Medical-Surgical Practice Exam
A 60-year-old client with benign prostatic hyperplasia (BPH) has been up to the
bathroom six times during the night. The client asked the practical nurse (PN) if
there is something the healthcare provider can do to help him with this problem
before he has a transurethral resection of the prostate (TURP). What information
should the PN offer? - ANS - D. An indwelling catheter is sometimes prescribed to
alleviate symptoms.
\A client arrives at the oncology clinic for the next treatment in the prescribed
course of chemotherapy (CT). The practical nurse (PN) reviews the client's
laboratory results: white blood cells 700/mmd, red blood cells 2.8 million/mm3,
hemoglobin 7.9 grams/dl, hematocrit 25.5%, and platelet count 14,000/mm3.
Which action should the PN take first? - ANS - B. Place an isolation mask on the
client.
\A client is admitted with a C4 spinal cord injury (SCI) after falling from a roof at a
construction site. After returning to the unit for a CT scan to confirm the vertebral
fracture, which assessment by the practical nurse has the highest priority? - ANS
- B. Check the respiratory effort and pulse oximeter reading.
\A client is receiving a unit of packed red blood cells (RBC's). Which finding
should the practical nurse (PN) report to the healthcare provider? - ANS - D.
Urticaria on the neck and chest.
\A client is scheduled for transurethral resction of the prostate (TURP). What
statement by the client reveals to the practical nurse that the client needs
additional information? - ANS - C. My incision will probably be painful.
\A client who experienced a thrombolic stroke has received recombinant tissue
plasminogen activator (TPA)(Alteplase) two hours ago in the emergency center.
Which priority precaution should the practical nurse implement for this client on
admission to the medical unit? - ANS - D. Bleeding precautions.
\A client who has vomiting, dysuria, and urinary tract infection (UTI) arrives in the
clinic and receives an IV antiemetic and a liter of IV fluids. The healthcare
provider prescribes oral antibiotics for the client's discharge. Which finding is
essential for the practical nurse to determine before the client is discharged? -
ANS - B. No vomiting with oral fluid intake.
\A client who is 2-days postoperative for abdominal surgery has a nasogastric
tube (NGT) to low continuous suction. The client tells the practical nurse (PN) his
mouth is so dry that he has been drinking water to quench his thirst. Which
potential imbalance should the PN monitor for development in the client? - ANS -
B. Metabolic alkalosis
, \A client who is 3 days postoperative after a laminectomy is coughing up thick
green sputum and wheezing. What action is most important for the practical
nurse (PN) to implement? - ANS - D. Report the change in condition to the
healthcare provider.
\A client who received graphs for a full-thickness burn of the right arm is admitted
to the rehabilitation unit. Which action is important for the practical nurse to
reinforce with the client to prevent long-term complications? - ANS - A. Exercise
the affected arm everyday.
\A client who received several units of blood for a hemorrhagic event is reporting
muscle cramps and tingling sensation. Which action should the practical nurse
implement? - ANS - D. Review laboratory results for serum calcium and
magnesium levels.
\A client who was hit in the head with a baseball is admitted to the hospital for
observation. Which finding requires the practical nurse (PN) to follow-up with
further assessment? - ANS - D. Reports the hospital room is an office.
\A client with cholelithiasis is admitted with jaundice due to obstruction of the
common bile duct. Which finding is most important for the practical nurse to
report to the healthcare provider? - ANS - C. Hard, rigid abdomen.
\A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 2 L/minute. During the bed bath, the client complains of shortness of breath.
Which action should the practical nurse (PN) implement? - ANS - D. Assist the
client into a Fowler's position.
\A client with epilepsy is having bilateral rhythmic jerking movements of all
extremities. After calling for help, which action should the practical nurse (PN) do
next? - ANS - 1. Maintain the client's airway
2. Apply pads to the bedside rails.
3. Avoid stimulation during post-ictal phase.
4. Observe the client for incontinence.
\A client with heart failure (HF) takes a daily tablet of furosemide (Lasix) and
lisinopril (Zestril). Which finding during the clinic visit should indicate to the
practical nurse that the client's condition is worsening? - ANS - D. Sleeps with
two additional pillows.
\A client with major burns is receiving cimetidine (Tagamet). Which finding should
the practical nurse (PN) obtain to best evaluate the effectiveness of the
medication? - ANS - D. Absense of blood in the stool.
\A client with newly diagnosed essential hypertension is learning to cope with
stressful situations in his life. Which activity should the practical nurse (PN)
implement to help the client learn constructive coping? - ANS - A. Role play a
situation the client identifies as stressful.
A 60-year-old client with benign prostatic hyperplasia (BPH) has been up to the
bathroom six times during the night. The client asked the practical nurse (PN) if
there is something the healthcare provider can do to help him with this problem
before he has a transurethral resection of the prostate (TURP). What information
should the PN offer? - ANS - D. An indwelling catheter is sometimes prescribed to
alleviate symptoms.
\A client arrives at the oncology clinic for the next treatment in the prescribed
course of chemotherapy (CT). The practical nurse (PN) reviews the client's
laboratory results: white blood cells 700/mmd, red blood cells 2.8 million/mm3,
hemoglobin 7.9 grams/dl, hematocrit 25.5%, and platelet count 14,000/mm3.
Which action should the PN take first? - ANS - B. Place an isolation mask on the
client.
\A client is admitted with a C4 spinal cord injury (SCI) after falling from a roof at a
construction site. After returning to the unit for a CT scan to confirm the vertebral
fracture, which assessment by the practical nurse has the highest priority? - ANS
- B. Check the respiratory effort and pulse oximeter reading.
\A client is receiving a unit of packed red blood cells (RBC's). Which finding
should the practical nurse (PN) report to the healthcare provider? - ANS - D.
Urticaria on the neck and chest.
\A client is scheduled for transurethral resction of the prostate (TURP). What
statement by the client reveals to the practical nurse that the client needs
additional information? - ANS - C. My incision will probably be painful.
\A client who experienced a thrombolic stroke has received recombinant tissue
plasminogen activator (TPA)(Alteplase) two hours ago in the emergency center.
Which priority precaution should the practical nurse implement for this client on
admission to the medical unit? - ANS - D. Bleeding precautions.
\A client who has vomiting, dysuria, and urinary tract infection (UTI) arrives in the
clinic and receives an IV antiemetic and a liter of IV fluids. The healthcare
provider prescribes oral antibiotics for the client's discharge. Which finding is
essential for the practical nurse to determine before the client is discharged? -
ANS - B. No vomiting with oral fluid intake.
\A client who is 2-days postoperative for abdominal surgery has a nasogastric
tube (NGT) to low continuous suction. The client tells the practical nurse (PN) his
mouth is so dry that he has been drinking water to quench his thirst. Which
potential imbalance should the PN monitor for development in the client? - ANS -
B. Metabolic alkalosis
, \A client who is 3 days postoperative after a laminectomy is coughing up thick
green sputum and wheezing. What action is most important for the practical
nurse (PN) to implement? - ANS - D. Report the change in condition to the
healthcare provider.
\A client who received graphs for a full-thickness burn of the right arm is admitted
to the rehabilitation unit. Which action is important for the practical nurse to
reinforce with the client to prevent long-term complications? - ANS - A. Exercise
the affected arm everyday.
\A client who received several units of blood for a hemorrhagic event is reporting
muscle cramps and tingling sensation. Which action should the practical nurse
implement? - ANS - D. Review laboratory results for serum calcium and
magnesium levels.
\A client who was hit in the head with a baseball is admitted to the hospital for
observation. Which finding requires the practical nurse (PN) to follow-up with
further assessment? - ANS - D. Reports the hospital room is an office.
\A client with cholelithiasis is admitted with jaundice due to obstruction of the
common bile duct. Which finding is most important for the practical nurse to
report to the healthcare provider? - ANS - C. Hard, rigid abdomen.
\A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 2 L/minute. During the bed bath, the client complains of shortness of breath.
Which action should the practical nurse (PN) implement? - ANS - D. Assist the
client into a Fowler's position.
\A client with epilepsy is having bilateral rhythmic jerking movements of all
extremities. After calling for help, which action should the practical nurse (PN) do
next? - ANS - 1. Maintain the client's airway
2. Apply pads to the bedside rails.
3. Avoid stimulation during post-ictal phase.
4. Observe the client for incontinence.
\A client with heart failure (HF) takes a daily tablet of furosemide (Lasix) and
lisinopril (Zestril). Which finding during the clinic visit should indicate to the
practical nurse that the client's condition is worsening? - ANS - D. Sleeps with
two additional pillows.
\A client with major burns is receiving cimetidine (Tagamet). Which finding should
the practical nurse (PN) obtain to best evaluate the effectiveness of the
medication? - ANS - D. Absense of blood in the stool.
\A client with newly diagnosed essential hypertension is learning to cope with
stressful situations in his life. Which activity should the practical nurse (PN)
implement to help the client learn constructive coping? - ANS - A. Role play a
situation the client identifies as stressful.
