WEST COST UNIVERSITY NURS 480 ADVANCED MED SURG 2026
1.) A nurse is conducting an in-service for a group of nurses who work in the emergency
department. For which of the following childhood diseases should the nurse initiate airborne
precautions?
Scabies
Whooping cough
Measles
Mumps
2.) A nurse is observing bonding between a client and her newborn. Which of the following
actionsby the client will require the nurse to intervene?
Holding the newborn in an face position
Asking the father to change the newborn’s diaper
Viewing the newborn’s actions to be uncooperative
Requesting the nurse to take the newborn to the nursery so she can rest
3.) A nurse is caring for a client who is taking levothyroxine (Synthroid). Which of the
followingfindings indicates to the nurse that the medication is effective?
Decreased Blood pressure
Weight loss
Decreased inflammation
Absence of seizure
4.) A nurse is planning to teach a group of parents regarding development of 15 month-old
toddlers.
Which of the following information should the nurse include in the teaching?
Understands simple commands
Build tower 6 to 7 cubes (2 years)
Picks up object without falling
Refers to self by name
5.) A nurse is assessing a client in the PACU. Which of the following findings indicates
decreasedcardiac output?
Oliguria
Constricted pupils
Shivering
Bradypnea
6.) A nurse is assisting with mass casualty triage following an explosion at a local factory.
Which ofthe following clients should the nurse identify as the priority?
A client who has an open fracture of the lower extremity
A client who has a massive head trauma
A client who has full-thickness burns to the face and trunk
A client who has indications of hypovolemic shock
7.) A nurse is receiving report on four clients. Which of the following clients should the nurse
assessfirst?
A client who has an ileal conduit and mucus in the pouch
A client who has an arteriovenous fistula that vibrates when palpated
,A client who had an transurethral resection of the prostate (TURP) with red-tinged urine in
the bed (Hemorrhage) SOUNDS MORE RIGHT
A client who has chronic kidney disease with cloudy dialysate outflow
8.) A nurse is caring for a client who has just received the first dose of lisinopril (Zestril).
Which ofthe following is the appropriate nursing intervention? (monitor for potassium –
hyper)
Provide standby assist when the client gets up from bed
Encourage foods high in potassium
Place the client on continuous cardiac monitoring???
Monitor the client’s oxygen saturation
9.) A nurse is caring for a client who is in labor and receiving electronic fetal monitoring. The
nurseis reviewing the monitor tracing and notes early decelerations. Which of the following
should the nurse expect?
Head compression
Fetal hypoxia
Abruptio placentae
Postmaturity
10.) A nurse is planning nonpharmacological pain management for a preschool child. Which
of thefollowing actions should the nurse take when using relaxation techniques?
Give the child a sticker following the procedure
Using a rocking motion while holding the child
Have the child blow bubbles
Ask the child to describe a favorite activity
11.) A nurse is caring for an infant who has a prescription for continuous pulse oximetry.
Which ofthe following is an appropriate action for the nurse to take?
Heat the skin 1 min prior to placing the probe
Place the infant under a radiant warmer
Place the sensor on the index finger
Move the probe site every 3 hour
12.) A nurse is evaluating a client’s understanding of a liver biopsy before obtaining a signed
informed consent. Which of the following statements by the client indicates understanding of
the procedure?
“I will know what is wrong with me before I leave the hospital.”
“I will be able to go home after I recover from general anesthesia.”
“I will leave the pressure dressing in place after discharge for 24 hours.”
“I will need to lie flat for 8 hours after the procedure.”
13.) A nurse working in a clinic is teaching a group of clients who are pregnant on the use of
the nonpharmacological pain management. Which of the following statements by the nurse is
an appropriate description of the use of hypnosis during labor?
“Hypnosis uses therapeutic touch to reduce anxiety during labor.”
“Hypnosis promotes increased control over pain perception during contractions.”
“Hypnosis provides distraction to minimize pain.”
“Hypnosis focuses on the use of biofeedback as a relaxation technique.”
,14.) A client says to the nurse, “I’m tired of being here! I hate all of you nurses!” Which of the
following is an appropriate response by the nurse?
“Why are you tired of being here?”
“Tell me more about how you are feeling”
“I think we should talk when you are in a better mood.”
“You shouldn’t take your anger out on the nurses.”
15.) A nurse is obtaining the medical story of a client who has a new prescription for
isosorbide mononitrate (Imdur). Which of the following should the nurse identify as a
contraindication tothe medication?
Migraine headaches
Polycythemia
Glaucoma
Hypertension
16.) A nurse is working in the emergency department. Which of the following triaged clients
shouldthe nurse assess first?
A client who has a headache and a blood pressure of 180/104
An older adult client who has a blood glucose of 250 mg/dL and numbness in both feet
A client who reports urinary frequency, burning, and hematuria
An older adult client who has had vomiting and diarrhea for 2 days
17.) A nurse is reviewing the laboratory report for a client who reports vomiting for 2 days.
The client’s serum potassium level is 2.9 mEq/L. Which of the following is an expected finding
of thisclient?
Positive Chvostek’s sign
Hyperactive reflexes
Muscle weakness
Numbess and tingling of fingers
18.) A nurse is caring for a client who has breast cancer and has been receiving chemotherapy.
Which of the following laboratory values should the nurse report to the provider?
aPTT 30 seconds
WBC 3,000/mm3 (Immunosuppressed)
Hemoglobin 14 g/dL
Platelet count 250,000/mm3
19.)A nurse is developing a plan or care for a client who is experiencing period manic
episodes.Which of the following interventions should the nurse include? (give them finger
foods, no groups)
Schedule frequent rest periods during the day
Encourage the client to stay in his room
Arrange for the client to attend group activities
Have the client sit in the dining room for meals
20.)A nurse is performing change-of-shift assessments on four clients. Which of the following
findings should the nurse report to the provider first?
A client who has gastroenteritis and is lethargic and confused
, A client who has cystic fibrosis and has a thick, productive cough and reports thirst
A Client who has sickle cell anemia and reports pain 15 min after receiving oral analgesic
A client who has diabetes mellitus and has a morning fasting capillary glucose of 185mg/dL
21.)A nurse is assessing a toddler’s fine motor development. Which of the following is an
appropriate developmental ability of the toddler?
Turns page of a book two or three at a time
Places small objects in a narrow necked bottle
Copies a triangular shape with a pencil
Uses scissors to cut out a picture
22.)A nurse manager is explaining a new protocol for the care of central venous devices to the
nurseon her unit. Which of the following methods should the nurse manager use to evaluate
adherence to the new protocol?
Survey client satisfaction with nursing care
Offer group discussions to promote questions about the new procedure—evaulting ifstaff
understood
Provide practices sessions for nurses to perform dressing changes
Monitor rates of catheter related bloodstream infections
23.) A nurse is caring for a client who is preparing his advanced directives. Which of the
followingstatements by the client indicates an understanding of advanced directives?
(Select all that apply)
“I have the right to refuse treatment.”
“I can’t change my advance directives once submitted.”
“I need an attorney to witness my signature on the advance directives.”
“My health care proxy can make medical decisions for me.”
“My doctor will need to approve my advanced directives.”
24.)A nurse is providing nutritional teaching to a school-age child who has cystic fibrosis. The
nurse should instruct the client to increase enzyme intake prior to consuming which of the
followingfoods?
Peach
Peanut butter (need to increase protein)
Plain yogurt
Oatmeal
25.)A nurse is caring for a group of clients. Which of the following clients should the nurse
assign toan assistive personnel?
A client who has chronic obstructive pulmonary disease and needs guidance on incentive
spirometry
A client who had a myocardial infarction 3 days ago and report chest discomfort
A client who had a cerebral accident 2 days ago and needs help toileting
A client who has awoken following a bronchoscopy and requests a drink
1.) A nurse is conducting an in-service for a group of nurses who work in the emergency
department. For which of the following childhood diseases should the nurse initiate airborne
precautions?
Scabies
Whooping cough
Measles
Mumps
2.) A nurse is observing bonding between a client and her newborn. Which of the following
actionsby the client will require the nurse to intervene?
Holding the newborn in an face position
Asking the father to change the newborn’s diaper
Viewing the newborn’s actions to be uncooperative
Requesting the nurse to take the newborn to the nursery so she can rest
3.) A nurse is caring for a client who is taking levothyroxine (Synthroid). Which of the
followingfindings indicates to the nurse that the medication is effective?
Decreased Blood pressure
Weight loss
Decreased inflammation
Absence of seizure
4.) A nurse is planning to teach a group of parents regarding development of 15 month-old
toddlers.
Which of the following information should the nurse include in the teaching?
Understands simple commands
Build tower 6 to 7 cubes (2 years)
Picks up object without falling
Refers to self by name
5.) A nurse is assessing a client in the PACU. Which of the following findings indicates
decreasedcardiac output?
Oliguria
Constricted pupils
Shivering
Bradypnea
6.) A nurse is assisting with mass casualty triage following an explosion at a local factory.
Which ofthe following clients should the nurse identify as the priority?
A client who has an open fracture of the lower extremity
A client who has a massive head trauma
A client who has full-thickness burns to the face and trunk
A client who has indications of hypovolemic shock
7.) A nurse is receiving report on four clients. Which of the following clients should the nurse
assessfirst?
A client who has an ileal conduit and mucus in the pouch
A client who has an arteriovenous fistula that vibrates when palpated
,A client who had an transurethral resection of the prostate (TURP) with red-tinged urine in
the bed (Hemorrhage) SOUNDS MORE RIGHT
A client who has chronic kidney disease with cloudy dialysate outflow
8.) A nurse is caring for a client who has just received the first dose of lisinopril (Zestril).
Which ofthe following is the appropriate nursing intervention? (monitor for potassium –
hyper)
Provide standby assist when the client gets up from bed
Encourage foods high in potassium
Place the client on continuous cardiac monitoring???
Monitor the client’s oxygen saturation
9.) A nurse is caring for a client who is in labor and receiving electronic fetal monitoring. The
nurseis reviewing the monitor tracing and notes early decelerations. Which of the following
should the nurse expect?
Head compression
Fetal hypoxia
Abruptio placentae
Postmaturity
10.) A nurse is planning nonpharmacological pain management for a preschool child. Which
of thefollowing actions should the nurse take when using relaxation techniques?
Give the child a sticker following the procedure
Using a rocking motion while holding the child
Have the child blow bubbles
Ask the child to describe a favorite activity
11.) A nurse is caring for an infant who has a prescription for continuous pulse oximetry.
Which ofthe following is an appropriate action for the nurse to take?
Heat the skin 1 min prior to placing the probe
Place the infant under a radiant warmer
Place the sensor on the index finger
Move the probe site every 3 hour
12.) A nurse is evaluating a client’s understanding of a liver biopsy before obtaining a signed
informed consent. Which of the following statements by the client indicates understanding of
the procedure?
“I will know what is wrong with me before I leave the hospital.”
“I will be able to go home after I recover from general anesthesia.”
“I will leave the pressure dressing in place after discharge for 24 hours.”
“I will need to lie flat for 8 hours after the procedure.”
13.) A nurse working in a clinic is teaching a group of clients who are pregnant on the use of
the nonpharmacological pain management. Which of the following statements by the nurse is
an appropriate description of the use of hypnosis during labor?
“Hypnosis uses therapeutic touch to reduce anxiety during labor.”
“Hypnosis promotes increased control over pain perception during contractions.”
“Hypnosis provides distraction to minimize pain.”
“Hypnosis focuses on the use of biofeedback as a relaxation technique.”
,14.) A client says to the nurse, “I’m tired of being here! I hate all of you nurses!” Which of the
following is an appropriate response by the nurse?
“Why are you tired of being here?”
“Tell me more about how you are feeling”
“I think we should talk when you are in a better mood.”
“You shouldn’t take your anger out on the nurses.”
15.) A nurse is obtaining the medical story of a client who has a new prescription for
isosorbide mononitrate (Imdur). Which of the following should the nurse identify as a
contraindication tothe medication?
Migraine headaches
Polycythemia
Glaucoma
Hypertension
16.) A nurse is working in the emergency department. Which of the following triaged clients
shouldthe nurse assess first?
A client who has a headache and a blood pressure of 180/104
An older adult client who has a blood glucose of 250 mg/dL and numbness in both feet
A client who reports urinary frequency, burning, and hematuria
An older adult client who has had vomiting and diarrhea for 2 days
17.) A nurse is reviewing the laboratory report for a client who reports vomiting for 2 days.
The client’s serum potassium level is 2.9 mEq/L. Which of the following is an expected finding
of thisclient?
Positive Chvostek’s sign
Hyperactive reflexes
Muscle weakness
Numbess and tingling of fingers
18.) A nurse is caring for a client who has breast cancer and has been receiving chemotherapy.
Which of the following laboratory values should the nurse report to the provider?
aPTT 30 seconds
WBC 3,000/mm3 (Immunosuppressed)
Hemoglobin 14 g/dL
Platelet count 250,000/mm3
19.)A nurse is developing a plan or care for a client who is experiencing period manic
episodes.Which of the following interventions should the nurse include? (give them finger
foods, no groups)
Schedule frequent rest periods during the day
Encourage the client to stay in his room
Arrange for the client to attend group activities
Have the client sit in the dining room for meals
20.)A nurse is performing change-of-shift assessments on four clients. Which of the following
findings should the nurse report to the provider first?
A client who has gastroenteritis and is lethargic and confused
, A client who has cystic fibrosis and has a thick, productive cough and reports thirst
A Client who has sickle cell anemia and reports pain 15 min after receiving oral analgesic
A client who has diabetes mellitus and has a morning fasting capillary glucose of 185mg/dL
21.)A nurse is assessing a toddler’s fine motor development. Which of the following is an
appropriate developmental ability of the toddler?
Turns page of a book two or three at a time
Places small objects in a narrow necked bottle
Copies a triangular shape with a pencil
Uses scissors to cut out a picture
22.)A nurse manager is explaining a new protocol for the care of central venous devices to the
nurseon her unit. Which of the following methods should the nurse manager use to evaluate
adherence to the new protocol?
Survey client satisfaction with nursing care
Offer group discussions to promote questions about the new procedure—evaulting ifstaff
understood
Provide practices sessions for nurses to perform dressing changes
Monitor rates of catheter related bloodstream infections
23.) A nurse is caring for a client who is preparing his advanced directives. Which of the
followingstatements by the client indicates an understanding of advanced directives?
(Select all that apply)
“I have the right to refuse treatment.”
“I can’t change my advance directives once submitted.”
“I need an attorney to witness my signature on the advance directives.”
“My health care proxy can make medical decisions for me.”
“My doctor will need to approve my advanced directives.”
24.)A nurse is providing nutritional teaching to a school-age child who has cystic fibrosis. The
nurse should instruct the client to increase enzyme intake prior to consuming which of the
followingfoods?
Peach
Peanut butter (need to increase protein)
Plain yogurt
Oatmeal
25.)A nurse is caring for a group of clients. Which of the following clients should the nurse
assign toan assistive personnel?
A client who has chronic obstructive pulmonary disease and needs guidance on incentive
spirometry
A client who had a myocardial infarction 3 days ago and report chest discomfort
A client who had a cerebral accident 2 days ago and needs help toileting
A client who has awoken following a bronchoscopy and requests a drink
