Galen College of Nursing Advanced MedSurg (NUR 265) –
Comprehensive Nursing Topics A: Discharge Planning &
Client Care 2026 | Practice Questions & Verified Answers
1. The nurse is assisting with discharge planning for assigned clients. Which of the following
referrals is appropriate for the nurse to make?
a. A social worker referral for a client who has diabetes mellitus (type 2) and has neuropathy.
b. A physical therapy (PT) referral for a client who had a total knee replacement (TKR) and
needs instruction on the use of a walker.
c. An occupational therapy (OT) referral for a client who had an amputation and requires long-
term IV antibiotics.
d. A speech therapy referral for a client who is scheduled to undergo an outpatient
esophagogastroduodenoscopy (EGD).
2. The nurse has attended a continuing education program on legal issues in nursing practice.
Which of the following statements by the nurse indicates a correct understanding of the
conference?
a. “Failure to communicate concerns about an older adult client who is confused and is being
discharged home is an example of
neglect.”
b. “Giving clients false assurance about a health care condition or expected outcome is an
example of libel.”
c. “Threatening to touch a client without the client’s consent is an example of battery.”
d. “Posting information about a client on social media without the client’s permission is an
example of slander.”
3. The nurse working in a medical-surgical unit is caring for assigned clients. Which of the
following tasks is appropriate to delegate?
a. Asking an unlicensed assistive personnel (UAP) to turn off the tube feeding for a client who is
receiving continuous tube feedings and is
vomiting.
b. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood glucose reading on a
client who has become diaphoretic.
c. Asking an unlicensed assistive personnel (UAP) to flush the closed-wound drainage system
(JP) drain of a client who is 2 days postoperative from an open appendectomy.
,d. Asking a licensed practical nurse (LPN/VN) to teach a client who has a newly created
ileostomy how to change the appliance.
4. The nurse working on the pediatric unit is caring for the following clients. It is most
appropriate for the nurse to initiate an interdisciplinary conference for a client who is:
a. 7 months old, has intussusception, is vomiting, has colicky abdominal pain, and is having
jelly-like stools.
b. 6 months old, has respiratory syncytial virus (RSV), is wheezing, and has copious nasal
discharge.
c. 2 years old, has impaired fine and gross motor sills, and was just diagnosed with cerebral
palsy.
d. 2 months old, has developmental dysplasia of the hip, unequal leg lengths, internal abduction
of the left hip, and asymmetry of the gluteal folds.
5. The nurse working on the medical-surgical unit is caring for assigned clients. The nurse
should initially assess the client who:
a. Has pericarditis with a temperature (T) of 101.8 F and chest pain that is relieved when the
client leans forward.
b. Has atrial fibrillation (AFib) with a pulse (P) that varies from 110 to 140 and is refusing to
take the scheduled dose of warfarin.
c. Has status asthmaticus, had wheezing on inspiration and expiration upon admission 30
minutes ago, received a nebulizer treatment, and now has vesicular breath sounds.
d. Had thoracic surgery 12 hours ago with a chest tube to water seal drainage and has drained
175 mL of serous sanguineous fluid in the past hour.
6. The nurse is caring for a client who weighs 150 lbs (68 kg) and has developed hepatic
encephalopathy. It is a priority for the nurse to notify the primary health care provider (PHCP) if
the client develops:
a. The development of flaccidity to the lower extremities.
b. An increase in urine output to 1,450 mL/day.
c. A change in pupil size from 7 to 5 mm.
d. An increase in alanine aminotransferase (ALT) levels.
,7. The nurse working in the emergency department (ED) has received the following prescriptions
for newly admitted clients. Which prescription should the nurse implement first?
a. Initiate an IV of 0.9% sodium chloride (normal saline) for a client who was admitted with a
urinary tract infection (UT() and has a blood pressure (BP) of 122/68 mm Hg.
b. Administer a second unit of packed red blood cells (PRBCs) to a client who has a hemoglobin
(Hgb) of 8 mg/dL.
c. Administer labetalol IV to a client who has a blood pressure (BP) of 192/98 mm Hg and a
pulse (P) of 138.
d. Administer lactulose to a client who has portal hypertension and is reporting nausea.
8. The nurse is caring for a teenage client who has chronic streptococcal infections of the throat
and is now reporting swelling around the eyes. Which of the following is the priority action for
the nurse?
a. Test the urine for glucose and ketones.
b. Administer an antihistamine to decrease swelling.
c. Inspect for generalized edema.
d. Check the blood pressure for hypotension.
9. The nurse preceptor is observing care provided by a newly hired nurse. The nurse preceptor
identifies that follow-up is needed if the newly hired nurse:
a. Preps an IV insertion site with alcohol using a back-and-forth pattern.
b. Primes IV tubing with 0.9% sodium chloride (normal saline) before starting a blood
transfusion.
c. Uses clean gloves when colleting a 24-hour urine specimen.
d. Administers an influenza vaccine using the Z-track method.
10. The nurse manager has provided a continuing education session to nursing staff regarding
client rights and responsibilities. Which of the following statements by a participant indicates a
correct understanding of the teaching?
a. “Clients who have a mental health diagnosis waive the right to confidentiality once
hospitalized.”
b. “Clients are not allowed to review their medical record during hospitalization.”
, c. “Clients will be provided a list of home health agencies to contact for any ordered follow-up
care.”
d. “Clients have a right to know about alternatives to treatment and hospitalization.”
11. The nurse is caring for a child who has impetigo and has provided home instructions to the
parents. Which of the following should the nurse include in the instructions?
a. Towels should be washed separately from other family members.
b. Seal non-washable items in an airtight plastic bag for 14 days.
c. Soak combs and hairbrushes in boiling water for 10 minutes.
d. Spray household surfaces with an over-the-counter (OTC) insecticide.
12. The nurse preceptor is observing a newly hired nurse care for the following assigned clients
who have restraints in place. Which client situation requires immediate follow-up by the nurse
preceptor?
a. The client whose wrist restraints are removed every 4 hours.
b. The client whose safety vest is tied in a half bow to the bedframe.
c. The client who received alprazolam and has all 4 siderails up.
d. The client whose roll belt is loose enough to allow for movement in the bed.
13. The nurse is caring for a client and administers the wrong drug. Which of the following
actions should the nurse take first?
a. Determine if the client is experiencing any adverse effects.
b. Notify the client’s primary health care provider (PHCP).
c. Complete an incident report.
d. Inform the client to report the development of any unusual symptoms.
14. The nurse is assessing clients at the scene of a mass casualty disaster and prioritizing care
based on the disaster triage tag system. Which of the following clients should be transported to
the healthcare facility first?
a. The client who has a closed fracture to the leg and a 2+ pedal pulse.
b. The client who is confused and has an open wound on the right lower leg.
Comprehensive Nursing Topics A: Discharge Planning &
Client Care 2026 | Practice Questions & Verified Answers
1. The nurse is assisting with discharge planning for assigned clients. Which of the following
referrals is appropriate for the nurse to make?
a. A social worker referral for a client who has diabetes mellitus (type 2) and has neuropathy.
b. A physical therapy (PT) referral for a client who had a total knee replacement (TKR) and
needs instruction on the use of a walker.
c. An occupational therapy (OT) referral for a client who had an amputation and requires long-
term IV antibiotics.
d. A speech therapy referral for a client who is scheduled to undergo an outpatient
esophagogastroduodenoscopy (EGD).
2. The nurse has attended a continuing education program on legal issues in nursing practice.
Which of the following statements by the nurse indicates a correct understanding of the
conference?
a. “Failure to communicate concerns about an older adult client who is confused and is being
discharged home is an example of
neglect.”
b. “Giving clients false assurance about a health care condition or expected outcome is an
example of libel.”
c. “Threatening to touch a client without the client’s consent is an example of battery.”
d. “Posting information about a client on social media without the client’s permission is an
example of slander.”
3. The nurse working in a medical-surgical unit is caring for assigned clients. Which of the
following tasks is appropriate to delegate?
a. Asking an unlicensed assistive personnel (UAP) to turn off the tube feeding for a client who is
receiving continuous tube feedings and is
vomiting.
b. Asking a licensed practical nurse (LPN/VN) to obtain a capillary blood glucose reading on a
client who has become diaphoretic.
c. Asking an unlicensed assistive personnel (UAP) to flush the closed-wound drainage system
(JP) drain of a client who is 2 days postoperative from an open appendectomy.
,d. Asking a licensed practical nurse (LPN/VN) to teach a client who has a newly created
ileostomy how to change the appliance.
4. The nurse working on the pediatric unit is caring for the following clients. It is most
appropriate for the nurse to initiate an interdisciplinary conference for a client who is:
a. 7 months old, has intussusception, is vomiting, has colicky abdominal pain, and is having
jelly-like stools.
b. 6 months old, has respiratory syncytial virus (RSV), is wheezing, and has copious nasal
discharge.
c. 2 years old, has impaired fine and gross motor sills, and was just diagnosed with cerebral
palsy.
d. 2 months old, has developmental dysplasia of the hip, unequal leg lengths, internal abduction
of the left hip, and asymmetry of the gluteal folds.
5. The nurse working on the medical-surgical unit is caring for assigned clients. The nurse
should initially assess the client who:
a. Has pericarditis with a temperature (T) of 101.8 F and chest pain that is relieved when the
client leans forward.
b. Has atrial fibrillation (AFib) with a pulse (P) that varies from 110 to 140 and is refusing to
take the scheduled dose of warfarin.
c. Has status asthmaticus, had wheezing on inspiration and expiration upon admission 30
minutes ago, received a nebulizer treatment, and now has vesicular breath sounds.
d. Had thoracic surgery 12 hours ago with a chest tube to water seal drainage and has drained
175 mL of serous sanguineous fluid in the past hour.
6. The nurse is caring for a client who weighs 150 lbs (68 kg) and has developed hepatic
encephalopathy. It is a priority for the nurse to notify the primary health care provider (PHCP) if
the client develops:
a. The development of flaccidity to the lower extremities.
b. An increase in urine output to 1,450 mL/day.
c. A change in pupil size from 7 to 5 mm.
d. An increase in alanine aminotransferase (ALT) levels.
,7. The nurse working in the emergency department (ED) has received the following prescriptions
for newly admitted clients. Which prescription should the nurse implement first?
a. Initiate an IV of 0.9% sodium chloride (normal saline) for a client who was admitted with a
urinary tract infection (UT() and has a blood pressure (BP) of 122/68 mm Hg.
b. Administer a second unit of packed red blood cells (PRBCs) to a client who has a hemoglobin
(Hgb) of 8 mg/dL.
c. Administer labetalol IV to a client who has a blood pressure (BP) of 192/98 mm Hg and a
pulse (P) of 138.
d. Administer lactulose to a client who has portal hypertension and is reporting nausea.
8. The nurse is caring for a teenage client who has chronic streptococcal infections of the throat
and is now reporting swelling around the eyes. Which of the following is the priority action for
the nurse?
a. Test the urine for glucose and ketones.
b. Administer an antihistamine to decrease swelling.
c. Inspect for generalized edema.
d. Check the blood pressure for hypotension.
9. The nurse preceptor is observing care provided by a newly hired nurse. The nurse preceptor
identifies that follow-up is needed if the newly hired nurse:
a. Preps an IV insertion site with alcohol using a back-and-forth pattern.
b. Primes IV tubing with 0.9% sodium chloride (normal saline) before starting a blood
transfusion.
c. Uses clean gloves when colleting a 24-hour urine specimen.
d. Administers an influenza vaccine using the Z-track method.
10. The nurse manager has provided a continuing education session to nursing staff regarding
client rights and responsibilities. Which of the following statements by a participant indicates a
correct understanding of the teaching?
a. “Clients who have a mental health diagnosis waive the right to confidentiality once
hospitalized.”
b. “Clients are not allowed to review their medical record during hospitalization.”
, c. “Clients will be provided a list of home health agencies to contact for any ordered follow-up
care.”
d. “Clients have a right to know about alternatives to treatment and hospitalization.”
11. The nurse is caring for a child who has impetigo and has provided home instructions to the
parents. Which of the following should the nurse include in the instructions?
a. Towels should be washed separately from other family members.
b. Seal non-washable items in an airtight plastic bag for 14 days.
c. Soak combs and hairbrushes in boiling water for 10 minutes.
d. Spray household surfaces with an over-the-counter (OTC) insecticide.
12. The nurse preceptor is observing a newly hired nurse care for the following assigned clients
who have restraints in place. Which client situation requires immediate follow-up by the nurse
preceptor?
a. The client whose wrist restraints are removed every 4 hours.
b. The client whose safety vest is tied in a half bow to the bedframe.
c. The client who received alprazolam and has all 4 siderails up.
d. The client whose roll belt is loose enough to allow for movement in the bed.
13. The nurse is caring for a client and administers the wrong drug. Which of the following
actions should the nurse take first?
a. Determine if the client is experiencing any adverse effects.
b. Notify the client’s primary health care provider (PHCP).
c. Complete an incident report.
d. Inform the client to report the development of any unusual symptoms.
14. The nurse is assessing clients at the scene of a mass casualty disaster and prioritizing care
based on the disaster triage tag system. Which of the following clients should be transported to
the healthcare facility first?
a. The client who has a closed fracture to the leg and a 2+ pedal pulse.
b. The client who is confused and has an open wound on the right lower leg.
