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BRUNNER & SUDDARTH'S MEDICAL-SURGICAL NURSING, 15TH
EDITION (HINKLE, CHEEVER, OVERBAUGH) EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND ANSWERS
Brunner & Suddarth's Medical-Surgical Nursing, 15th Edition (Hinkle, Cheever,
Overbaugh): 250 Practice Questions with Rationales
DOMAIN 1: PROFESSIONAL NURSING PRACTICE AND OLDER ADULT CARE
(25 Questions)
1. Which assessment finding is most indicative of a urinary tract infection (UTI) in an
older adult client?
A) Dysuria and frequency
B) Fever and chills
C) Acute onset of confusion and incontinence
D) Flank pain and hematuria
Answer: C) Acute onset of confusion and incontinence
Rationale: Classic UTI symptoms (dysuria, frequency, fever) are often absent in older adults.
Instead, the first sign of an infection may be a change in mental status (acute confusion,
lethargy) or new-onset incontinence. This is a key geriatric principle from Brunner &
Suddarth. Delirium is characterized by an acute onset and fluctuating course of confusion
and altered mental status, often caused by an underlying medical condition such as infection .
2. The Beers Criteria is a screening tool used to:
A) Assess an older adult's risk for falls
B) Evaluate an older adult's cognitive function
C) Identify potentially inappropriate medications for older adults
D) Determine an older adult's need for long-term care placement
Answer: C) Identify potentially inappropriate medications for older adults
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Rationale: The Beers Criteria, published by the American Geriatrics Society, is a list of
medications that are potentially inappropriate for older adults due to risks outweighing
benefits or the availability of safer alternatives. It is a crucial tool for promoting medication
safety in geriatric care .
3. A client in a long-term care facility has become incontinent of urine. Which
intervention should the nurse implement first?
A) Insert an indwelling urinary catheter
B) Apply absorbent incontinence briefs
C) Restrict oral fluids to reduce urine output
D) Implement a scheduled toileting program
Answer: D) Implement a scheduled toileting program
Rationale: Incontinence in older adults should not be accepted as inevitable. A scheduled
toileting program (e.g., prompted voiding, habit training) is a non-invasive, first-line
intervention. Catheters and absorbent products are used only after other measures fail and
increase the risk of complications .
4. A client with a living will is admitted to the hospital. The client's family requests that
the nurse withhold a treatment that the client's living will permits but the family
believes is inappropriate. What is the nurse's best response?
A) "I will honor your request and withhold the treatment."
B) "The living will is a legal document that I must follow."
C) "I will contact the healthcare provider to discuss this situation."
D) "I cannot discuss this with you; it is between the client and the provider."
Answer: C) "I will contact the healthcare provider to discuss this situation."
Rationale: Advance directives, such as living wills, are legal documents that specify a client's
wishes in terminal cases. When family members disagree, the nurse should facilitate
communication between the family and the healthcare provider to ensure the client's wishes
are respected while addressing family concerns .
5. A nurse is caring for a client whose provider has prescribed a treatment the nurse
believes to be ethically questionable. Which principle should guide the nurse's actions?
A) The nurse must always follow the provider's orders
B) The nurse should refuse the assignment and leave the unit
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C) The nurse should uphold nonmaleficence by not refusing prescribed pain medications
D) The nurse should document the disagreement and implement the treatment
Answer: C) The nurse should uphold nonmaleficence by not refusing prescribed pain
medications
Rationale: Professional nursing practice involves upholding ethical obligations. The
principle of nonmaleficence (do no harm) guides nurses to prioritize patient well-being. In
conflicting procedures, nurses may have ethical reservations, but they must not withhold
beneficial treatments such as pain medications .
6. A client asks the nurse, "What is the difference between a living will and a durable
power of attorney for healthcare?" Which response is most accurate?
A) "A living will makes decisions for you, while a durable power of attorney lets you choose
who decides."
B) "A living will specifies your wishes for treatment, while a durable power of attorney
appoints someone to make decisions if you cannot."
C) "Both documents are the same and serve the same purpose."
D) "A living will is only for older adults, while a durable power of attorney is for everyone."
Answer: B) "A living will specifies your wishes for treatment, while a durable power of
attorney appoints someone to make decisions if you cannot."
Rationale: Advance directives include living wills (which specify treatment wishes in terminal
cases) and durable powers of attorney for healthcare (which appoint a surrogate decision-
maker). Both are legal documents that help ensure a client's wishes are respected .
7. A nurse is teaching a client about health promotion. Which statement by the client
indicates understanding?
A) "Health promotion is only important after I get sick."
B) "I can reduce my risk of illness by making healthy lifestyle choices."
C) "My genetics determine my health outcomes, so I cannot change anything."
D) "Health promotion is only for people with chronic illnesses."
Answer: B) "I can reduce my risk of illness by making healthy lifestyle choices."
Rationale: Health promotion focuses on prevention and wellness. Lifestyle choices such as
diet, exercise, and avoiding harmful behaviors can significantly reduce the risk of illness and
improve health outcomes .
, Page 4 of 76
8. A nurse is reviewing evidence-based practice (EBP) with a student. Which statement
best describes the purpose of EBP?
A) EBP replaces the need for clinical judgment
B) EBP integrates the best available evidence with clinical expertise and patient values
C) EBP is only used for research purposes
D) EBP is optional in nursing practice
Answer: B) EBP integrates the best available evidence with clinical expertise and
patient values
Rationale: Evidence-based practice involves integrating the best available research evidence
with clinical expertise and patient preferences to guide clinical decision-making. It does not
replace clinical judgment but enhances it .
9. A nurse is assessing an older adult client with delirium. Which intervention is a
priority?
A) Administer a sedative to calm the client
B) Identify and treat the underlying cause of the delirium
C) Restrain the client to prevent injury
D) Place the client in a dark, quiet room
Answer: B) Identify and treat the underlying cause of the delirium
Rationale: Delirium is characterized by an acute onset and fluctuating course of confusion
and altered mental status. It is often caused by an underlying medical condition (e.g.,
infection, medication side effect) and is potentially reversible, making it a priority to identify
and treat. Delirium may be the first sign of a UTI in older adults .
10. The nurse is providing care to an older adult client with chronic illness. Which
principle guides the nurse's care?
A) Chronic illness is a normal part of aging and requires no intervention
B) Chronic illness management focuses on maximizing function and quality of life
C) Older adults with chronic illness should be in long-term care facilities
D) Chronic illness is always progressive and irreversible
Answer: B) Chronic illness management focuses on maximizing function and quality of
life
BRUNNER & SUDDARTH'S MEDICAL-SURGICAL NURSING, 15TH
EDITION (HINKLE, CHEEVER, OVERBAUGH) EXAM 2026
QUESTIONS LATEST VERSION QUESTIONS AND ANSWERS
Brunner & Suddarth's Medical-Surgical Nursing, 15th Edition (Hinkle, Cheever,
Overbaugh): 250 Practice Questions with Rationales
DOMAIN 1: PROFESSIONAL NURSING PRACTICE AND OLDER ADULT CARE
(25 Questions)
1. Which assessment finding is most indicative of a urinary tract infection (UTI) in an
older adult client?
A) Dysuria and frequency
B) Fever and chills
C) Acute onset of confusion and incontinence
D) Flank pain and hematuria
Answer: C) Acute onset of confusion and incontinence
Rationale: Classic UTI symptoms (dysuria, frequency, fever) are often absent in older adults.
Instead, the first sign of an infection may be a change in mental status (acute confusion,
lethargy) or new-onset incontinence. This is a key geriatric principle from Brunner &
Suddarth. Delirium is characterized by an acute onset and fluctuating course of confusion
and altered mental status, often caused by an underlying medical condition such as infection .
2. The Beers Criteria is a screening tool used to:
A) Assess an older adult's risk for falls
B) Evaluate an older adult's cognitive function
C) Identify potentially inappropriate medications for older adults
D) Determine an older adult's need for long-term care placement
Answer: C) Identify potentially inappropriate medications for older adults
, Page 2 of 76
Rationale: The Beers Criteria, published by the American Geriatrics Society, is a list of
medications that are potentially inappropriate for older adults due to risks outweighing
benefits or the availability of safer alternatives. It is a crucial tool for promoting medication
safety in geriatric care .
3. A client in a long-term care facility has become incontinent of urine. Which
intervention should the nurse implement first?
A) Insert an indwelling urinary catheter
B) Apply absorbent incontinence briefs
C) Restrict oral fluids to reduce urine output
D) Implement a scheduled toileting program
Answer: D) Implement a scheduled toileting program
Rationale: Incontinence in older adults should not be accepted as inevitable. A scheduled
toileting program (e.g., prompted voiding, habit training) is a non-invasive, first-line
intervention. Catheters and absorbent products are used only after other measures fail and
increase the risk of complications .
4. A client with a living will is admitted to the hospital. The client's family requests that
the nurse withhold a treatment that the client's living will permits but the family
believes is inappropriate. What is the nurse's best response?
A) "I will honor your request and withhold the treatment."
B) "The living will is a legal document that I must follow."
C) "I will contact the healthcare provider to discuss this situation."
D) "I cannot discuss this with you; it is between the client and the provider."
Answer: C) "I will contact the healthcare provider to discuss this situation."
Rationale: Advance directives, such as living wills, are legal documents that specify a client's
wishes in terminal cases. When family members disagree, the nurse should facilitate
communication between the family and the healthcare provider to ensure the client's wishes
are respected while addressing family concerns .
5. A nurse is caring for a client whose provider has prescribed a treatment the nurse
believes to be ethically questionable. Which principle should guide the nurse's actions?
A) The nurse must always follow the provider's orders
B) The nurse should refuse the assignment and leave the unit
, Page 3 of 76
C) The nurse should uphold nonmaleficence by not refusing prescribed pain medications
D) The nurse should document the disagreement and implement the treatment
Answer: C) The nurse should uphold nonmaleficence by not refusing prescribed pain
medications
Rationale: Professional nursing practice involves upholding ethical obligations. The
principle of nonmaleficence (do no harm) guides nurses to prioritize patient well-being. In
conflicting procedures, nurses may have ethical reservations, but they must not withhold
beneficial treatments such as pain medications .
6. A client asks the nurse, "What is the difference between a living will and a durable
power of attorney for healthcare?" Which response is most accurate?
A) "A living will makes decisions for you, while a durable power of attorney lets you choose
who decides."
B) "A living will specifies your wishes for treatment, while a durable power of attorney
appoints someone to make decisions if you cannot."
C) "Both documents are the same and serve the same purpose."
D) "A living will is only for older adults, while a durable power of attorney is for everyone."
Answer: B) "A living will specifies your wishes for treatment, while a durable power of
attorney appoints someone to make decisions if you cannot."
Rationale: Advance directives include living wills (which specify treatment wishes in terminal
cases) and durable powers of attorney for healthcare (which appoint a surrogate decision-
maker). Both are legal documents that help ensure a client's wishes are respected .
7. A nurse is teaching a client about health promotion. Which statement by the client
indicates understanding?
A) "Health promotion is only important after I get sick."
B) "I can reduce my risk of illness by making healthy lifestyle choices."
C) "My genetics determine my health outcomes, so I cannot change anything."
D) "Health promotion is only for people with chronic illnesses."
Answer: B) "I can reduce my risk of illness by making healthy lifestyle choices."
Rationale: Health promotion focuses on prevention and wellness. Lifestyle choices such as
diet, exercise, and avoiding harmful behaviors can significantly reduce the risk of illness and
improve health outcomes .
, Page 4 of 76
8. A nurse is reviewing evidence-based practice (EBP) with a student. Which statement
best describes the purpose of EBP?
A) EBP replaces the need for clinical judgment
B) EBP integrates the best available evidence with clinical expertise and patient values
C) EBP is only used for research purposes
D) EBP is optional in nursing practice
Answer: B) EBP integrates the best available evidence with clinical expertise and
patient values
Rationale: Evidence-based practice involves integrating the best available research evidence
with clinical expertise and patient preferences to guide clinical decision-making. It does not
replace clinical judgment but enhances it .
9. A nurse is assessing an older adult client with delirium. Which intervention is a
priority?
A) Administer a sedative to calm the client
B) Identify and treat the underlying cause of the delirium
C) Restrain the client to prevent injury
D) Place the client in a dark, quiet room
Answer: B) Identify and treat the underlying cause of the delirium
Rationale: Delirium is characterized by an acute onset and fluctuating course of confusion
and altered mental status. It is often caused by an underlying medical condition (e.g.,
infection, medication side effect) and is potentially reversible, making it a priority to identify
and treat. Delirium may be the first sign of a UTI in older adults .
10. The nurse is providing care to an older adult client with chronic illness. Which
principle guides the nurse's care?
A) Chronic illness is a normal part of aging and requires no intervention
B) Chronic illness management focuses on maximizing function and quality of life
C) Older adults with chronic illness should be in long-term care facilities
D) Chronic illness is always progressive and irreversible
Answer: B) Chronic illness management focuses on maximizing function and quality of
life
