MEDICAL SURGICAL NURSING 2 FINAL SCRIPT
2026 SOLVED QUESTIONS WITH FULL
SOLUTIONS
◉ A client who has just tested positive for HIV does not appear to
hear what the nurse is saying during post-test counseling. Which
information should the nurse offer to facilitate the client's
adjustment to HIV infection?
A. teach the client about the medications that are available for
treatment
B. discuss retesting to verify the results, which will ensure
continuing contact
C. identify the need to test others who have had risky contact with
the client
D. inform the client how to protect sexual and needle-sharing
partners. Answer: B. discuss retesting to verify results, which will
ensure continuing contact
encouraging retesting supports hope and gives the client time to
cope with the diagnosis. Although post-test counseling should
include education about A, B, and C, retesting encourages the client
to maintain medical follow-up and management.
,◉ The nurse is caring for a client with HIV infection who develops
Mycobacterium avium complex (MAC). what is the most significant
desired outcome for this client?
A. free from injury of drug side effects
B. maintenance of intact perineal skin
c. adequate oxygenation
D. return to pre-illness weight. Answer: D. return to pre-illness
weight
MAC is an opportunistic infection that presents as a TB like
pulmonary process. MAC is a major contributing factor to the
development of wasting syndrome, so the most significant desired
outcome is the client's return to a pre-illness weight. drug schedules
and side effects remain a life-long management problem. Client
outcomes for adequate oxygenation are often dependent on
management of anemia, maintenance of activities without fatigue,
and supplemental oxygen to prevent hypoxia. Skin integrity is
dependent upon resolution of diarrhea, which is not as significant as
optimal nutrition.
◉ A client who had abdominal surgery two days ago has
prescriptions for intravenous morphine sulfate 4 mg every 2 hours
and a clear liquid diet. the client complains of feeling distended and
has sharp, cramping gas pains. What nursing intervention should be
implemented?
A. assist the client to ambulate in the hall
,B. obtain a prescription for a laxative
C. administer the prescribed morphine sulfate
D. withhold all oral fluid and food. Answer: a. assist the client to
ambulate in the hall
Post-operative abdominal distention is caused by decreased
peristalsis as a result of handling the intestine during surgery,
limited dietary intake before and after surgery, and anesthetic and
analgesic agents. Peristalsis is stimulated and distention minimized
by implementing early and frequent ambulation. Based on the
client's status, laxatives or withholding dietary progression are not
indicated at this time. although pain management should be
implemented, another analgesic prescription may be needed
because morphine reduces intestinal motility and contributes to the
client's gas pains.
◉ A client with Meniere's disease is incapacitated by vertigo and is
lying in bed grasping the side rails and staring at the television.
Which nursing intervention should the nurse implement?
A. keep the head of the bed elevated 30 degrees
B. turn off the television and darken the room
c. encourage fluids to 3000 mL per day
D. change the client's position every two hours. Answer: B. turn off
the television and darken the room
, to decrease the client's vertigo during an acute attack of Meniere's
disease, any visual stimuli or rotational movement, such as sudden
head movements or position changes, should be minimized. Turning
off the television and darkening the room minimize fluorescent
lights, flickering television lights, and distracting sound. The other
are ineffective in managing the client's symptoms.
◉ a client who has a chronic cough with blood-tinged sputum
returns to the unit after a bronchoscopy. What nursing interventions
should be implemented in the immediate post-procedural period?
A. check vital signs every 15 minutes for 2 hours
B. allow the client nothing by mouth until the gag reflex returns
C. encourage fluid intake to promote elimination of the contrast
media
D. keep the client on bed rest for 8 hours. Answer: B. allow the client
nothing by mouth until the gag reflex returns
the nasal pharynx and oral pharynx are anesthetized with local
anesthetic spray prior to bronchoscopy, and the bronchoscope is
coated with lidocaine gel to inhibit the gag reflex and prevent
laryngeal spasm during insertion. The client should be NPO until the
client's gag reflex returns to prevent aspiration from any oral intake
or secretions. The others are not indicated after bronchoscopy
◉ The nurse is assessing a client with a cuffed tracheostomy tube in
place who is breathing spontaneously. to evaluate if the client can
2026 SOLVED QUESTIONS WITH FULL
SOLUTIONS
◉ A client who has just tested positive for HIV does not appear to
hear what the nurse is saying during post-test counseling. Which
information should the nurse offer to facilitate the client's
adjustment to HIV infection?
A. teach the client about the medications that are available for
treatment
B. discuss retesting to verify the results, which will ensure
continuing contact
C. identify the need to test others who have had risky contact with
the client
D. inform the client how to protect sexual and needle-sharing
partners. Answer: B. discuss retesting to verify results, which will
ensure continuing contact
encouraging retesting supports hope and gives the client time to
cope with the diagnosis. Although post-test counseling should
include education about A, B, and C, retesting encourages the client
to maintain medical follow-up and management.
,◉ The nurse is caring for a client with HIV infection who develops
Mycobacterium avium complex (MAC). what is the most significant
desired outcome for this client?
A. free from injury of drug side effects
B. maintenance of intact perineal skin
c. adequate oxygenation
D. return to pre-illness weight. Answer: D. return to pre-illness
weight
MAC is an opportunistic infection that presents as a TB like
pulmonary process. MAC is a major contributing factor to the
development of wasting syndrome, so the most significant desired
outcome is the client's return to a pre-illness weight. drug schedules
and side effects remain a life-long management problem. Client
outcomes for adequate oxygenation are often dependent on
management of anemia, maintenance of activities without fatigue,
and supplemental oxygen to prevent hypoxia. Skin integrity is
dependent upon resolution of diarrhea, which is not as significant as
optimal nutrition.
◉ A client who had abdominal surgery two days ago has
prescriptions for intravenous morphine sulfate 4 mg every 2 hours
and a clear liquid diet. the client complains of feeling distended and
has sharp, cramping gas pains. What nursing intervention should be
implemented?
A. assist the client to ambulate in the hall
,B. obtain a prescription for a laxative
C. administer the prescribed morphine sulfate
D. withhold all oral fluid and food. Answer: a. assist the client to
ambulate in the hall
Post-operative abdominal distention is caused by decreased
peristalsis as a result of handling the intestine during surgery,
limited dietary intake before and after surgery, and anesthetic and
analgesic agents. Peristalsis is stimulated and distention minimized
by implementing early and frequent ambulation. Based on the
client's status, laxatives or withholding dietary progression are not
indicated at this time. although pain management should be
implemented, another analgesic prescription may be needed
because morphine reduces intestinal motility and contributes to the
client's gas pains.
◉ A client with Meniere's disease is incapacitated by vertigo and is
lying in bed grasping the side rails and staring at the television.
Which nursing intervention should the nurse implement?
A. keep the head of the bed elevated 30 degrees
B. turn off the television and darken the room
c. encourage fluids to 3000 mL per day
D. change the client's position every two hours. Answer: B. turn off
the television and darken the room
, to decrease the client's vertigo during an acute attack of Meniere's
disease, any visual stimuli or rotational movement, such as sudden
head movements or position changes, should be minimized. Turning
off the television and darkening the room minimize fluorescent
lights, flickering television lights, and distracting sound. The other
are ineffective in managing the client's symptoms.
◉ a client who has a chronic cough with blood-tinged sputum
returns to the unit after a bronchoscopy. What nursing interventions
should be implemented in the immediate post-procedural period?
A. check vital signs every 15 minutes for 2 hours
B. allow the client nothing by mouth until the gag reflex returns
C. encourage fluid intake to promote elimination of the contrast
media
D. keep the client on bed rest for 8 hours. Answer: B. allow the client
nothing by mouth until the gag reflex returns
the nasal pharynx and oral pharynx are anesthetized with local
anesthetic spray prior to bronchoscopy, and the bronchoscope is
coated with lidocaine gel to inhibit the gag reflex and prevent
laryngeal spasm during insertion. The client should be NPO until the
client's gag reflex returns to prevent aspiration from any oral intake
or secretions. The others are not indicated after bronchoscopy
◉ The nurse is assessing a client with a cuffed tracheostomy tube in
place who is breathing spontaneously. to evaluate if the client can
