONS
Ch. 56, 57, 61, 62, 63, 64
Which finding would the nurse expect when assessing a patient who is experiencing a cluster headache?
a. Nuchal rigidity
b. Unilateral ptosis
c. Projectile vomiting
d. Bilateral facial pain
b. Unilateral ptosis
While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins
having a tonic-clonic seizure. Which action would the nurse take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation.
c. Time and observe and record the details of the seizure and postictal state.
A high school teacher who has been diagnosed with epilepsy after having a generalized tonic-clonic
seizure tells the nurse, "I cannot teach any more. It will be too upsetting if I have a seizure at work." How
would the nurse respond to specifically address the patient's concern?
a. "You might benefit from some psychologic counseling."
,GNRS 558, Intermediate Medical-Surgical Care of the Adult
b. "Epilepsy usually can be well controlled with medications."
c. "You will want to contact the Epilepsy Foundation for assistance."
d. "The Department of Vocational Rehabilitation can help with work retraining."
b. "Epilepsy usually can be well controlled with medications."
A patient has been taking phenytoin (Dilantin) for 2 years. Which action would the nurse take when
evaluating possible adverse effects of the medication?
a. Inspect the oral mucosa.
b. Listen to the lung sounds.
c. Auscultate the bowel sounds.
d. Check pupil reaction to light.
a. Inspect the oral mucosa.
Rationale: Phenytoin can cause gingival hyperplasia, but does not affect bowel sounds, lung sounds, or
pupil reaction to light.
A patient reports feeling numbness and tingling of the left arm before experiencing a seizure.
Which type of seizure would the nurse suspect?
a. Focal-onset
b. Atonic
c. Absence
d. Myoclonic
a. Focal-onset
,GNRS 558, Intermediate Medical-Surgical Care of the Adult
Rationale:The initial symptoms of a focal-onset seizure involve clinical manifestations that are localized
to a particular part of the body or brain; patients may have unusual feelings or sensations.
Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the
patient loses muscle tone and (typically) falls to the ground. Myoclonic seizures
are characterized by a sudden jerk of the body or extremities.
Which action would the nurse include in completing a health history and physical assessment for a 36-
yr-old female patient with possible multiple sclerosis (MS)?
a. Assess for the presence of chest pain.
b. Inquire about urinary tract problems.
c. Inspect the skin for rashes or discoloration.
d. Ask the patient about any increase in libido.
b. Inquire about urinary tract problems.
A woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which
response would the nurse provide?
a. "MS symptoms will be worse after the pregnancy."
b. "Symptoms of MS may improve during pregnancy."
c. "Women with MS frequently have premature labor."
d. "MS is associated with an increased risk for congenital defects."
b. "Symptoms of MS may improve during pregnancy."
A patient with multiple sclerosis (MS) is to begin treatment with glatiramer acetate (Copaxone). Which
information would the nurse include in patient teaching?
a. Recommendation to drink at least 4 L of fluid daily
, GNRS 558, Intermediate Medical-Surgical Care of the Adult
b. Need to avoid driving or operating heavy machinery
c. How to draw up and administer injections of the medication
d. Use of contraceptive methods other than oral contraceptives
c. How to draw up and administer injections of the medication
Which information about a patient with multiple sclerosis (MS) indicates that the nurse would consult
with the health care provider before giving the prescribed dose of dalfampridine
(Ampyra)?
a. The patient reports pain with neck flexion.
b. The patient walks a mile each day for exercise.
c. The patient has epilepsy controlled by medication.
d. The patient has the relapsing-remitting form of MS.
b. The patient walks a mile each day for exercise.
Which action would the nurse plan to take for a patient with multiple sclerosis who has urinary
retention caused by a flaccid bladder?
a. Teach the patient how to self-catheterize.
b. Encourage decreased evening fluid intake.
c. Suggest the use of adult incontinence briefs.
d. Assist the patient to the commode every 2 hours.
a. Teach the patient how to self-catheterize.
A patient with Parkinson's disease (PD) has bradykinesia. Which action would the nurse include in the
plan of care?
GNRS 558 ACTUAL Final Exam 2025 Azusa
Pacific University COMPLETE EXAM WITH
DETAILED ANSWERS/RATIONALE SOLVED
THIS EXAM CONTAINS REAL EXAM INSIGHT QUESTIONS 200 QUESTIONS
Ch. 56, 57, 61, 62, 63, 64
Which finding would the nurse expect when assessing a patient who is experiencing a cluster headache?
a. Nuchal rigidity
b. Unilateral ptosis
c. Projectile vomiting
d. Bilateral facial pain
b. Unilateral ptosis
While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins
having a tonic-clonic seizure. Which action would the nurse take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation.
c. Time and observe and record the details of the seizure and postictal state.
A high school teacher who has been diagnosed with epilepsy after having a generalized tonic-clonic
seizure tells the nurse, "I cannot teach any more. It will be too upsetting if I have a seizure at work." How
would the nurse respond to specifically address the patient's concern?
a. "You might benefit from some psychologic counseling."
,GNRS 558, Intermediate Medical-Surgical Care of the Adult
b. "Epilepsy usually can be well controlled with medications."
c. "You will want to contact the Epilepsy Foundation for assistance."
d. "The Department of Vocational Rehabilitation can help with work retraining."
b. "Epilepsy usually can be well controlled with medications."
A patient has been taking phenytoin (Dilantin) for 2 years. Which action would the nurse take when
evaluating possible adverse effects of the medication?
a. Inspect the oral mucosa.
b. Listen to the lung sounds.
c. Auscultate the bowel sounds.
d. Check pupil reaction to light.
a. Inspect the oral mucosa.
Rationale: Phenytoin can cause gingival hyperplasia, but does not affect bowel sounds, lung sounds, or
pupil reaction to light.
A patient reports feeling numbness and tingling of the left arm before experiencing a seizure.
Which type of seizure would the nurse suspect?
a. Focal-onset
b. Atonic
c. Absence
d. Myoclonic
a. Focal-onset
,GNRS 558, Intermediate Medical-Surgical Care of the Adult
Rationale:The initial symptoms of a focal-onset seizure involve clinical manifestations that are localized
to a particular part of the body or brain; patients may have unusual feelings or sensations.
Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the
patient loses muscle tone and (typically) falls to the ground. Myoclonic seizures
are characterized by a sudden jerk of the body or extremities.
Which action would the nurse include in completing a health history and physical assessment for a 36-
yr-old female patient with possible multiple sclerosis (MS)?
a. Assess for the presence of chest pain.
b. Inquire about urinary tract problems.
c. Inspect the skin for rashes or discoloration.
d. Ask the patient about any increase in libido.
b. Inquire about urinary tract problems.
A woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which
response would the nurse provide?
a. "MS symptoms will be worse after the pregnancy."
b. "Symptoms of MS may improve during pregnancy."
c. "Women with MS frequently have premature labor."
d. "MS is associated with an increased risk for congenital defects."
b. "Symptoms of MS may improve during pregnancy."
A patient with multiple sclerosis (MS) is to begin treatment with glatiramer acetate (Copaxone). Which
information would the nurse include in patient teaching?
a. Recommendation to drink at least 4 L of fluid daily
, GNRS 558, Intermediate Medical-Surgical Care of the Adult
b. Need to avoid driving or operating heavy machinery
c. How to draw up and administer injections of the medication
d. Use of contraceptive methods other than oral contraceptives
c. How to draw up and administer injections of the medication
Which information about a patient with multiple sclerosis (MS) indicates that the nurse would consult
with the health care provider before giving the prescribed dose of dalfampridine
(Ampyra)?
a. The patient reports pain with neck flexion.
b. The patient walks a mile each day for exercise.
c. The patient has epilepsy controlled by medication.
d. The patient has the relapsing-remitting form of MS.
b. The patient walks a mile each day for exercise.
Which action would the nurse plan to take for a patient with multiple sclerosis who has urinary
retention caused by a flaccid bladder?
a. Teach the patient how to self-catheterize.
b. Encourage decreased evening fluid intake.
c. Suggest the use of adult incontinence briefs.
d. Assist the patient to the commode every 2 hours.
a. Teach the patient how to self-catheterize.
A patient with Parkinson's disease (PD) has bradykinesia. Which action would the nurse include in the
plan of care?
