MEDICAL-SURGICAL QUESTIONS WITH RATIONALES 2026.
CHAMBERLAIN SCHOOL OF NURSING 2026.
1. Which client medical diagnosis is a contraindication for peritoneal dialysis in a client with chronic
renal failure?
A) Anemia.
B) Peritonitis.
C) Diabetes mellitus.
D) Hypercholesterolemia.
Peritoneal dialysis is contraindicated for a client in renal failure with peritonitis (B), which compromises
the effectiveness of the peritoneum as the semipermeable membrane for the exchange of solutes and
waste products between the blood and peritoneal dialysate. (A, C, and D) are not contraindications for
peritoneal dialysis.
Correct Answer(s): B
2. A male client who has been taking a four-drug regimen for tuberculosis (TB) tells the practical nurse
(PN) that he has finished the first drug, isoniazid, and will start taking rifampin next. How should the PN
respond?
A) Observe for side effects, such as an orange discoloration of urine.
B) A vitamin B supplement should be added to the daily medications.
C) TB is contagious until all four medications are completed.
D) The four-drug protocol should be taken concurrently.
To prevent resistant strains of tuberculosis, a client with tuberculosis is initially prescribed a four-drug
regimen, which requires strict compliance. Information about the concurrent administration of all of the
four-drugs in this treatment plan (D) should be reinforced with the client and the healthcare provider
notified of the client's past use of the protocol. (A and B) provide additional information for the client,
but (D) is the most important information to convey to the client. Although partial use of the medication
may be less effective (C), the client's use of the medication must be addressed.
Correct Answer(s): D
,3. The practical nurse (PN) auscultates the abdomen of a client who had a barium swallow 24 hours ago
and determines the client has decreased bowel sounds. The client reports having no bowel movements
for 2 days. Which nursing intervention should the PN implement?
A) Collect a stool specimen for analysis.
B) Limit intake of products with caffeine.
C) Increase fluid intake to 3,000 ml daily.
D) Check digitally for a bowel impaction.
Findings such as decreased or absent bowel sounds and reports of constipation after barium swallow are
indicative of a barium impaction, which can be confirmed by a digital check (D). Although stool analysis
confirms the presence of barium, the client is unable to have a bowel movement (A). (B and C) may
reduce the risk of constipation, but do not address the consequences of retained barium.
Correct Answer(s): D
4. Which client should the practical nurse question a PRN prescription for sumatriptan (Imitrex) for
migraine headaches?
A) 30-year-old with bronchial asthma.
B) 40-year-old with diabetes mellitus.
C) 50-year-old with Prinzmetal’s angina.
D) 60-year-old with chronic kidney disease.
Imitrex reduces pain and other associated symptoms of migraine headache by binding to serotonin
receptors and triggering generalized vasoconstriction, which can cause coronary vasospasm in clients
with Prinzmetal's or variant angina (C). (A, B, and D) are inaccurate.
Correct Answer(s): C
5. An older female client with osteoporosis asks the practical nurse (PN) to explain why she is now 2
inches shorter than when she was younger. What information is best for the practical nurse (PN) to
provide?
A) Loss of calcium in the bones causes the change.
B) Bones get shorter with age due to wear and tear.
, C) Less fluid in each of the disks between the vertebrae occurs with degeneration.
D) It is a combination of wear and tear and calcium loss that causes the change.
A biological theory of aging includes the wear-and-tear theory, which explains that after repeated use
and damage, body structures and functions wear out because of stress. A normal spine at 40 years of
age and osteoporotic changes at 60 and 70 years of age can cause a loss of as much as 6 inches in
height. Small losses in the thickness of each of the intervertebral disks, which results from changes in
disk consistency, erosion, and osteoporosis, can lead to significant changes in height (D). Calcium
changes (A) and wear and tear (B and C) alone do not support significant height loss in aging, but a basic
explanation of disk degeneration that combines several factors provides the client with the best
information.
Correct Answer(s): D
6. A client is scheduled for a transurethral resection of the prostate (TURP). What statement by the
client reveals to the practical nurse that the client needs additional information?
A) “I need to drink a lot after surgery.”
B) “My urine should be red after surgery.”
C) “My incision will probably be painful.”
D) “I should have a catheter after surgery.”
Transurethral resection of the prostate (TURP) is performed by inserting a rectoscope through the
urethra. No incision is made, so the client's statement about an incision (C) indicates the need for more
information about the procedure. Liberal oral fluids are often encouraged (A) after surgery to prevent
infection. Postoperatively, urine is blood-tinged (B) due to resection and traumatized urinary
membranes. A client with TURP should have an indwelling catheter (D) for drainage and bladder
irrigation to prevent occlusion of the catheter with blood clots.
Correct Answer(s): C
7. A male client who had a stroke is incontinent of urine. Which action should the practical nurse (PN)
implement in providing bladder training?
A) Insert a Foley catheter at night to prevent accidents.
B) Offer the client the commode or urinal every two hours.
C) Decrease the client’s oral fluid intake to one liter per day
CHAMBERLAIN SCHOOL OF NURSING 2026.
1. Which client medical diagnosis is a contraindication for peritoneal dialysis in a client with chronic
renal failure?
A) Anemia.
B) Peritonitis.
C) Diabetes mellitus.
D) Hypercholesterolemia.
Peritoneal dialysis is contraindicated for a client in renal failure with peritonitis (B), which compromises
the effectiveness of the peritoneum as the semipermeable membrane for the exchange of solutes and
waste products between the blood and peritoneal dialysate. (A, C, and D) are not contraindications for
peritoneal dialysis.
Correct Answer(s): B
2. A male client who has been taking a four-drug regimen for tuberculosis (TB) tells the practical nurse
(PN) that he has finished the first drug, isoniazid, and will start taking rifampin next. How should the PN
respond?
A) Observe for side effects, such as an orange discoloration of urine.
B) A vitamin B supplement should be added to the daily medications.
C) TB is contagious until all four medications are completed.
D) The four-drug protocol should be taken concurrently.
To prevent resistant strains of tuberculosis, a client with tuberculosis is initially prescribed a four-drug
regimen, which requires strict compliance. Information about the concurrent administration of all of the
four-drugs in this treatment plan (D) should be reinforced with the client and the healthcare provider
notified of the client's past use of the protocol. (A and B) provide additional information for the client,
but (D) is the most important information to convey to the client. Although partial use of the medication
may be less effective (C), the client's use of the medication must be addressed.
Correct Answer(s): D
,3. The practical nurse (PN) auscultates the abdomen of a client who had a barium swallow 24 hours ago
and determines the client has decreased bowel sounds. The client reports having no bowel movements
for 2 days. Which nursing intervention should the PN implement?
A) Collect a stool specimen for analysis.
B) Limit intake of products with caffeine.
C) Increase fluid intake to 3,000 ml daily.
D) Check digitally for a bowel impaction.
Findings such as decreased or absent bowel sounds and reports of constipation after barium swallow are
indicative of a barium impaction, which can be confirmed by a digital check (D). Although stool analysis
confirms the presence of barium, the client is unable to have a bowel movement (A). (B and C) may
reduce the risk of constipation, but do not address the consequences of retained barium.
Correct Answer(s): D
4. Which client should the practical nurse question a PRN prescription for sumatriptan (Imitrex) for
migraine headaches?
A) 30-year-old with bronchial asthma.
B) 40-year-old with diabetes mellitus.
C) 50-year-old with Prinzmetal’s angina.
D) 60-year-old with chronic kidney disease.
Imitrex reduces pain and other associated symptoms of migraine headache by binding to serotonin
receptors and triggering generalized vasoconstriction, which can cause coronary vasospasm in clients
with Prinzmetal's or variant angina (C). (A, B, and D) are inaccurate.
Correct Answer(s): C
5. An older female client with osteoporosis asks the practical nurse (PN) to explain why she is now 2
inches shorter than when she was younger. What information is best for the practical nurse (PN) to
provide?
A) Loss of calcium in the bones causes the change.
B) Bones get shorter with age due to wear and tear.
, C) Less fluid in each of the disks between the vertebrae occurs with degeneration.
D) It is a combination of wear and tear and calcium loss that causes the change.
A biological theory of aging includes the wear-and-tear theory, which explains that after repeated use
and damage, body structures and functions wear out because of stress. A normal spine at 40 years of
age and osteoporotic changes at 60 and 70 years of age can cause a loss of as much as 6 inches in
height. Small losses in the thickness of each of the intervertebral disks, which results from changes in
disk consistency, erosion, and osteoporosis, can lead to significant changes in height (D). Calcium
changes (A) and wear and tear (B and C) alone do not support significant height loss in aging, but a basic
explanation of disk degeneration that combines several factors provides the client with the best
information.
Correct Answer(s): D
6. A client is scheduled for a transurethral resection of the prostate (TURP). What statement by the
client reveals to the practical nurse that the client needs additional information?
A) “I need to drink a lot after surgery.”
B) “My urine should be red after surgery.”
C) “My incision will probably be painful.”
D) “I should have a catheter after surgery.”
Transurethral resection of the prostate (TURP) is performed by inserting a rectoscope through the
urethra. No incision is made, so the client's statement about an incision (C) indicates the need for more
information about the procedure. Liberal oral fluids are often encouraged (A) after surgery to prevent
infection. Postoperatively, urine is blood-tinged (B) due to resection and traumatized urinary
membranes. A client with TURP should have an indwelling catheter (D) for drainage and bladder
irrigation to prevent occlusion of the catheter with blood clots.
Correct Answer(s): C
7. A male client who had a stroke is incontinent of urine. Which action should the practical nurse (PN)
implement in providing bladder training?
A) Insert a Foley catheter at night to prevent accidents.
B) Offer the client the commode or urinal every two hours.
C) Decrease the client’s oral fluid intake to one liter per day
