Comprehensive Adult Medical-Surgical
Nursing Certification Exam Prep LATEST ALL
VERSIONS ACTUAL EXAM COMPLETE
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) | ALREADY
GRADED A+ 2026/2027 WITH FREE
PRACTICE TEST SETS.
Section 1: Original Practice Questions (46-90)
1. A nurse is preparing to suction a client who has a tracheostomy. Which of the following
actions should the nurse take first?
A. Insert the suction catheter into the tracheostomy
B. Rinse the catheter with sterile 0.9% sodium chloride
C. Ventilate the client with 100% oxygen
D. Occlude the vent on the catheter for 10 seconds
Correct Answer: C. Ventilate the client with 100% oxygen
Rationale: The nurse should first ventilate the client with 100% oxygen to prevent hypoxemia
during the suctioning procedure. Suctioning removes oxygen along with secretions, so pre-
oxygenation is essential. Inserting the catheter (A) occurs after pre-oxygenation. Rinsing the
catheter (B) is done after suctioning to clear the tubing. Occluding the vent (D) is done during
the actual suctioning process.
,2. A nurse is caring for a client who is scheduled for surgery and is experiencing anxiety.
Which of the following interventions should the nurse identify as the priority?
A. Determine the client's understanding of the procedure
B. Encourage the client to express their feelings
C. Allow the client's partner to stay with them
D. Provide music as a distraction
Correct Answer: A. Determine the client's understanding of the procedure
Rationale: The priority intervention is to assess the client's understanding of the procedure.
Anxiety often stems from lack of knowledge or misconceptions. Using the nursing process,
assessment comes first. Encouraging expression of feelings (B) is important but secondary to
assessment. Allowing the partner to stay (C) and providing music (D) are comfort measures that
can be implemented after determining the client's knowledge deficits.
3. A nurse is caring for a client who reports stomatitis. Which of the following dietary
recommendations should the nurse make?
A. "Eat soft foods."
B. "Season foods with salt."
C. "Select foods that are low in protein."
D. "Choose foods that are served hot."
Correct Answer: A. "Eat soft foods."
Rationale: Stomatitis causes inflammation and ulceration of the oral mucosa, making chewing
and swallowing painful. Soft foods are easier to tolerate and less likely to cause further
irritation. Salty foods (B) can irritate the oral mucosa. Low-protein foods (C) would impair
healing. Hot foods (D) can cause additional pain and irritation to inflamed tissues.
,4. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c) testing with a client
who has diabetes mellitus. Which of the following statements indicates that the client
understands the teaching?
A. "The HbA1c test should be performed 2 hr after I eat a meal that is high in carbohydrates."
B. "The HbA1c test can help detect the presence of ketones in my body."
C. "I will have my HbA1c checked twice per year."
D. "I will plan to fast before I have my HbA1c tested."
Correct Answer: C. "I will have my HbA1c checked twice per year."
Rationale: The HbA1c test reflects average blood glucose levels over the past 2-3 months.
Clients with diabetes should have this test performed at least twice yearly, or quarterly if
treatment changes are needed. The test does not require fasting (D) or timing after meals (A).
Ketones are detected through urine or blood ketone testing, not HbA1c (B).
5. A nurse is caring for a client who is preoperative and is receiving an IV infusion of cefazolin.
Ten minutes after beginning the infusion, the client reports intense itching. Which of the
following actions should the nurse take first?
A. Stop the medication infusion.
B. Notify the charge nurse.
C. Administer a PRN dose of diphenhydramine.
D. Follow facility policy for appropriate reporting of the adverse reaction.
Correct Answer: A. Stop the medication infusion.
Rationale: Intense itching indicates a potential allergic reaction to cefazolin. The first action is to
stop the infusion immediately to prevent further exposure to the allergen and potential
progression to anaphylaxis. Notifying the charge nurse (B), administering diphenhydramine (C),
and reporting (D) occur after stopping the infusion.
, 6. A home health nurse is reinforcing teaching with a client about preventing complications of
peripheral vascular disease. Which of the following statements indicates that the client is
adhering to the nurse's instructions?
A. "I apply rubbing alcohol to my feet every day to prevent infection."
B. "I will wear clean, knee-high wool socks every day to help improve my circulation."
C. "I use hot water bottles to keep my feet warm at night."
D. "I don't cross my legs anymore."
Correct Answer: D. "I don't cross my legs anymore."
Rationale: Crossing the legs impairs circulation and should be avoided by clients with peripheral
vascular disease. Rubbing alcohol (A) is drying and can damage fragile skin. Wool socks (B) can
irritate sensitive skin and are not recommended. Hot water bottles (C) can cause burns because
clients with PVD have decreased sensation and impaired circulation.
7. A nurse is preparing to administer scheduled medications to a client. Which of the
following prescriptions should the nurse verify with the provider?
A. Ceftriaxone
B. Diltiazem
C. Pioglitazone
D. Hydrocodone 5 mg/acetaminophen 500 mg
Correct Answer: A. Ceftriaxone
Rationale: Ceftriaxone should be verified with the provider because it can interact with calcium-
containing solutions and is contraindicated in clients with certain allergies. The nurse should
always verify medications when there are potential contraindications, interactions, or when the
prescription falls outside standard guidelines. Diltiazem (B), pioglitazone (C), and
hydrocodone/acetaminophen (D) are standard medications that would not require verification
unless there were specific client factors.
Nursing Certification Exam Prep LATEST ALL
VERSIONS ACTUAL EXAM COMPLETE
QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) | ALREADY
GRADED A+ 2026/2027 WITH FREE
PRACTICE TEST SETS.
Section 1: Original Practice Questions (46-90)
1. A nurse is preparing to suction a client who has a tracheostomy. Which of the following
actions should the nurse take first?
A. Insert the suction catheter into the tracheostomy
B. Rinse the catheter with sterile 0.9% sodium chloride
C. Ventilate the client with 100% oxygen
D. Occlude the vent on the catheter for 10 seconds
Correct Answer: C. Ventilate the client with 100% oxygen
Rationale: The nurse should first ventilate the client with 100% oxygen to prevent hypoxemia
during the suctioning procedure. Suctioning removes oxygen along with secretions, so pre-
oxygenation is essential. Inserting the catheter (A) occurs after pre-oxygenation. Rinsing the
catheter (B) is done after suctioning to clear the tubing. Occluding the vent (D) is done during
the actual suctioning process.
,2. A nurse is caring for a client who is scheduled for surgery and is experiencing anxiety.
Which of the following interventions should the nurse identify as the priority?
A. Determine the client's understanding of the procedure
B. Encourage the client to express their feelings
C. Allow the client's partner to stay with them
D. Provide music as a distraction
Correct Answer: A. Determine the client's understanding of the procedure
Rationale: The priority intervention is to assess the client's understanding of the procedure.
Anxiety often stems from lack of knowledge or misconceptions. Using the nursing process,
assessment comes first. Encouraging expression of feelings (B) is important but secondary to
assessment. Allowing the partner to stay (C) and providing music (D) are comfort measures that
can be implemented after determining the client's knowledge deficits.
3. A nurse is caring for a client who reports stomatitis. Which of the following dietary
recommendations should the nurse make?
A. "Eat soft foods."
B. "Season foods with salt."
C. "Select foods that are low in protein."
D. "Choose foods that are served hot."
Correct Answer: A. "Eat soft foods."
Rationale: Stomatitis causes inflammation and ulceration of the oral mucosa, making chewing
and swallowing painful. Soft foods are easier to tolerate and less likely to cause further
irritation. Salty foods (B) can irritate the oral mucosa. Low-protein foods (C) would impair
healing. Hot foods (D) can cause additional pain and irritation to inflamed tissues.
,4. A nurse is reinforcing teaching about glycosylated hemoglobin (HbA1c) testing with a client
who has diabetes mellitus. Which of the following statements indicates that the client
understands the teaching?
A. "The HbA1c test should be performed 2 hr after I eat a meal that is high in carbohydrates."
B. "The HbA1c test can help detect the presence of ketones in my body."
C. "I will have my HbA1c checked twice per year."
D. "I will plan to fast before I have my HbA1c tested."
Correct Answer: C. "I will have my HbA1c checked twice per year."
Rationale: The HbA1c test reflects average blood glucose levels over the past 2-3 months.
Clients with diabetes should have this test performed at least twice yearly, or quarterly if
treatment changes are needed. The test does not require fasting (D) or timing after meals (A).
Ketones are detected through urine or blood ketone testing, not HbA1c (B).
5. A nurse is caring for a client who is preoperative and is receiving an IV infusion of cefazolin.
Ten minutes after beginning the infusion, the client reports intense itching. Which of the
following actions should the nurse take first?
A. Stop the medication infusion.
B. Notify the charge nurse.
C. Administer a PRN dose of diphenhydramine.
D. Follow facility policy for appropriate reporting of the adverse reaction.
Correct Answer: A. Stop the medication infusion.
Rationale: Intense itching indicates a potential allergic reaction to cefazolin. The first action is to
stop the infusion immediately to prevent further exposure to the allergen and potential
progression to anaphylaxis. Notifying the charge nurse (B), administering diphenhydramine (C),
and reporting (D) occur after stopping the infusion.
, 6. A home health nurse is reinforcing teaching with a client about preventing complications of
peripheral vascular disease. Which of the following statements indicates that the client is
adhering to the nurse's instructions?
A. "I apply rubbing alcohol to my feet every day to prevent infection."
B. "I will wear clean, knee-high wool socks every day to help improve my circulation."
C. "I use hot water bottles to keep my feet warm at night."
D. "I don't cross my legs anymore."
Correct Answer: D. "I don't cross my legs anymore."
Rationale: Crossing the legs impairs circulation and should be avoided by clients with peripheral
vascular disease. Rubbing alcohol (A) is drying and can damage fragile skin. Wool socks (B) can
irritate sensitive skin and are not recommended. Hot water bottles (C) can cause burns because
clients with PVD have decreased sensation and impaired circulation.
7. A nurse is preparing to administer scheduled medications to a client. Which of the
following prescriptions should the nurse verify with the provider?
A. Ceftriaxone
B. Diltiazem
C. Pioglitazone
D. Hydrocodone 5 mg/acetaminophen 500 mg
Correct Answer: A. Ceftriaxone
Rationale: Ceftriaxone should be verified with the provider because it can interact with calcium-
containing solutions and is contraindicated in clients with certain allergies. The nurse should
always verify medications when there are potential contraindications, interactions, or when the
prescription falls outside standard guidelines. Diltiazem (B), pioglitazone (C), and
hydrocodone/acetaminophen (D) are standard medications that would not require verification
unless there were specific client factors.
