Medical-Surgical Exam 2025 Latest Actual
Exam Questions and Correct Detailed Answers with
Rationales Already Graded A
1. A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the
priority for this client?
a. Fluid and electrolyte balance.
b. Prevention of water toxicity.
c. Reduced glucose in the urine.
d. Adequate cellular nourishment. - CORRECT ANSWER >>> D
Rationale
Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and
polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
Polyphagia is a consequence of cellular malnourishment when insulin deficiency prevents
utilization of glucose into the cell for energy, so the outcome statement should include
stabilization of adequate cellular nutrition which is done by providing the insulin supplement
the client needs.
2. A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this
client? Assess the client's
a. pulse rate, both apically and radially.
b. blood pressure, both standing and sitting.
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,c. temperature.
d. skin color and turgor. - CORRECT ANSWER >>> C
Rationale
It is very important to check the client's temperature. Long term use of steroids use COPD
clients is effective in suppressing inflammation in their airways making it easier for them to
breath, but at the same time suppresses the immune system, placing the client at risk for
infection.
3. Which intervention should the nurse plan to implement when caring for a client who has just
undergone a right above-the-knee amputation?
a. Maintain the residual limb on three pillows at all times.
b. Place a large tourniquet at the client's bedside.
c. Apply constant, direct pressure to the residual limb.
d. Do not allow the client to lie in the prone position. - CORRECT ANSWER >>> B
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe
bleeding occurs. The purpose is to have the tourniquet available to applied to the residual limb
to control bleeding if hemorrhaging was to occur. The residual limb should not be placed on a
pillow because a flexion contracture of the hip may result and the client should be encouraged
to lie in the prone position to prevent flexion contracture of the hip.
4. The nurse knows that lab values sometimes vary for the older client. Which data would the
nurse expect to find when reviewing laboratory values of an 80-year-old male?
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,a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity. - CORRECT ANSWER >>>
C
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and
the serum glucose increases slightly, also due to changes in the kidney. The specific gravity
declines by age 80 from 1.032 to 1.024.
5. In preparing to administer intravenous albumin to a client following surgery, what is the
priority nursing intervention? (Select all that apply.)
a. Set the infusion pump to infuse the albumin within four hours.
b. Compare the client's blood type with the label on the albumin.
c. Assign a UAP to monitor blood pressure q15 minutes.
d. Administer through a large gauge catheter.
e. Monitor hemoglobin and hematocrit levels.
f. Assess for increased bleeding after administration. - CORRECT ANSWER >>> A, C, D, E,
F
Rationale
Albumin should be infused within four hours because it does not contain any preservatives. Any
fluid remaining after four hours should be discarded. Albumin administration does not require
blood typing. Vital signs should be monitored periodically to assess for fluid volume overload. A
large gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution may
3|Page
, decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT levels should be
monitored. While monitoring for bleeding because of the increased blood volume and blood
pressure.
6. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet
PO PRN, for a client with chronic kidney disease (CKD) who is complaining of indigestion. What
intervention should the nurse implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription. - CORRECT ANSWER >>> D
Rationale
Magnesium agents are not usually used for clients with CKD due to the risk of
hypermagnesemia, so this prescription should be questioned by the nurse.
7. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping. - CORRECT ANSWER >>> A
Rationale
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Exam Questions and Correct Detailed Answers with
Rationales Already Graded A
1. A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the
priority for this client?
a. Fluid and electrolyte balance.
b. Prevention of water toxicity.
c. Reduced glucose in the urine.
d. Adequate cellular nourishment. - CORRECT ANSWER >>> D
Rationale
Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and
polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
Polyphagia is a consequence of cellular malnourishment when insulin deficiency prevents
utilization of glucose into the cell for energy, so the outcome statement should include
stabilization of adequate cellular nutrition which is done by providing the insulin supplement
the client needs.
2. A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this
client? Assess the client's
a. pulse rate, both apically and radially.
b. blood pressure, both standing and sitting.
1|Page
,c. temperature.
d. skin color and turgor. - CORRECT ANSWER >>> C
Rationale
It is very important to check the client's temperature. Long term use of steroids use COPD
clients is effective in suppressing inflammation in their airways making it easier for them to
breath, but at the same time suppresses the immune system, placing the client at risk for
infection.
3. Which intervention should the nurse plan to implement when caring for a client who has just
undergone a right above-the-knee amputation?
a. Maintain the residual limb on three pillows at all times.
b. Place a large tourniquet at the client's bedside.
c. Apply constant, direct pressure to the residual limb.
d. Do not allow the client to lie in the prone position. - CORRECT ANSWER >>> B
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe
bleeding occurs. The purpose is to have the tourniquet available to applied to the residual limb
to control bleeding if hemorrhaging was to occur. The residual limb should not be placed on a
pillow because a flexion contracture of the hip may result and the client should be encouraged
to lie in the prone position to prevent flexion contracture of the hip.
4. The nurse knows that lab values sometimes vary for the older client. Which data would the
nurse expect to find when reviewing laboratory values of an 80-year-old male?
2|Page
,a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity. - CORRECT ANSWER >>>
C
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and
the serum glucose increases slightly, also due to changes in the kidney. The specific gravity
declines by age 80 from 1.032 to 1.024.
5. In preparing to administer intravenous albumin to a client following surgery, what is the
priority nursing intervention? (Select all that apply.)
a. Set the infusion pump to infuse the albumin within four hours.
b. Compare the client's blood type with the label on the albumin.
c. Assign a UAP to monitor blood pressure q15 minutes.
d. Administer through a large gauge catheter.
e. Monitor hemoglobin and hematocrit levels.
f. Assess for increased bleeding after administration. - CORRECT ANSWER >>> A, C, D, E,
F
Rationale
Albumin should be infused within four hours because it does not contain any preservatives. Any
fluid remaining after four hours should be discarded. Albumin administration does not require
blood typing. Vital signs should be monitored periodically to assess for fluid volume overload. A
large gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution may
3|Page
, decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT levels should be
monitored. While monitoring for bleeding because of the increased blood volume and blood
pressure.
6. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet
PO PRN, for a client with chronic kidney disease (CKD) who is complaining of indigestion. What
intervention should the nurse implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription. - CORRECT ANSWER >>> D
Rationale
Magnesium agents are not usually used for clients with CKD due to the risk of
hypermagnesemia, so this prescription should be questioned by the nurse.
7. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping. - CORRECT ANSWER >>> A
Rationale
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