Medical surgical practice exam
reviewed with correct answers
A 20 year old female client calls the nurse to report a lump she found in her breast. Which response is the best
for the nurse to provide? - CORRECT ANSWER-Most lumps are benign, but it is always best to come in form an
examination.
A 32 year old female client complains of severe abdominal pain each month before her menstrual period, painful
intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the
client's complaints? - CORRECT ANSWER-Inability to get pregnant
A 46 year old female client is admitted for acute renal failure secondary to diabetes and hypertension. Which test
is the best indicator of adequate glomerular filtration? - CORRECT ANSWER-Serum creatinine
A 49 year old female client arrives at the clinic for an annual exam and asks the nurse why she becomes
excessively diaphoretic and feels warm during nighttime. What is the nurse's best response? - CORRECT
ANSWER-Discuss perimenopause and related comfort measures
A 51 year old truck driver who smokes two packs of cigarettes a day and is 30 pounds overweight is diagnosed
with having a gastric ulcer. Which content is most important for the nurse to include in the discharge teaching for
this client? - CORRECT ANSWER-Information about smoking cessation
A 57 year old male client is scheduled to have a stress thallium test the following morning and is NPO after
midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the
nurse to provide to this client? - CORRECT ANSWER-The test you are having tomorrow requires that you have
nothing by mouth tonight
A 58 year old client who has been post menopausal for five years is concerned about the risk of osteoporosis
because her mother has the condition. Which information should the nurse offer? - CORRECT ANSWER-
Calcium loss from bones can be slowed by increasing calcium intake and exercise
A 58 year old client, who has no health problems, asks the nurse about the Pneumovax vaccine. The nurse's
response to the client should be based on which information? - CORRECT ANSWER-The immunization is
administered once to older adults or persons with a history of chronic illness
A 67 year old woman who lives alone tripped on a rug in her home and fractured her hip. Which predisposing
factor probably led to the fracture in the proximal end of her femur? - CORRECT ANSWER-Osteoporosis
resulting from hormonal changes
A 77 year old female client is admitted to the hospital. She is confused, has no appetite, is nauseated and
vomiting, and is complaining of a headache. Her pulse rate is 43 beats per minute. It is most important for the
nurse to assess for which finding? - CORRECT ANSWER-Takes digitalis
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What initial medication should
the nurse anticipate administering to the client? - CORRECT ANSWER-Digoxin
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer has the
poorest prognosis. Which information should the nurse offer the client? - CORRECT ANSWER-Inflammatory with
peau d'orange
, A client has been hospitalized with a femur fracture and is being treated with traction. which action by the nurse is
the priority when caring for this client? - CORRECT ANSWER-Assess neurovascular status
A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which
assessment finding is of most concern to the nurse? - CORRECT ANSWER-Purulent sputum
A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease (COPD). When
making a home visit, which nursing function is of greatest importance to this client? Assess the client's -
CORRECT ANSWER-temperature
A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the
nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most
important to teach the client? - CORRECT ANSWER-Feelings of dizziness
A client is admitted for further testing to confirm sarcoidosis Which diagnostic test provides definitive information
that the nurse should report to the HCP? - CORRECT ANSWER-Lung tissue biopsy
A client is admitted to the emergency department after falling from a high roof. Which finding should the nurse
report immediately? - CORRECT ANSWER-Clear, watery drainage from the ear
A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse knows that
the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very
poor. Which information relates most directly to the prognosis for gram negative pneumonias? - CORRECT
ANSWER-Gram negative organisms are more resistant to antibiotic therapy
A client is admitted to the hospital with diagnosis of severe acute diverticulitis. Which assessment finding should
the nurse expect this client to exhibit? - CORRECT ANSWER-Lower left quadrant pain and a low-grade fever
A client is admitted to the medical intensive care unit with a diagnosis of myocardial infarction. The client's history
indicates the infarction occurred ten hours ago. Which lab test result would the nurse expect this client to exhibit?
- CORRECT ANSWER-Elevated CK-MB
A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the client's basic
knowledge about the disease process. Which statement by the client conveys an understanding of the etiology of
diverticula? - CORRECT ANSWER-Chronic constipation causes weakening of colon wall which results in out
pouching sacs
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide 0.04
mg/kg q12 hours IV is prescribed. Which is the priority nursing diagnosis for this client? - CORRECT ANSWER-
impaired communication related to paralysis of skeletal muscles
A client presents with chronic venous insufficiency. Which assessment finding should the nurse anticipate? -
CORRECT ANSWER-Bilateral lower leg stasis dermatitis
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for what vitamin deficiency?
- CORRECT ANSWER-K
A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The nurse anticipates
which change in prescription for the client? - CORRECT ANSWER-A potassium supplement will be prescribed
A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for the nurse to ask the
client? - CORRECT ANSWER-At what time do you take your medication
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which action
is most important for the nurse to implement? - CORRECT ANSWER-Initiate continuous cardiac monitoring
A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids
are allowed, which assessment action should the nurse consider a priority? - CORRECT ANSWER-Check the
client's gag and swallow reflexes
A client who is HIV positive asks the nurse, "How will I know when I have AIDS?" Which response is best for the
nurse to provide? - CORRECT ANSWER-AIDS is diagnosed when a specific opportunistic infection is found in an
otherwise health individual.
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day?" Which
response by the nurse best explains the reason for alopecia? - CORRECT ANSWER-Chemotherapy affects the
cells of the body that grow rapidly, both normal and malignant
reviewed with correct answers
A 20 year old female client calls the nurse to report a lump she found in her breast. Which response is the best
for the nurse to provide? - CORRECT ANSWER-Most lumps are benign, but it is always best to come in form an
examination.
A 32 year old female client complains of severe abdominal pain each month before her menstrual period, painful
intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the
client's complaints? - CORRECT ANSWER-Inability to get pregnant
A 46 year old female client is admitted for acute renal failure secondary to diabetes and hypertension. Which test
is the best indicator of adequate glomerular filtration? - CORRECT ANSWER-Serum creatinine
A 49 year old female client arrives at the clinic for an annual exam and asks the nurse why she becomes
excessively diaphoretic and feels warm during nighttime. What is the nurse's best response? - CORRECT
ANSWER-Discuss perimenopause and related comfort measures
A 51 year old truck driver who smokes two packs of cigarettes a day and is 30 pounds overweight is diagnosed
with having a gastric ulcer. Which content is most important for the nurse to include in the discharge teaching for
this client? - CORRECT ANSWER-Information about smoking cessation
A 57 year old male client is scheduled to have a stress thallium test the following morning and is NPO after
midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the
nurse to provide to this client? - CORRECT ANSWER-The test you are having tomorrow requires that you have
nothing by mouth tonight
A 58 year old client who has been post menopausal for five years is concerned about the risk of osteoporosis
because her mother has the condition. Which information should the nurse offer? - CORRECT ANSWER-
Calcium loss from bones can be slowed by increasing calcium intake and exercise
A 58 year old client, who has no health problems, asks the nurse about the Pneumovax vaccine. The nurse's
response to the client should be based on which information? - CORRECT ANSWER-The immunization is
administered once to older adults or persons with a history of chronic illness
A 67 year old woman who lives alone tripped on a rug in her home and fractured her hip. Which predisposing
factor probably led to the fracture in the proximal end of her femur? - CORRECT ANSWER-Osteoporosis
resulting from hormonal changes
A 77 year old female client is admitted to the hospital. She is confused, has no appetite, is nauseated and
vomiting, and is complaining of a headache. Her pulse rate is 43 beats per minute. It is most important for the
nurse to assess for which finding? - CORRECT ANSWER-Takes digitalis
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What initial medication should
the nurse anticipate administering to the client? - CORRECT ANSWER-Digoxin
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer has the
poorest prognosis. Which information should the nurse offer the client? - CORRECT ANSWER-Inflammatory with
peau d'orange
, A client has been hospitalized with a femur fracture and is being treated with traction. which action by the nurse is
the priority when caring for this client? - CORRECT ANSWER-Assess neurovascular status
A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which
assessment finding is of most concern to the nurse? - CORRECT ANSWER-Purulent sputum
A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease (COPD). When
making a home visit, which nursing function is of greatest importance to this client? Assess the client's -
CORRECT ANSWER-temperature
A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the
nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most
important to teach the client? - CORRECT ANSWER-Feelings of dizziness
A client is admitted for further testing to confirm sarcoidosis Which diagnostic test provides definitive information
that the nurse should report to the HCP? - CORRECT ANSWER-Lung tissue biopsy
A client is admitted to the emergency department after falling from a high roof. Which finding should the nurse
report immediately? - CORRECT ANSWER-Clear, watery drainage from the ear
A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse knows that
the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very
poor. Which information relates most directly to the prognosis for gram negative pneumonias? - CORRECT
ANSWER-Gram negative organisms are more resistant to antibiotic therapy
A client is admitted to the hospital with diagnosis of severe acute diverticulitis. Which assessment finding should
the nurse expect this client to exhibit? - CORRECT ANSWER-Lower left quadrant pain and a low-grade fever
A client is admitted to the medical intensive care unit with a diagnosis of myocardial infarction. The client's history
indicates the infarction occurred ten hours ago. Which lab test result would the nurse expect this client to exhibit?
- CORRECT ANSWER-Elevated CK-MB
A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the client's basic
knowledge about the disease process. Which statement by the client conveys an understanding of the etiology of
diverticula? - CORRECT ANSWER-Chronic constipation causes weakening of colon wall which results in out
pouching sacs
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide 0.04
mg/kg q12 hours IV is prescribed. Which is the priority nursing diagnosis for this client? - CORRECT ANSWER-
impaired communication related to paralysis of skeletal muscles
A client presents with chronic venous insufficiency. Which assessment finding should the nurse anticipate? -
CORRECT ANSWER-Bilateral lower leg stasis dermatitis
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for what vitamin deficiency?
- CORRECT ANSWER-K
A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The nurse anticipates
which change in prescription for the client? - CORRECT ANSWER-A potassium supplement will be prescribed
A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for the nurse to ask the
client? - CORRECT ANSWER-At what time do you take your medication
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which action
is most important for the nurse to implement? - CORRECT ANSWER-Initiate continuous cardiac monitoring
A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids
are allowed, which assessment action should the nurse consider a priority? - CORRECT ANSWER-Check the
client's gag and swallow reflexes
A client who is HIV positive asks the nurse, "How will I know when I have AIDS?" Which response is best for the
nurse to provide? - CORRECT ANSWER-AIDS is diagnosed when a specific opportunistic infection is found in an
otherwise health individual.
A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day?" Which
response by the nurse best explains the reason for alopecia? - CORRECT ANSWER-Chemotherapy affects the
cells of the body that grow rapidly, both normal and malignant
