RN ADULT MEDICAL
SURGICAL ONLINE PRACTICE
B 2025 UPDATED VERIFIED
SOLUTIONS
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,1. Cholecystitis Case
Question:
A nurse is caring for a client in the emergency department (ED) with upper abdominal
pain radiating to the right shoulder (7/10), nausea, vomiting, and dyspepsia. What
condition is the client likely experiencing, and what actions should the nurse take?
Answer:
• Condition: Cholecystitis (due to symptoms like right shoulder pain, nausea,
and elevated liver enzymes/WBC).
• Actions:
1. Administer morphine for pain.
2. Keep the client NPO.
• Monitor:
1. Stool color (clay-colored stools suggest biliary obstruction).
2. Urine color (dark urine indicates obstruction).
2. Sickle Cell Crisis & Acute Chest Syndrome
Question:
A nurse is caring for a client admitted with sickle cell crisis, now reporting chest pain
(4/10), wheezing, and tachypnea. What complication is most likely occurring?
Answer:
• Acute Chest Syndrome (due to chest pain, wheezing, and hypoxia).
• Key Findings:
o Not fluid overload (no crackles/edema).
o Not right-sided heart failure (no JVD/edema).
3. Emphysema, Asthma, or Pneumonia?
Question:
A nurse assesses a client with shortness of breath, nonproductive cough, and myalgia.
Which findings align with emphysema, asthma, or pneumonia?
Answer:
, • Fever → Pneumonia (infection-related).
• Wheezing → All three (narrowed airways).
• Respiratory acidosis (ABG) → Emphysema & Pneumonia.
• Tachycardia → Emphysema & Pneumonia.
4. Preoperative Teaching for Knee Arthroplasty
Question:
Which statement by a client scheduled for knee arthroplasty indicates correct
understanding of teaching?
Answer:
• "I’ll do breathing exercises every 1–2 hours post-op."
• "I’ll ask for pain meds before pain gets severe."
• "I’ll likely go home with a walker."
• "PT starts after discharge." (Incorrect—PT starts immediately).
5. Lyme Disease Teaching
Question:
Which statement by a client with stage II Lyme disease shows understanding?
Answer:
• "My joint pain is from Lyme disease." (Correct—joint pain is a hallmark
symptom).
6. Enoxaparin Administration
Question:
Where should a nurse inject enoxaparin in a bedridden client?
Answer:
• Anterolateral abdominal wall (best absorption, avoids bruising).
7. Long-Term Mechanical Ventilation Complication
SURGICAL ONLINE PRACTICE
B 2025 UPDATED VERIFIED
SOLUTIONS
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,1. Cholecystitis Case
Question:
A nurse is caring for a client in the emergency department (ED) with upper abdominal
pain radiating to the right shoulder (7/10), nausea, vomiting, and dyspepsia. What
condition is the client likely experiencing, and what actions should the nurse take?
Answer:
• Condition: Cholecystitis (due to symptoms like right shoulder pain, nausea,
and elevated liver enzymes/WBC).
• Actions:
1. Administer morphine for pain.
2. Keep the client NPO.
• Monitor:
1. Stool color (clay-colored stools suggest biliary obstruction).
2. Urine color (dark urine indicates obstruction).
2. Sickle Cell Crisis & Acute Chest Syndrome
Question:
A nurse is caring for a client admitted with sickle cell crisis, now reporting chest pain
(4/10), wheezing, and tachypnea. What complication is most likely occurring?
Answer:
• Acute Chest Syndrome (due to chest pain, wheezing, and hypoxia).
• Key Findings:
o Not fluid overload (no crackles/edema).
o Not right-sided heart failure (no JVD/edema).
3. Emphysema, Asthma, or Pneumonia?
Question:
A nurse assesses a client with shortness of breath, nonproductive cough, and myalgia.
Which findings align with emphysema, asthma, or pneumonia?
Answer:
, • Fever → Pneumonia (infection-related).
• Wheezing → All three (narrowed airways).
• Respiratory acidosis (ABG) → Emphysema & Pneumonia.
• Tachycardia → Emphysema & Pneumonia.
4. Preoperative Teaching for Knee Arthroplasty
Question:
Which statement by a client scheduled for knee arthroplasty indicates correct
understanding of teaching?
Answer:
• "I’ll do breathing exercises every 1–2 hours post-op."
• "I’ll ask for pain meds before pain gets severe."
• "I’ll likely go home with a walker."
• "PT starts after discharge." (Incorrect—PT starts immediately).
5. Lyme Disease Teaching
Question:
Which statement by a client with stage II Lyme disease shows understanding?
Answer:
• "My joint pain is from Lyme disease." (Correct—joint pain is a hallmark
symptom).
6. Enoxaparin Administration
Question:
Where should a nurse inject enoxaparin in a bedridden client?
Answer:
• Anterolateral abdominal wall (best absorption, avoids bruising).
7. Long-Term Mechanical Ventilation Complication
