NUR-258 Final MedSurg | Comprehensive Practice Questions With Correct
Answers and Rationales | 2026 Exam Preparation
A gerontologic nurse is teaching students about the high incidence and prevalence of
dehydration in older adults. Which factors contribute to this phenomenon? Select all that
apply. - correct answer Decreased kidney mass, Decreased renal blood flow, Decreased
excretion of potassium
A client has questioned the nurse's administration of intravenous (IV) normal saline, asking,
"Wouldn't sterile water be a more appropriate choice than saltwater?" Under what
circumstances would the nurse administer electrolyte-free water intravenously? - correct
answer Never, because it rapidly enters red blood cells, causing them to rupture
The nurse in the medical intensive care unit is caring for a client who is in respiratory acidosis
due to inadequate ventilation. Which diagnosis could the client have that could cause
inadequate ventilation? - correct answer Guillain- Barre syndrome
The nurse is caring for a client who is to receive IV daunorubicin, a chemotherapeutic agent.
The nurse starts the infusion and checks the insertion site as per protocol. During the most
recent check, the nurse observes that the IV has infiltrated so the nurse stops the infusion.
What is the nurse's priority concern with this infiltration? - correct answer Extravasation of the
medication
A client with hypertension has been prescribed hydrochlorothiazide. What nursing action will
best reduce the client's risk for electrolyte disturbances? - correct answer Ensure the client has
sufficient potassium intake
A client comes into the emergency department (ED) by ambulance with a hip fracture after
slipping and falling while at home. The client is alert and oriented but anxious and reports
thirst. The client's pupils are equal and reactive to light and accommodation, and the heart rate
is elevated. An indwelling urinary catheter is inserted, and 40 mL of urine is present. What is
the nurse's most likely explanation for the client's urinary output? - correct answer The client is
having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system,
which results in diminished urine output.
The nurse is performing an admission assessment on a 79-year-old client newly admitted for
end-stage liver disease. What principle should guide the nurse's assessment of the client's skin
turgor? - correct answer Inelastic skin turgor is a normal part of aging.
The nurse is assuming the care of an adult client who has been experiencing severe and
intractable pain. When reviewing the client's medication administration record, the nurse notes
the presence of gabapentin. The nurse is justified in suspecting which phenomenon in the
etiology of the client's pain? - correct answer Neuropathy
,A recent nursing graduate is aware of the differences between nursing actions that are
independent and nursing actions that are interdependent. A nurse performs an interdependent
nursing intervention when performing which of the following actions? - correct answer
Administering an IV bolus of normal saline to a patient with hypotension
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health? - correct answer
The nurse is preparing a wellness program for seniors at a community center. Which concept of
wellness should the nurse utilize when planning the program? - correct answer
A nurse on a medical-surgical unit has asked to represent the unit on the hospital's quality
committee. When describing quality improvement programs to nursing colleagues and
members of other health disciplines, what characteristic should the nurse cite? - correct answer
The nurse is admitting a client to the medical unit after the client has been transferred from the
emergency department. What is the nurse's priority action at this time? - correct answer
The nurse navigator is coordinating the transition from the hospital to a rehabilitation facility of
a client who had a total hip replacement. Which activity would be an example of the nurse
navigator role for this client? - correct answer
The community health nurse is preparing to conduct a home visit on a client without an active
infection. When performing the home visit, how should the nurse best implement the
principles of infection control?A nurse who has an advanced degree in primary care for a
pediatric population is employed in a health clinic. In what role is this nurse functioning? -
correct answer
A nurse is collaborating with a team of community nurses to identify the vision and mission for
community care. What is the central focus of nursing? - correct answer
A community-based case manager is sending a community nurse to perform an initial home
assessment of a newly referred client. To ensure safety, the case manager must make the nurse
aware of which of the following? - correct answer
The community-health nurse has received a referral for a new client who resides in a high-crime
area. What is the most important request that the nurse should make of the agency to ensure
safety? - correct answer
The nurse is performing initial visits to two new clients of the local home health care service.
These clients live within two blocks of each other and both homes are in a high-crime area.
What action best protects the nurse's personal safety? - correct answer
The nurse is planning discharge for a client receiving Medicare. The Medicare program
facilitates what aspect of home health care for the client - correct answer
, The home care nurse is assessing a client's use of crutches in the home. Which of the following
actions by the client indicates that the client is using the crutches effectively? - correct answer
A nurse has been working with a client whose poorly controlled type 1 diabetes has led to
numerous health problems. Over the past several years the client has had several admissions to
the hospital medical unit, and the nurse has often carried out health promotion interventions.
Who is ultimately responsible for maintaining and promoting this client's health? - correct
answer
A 20-year-old client newly diagnosed with type 1 diabetes needs to learn how to self-administer
insulin. When planning the appropriate educational interventions and considering variables
that will affect the client's learning, the nurse should prioritize what factor? - correct answer
The nurse is preparing discharge teaching for an adult client diagnosed with urinary retention
secondary to multiple sclerosis. The nurse will teach the client to self-catheterize at home upon
discharge. What teaching method is most likely to be effective for this client? - correct answer
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has just
received a new diagnosis of diabetes. Which client behavior demonstrates to the nurse the
client's emotional readiness to learn? - correct answer
A public health nurse is planning educational interventions that are based on Becker's Health
Belief Model. When identifying the variables that affect local residents' health promotion
behaviors, what question should the nurse seek to answer? - correct answer
How should the nurse best define health? - correct answer
A nurse has planned a teaching-learning interaction that is aimed at middle-school-aged
students. To foster successful health education, the nurse's planning should prioritize what
component? - correct answer
Middle-aged adults are part of an age group that is known to be interested in health and health
promotion, and the nurse is planning health promotion activities accordingly. To what
suggestions do members of this age group usually respond with enthusiasm? Select all that
apply. - correct answer
A nurse who provides care at the campus medical clinic of a large university puts much effort
into health promotion. What purpose of health promotion should guide the nurse's efforts? -
correct answer
A client will be receiving outpatient intravenous antibiotic therapy for the treatment of
endocarditis. The nurse is preparing health education to promote the client's adherence to the
course of treatment. What cultural consideration should the nurse use when developing a
teaching plan for the client? - correct answer
Answers and Rationales | 2026 Exam Preparation
A gerontologic nurse is teaching students about the high incidence and prevalence of
dehydration in older adults. Which factors contribute to this phenomenon? Select all that
apply. - correct answer Decreased kidney mass, Decreased renal blood flow, Decreased
excretion of potassium
A client has questioned the nurse's administration of intravenous (IV) normal saline, asking,
"Wouldn't sterile water be a more appropriate choice than saltwater?" Under what
circumstances would the nurse administer electrolyte-free water intravenously? - correct
answer Never, because it rapidly enters red blood cells, causing them to rupture
The nurse in the medical intensive care unit is caring for a client who is in respiratory acidosis
due to inadequate ventilation. Which diagnosis could the client have that could cause
inadequate ventilation? - correct answer Guillain- Barre syndrome
The nurse is caring for a client who is to receive IV daunorubicin, a chemotherapeutic agent.
The nurse starts the infusion and checks the insertion site as per protocol. During the most
recent check, the nurse observes that the IV has infiltrated so the nurse stops the infusion.
What is the nurse's priority concern with this infiltration? - correct answer Extravasation of the
medication
A client with hypertension has been prescribed hydrochlorothiazide. What nursing action will
best reduce the client's risk for electrolyte disturbances? - correct answer Ensure the client has
sufficient potassium intake
A client comes into the emergency department (ED) by ambulance with a hip fracture after
slipping and falling while at home. The client is alert and oriented but anxious and reports
thirst. The client's pupils are equal and reactive to light and accommodation, and the heart rate
is elevated. An indwelling urinary catheter is inserted, and 40 mL of urine is present. What is
the nurse's most likely explanation for the client's urinary output? - correct answer The client is
having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system,
which results in diminished urine output.
The nurse is performing an admission assessment on a 79-year-old client newly admitted for
end-stage liver disease. What principle should guide the nurse's assessment of the client's skin
turgor? - correct answer Inelastic skin turgor is a normal part of aging.
The nurse is assuming the care of an adult client who has been experiencing severe and
intractable pain. When reviewing the client's medication administration record, the nurse notes
the presence of gabapentin. The nurse is justified in suspecting which phenomenon in the
etiology of the client's pain? - correct answer Neuropathy
,A recent nursing graduate is aware of the differences between nursing actions that are
independent and nursing actions that are interdependent. A nurse performs an interdependent
nursing intervention when performing which of the following actions? - correct answer
Administering an IV bolus of normal saline to a patient with hypotension
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health? - correct answer
The nurse is preparing a wellness program for seniors at a community center. Which concept of
wellness should the nurse utilize when planning the program? - correct answer
A nurse on a medical-surgical unit has asked to represent the unit on the hospital's quality
committee. When describing quality improvement programs to nursing colleagues and
members of other health disciplines, what characteristic should the nurse cite? - correct answer
The nurse is admitting a client to the medical unit after the client has been transferred from the
emergency department. What is the nurse's priority action at this time? - correct answer
The nurse navigator is coordinating the transition from the hospital to a rehabilitation facility of
a client who had a total hip replacement. Which activity would be an example of the nurse
navigator role for this client? - correct answer
The community health nurse is preparing to conduct a home visit on a client without an active
infection. When performing the home visit, how should the nurse best implement the
principles of infection control?A nurse who has an advanced degree in primary care for a
pediatric population is employed in a health clinic. In what role is this nurse functioning? -
correct answer
A nurse is collaborating with a team of community nurses to identify the vision and mission for
community care. What is the central focus of nursing? - correct answer
A community-based case manager is sending a community nurse to perform an initial home
assessment of a newly referred client. To ensure safety, the case manager must make the nurse
aware of which of the following? - correct answer
The community-health nurse has received a referral for a new client who resides in a high-crime
area. What is the most important request that the nurse should make of the agency to ensure
safety? - correct answer
The nurse is performing initial visits to two new clients of the local home health care service.
These clients live within two blocks of each other and both homes are in a high-crime area.
What action best protects the nurse's personal safety? - correct answer
The nurse is planning discharge for a client receiving Medicare. The Medicare program
facilitates what aspect of home health care for the client - correct answer
, The home care nurse is assessing a client's use of crutches in the home. Which of the following
actions by the client indicates that the client is using the crutches effectively? - correct answer
A nurse has been working with a client whose poorly controlled type 1 diabetes has led to
numerous health problems. Over the past several years the client has had several admissions to
the hospital medical unit, and the nurse has often carried out health promotion interventions.
Who is ultimately responsible for maintaining and promoting this client's health? - correct
answer
A 20-year-old client newly diagnosed with type 1 diabetes needs to learn how to self-administer
insulin. When planning the appropriate educational interventions and considering variables
that will affect the client's learning, the nurse should prioritize what factor? - correct answer
The nurse is preparing discharge teaching for an adult client diagnosed with urinary retention
secondary to multiple sclerosis. The nurse will teach the client to self-catheterize at home upon
discharge. What teaching method is most likely to be effective for this client? - correct answer
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has just
received a new diagnosis of diabetes. Which client behavior demonstrates to the nurse the
client's emotional readiness to learn? - correct answer
A public health nurse is planning educational interventions that are based on Becker's Health
Belief Model. When identifying the variables that affect local residents' health promotion
behaviors, what question should the nurse seek to answer? - correct answer
How should the nurse best define health? - correct answer
A nurse has planned a teaching-learning interaction that is aimed at middle-school-aged
students. To foster successful health education, the nurse's planning should prioritize what
component? - correct answer
Middle-aged adults are part of an age group that is known to be interested in health and health
promotion, and the nurse is planning health promotion activities accordingly. To what
suggestions do members of this age group usually respond with enthusiasm? Select all that
apply. - correct answer
A nurse who provides care at the campus medical clinic of a large university puts much effort
into health promotion. What purpose of health promotion should guide the nurse's efforts? -
correct answer
A client will be receiving outpatient intravenous antibiotic therapy for the treatment of
endocarditis. The nurse is preparing health education to promote the client's adherence to the
course of treatment. What cultural consideration should the nurse use when developing a
teaching plan for the client? - correct answer
