CAPSTONE ATI NCLEX MEDICAL
SURGICAL ASSESSMENT 1 QUESTIONS
WITH DETAILED SOLUTIONS 2025
A nurse is caring for a client who has developed a pulmonary embolus (PE). Which
of the following assessment findings should the nurse expect
A. bradycardia
B. lethargy
C. sharp chest pain
D. petechiae over lower extremities - ANSWER-C. sharp chest pain
A nurse is providing discharge teaching to a client who is postoperative following
glaucoma surgery. Which of the following instructions should the nurse include to
prevent increased intraocular pressure
A. "Avoid straining to have a bowel movement"
B. "Avoid lying on your right side"
C. "Avoid lifting objects that weigh more than 5 pounds"
,D. "Avoid sleeping with your head elevated" - ANSWER-A
Consume a diet high in fiber and fluids to prevent constipation and straining to
have a bowel movement, which can increase intraocular pressure
A nurse is providing teaching about health promotion activities to an older adult
client. Which of the following recommendations should the nurse include in the
teaching
A. "Maintain your dietary fat intake at 45% of your daily caloric intake"
B. "Obtain 15 minutes of sunlight exposure 3 times per week"
C. "Exercise for 30 minutes twice per week"
D. "Decrease your fiber intake to less than 20 grams per day" - ANSWER-B)
"Obtain 15 minutes of sunlight exposure 3 times per week"
Instruct the client to obtain at least 10-15 min of exposure to sunlight 2-3 times
per week to ensure adequate vitamin D production
A nurse is caring for a client who has an above the knee amputation related to
trauma and is experiencing phantom limb pain. Which of the following
medications should the nurse administer to treat the client's pain?
A. Meloxicam
,B. Cyclobenzaprine
C. Gabapentin
D. Lidocaine - ANSWER-C) Gabapentin
phantom limb pain is a type of neuropathic pain resulting from damage to
peripheral and central nervous system pathways. Gabapentin is an anticonvulsant
medication that helps treat neuropathic pain
A nurse is reviewing the laboratory findings for a client who has a urinary tract
infection. Which of the following laboratory findings should the nurse identify as
an indication the client is in the initial stages of systemic inflammatory response
syndrome (SIRS)?
A. WBC count 14,000/mm
B. Platelets 110,000/ mm
C. Lactic acid 19 mg/dL
D. C reactive protein 2.8 mg/L - ANSWER-A. ) WBC count 14,000/mm
WBC count of 14,000 is above the expected range of 5,000-10,000. SIRS
overwhelms the body's defenses, resulting in a widespread inflammation. WBCs
might increase initially, but depending on the bone marrow's ability to produce
neutrophils and WBCs, the WBC count can become extremely low
A nurse is caring for a client who is receiving brachytherapy. Which of the
following actions should the nurse take?
, A. Limit visitation time to 2 hr per day, per visitor
B. Wear a dosimeter film badge when caring for the client
C. Open the door toe the client's room when visitors are present
D. Double bag bed linens and remove them daily from the client's room -
ANSWER-B ) Wear a dosimeter film badge when caring for the client
the badge does not protect the nurse form the effects of radiation, it does record
the amount of individual exposure to the radiation
A nurse is panning care for a client who has been newly diagnosed with acute
pancreatitis. Which of the following interventions should the nurse include in the
plan of care
A. Encourage liquid nutritional supplements
B. Administer opioid medications via a PCA
C. Assess for signs of hypercalcemia
D. Administer hypotonic IV fluids - ANSWER-B) Administer opioid medications via
a PCA
pain mangement is important in the care of a client who has pancreatitis. Clients
are most often started on opioid medication via PCA in the early stages of
pancreatitis to mange pain
SURGICAL ASSESSMENT 1 QUESTIONS
WITH DETAILED SOLUTIONS 2025
A nurse is caring for a client who has developed a pulmonary embolus (PE). Which
of the following assessment findings should the nurse expect
A. bradycardia
B. lethargy
C. sharp chest pain
D. petechiae over lower extremities - ANSWER-C. sharp chest pain
A nurse is providing discharge teaching to a client who is postoperative following
glaucoma surgery. Which of the following instructions should the nurse include to
prevent increased intraocular pressure
A. "Avoid straining to have a bowel movement"
B. "Avoid lying on your right side"
C. "Avoid lifting objects that weigh more than 5 pounds"
,D. "Avoid sleeping with your head elevated" - ANSWER-A
Consume a diet high in fiber and fluids to prevent constipation and straining to
have a bowel movement, which can increase intraocular pressure
A nurse is providing teaching about health promotion activities to an older adult
client. Which of the following recommendations should the nurse include in the
teaching
A. "Maintain your dietary fat intake at 45% of your daily caloric intake"
B. "Obtain 15 minutes of sunlight exposure 3 times per week"
C. "Exercise for 30 minutes twice per week"
D. "Decrease your fiber intake to less than 20 grams per day" - ANSWER-B)
"Obtain 15 minutes of sunlight exposure 3 times per week"
Instruct the client to obtain at least 10-15 min of exposure to sunlight 2-3 times
per week to ensure adequate vitamin D production
A nurse is caring for a client who has an above the knee amputation related to
trauma and is experiencing phantom limb pain. Which of the following
medications should the nurse administer to treat the client's pain?
A. Meloxicam
,B. Cyclobenzaprine
C. Gabapentin
D. Lidocaine - ANSWER-C) Gabapentin
phantom limb pain is a type of neuropathic pain resulting from damage to
peripheral and central nervous system pathways. Gabapentin is an anticonvulsant
medication that helps treat neuropathic pain
A nurse is reviewing the laboratory findings for a client who has a urinary tract
infection. Which of the following laboratory findings should the nurse identify as
an indication the client is in the initial stages of systemic inflammatory response
syndrome (SIRS)?
A. WBC count 14,000/mm
B. Platelets 110,000/ mm
C. Lactic acid 19 mg/dL
D. C reactive protein 2.8 mg/L - ANSWER-A. ) WBC count 14,000/mm
WBC count of 14,000 is above the expected range of 5,000-10,000. SIRS
overwhelms the body's defenses, resulting in a widespread inflammation. WBCs
might increase initially, but depending on the bone marrow's ability to produce
neutrophils and WBCs, the WBC count can become extremely low
A nurse is caring for a client who is receiving brachytherapy. Which of the
following actions should the nurse take?
, A. Limit visitation time to 2 hr per day, per visitor
B. Wear a dosimeter film badge when caring for the client
C. Open the door toe the client's room when visitors are present
D. Double bag bed linens and remove them daily from the client's room -
ANSWER-B ) Wear a dosimeter film badge when caring for the client
the badge does not protect the nurse form the effects of radiation, it does record
the amount of individual exposure to the radiation
A nurse is panning care for a client who has been newly diagnosed with acute
pancreatitis. Which of the following interventions should the nurse include in the
plan of care
A. Encourage liquid nutritional supplements
B. Administer opioid medications via a PCA
C. Assess for signs of hypercalcemia
D. Administer hypotonic IV fluids - ANSWER-B) Administer opioid medications via
a PCA
pain mangement is important in the care of a client who has pancreatitis. Clients
are most often started on opioid medication via PCA in the early stages of
pancreatitis to mange pain
