PN ADULT MEDICAL SURGICAL ONLINE PRACTICE B NEW
SOLUTION UPDATED FOR 2023/2026 - QUESTIONS WITH
ANSWERS & RATIONALES INSTANT DOWNLOAD PDF
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for adults with acute and chronic medical-surgical conditions
2 Interpret laboratory, diagnostic, and assessment data to make safe clinical decisions
3 Evaluate the appropriateness of prescribed interventions and medications using current guidelines
4 Demonstrate knowledge of safety, infection control, and complication prevention in medical-surgical
settings
5 PN ADULT MEDICAL SURGICAL ONLINE PRACTICE B NEW SOLUTION UPDATED FOR 2023
6 2026
7 QUESTIONS WITH ANSWERS & RATIONALES INSTANT DOWNLOAD PDF
8 Foundations of Adult Medical-Surgical Nursing
9 Applied Adult Medical-Surgical Nursing
10 Advanced Adult Medical-Surgical Nursing
11 Adult Medical-Surgical Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from PN ADULT
MEDICAL SURGICAL ONLINE PRACTICE B NEW SOLUTION UPDATED FOR 2023/2026 -
QUESTIONS WITH ANSWERS & RATIONALES INSTANT DOWNLOAD PDF, with the strongest
emphasis placed on Apply the nursing process to prioritize care for adults with acute and chronic
medical-surgical conditions, Interpret laboratory, diagnostic, and assessment data to make safe
clinical decisions and Evaluate the appropriateness of prescribed interventions and medications
using current guidelines. Every item follows the wording style and level of reasoning you meet in
the real paper, and each one is paired with a clear rationale so the correct choice is never a guess.
Work through the set at your own pace, mark the questions that slow you down, then come back to
them until the reasoning feels automatic. Learners who revise this way walk into the exam room
recognising the pattern behind the questions instead of meeting them for the first time. Keep going
- steady, honest practice is what turns a difficult paper into a comfortable pass.
Page 1
,Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with acute decompensated heart failure is prescribed IV furosemide.
Which assessment finding most urgently indicates a need to hold the dose and
notify the provider?
A. Serum potassium 3.1 mEq/L with new-onset U waves on ECG CORRECT
B. Urine output of 40 mL/hr over the past 2 hours
C. Blood pressure 108/68 mm Hg with mild dizziness on standing
D. Serum sodium 134 mEq/L and dry mucous membranes
RATIONALE: Hypokalemia with ECG changes (U waves) predisposes to lethal dysrhythmias, so
loop diuretics should be held and potassium replaced before continuing. Mild hypotension,
modest diuresis, and borderline sodium are expected or less immediately dangerous. The ECG
change distinguishes a true emergency from routine monitoring findings.
Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
Which instruction is most important for a patient starting rifampin, isoniazid,
pyrazinamide, and ethambutol for active tuberculosis?
A. Expect orange-red discoloration of urine, sweat, and tears while taking rifampin. CORRECT
B. Take the medications with a high-protein meal to reduce nausea.
C. Stop all medications once the cough resolves to avoid hepatotoxicity.
D. Schedule an eye exam only if vision changes occur after 6 months.
RATIONALE: Rifampin predictably causes harmless orange-red body fluid discoloration and
patients must be warned to prevent alarm and nonadherence. Taking the drugs with food can
impair absorption, stopping early causes resistance, and ethambutol requires baseline and
periodic vision testing, not reactive testing only.
Page 2
,Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with diabetic ketoacidosis has a blood glucose of 480 mg/dL, pH 7.15,
and potassium 5.6 mEq/L. After starting an insulin infusion, which action is the
priority?
A. Administer sodium bicarbonate to correct the acidosis.
B. Add dextrose to the IV fluids when glucose reaches 250 mg/dL. CORRECT
C. Give additional potassium IV push to prevent hypokalemia.
D. Hold insulin until the potassium level normalizes.
RATIONALE: As insulin drives glucose and potassium intracellularly, dextrose is added once
glucose approaches 250 mg/dL to prevent hypoglycemia while continuing insulin to close the
anion gap. Bicarbonate is not routine, IV push potassium is never given, and holding insulin
would worsen acidosis.
Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with chronic kidney disease (stage 4) reports fatigue and pruritus.
Laboratory results show hemoglobin 8.9 g/dL, ferritin 120 ng/mL, and transferrin
saturation 18%. Which prescribed intervention should the nurse question?
A. Epoetin alfa subcutaneously three times weekly
B. Ferrous sulfate 325 mg orally three times daily CORRECT
C. Calcium acetate with meals
D. Sodium polystyrene sulfonate as needed for hyperkalemia
RATIONALE: Oral iron absorption is poor in CKD and ferritin/TSAT indicate functional iron
deficiency; IV iron is preferred before or with an ESA. Epoetin, phosphate binders, and potassium
binders are appropriate. High-dose oral iron also risks GI upset and is less effective in this
population.
Page 3
, Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with a new colostomy has liquid stool and skin excoriation around the
stoma. Which action best promotes healing and pouch adherence?
A. Apply a thin layer of petroleum jelly to the peristomal skin before the wafer.
B. Cleanse the skin with alcohol and allow it to dry completely.
C. Measure the stoma and use a skin barrier powder with a barrier wipe. CORRECT
D. Change the pouch every 5 to 7 days regardless of leakage.
RATIONALE: For denuded peristomal skin, crusting with skin barrier powder and a barrier wipe
creates a dry adherent surface for the wafer. Petroleum jelly prevents adherence, alcohol is
drying and painful, and prolonged wear time with leakage worsens breakdown.
Q6 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient is 24 hours post-total hip arthroplasty. Which finding requires immediate
intervention?
A. Hemoglobin 9.8 g/dL and mild incisional pain
B. Calf pain, unilateral swelling, and shortness of breath CORRECT
C. Temperature 100.2°F (37.9°C) and incisional drainage
D. Complaint of constipation and reduced appetite
RATIONALE: Unilateral calf pain with dyspnea suggests deep vein thrombosis with possible
pulmonary embolism, a life-threatening postoperative complication requiring immediate
evaluation. Low hemoglobin, low-grade fever, and constipation are common and managed
supportively.
Page 4
SOLUTION UPDATED FOR 2023/2026 - QUESTIONS WITH
ANSWERS & RATIONALES INSTANT DOWNLOAD PDF
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply the nursing process to prioritize care for adults with acute and chronic medical-surgical conditions
2 Interpret laboratory, diagnostic, and assessment data to make safe clinical decisions
3 Evaluate the appropriateness of prescribed interventions and medications using current guidelines
4 Demonstrate knowledge of safety, infection control, and complication prevention in medical-surgical
settings
5 PN ADULT MEDICAL SURGICAL ONLINE PRACTICE B NEW SOLUTION UPDATED FOR 2023
6 2026
7 QUESTIONS WITH ANSWERS & RATIONALES INSTANT DOWNLOAD PDF
8 Foundations of Adult Medical-Surgical Nursing
9 Applied Adult Medical-Surgical Nursing
10 Advanced Adult Medical-Surgical Nursing
11 Adult Medical-Surgical Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from PN ADULT
MEDICAL SURGICAL ONLINE PRACTICE B NEW SOLUTION UPDATED FOR 2023/2026 -
QUESTIONS WITH ANSWERS & RATIONALES INSTANT DOWNLOAD PDF, with the strongest
emphasis placed on Apply the nursing process to prioritize care for adults with acute and chronic
medical-surgical conditions, Interpret laboratory, diagnostic, and assessment data to make safe
clinical decisions and Evaluate the appropriateness of prescribed interventions and medications
using current guidelines. Every item follows the wording style and level of reasoning you meet in
the real paper, and each one is paired with a clear rationale so the correct choice is never a guess.
Work through the set at your own pace, mark the questions that slow you down, then come back to
them until the reasoning feels automatic. Learners who revise this way walk into the exam room
recognising the pattern behind the questions instead of meeting them for the first time. Keep going
- steady, honest practice is what turns a difficult paper into a comfortable pass.
Page 1
,Q1 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with acute decompensated heart failure is prescribed IV furosemide.
Which assessment finding most urgently indicates a need to hold the dose and
notify the provider?
A. Serum potassium 3.1 mEq/L with new-onset U waves on ECG CORRECT
B. Urine output of 40 mL/hr over the past 2 hours
C. Blood pressure 108/68 mm Hg with mild dizziness on standing
D. Serum sodium 134 mEq/L and dry mucous membranes
RATIONALE: Hypokalemia with ECG changes (U waves) predisposes to lethal dysrhythmias, so
loop diuretics should be held and potassium replaced before continuing. Mild hypotension,
modest diuresis, and borderline sodium are expected or less immediately dangerous. The ECG
change distinguishes a true emergency from routine monitoring findings.
Q2 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
Which instruction is most important for a patient starting rifampin, isoniazid,
pyrazinamide, and ethambutol for active tuberculosis?
A. Expect orange-red discoloration of urine, sweat, and tears while taking rifampin. CORRECT
B. Take the medications with a high-protein meal to reduce nausea.
C. Stop all medications once the cough resolves to avoid hepatotoxicity.
D. Schedule an eye exam only if vision changes occur after 6 months.
RATIONALE: Rifampin predictably causes harmless orange-red body fluid discoloration and
patients must be warned to prevent alarm and nonadherence. Taking the drugs with food can
impair absorption, stopping early causes resistance, and ethambutol requires baseline and
periodic vision testing, not reactive testing only.
Page 2
,Q3 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with diabetic ketoacidosis has a blood glucose of 480 mg/dL, pH 7.15,
and potassium 5.6 mEq/L. After starting an insulin infusion, which action is the
priority?
A. Administer sodium bicarbonate to correct the acidosis.
B. Add dextrose to the IV fluids when glucose reaches 250 mg/dL. CORRECT
C. Give additional potassium IV push to prevent hypokalemia.
D. Hold insulin until the potassium level normalizes.
RATIONALE: As insulin drives glucose and potassium intracellularly, dextrose is added once
glucose approaches 250 mg/dL to prevent hypoglycemia while continuing insulin to close the
anion gap. Bicarbonate is not routine, IV push potassium is never given, and holding insulin
would worsen acidosis.
Q4 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with chronic kidney disease (stage 4) reports fatigue and pruritus.
Laboratory results show hemoglobin 8.9 g/dL, ferritin 120 ng/mL, and transferrin
saturation 18%. Which prescribed intervention should the nurse question?
A. Epoetin alfa subcutaneously three times weekly
B. Ferrous sulfate 325 mg orally three times daily CORRECT
C. Calcium acetate with meals
D. Sodium polystyrene sulfonate as needed for hyperkalemia
RATIONALE: Oral iron absorption is poor in CKD and ferritin/TSAT indicate functional iron
deficiency; IV iron is preferred before or with an ESA. Epoetin, phosphate binders, and potassium
binders are appropriate. High-dose oral iron also risks GI upset and is less effective in this
population.
Page 3
, Q5 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient with a new colostomy has liquid stool and skin excoriation around the
stoma. Which action best promotes healing and pouch adherence?
A. Apply a thin layer of petroleum jelly to the peristomal skin before the wafer.
B. Cleanse the skin with alcohol and allow it to dry completely.
C. Measure the stoma and use a skin barrier powder with a barrier wipe. CORRECT
D. Change the pouch every 5 to 7 days regardless of leakage.
RATIONALE: For denuded peristomal skin, crusting with skin barrier powder and a barrier wipe
creates a dry adherent surface for the wafer. Petroleum jelly prevents adherence, alcohol is
drying and painful, and prolonged wear time with leakage worsens breakdown.
Q6 APPLY THE NURSING PROCESS TO PRIORITIZE CARE FOR ADULTS WITH ACUTE AND
CHRONIC MEDICAL-SURGICAL CONDITIONS
A patient is 24 hours post-total hip arthroplasty. Which finding requires immediate
intervention?
A. Hemoglobin 9.8 g/dL and mild incisional pain
B. Calf pain, unilateral swelling, and shortness of breath CORRECT
C. Temperature 100.2°F (37.9°C) and incisional drainage
D. Complaint of constipation and reduced appetite
RATIONALE: Unilateral calf pain with dyspnea suggests deep vein thrombosis with possible
pulmonary embolism, a life-threatening postoperative complication requiring immediate
evaluation. Low hemoglobin, low-grade fever, and constipation are common and managed
supportively.
Page 4
