ADVANCED MEDICAL-SURGICAL &
CRITICAL CARE NURSING EXAM 2026-2027
ACTUAL EXAM WITH 100% SOLVED
QUESTIONS AND GRADED A+
A nurse is caring for a group of older adult clients. Which of the
following manifestations indicates one of the clients is
experiencing delirium?
A. A client wants to know the current time while there is a clock on
the wall.
B. A client attempts to climb out of bed and repeatedly states she
must get home.
C. A client requests extra blankets when the thermostat in the
room indicates 25.6 Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to
attend to daily hygiene. Correct Answer B.
(Delirium is characterized by a change in cognition that
occurs over a short period of time. It results from a
secondary physiological condition (e.g., infection, surgery,
prolonged hospitalization, hypoxia, fever, medications) and
is a transient disorder. Although delirium can occur with any
age, it is more common in older adults. It frequently
progresses in the evening hours and is sometimes called
"sundown syndrome." Delirium is characterized by
alterations in memory, agitation, restlessness, illusions, or
,hallucinations. A client who becomes acutely confused and
agitated may be showing manifestations of delirium.)
The family of an older adult client brings him to the emergency
department after finding him wandering outside. During the initial
assessment, the nurse notes that the client flinches when she
palpates his abdomen yet response to questions only by nodding
and smiling. Which of the following factors should the nurse
identify as a likely explanation for the clients behavior?
A. he is hard of hearing
B. pain
C. confusion
D. language barrier Correct Answer C
(since the client was manifesting signs of confusion before
coming to the emergency department and currently seems
unable to understand or respond to speech, the nurse should
determine that the client has confusion)
A nurse is performing a mental status examination (MSE) on a
client who has a new diagnosis of dementia. Which of the
following components should the nurse include? (Select all that
apply.)
A. grooming
B. long-term memory
C. support systems
,D. affect
E. presence of pain Correct Answer A, B, D
(Grooming is included in an MSE which consists of
appearance, behavior, speech, mood, disorders of the form
of thought, perceptual disturbances, cognition, and ideas of
harming self or others. Long-term memory is included in an
MSE which consists of appearance, behavior, speech, and
mood, disorders of the form of thought, perceptual
disturbances, cognition, and ideas of harming self or others.
Support systems are not included in an MSE which consists
of appearance, behavior, speech, mood, disorders of the
form of thought, perceptual disturbances, cognition, and
ideas of harming self or others. Affect is included in an MSE
which consists of appearance, behavior, speech, and mood,
disorders of the form of thought, perceptual disturbances,
cognition, and ideas of harming self or others. The presence
of pain is not included in an MSE which consists of
appearance, behavior, speech, mood, disorders of the form
of thought, perceptual disturbances, cognition, and ideas of
harming self or others.)
A nurse is caring for a client who has late stage Alzheimer's
disease and is hospitalized for treatment of pneumonia. During
the night shift, the client is found climbing into the bed of another
client who becomes upset and frightened. Which of the following
actions should the nurse take?
A. assist the client to the correct room.
B. place the client in restraints.
, C. re-orient the client to time and place.
D. move the client to a room at the end of the hall. Correct Answer
A
(assisting the client to the correct room protects both clients.
It helps re-orient the client who is unable to find her own
room, and it prevents the other client from an invasion of her
personal space.)
A nurse in a long-term care facility is caring for a client who has
late stage Alzheimer's disease. Which of the following actions
should the nurse include in the plan of care?
A. post a written schedule of daily activities.
B. use an overhead loudspeaker to announce events.
C. provide a consistent daily routine.
D. allow the client to choose free time activities. Correct Answer C
(A consistent daily routine is appropriate for the care of a
client who has Alzheimer's disease.)
A nurse is monitoring a client who is post operative and unable to
respond to questions. Which of the following nonverbal behaviors
should the nurse identify as an indication that the client has pain?
(Select all that apply.)
A. Restlessness
B. Grimacing
C. Moaning