PN ADULT MEDICAL SURGICAL ONLINE
PRACTICE B NEW SOLUTION UPDATED FOR
2023/2026 – QUESTIONS WITH ANSWERS &
RATIONALES | INSTANT DOWNLOAD PDF
Core Domains
1. Perioperative Nursing Care
2. Cardiovascular and Hematologic Disorders
3. Respiratory and Oxygenation Management
4. Neurological and Sensory Disorders
5. Endocrine and Metabolic Disorders
6. Gastrointestinal and Genitourinary Disorders
7. Musculoskeletal and Integumentary Care
8. Oncology, Immune, and Infectious Disease
9. Emergency, Critical Care, and Fluid/Electrolyte Balance
10. Pharmacological and Parenteral Therapies
Introduction
This comprehensive examination is designed to assess the clinical knowledge and decision-
making skills of practical nursing students preparing for the PN Adult Medical Surgical
Online Practice B assessment. The assessment evaluates proficiency in perioperative care,
cardiovascular and respiratory management, endocrine and neurological disorders,
musculoskeletal and integumentary care, and emergency interventions. Multiple-choice and
scenario-based questions emphasize real-world application, critical thinking, and safe
clinical judgment essential for professional practical nursing practice. Content aligns with
the NCLEX-PN test plan and ATI Medical-Surgical nursing blueprint, ensuring rigorous
preparation for contemporary clinical challenges.
SECTION ONE: QUESTIONS 1–100
,1. A nurse is assisting with the care of a client who has a new cast on their left
forearm and reports severe pain in the affected arm with numbness in the fingers.
The nurse finds the skin is pale and cold with sluggish capillary refill. Which of the
following fracture complications should the nurse suspect?
A. Fat embolism syndrome
B. Compartment syndrome
C. Osteomyelitis
D. Venous thromboembolism
B. Compartment syndrome
RATIONALE: Severe pain, pallor, cold skin, numbness, and sluggish capillary refill are
classic manifestations of compartment syndrome, a limb-threatening emergency requiring
immediate notification of the provider and possible fasciotomy.
2. A nurse is contributing to the plan of care for a client who has multiple sclerosis
and is taking dantrolene to manage muscle spasms. Which of the following
interventions should the nurse include?
A. Apply hot packs to the client's muscles
B. Schedule physical therapy in the afternoon
C. Encourage the client to complete ADLs
D. Administer valerian to promote sleep
C. Encourage the client to complete ADLs
RATIONALE: Dantrolene is a muscle relaxant used to manage spasticity in multiple
sclerosis. Encouraging independence with ADLs maintains muscle function and promotes
client autonomy.
3. A nurse is caring for a client who has an intestinal obstruction and reports a new
onset of nausea. The client has an NG tube set at low intermittent suction and is
receiving continuous IV infusion of 0.9% sodium chloride. Which of the following
actions should the nurse take first?
A. Increase the IV fluid rate
B. Provide ice chips
,C. Administer an antiemetic
D. Check for kinks in the NG tube
D. Check for kinks in the NG tube
RATIONALE: The first action is to assess the patency of the NG tube. Nausea in a client
with an intestinal obstruction may indicate that the NG tube is not effectively
decompressing the stomach.
4. A nurse is monitoring a client who has a history of an enlarged prostate and is
experiencing suprapubic discomfort. Which of the following actions should the
nurse take first?
A. Administer doxazosin
B. Palpate the bladder
C. Insert a urinary catheter
D. Encourage increased fluid intake
B. Palpate the bladder
RATIONALE: The nurse should first assess the bladder for distention by palpation.
Suprapubic discomfort in a client with an enlarged prostate may indicate urinary retention.
5. A nurse is caring for a client and administers penicillin IM. The client begins
exhibiting hives and has severe difficulty breathing. After establishing a patent
airway, which of the following actions should the nurse take next?
A. Monitor the client's vital signs
B. Administer epinephrine
C. Monitor oxygen saturation
D. Administer an antihistamine
B. Administer epinephrine
RATIONALE: The client is experiencing anaphylaxis. After ensuring airway patency,
epinephrine is the priority medication to reverse bronchoconstriction and hypotension.
6. A nurse is caring for a client who has acute pancreatitis. While providing care,
the nurse observes ecchymosis around the umbilicus. The nurse should identify
that this is a manifestation of which of the following?
, A. Cullen's sign
B. Turner's sign
C. Murphy's sign
D. Grey Turner's sign
A. Cullen's sign
RATIONALE: Cullen's sign is periumbilical ecchymosis associated with acute
pancreatitis and indicates retroperitoneal hemorrhage.
7. A nurse is assisting with the development of a plan of care to manage pain for a
client who has herpes zoster with lesions on the lower extremities. Which of the
following interventions should the nurse include in the plan of care?
A. Position a heat lamp over the lower extremities
B. Apply warm, moist compresses to the affected areas
C. Keep bed linens off the affected areas
D. Initiate droplet isolation precautions
C. Keep bed linens off the affected areas
RATIONALE: Using a bed cradle to keep linens off the lesions relieves pain caused by
friction. Heat and moisture can worsen the pain of herpes zoster lesions.
8. A nurse in an orthopedic clinic is reinforcing teaching with a client who has
osteoarthritis. Which of the following instructions should the nurse include to
promote comfort?
A. Try jogging in place when joints feel stiff
B. Use a soft chair or recliner for sitting
C. Sleep on a firm mattress
D. Apply ice packs to painful joints
C. Sleep on a firm mattress
RATIONALE: A firm mattress or bed board helps the client maintain joint alignment
while sleeping, reducing pain and stiffness in osteoarthritis.
PRACTICE B NEW SOLUTION UPDATED FOR
2023/2026 – QUESTIONS WITH ANSWERS &
RATIONALES | INSTANT DOWNLOAD PDF
Core Domains
1. Perioperative Nursing Care
2. Cardiovascular and Hematologic Disorders
3. Respiratory and Oxygenation Management
4. Neurological and Sensory Disorders
5. Endocrine and Metabolic Disorders
6. Gastrointestinal and Genitourinary Disorders
7. Musculoskeletal and Integumentary Care
8. Oncology, Immune, and Infectious Disease
9. Emergency, Critical Care, and Fluid/Electrolyte Balance
10. Pharmacological and Parenteral Therapies
Introduction
This comprehensive examination is designed to assess the clinical knowledge and decision-
making skills of practical nursing students preparing for the PN Adult Medical Surgical
Online Practice B assessment. The assessment evaluates proficiency in perioperative care,
cardiovascular and respiratory management, endocrine and neurological disorders,
musculoskeletal and integumentary care, and emergency interventions. Multiple-choice and
scenario-based questions emphasize real-world application, critical thinking, and safe
clinical judgment essential for professional practical nursing practice. Content aligns with
the NCLEX-PN test plan and ATI Medical-Surgical nursing blueprint, ensuring rigorous
preparation for contemporary clinical challenges.
SECTION ONE: QUESTIONS 1–100
,1. A nurse is assisting with the care of a client who has a new cast on their left
forearm and reports severe pain in the affected arm with numbness in the fingers.
The nurse finds the skin is pale and cold with sluggish capillary refill. Which of the
following fracture complications should the nurse suspect?
A. Fat embolism syndrome
B. Compartment syndrome
C. Osteomyelitis
D. Venous thromboembolism
B. Compartment syndrome
RATIONALE: Severe pain, pallor, cold skin, numbness, and sluggish capillary refill are
classic manifestations of compartment syndrome, a limb-threatening emergency requiring
immediate notification of the provider and possible fasciotomy.
2. A nurse is contributing to the plan of care for a client who has multiple sclerosis
and is taking dantrolene to manage muscle spasms. Which of the following
interventions should the nurse include?
A. Apply hot packs to the client's muscles
B. Schedule physical therapy in the afternoon
C. Encourage the client to complete ADLs
D. Administer valerian to promote sleep
C. Encourage the client to complete ADLs
RATIONALE: Dantrolene is a muscle relaxant used to manage spasticity in multiple
sclerosis. Encouraging independence with ADLs maintains muscle function and promotes
client autonomy.
3. A nurse is caring for a client who has an intestinal obstruction and reports a new
onset of nausea. The client has an NG tube set at low intermittent suction and is
receiving continuous IV infusion of 0.9% sodium chloride. Which of the following
actions should the nurse take first?
A. Increase the IV fluid rate
B. Provide ice chips
,C. Administer an antiemetic
D. Check for kinks in the NG tube
D. Check for kinks in the NG tube
RATIONALE: The first action is to assess the patency of the NG tube. Nausea in a client
with an intestinal obstruction may indicate that the NG tube is not effectively
decompressing the stomach.
4. A nurse is monitoring a client who has a history of an enlarged prostate and is
experiencing suprapubic discomfort. Which of the following actions should the
nurse take first?
A. Administer doxazosin
B. Palpate the bladder
C. Insert a urinary catheter
D. Encourage increased fluid intake
B. Palpate the bladder
RATIONALE: The nurse should first assess the bladder for distention by palpation.
Suprapubic discomfort in a client with an enlarged prostate may indicate urinary retention.
5. A nurse is caring for a client and administers penicillin IM. The client begins
exhibiting hives and has severe difficulty breathing. After establishing a patent
airway, which of the following actions should the nurse take next?
A. Monitor the client's vital signs
B. Administer epinephrine
C. Monitor oxygen saturation
D. Administer an antihistamine
B. Administer epinephrine
RATIONALE: The client is experiencing anaphylaxis. After ensuring airway patency,
epinephrine is the priority medication to reverse bronchoconstriction and hypotension.
6. A nurse is caring for a client who has acute pancreatitis. While providing care,
the nurse observes ecchymosis around the umbilicus. The nurse should identify
that this is a manifestation of which of the following?
, A. Cullen's sign
B. Turner's sign
C. Murphy's sign
D. Grey Turner's sign
A. Cullen's sign
RATIONALE: Cullen's sign is periumbilical ecchymosis associated with acute
pancreatitis and indicates retroperitoneal hemorrhage.
7. A nurse is assisting with the development of a plan of care to manage pain for a
client who has herpes zoster with lesions on the lower extremities. Which of the
following interventions should the nurse include in the plan of care?
A. Position a heat lamp over the lower extremities
B. Apply warm, moist compresses to the affected areas
C. Keep bed linens off the affected areas
D. Initiate droplet isolation precautions
C. Keep bed linens off the affected areas
RATIONALE: Using a bed cradle to keep linens off the lesions relieves pain caused by
friction. Heat and moisture can worsen the pain of herpes zoster lesions.
8. A nurse in an orthopedic clinic is reinforcing teaching with a client who has
osteoarthritis. Which of the following instructions should the nurse include to
promote comfort?
A. Try jogging in place when joints feel stiff
B. Use a soft chair or recliner for sitting
C. Sleep on a firm mattress
D. Apply ice packs to painful joints
C. Sleep on a firm mattress
RATIONALE: A firm mattress or bed board helps the client maintain joint alignment
while sleeping, reducing pain and stiffness in osteoarthritis.
