NR 341: Medical-Surgical Nursing Prep with Detailed
Rationales
Course Code: NR 341
Course Name: Medical-Surgical Nursing
Topic: Advanced Clinical Concepts, Critical Care Resuscitation, and Burn
Management
Academic Year: 2026/2027
1. A client with an abdominal wound infected with methicillin-resistant
Staphylococcus aureus (MRSA) is scheduled for a computed tomography (CT)
scan of the abdomen. To ensure client and visitor safety during transport,
which precaution should the nurse implement?
A. No special isolation precautions are required during transport.
B. Cover the infected site with a fresh, clean dressing.
C. Drape the client with a protective covering labeled biohazardous.
D. Place a tight-fitting surgical mask on the client's face during transit.
CORRECT ANSWER: B
RATIONALE: To prevent the transmission of contact-isolated pathogens like
MRSA during transport through public hospital corridors, the nurse must ensure
that the infected site is completely covered with a fresh, clean dressing. This
effectively contains the contaminated drainage and prevents it from transferring
onto environmental surfaces or sheets. Draping a client with "biohazardous" labels
violates privacy and patient dignity. Surgical masks are reserved for droplet or
airborne transmission precautions and do not apply to localized abdominal skin
wounds.
2. A registered nurse (RN) is organizing a community healthcare program for
administering tetanus vaccinations. Which member of the healthcare team is
most suitable for being delegated the task of administering vaccinations?
A. Nursing aide
B. Certified technician
C. Patient care associate
D. Licensed practical nurse (LPN)
, CORRECT ANSWER: D
RATIONALE: Under the guidelines of safe professional delegation,
administering intramuscular medications such as tetanus vaccinations falls
explicitly within the legal scope of practice for a licensed practical nurse (LPN)
or licensed vocational nurse (LVN). Unlicensed personnel, including nursing aides,
certified technicians, and patient care associates, do not hold independent clinical
nursing licenses and are legally barred from administering prescription biologic or
medication injections.
3. A nurse finds that an 80-year-old client's family is not caring for the client
properly. The client has lost weight and is wearing soiled, inappropriate
clothing. Which action of the nurse indicates leadership quality?
A. Advocating on behalf of the client by reporting suspicions to adult
protective services.
B. Discussing the client's specific home care problem with another floor nurse.
C. Arranging an unauthorized permanent accommodation in an acute hospital bed.
D. Suggesting the family join the client in a long-term healthcare facility.
CORRECT ANSWER: A
RATIONALE: The nurse demonstrates professional leadership and advocacy
by reporting suspected elder neglect directly to adult protective services. This
fulfills a mandatory legal obligation to protect a vulnerable, dependent older adult
from systemic harm or physical neglect. Discussing the case casually with a peer
does not resolve the threat. Permanently holding a patient in an acute care bed
without a medical indication is an improper use of hospital resources, and forcing
family members into a facility is unrealistic and outside a nurse's authority.
4. Which noninvasive assessment and management skills certification would
the nurse be required to use for baseline airway maintenance and
cardiopulmonary resuscitation (CPR)?
A. Basic Life Support (BLS)
B. Certified Emergency Nurse (CEN)
C. Advanced Cardiac Life Support (ACLS)
D. Pediatric Advanced Life Support (PALS)
CORRECT ANSWER: A
RATIONALE: Basic Life Support (BLS) is the foundational certification
, that equips healthcare workers with noninvasive skills for airway maintenance,
chest compressions, and cardiopulmonary resuscitation (CPR) for individuals
experiencing cardiopulmonary arrest. CEN is an advanced specialty examination
for emergency care. ACLS and PALS involve invasive airway placement and
advanced pharmacological protocols, moving beyond purely noninvasive
resuscitation measures.
5. A nurse is caring for a client who experienced serious burns in a fire. Which
relationship between a client's burned body surface area and fluid loss should
the nurse consider when evaluating fluid loss in a client with burns?
A. Equal
B. Unrelated
C. Inversely related
D. Directly proportional
CORRECT ANSWER: D
RATIONALE: In severe thermal injuries, the relationship between the total
body surface area (TBSA) burned and fluid loss is directly proportional. As
the percentage of burned skin increases, the corresponding loss of intravascular
volume through capillary evaporation, denuded tissue weeping, and systemic third-
spacing escalates in a predictable linear fashion. This necessitates accurate TBSA
calculations using the Rule of Nines to guide fluid resuscitation formulas.
6. A nurse is reviewing the laboratory reports of a client who has acute
pancreatitis. Which of the following findings should the nurse expect?
A. Decreased serum amylase
B. Elevated blood glucose
C. Elevated serum calcium
D. Decreased erythrocyte sedimentation rate
CORRECT ANSWER: B
RATIONALE: Acute pancreatitis triggers auto-digestion of pancreatic tissue,
which can damage the beta cells within the islets of Langerhans. This impairs the
synthesis and secretion of insulin, leading to elevated blood glucose levels
(hyperglycemia). Pancreatitis is also characterized by a significant increase in
serum amylase and lipase, hypocalcemia (due to calcium binding with fatty acids
Rationales
Course Code: NR 341
Course Name: Medical-Surgical Nursing
Topic: Advanced Clinical Concepts, Critical Care Resuscitation, and Burn
Management
Academic Year: 2026/2027
1. A client with an abdominal wound infected with methicillin-resistant
Staphylococcus aureus (MRSA) is scheduled for a computed tomography (CT)
scan of the abdomen. To ensure client and visitor safety during transport,
which precaution should the nurse implement?
A. No special isolation precautions are required during transport.
B. Cover the infected site with a fresh, clean dressing.
C. Drape the client with a protective covering labeled biohazardous.
D. Place a tight-fitting surgical mask on the client's face during transit.
CORRECT ANSWER: B
RATIONALE: To prevent the transmission of contact-isolated pathogens like
MRSA during transport through public hospital corridors, the nurse must ensure
that the infected site is completely covered with a fresh, clean dressing. This
effectively contains the contaminated drainage and prevents it from transferring
onto environmental surfaces or sheets. Draping a client with "biohazardous" labels
violates privacy and patient dignity. Surgical masks are reserved for droplet or
airborne transmission precautions and do not apply to localized abdominal skin
wounds.
2. A registered nurse (RN) is organizing a community healthcare program for
administering tetanus vaccinations. Which member of the healthcare team is
most suitable for being delegated the task of administering vaccinations?
A. Nursing aide
B. Certified technician
C. Patient care associate
D. Licensed practical nurse (LPN)
, CORRECT ANSWER: D
RATIONALE: Under the guidelines of safe professional delegation,
administering intramuscular medications such as tetanus vaccinations falls
explicitly within the legal scope of practice for a licensed practical nurse (LPN)
or licensed vocational nurse (LVN). Unlicensed personnel, including nursing aides,
certified technicians, and patient care associates, do not hold independent clinical
nursing licenses and are legally barred from administering prescription biologic or
medication injections.
3. A nurse finds that an 80-year-old client's family is not caring for the client
properly. The client has lost weight and is wearing soiled, inappropriate
clothing. Which action of the nurse indicates leadership quality?
A. Advocating on behalf of the client by reporting suspicions to adult
protective services.
B. Discussing the client's specific home care problem with another floor nurse.
C. Arranging an unauthorized permanent accommodation in an acute hospital bed.
D. Suggesting the family join the client in a long-term healthcare facility.
CORRECT ANSWER: A
RATIONALE: The nurse demonstrates professional leadership and advocacy
by reporting suspected elder neglect directly to adult protective services. This
fulfills a mandatory legal obligation to protect a vulnerable, dependent older adult
from systemic harm or physical neglect. Discussing the case casually with a peer
does not resolve the threat. Permanently holding a patient in an acute care bed
without a medical indication is an improper use of hospital resources, and forcing
family members into a facility is unrealistic and outside a nurse's authority.
4. Which noninvasive assessment and management skills certification would
the nurse be required to use for baseline airway maintenance and
cardiopulmonary resuscitation (CPR)?
A. Basic Life Support (BLS)
B. Certified Emergency Nurse (CEN)
C. Advanced Cardiac Life Support (ACLS)
D. Pediatric Advanced Life Support (PALS)
CORRECT ANSWER: A
RATIONALE: Basic Life Support (BLS) is the foundational certification
, that equips healthcare workers with noninvasive skills for airway maintenance,
chest compressions, and cardiopulmonary resuscitation (CPR) for individuals
experiencing cardiopulmonary arrest. CEN is an advanced specialty examination
for emergency care. ACLS and PALS involve invasive airway placement and
advanced pharmacological protocols, moving beyond purely noninvasive
resuscitation measures.
5. A nurse is caring for a client who experienced serious burns in a fire. Which
relationship between a client's burned body surface area and fluid loss should
the nurse consider when evaluating fluid loss in a client with burns?
A. Equal
B. Unrelated
C. Inversely related
D. Directly proportional
CORRECT ANSWER: D
RATIONALE: In severe thermal injuries, the relationship between the total
body surface area (TBSA) burned and fluid loss is directly proportional. As
the percentage of burned skin increases, the corresponding loss of intravascular
volume through capillary evaporation, denuded tissue weeping, and systemic third-
spacing escalates in a predictable linear fashion. This necessitates accurate TBSA
calculations using the Rule of Nines to guide fluid resuscitation formulas.
6. A nurse is reviewing the laboratory reports of a client who has acute
pancreatitis. Which of the following findings should the nurse expect?
A. Decreased serum amylase
B. Elevated blood glucose
C. Elevated serum calcium
D. Decreased erythrocyte sedimentation rate
CORRECT ANSWER: B
RATIONALE: Acute pancreatitis triggers auto-digestion of pancreatic tissue,
which can damage the beta cells within the islets of Langerhans. This impairs the
synthesis and secretion of insulin, leading to elevated blood glucose levels
(hyperglycemia). Pancreatitis is also characterized by a significant increase in
serum amylase and lipase, hypocalcemia (due to calcium binding with fatty acids
