RN ADULT MEDICAL SURGICAL ONLINE
PRACTICE 2026 WITH UPDATED QUESTIONS
AND ANSWERS
1. NGN
*0900:Client presents with abdominal pain in the upper left quadrant for the
past 2 days. States pain became worse this morning and is radiating to the
back. Rates pain as 8 on a scale of 0 to 10.Hypoactive bowel sounds; reports
nausea, no vomiting; client is passing flatus.Febrile, oriented to person, place,
and time.Tachypnea with diminished breath sounds.Sinus tachycardia.Client
voids 300 mL of clear, amber urine.
*0930:Client vomited 100 mL brown liquid.: The client is experiencing manifestations of pancre-
atitis as evidenced by the amylase and lipase.
Rational:
Drop Down 1:
Pancreatitis is correct. The client's laboratory results and physical assessment indicate the client is experiencing
manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase,
and lipase.
Paralytic ileus, adult respiratory distress syndrome (ARDS), cardiogenic shock, and a cerebral vascular accident (CVA)
are incorrect. The client is not experiencing manifestations of paralytic ileus because they have bowel sounds and are
passing flatus. The client is not experiencing manifestations of ARDS because there is no indication the client is in
respiratory distress. The client is not experiencing manifestations of cardiogenic shock because there is no indication
from the client's medical record that there is a risk for cardiogenic shock. The client is not experiencing manifestations
of a CVA because there is no indication from the client's medical record that there is a risk for a CVA.
Drop Down 2:
Amylase and lipase is correct. The client's laboratory results and physical assessment indicate the client is experiencing
manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase,
and lipase.
Oxygen saturation, urine output, platelet levels, and blood pressure are incorrect. These findings do not indicate
,pancreatitis.
2. A nurse is caring for a client who is postoperative.
Client admitted to medical-surgical unit from PACU. Client reports incisional
,pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for
water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40
mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical
incision dressing.: Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the
nurse should monitor to assess the client's progress.
Answer:
*Insert a large-gauge
*IV.Initiate a fluid challenge.
*Hypovolemia
*Urine output
*Blood pressure
Rational:
The nurse should insert a large-gauge IV and initiate a fluid challenge because the client is most likely experiencing
hypovolemia as evidenced by the client's restlessness, tachycardia, hypotension, decreased pulses, cool extremities,
and decreased urine output. The nurse should monitor the client's urine output and blood pressure to evaluate the
ettectiveness of treatment.
3. A nurse on a medical-surgical unit is reviewing the medical record of an older
adult client who is receiving IV fluid therapy. Which of the following client
information should indicate to the nurse that the client requires re-evaluation
of the IV therapy prescription? (Click on the "Exhibit" button for additional infor-
mation about the client. There are three tabs that contain separate categories
of data.): Answer:
BUN
Rational:
The client's Hct and BUN levels indicate dehydration and require an increase in the IV fluid infusion rate.
, 4. A nurse is assessing a client while suctioning the client's tracheostomy tube.
Which of the following findings should indicate to the nurse the client is expe-
riencing hypoxia?: The client's heart rate increases.
Rational:
Hypoxia related to suctioning can cause the client's heart rate to increase. If this occurs, the nurse should discontinue
the suctioning and manually oxygenate the client with 100% oxygen. The nurse should instruct the client to take three
or four deep breaths prior to suctioning to reduce the risk for hypoxia.
5. A nurse is providing teaching to a client who takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?: "Ginkgo
biloba can cause an increased risk for bleeding."
Rational:
Ginkgo biloba increases blood flow and is ettective in decreasing the pain associated with peripheral artery disease.
The supplement also decreases platelet aggregation, which in turn increases the risk for bleeding. Clients who have
been prescribed antiplatelet medications, such as aspirin, should avoid taking ginkgo biloba without first speaking with
their provider.
6. A nurse is teaching a class about client rights. Which of the following instruc-
tions should the nurse include?: A client should sign an informed consent before receiving a placebo
during a research trial.
Rational:
A nurse should ensure a client has provided informed consent before administering a placebo. Placebos should not
be used outside of approved clinical research in which the client has consented to participate.
7. A nurse is caring for a client who is 12 hr postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?: Place a pillow
between the client's legs.
Rational:
PRACTICE 2026 WITH UPDATED QUESTIONS
AND ANSWERS
1. NGN
*0900:Client presents with abdominal pain in the upper left quadrant for the
past 2 days. States pain became worse this morning and is radiating to the
back. Rates pain as 8 on a scale of 0 to 10.Hypoactive bowel sounds; reports
nausea, no vomiting; client is passing flatus.Febrile, oriented to person, place,
and time.Tachypnea with diminished breath sounds.Sinus tachycardia.Client
voids 300 mL of clear, amber urine.
*0930:Client vomited 100 mL brown liquid.: The client is experiencing manifestations of pancre-
atitis as evidenced by the amylase and lipase.
Rational:
Drop Down 1:
Pancreatitis is correct. The client's laboratory results and physical assessment indicate the client is experiencing
manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase,
and lipase.
Paralytic ileus, adult respiratory distress syndrome (ARDS), cardiogenic shock, and a cerebral vascular accident (CVA)
are incorrect. The client is not experiencing manifestations of paralytic ileus because they have bowel sounds and are
passing flatus. The client is not experiencing manifestations of ARDS because there is no indication the client is in
respiratory distress. The client is not experiencing manifestations of cardiogenic shock because there is no indication
from the client's medical record that there is a risk for cardiogenic shock. The client is not experiencing manifestations
of a CVA because there is no indication from the client's medical record that there is a risk for a CVA.
Drop Down 2:
Amylase and lipase is correct. The client's laboratory results and physical assessment indicate the client is experiencing
manifestations of pancreatitis. Clients who have pancreatitis experience an increase in pancreatic enzymes, amylase,
and lipase.
Oxygen saturation, urine output, platelet levels, and blood pressure are incorrect. These findings do not indicate
,pancreatitis.
2. A nurse is caring for a client who is postoperative.
Client admitted to medical-surgical unit from PACU. Client reports incisional
,pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for
water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40
mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical
incision dressing.: Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the
nurse should monitor to assess the client's progress.
Answer:
*Insert a large-gauge
*IV.Initiate a fluid challenge.
*Hypovolemia
*Urine output
*Blood pressure
Rational:
The nurse should insert a large-gauge IV and initiate a fluid challenge because the client is most likely experiencing
hypovolemia as evidenced by the client's restlessness, tachycardia, hypotension, decreased pulses, cool extremities,
and decreased urine output. The nurse should monitor the client's urine output and blood pressure to evaluate the
ettectiveness of treatment.
3. A nurse on a medical-surgical unit is reviewing the medical record of an older
adult client who is receiving IV fluid therapy. Which of the following client
information should indicate to the nurse that the client requires re-evaluation
of the IV therapy prescription? (Click on the "Exhibit" button for additional infor-
mation about the client. There are three tabs that contain separate categories
of data.): Answer:
BUN
Rational:
The client's Hct and BUN levels indicate dehydration and require an increase in the IV fluid infusion rate.
, 4. A nurse is assessing a client while suctioning the client's tracheostomy tube.
Which of the following findings should indicate to the nurse the client is expe-
riencing hypoxia?: The client's heart rate increases.
Rational:
Hypoxia related to suctioning can cause the client's heart rate to increase. If this occurs, the nurse should discontinue
the suctioning and manually oxygenate the client with 100% oxygen. The nurse should instruct the client to take three
or four deep breaths prior to suctioning to reduce the risk for hypoxia.
5. A nurse is providing teaching to a client who takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?: "Ginkgo
biloba can cause an increased risk for bleeding."
Rational:
Ginkgo biloba increases blood flow and is ettective in decreasing the pain associated with peripheral artery disease.
The supplement also decreases platelet aggregation, which in turn increases the risk for bleeding. Clients who have
been prescribed antiplatelet medications, such as aspirin, should avoid taking ginkgo biloba without first speaking with
their provider.
6. A nurse is teaching a class about client rights. Which of the following instruc-
tions should the nurse include?: A client should sign an informed consent before receiving a placebo
during a research trial.
Rational:
A nurse should ensure a client has provided informed consent before administering a placebo. Placebos should not
be used outside of approved clinical research in which the client has consented to participate.
7. A nurse is caring for a client who is 12 hr postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?: Place a pillow
between the client's legs.
Rational:
