RN Adult Medical Surgical Online
Practice 2026 B Questions and
Correct Answers
1200: Client is sitting up in high-Fowler's position and appears anxious. Client reports shortness
of breath and severe chest pain as 9 on a scale of 0 to 10. Client states that they have started
coughing and are expectorating pink-tinged mucus.
Lung sounds with increased wheezing in left lung and clear on the right side. Equal chest
expansion noted. Neck veins flat. No peripheral edema observed.
Blood pressure 136/90 mm Hg
Respiratory rate 32/min
Temperature 38.7° C (101.6° F)
Heart rate 110/min
SaO2 90% on 3 L/min via nasal cannula
The client is most likely experiencing _________ and__________.
A. Pnuemonia
B. Pneumothorax
C. Fluid Volume Overload
D. Acute Chest Syndrome - <CORRECT ANSWER >>Answer: The client is most likely experiencing
PNEUMONIA
and ACUTE CHEST SYNDROME
D - The client is most likely experiencing acute chest syndrome, which can be caused by
respiratory infections and debris from sickled cells. The client is displaying manifestations of
acute chest syndrome, which include cough, shortness of breath, wheezing, tachypnea, fever,
and chest pain.
A - The client is most likely experiencing pneumonia as evidenced by the manifestations of
cough, shortness of breath, fever, tachypnea, blood-tinged sputum, and chest pain.
,Rationale:
C - While the client is experiencing an increased respiratory rate and shortness of breath, fluid
volume overload typically includes moist crackles on auscultation, pitting edema in dependent
areas, neck vein distension, and hypertension.
B - While the client is experiencing increased respiratory distress, a pneumothorax typically
presents with reduced or absent breath sounds and unequal chest expansion.
A nurse and an assistive personnel (AP) are caring for a client who has bacterial meningitis. The
nurse should give the AP which of the following instructions?
A. Wear a mask.
B. Wear a gown.
C. Keep the client's room well-lit.
D. Maintain the head of the bed at a 45° elevation. - <CORRECT ANSWER >>Answer: A. Wear a
mask
- Bacterial meningitis requires droplet precautions. Therefore, the AP and the nurse should
wear a mask when coming within 0.9 m (3 ft) of the client until 24 hr after the client has begun
receiving antibiotic therapy.
Rationale:
B - A gown is necessary when caring for clients who require contact precautions. Bacterial
meningitis does not spread via direct contact.
C - Staff caring for this client should keep the illumination in the room dim and avoid bright light
from windows to promote comfort and rest and avoid photophobia.
D - Staff caring for this client should keep the head of the bed at a 30° elevation
A nurse is providing discharge teaching about infection prevention to a client who is receiving
chemotherapy. Which of the following statements by the client indicates understanding of the
teaching?
,A. "I will avoid eating raw fruits and vegetables."
B. "I can ask a friend to change my cats litter box."
C. "I will use a mild soap when washing my genital area."
D. "I can sip on a glass of juice for at least 2 hours before I should discard it." - <CORRECT
ANSWER >>Answer: B. "I can ask a friend to change my cats litter box."
- Changing a pet's litter box increases the client's risk of being exposed to toxoplasmosis.
Therefore, the client should wear gloves or avoid changing the pet's litter box.
Rationale:
A - The nurse should instruct the client to wash raw fruits and vegetables thoroughly prior to
eating them, because uncleaned fruits and vegetables can contain micro-organisms and place
the client at risk for an infection.
C - The nurse should instruct the client to wash genital area twice a day with anti-microbial soap
to prevent bacterial and fungal infections.
D - The nurse should instruct the client to avoid drinking any liquids that have been out for
more than 1 hr. Beverages left out for extended periods of time could expose the client to
micro-organisms and place them at risk for an infection.
A nurse is caring for a client who has a new diagnosis of hyperthyroidism. Which of the
following is the priority assessment finding that the nurse should report to the provider?
A.Restlessness
B. T3 level 215 ng/dL (40 to 180 ng/dL)
C. Blood pressure 170/80 mm Hg
D. Decreased weight - <CORRECT ANSWER >>Answer: C. Blood pressure 170/80 mm Hg
- Using the urgent vs. nonurgent approach to client care, the nurse should determine that the
priority finding is a systolic blood pressure of 170 mm Hg, which indicates that the client is at
risk for thyroid storm.
Rationale:
, A - Restlessness is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
B - An elevated T3 level is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
D - Decreased weight is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
A nurse is assessing for compartment syndrome in a client who has a short leg cast. Which of
the following findings should the nurse identify as a manifestation of this condition?
A. Bounding pedal pulse
B. Capillary refill less than 2 seconds
C. Pain that increases with passive movement
D. Areas of warmth on the cast - <CORRECT ANSWER >>Answer: C. Pain that increases with
passive movement
- The nurse should identify that a client who has compartment syndrome experiences pain that
increases with passive movement. Compartment syndrome results from a decrease in blood
flow in the extremity caused by a decrease in the muscle compartment size due to a cast that is
too tight.
Rationale:
A - The nurse should expect a client who has compartment syndrome to have a diminished
pulse or pulselessness in the affected extremity due to lack of distal perfusion caused by a
decrease in the muscle compartment size.
B - The nurse should expect a client who has compartment syndrome to have capillary refill
greater than 2 seconds in the affected extremity due to a lack of distal perfusion and venous
congestion caused by a decrease in the muscle compartment size.
D - A client who has a short leg cast can exhibit areas of warmth on the cast, which can indicate
an infection of the underlying tissue, not compartment syndrome.
Client presents with upper abdominal pain that radiates to the right shoulder. Client rates pain
as 7/ 10. Client also reports N/V and dyspepsia.
Practice 2026 B Questions and
Correct Answers
1200: Client is sitting up in high-Fowler's position and appears anxious. Client reports shortness
of breath and severe chest pain as 9 on a scale of 0 to 10. Client states that they have started
coughing and are expectorating pink-tinged mucus.
Lung sounds with increased wheezing in left lung and clear on the right side. Equal chest
expansion noted. Neck veins flat. No peripheral edema observed.
Blood pressure 136/90 mm Hg
Respiratory rate 32/min
Temperature 38.7° C (101.6° F)
Heart rate 110/min
SaO2 90% on 3 L/min via nasal cannula
The client is most likely experiencing _________ and__________.
A. Pnuemonia
B. Pneumothorax
C. Fluid Volume Overload
D. Acute Chest Syndrome - <CORRECT ANSWER >>Answer: The client is most likely experiencing
PNEUMONIA
and ACUTE CHEST SYNDROME
D - The client is most likely experiencing acute chest syndrome, which can be caused by
respiratory infections and debris from sickled cells. The client is displaying manifestations of
acute chest syndrome, which include cough, shortness of breath, wheezing, tachypnea, fever,
and chest pain.
A - The client is most likely experiencing pneumonia as evidenced by the manifestations of
cough, shortness of breath, fever, tachypnea, blood-tinged sputum, and chest pain.
,Rationale:
C - While the client is experiencing an increased respiratory rate and shortness of breath, fluid
volume overload typically includes moist crackles on auscultation, pitting edema in dependent
areas, neck vein distension, and hypertension.
B - While the client is experiencing increased respiratory distress, a pneumothorax typically
presents with reduced or absent breath sounds and unequal chest expansion.
A nurse and an assistive personnel (AP) are caring for a client who has bacterial meningitis. The
nurse should give the AP which of the following instructions?
A. Wear a mask.
B. Wear a gown.
C. Keep the client's room well-lit.
D. Maintain the head of the bed at a 45° elevation. - <CORRECT ANSWER >>Answer: A. Wear a
mask
- Bacterial meningitis requires droplet precautions. Therefore, the AP and the nurse should
wear a mask when coming within 0.9 m (3 ft) of the client until 24 hr after the client has begun
receiving antibiotic therapy.
Rationale:
B - A gown is necessary when caring for clients who require contact precautions. Bacterial
meningitis does not spread via direct contact.
C - Staff caring for this client should keep the illumination in the room dim and avoid bright light
from windows to promote comfort and rest and avoid photophobia.
D - Staff caring for this client should keep the head of the bed at a 30° elevation
A nurse is providing discharge teaching about infection prevention to a client who is receiving
chemotherapy. Which of the following statements by the client indicates understanding of the
teaching?
,A. "I will avoid eating raw fruits and vegetables."
B. "I can ask a friend to change my cats litter box."
C. "I will use a mild soap when washing my genital area."
D. "I can sip on a glass of juice for at least 2 hours before I should discard it." - <CORRECT
ANSWER >>Answer: B. "I can ask a friend to change my cats litter box."
- Changing a pet's litter box increases the client's risk of being exposed to toxoplasmosis.
Therefore, the client should wear gloves or avoid changing the pet's litter box.
Rationale:
A - The nurse should instruct the client to wash raw fruits and vegetables thoroughly prior to
eating them, because uncleaned fruits and vegetables can contain micro-organisms and place
the client at risk for an infection.
C - The nurse should instruct the client to wash genital area twice a day with anti-microbial soap
to prevent bacterial and fungal infections.
D - The nurse should instruct the client to avoid drinking any liquids that have been out for
more than 1 hr. Beverages left out for extended periods of time could expose the client to
micro-organisms and place them at risk for an infection.
A nurse is caring for a client who has a new diagnosis of hyperthyroidism. Which of the
following is the priority assessment finding that the nurse should report to the provider?
A.Restlessness
B. T3 level 215 ng/dL (40 to 180 ng/dL)
C. Blood pressure 170/80 mm Hg
D. Decreased weight - <CORRECT ANSWER >>Answer: C. Blood pressure 170/80 mm Hg
- Using the urgent vs. nonurgent approach to client care, the nurse should determine that the
priority finding is a systolic blood pressure of 170 mm Hg, which indicates that the client is at
risk for thyroid storm.
Rationale:
, A - Restlessness is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
B - An elevated T3 level is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
D - Decreased weight is nonurgent because it is an expected finding for a client who has
hyperthyroidism. Therefore, there is another finding that is the priority to report.
A nurse is assessing for compartment syndrome in a client who has a short leg cast. Which of
the following findings should the nurse identify as a manifestation of this condition?
A. Bounding pedal pulse
B. Capillary refill less than 2 seconds
C. Pain that increases with passive movement
D. Areas of warmth on the cast - <CORRECT ANSWER >>Answer: C. Pain that increases with
passive movement
- The nurse should identify that a client who has compartment syndrome experiences pain that
increases with passive movement. Compartment syndrome results from a decrease in blood
flow in the extremity caused by a decrease in the muscle compartment size due to a cast that is
too tight.
Rationale:
A - The nurse should expect a client who has compartment syndrome to have a diminished
pulse or pulselessness in the affected extremity due to lack of distal perfusion caused by a
decrease in the muscle compartment size.
B - The nurse should expect a client who has compartment syndrome to have capillary refill
greater than 2 seconds in the affected extremity due to a lack of distal perfusion and venous
congestion caused by a decrease in the muscle compartment size.
D - A client who has a short leg cast can exhibit areas of warmth on the cast, which can indicate
an infection of the underlying tissue, not compartment syndrome.
Client presents with upper abdominal pain that radiates to the right shoulder. Client rates pain
as 7/ 10. Client also reports N/V and dyspepsia.
