PN ADULT MEDICAL SURGICAL 2023 WITH NGN AND PN
ADULT MEDICAL SURGICAL 2023 EXAM PLUS PRACTICE
EXAM | FROM QUESTION TO PERFECTION| STUDY WITH
CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,TEST
A nurse is caring for a client who is taking lithium and reports persistent nausea and vomiting
for 2 days. Which of the following laboratory values should the nurse report to the provider?
a) Potassium 4.0 mEq/L
b) Lithium 0.9 mEq/L
c) BUN 12 mg/dL
d) Sodium 132 mEq/L Answer: D. Sodium 132 mEq/L
Rationale:
The nurse should identify that a sodium level of 132 mEq/L is not within the expected reference
range of 136 to 145 mEq/L. This finding indicates hyponatremia, which can lead to lithium
accumulation and places the client at risk for lithium toxicity. The nurse should report this
finding to the provider.
A nurse is caring for a client who has cancer and has a WBC count of 4,000/mm3. Which of the
following
actions should the nurse take?
a) Cleanse the client's toothbrush with hydrogen peroxide.
b) Instruct the client to use a disposable razor to shave.
c) Decrease the client's protein intake.
d) Encourage the client to eat unpasteurized dairy products. Answer: A. Cleanse the client's
toothbrush with hydrogen peroxide.
Rationale:
A WBC count of 4,000/mm3 is considered low and is known as leukopenia. A low WBC count
can be caused by cancer or cancer treatment. The nurse should instruct the client to cleanse their
toothbrush with hydrogen peroxide. People with leukemia or leukopenia should avoid using
disposable razors, which can cause cuts and bleeding that can lead to infections. Instead, they
recommend using an electric razor to reduce the risk of injury. Encouraging the client to eat
unpasteurized dairy products is not recommended as they can contain harmful bacteria that can
cause infections. Decreasing the client's protein intake is not recommended as protein is
important for wound healing and immune function
TEST
A nurse enters a client's room and sees smoke coming from the bathroom. Which of the
following actions should the nurse take first?
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,a) Activate the fire alarm system.
b) Use a fire extinguisher at the source of the
smoke.
c) Assist the client to a nearby common area.
d) Close the doors to the room and to the
bathroom. Answer: C. Assist the client to a nearby common area.
Rationale:
use
Rescue
Alarm
Contain
Extinguish
TEST
A nurse is contributing to the plan of care for a client who reports difficulty eating due to
chronic arthritis. Which of the following interventions should the nurse include in the plan?
a) Apply foam handles to the client's eating utensils.
b) Obtain a referral for physical therapy.
c) Have an assistive personnel feed the client.
d) Ask the provider for a prescription for a pureed diet. Answer: A. Apply foam handles to the
client's eating utensils.
Rationale:
To help a client with chronic arthritis who experiences difficulty eating, applying foam handles
to the eating utensils can provide a larger, more comfortable grip and reduce strain on the joints.
Asking for a puree diet may not be necessary unless swallowing difficulties are present. Having
an assistive personnel feed the client may not promote independence. While obtaining a referral
for physical therapy may be beneficial for overall mobility, it does not directly address the
client's difficulty with eating.
A nurse is providing directions to an assistive personnel about moving a client up in bed.
a. "Place a pillow under the client's head prior to repositioning."
b. "Keep your feet close together while moving the client"
c "Face in the direction of the client's movement"
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, d. "Move the client's arms to his sides prior to repositioning." Answer: C. "Face in the direction
of the client's movement."
Rational:
When moving a client up in bed, it is important for the nurse to face in the direction of the
client's movement to maintain proper body mechanics and ensure safe transfer.
1)Adjust the head of the bed to a flat position.
2)Remove all pillows from under the client.
3)Position the UAP on the side opposite the nurse.
4)Place a friction-reducing sheet under the client.
5)Ask the client to bend the legs and place the chin on the chest.
6)Grasp the sheet and move the client on the count of three.
A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for
chest discomfort with activity. Which of the following medications should the nurse instruct the
client to avoid taking within 24 hrs of using nitroglycerin?
a) Atorvastatin
b) Metformin
c) Sildenafil
d) Omeprazole Answer: C. Sildenafil
Rationale:
Sildenafil treats PAH (pulmonary arterial hypertension) by relaxing the blood vessels in the
lungs to allow blood to flow easily.
Same as, nitroglycerin is a vaso-dilator which is primarily to treat anginal chest pain and thereby
it reduces blood pressure.
Remaining drugs like omeprazole and atorvastatin can be given for patients with in 24hrs of
nitroglycerin administration.
A nurse is caring for a client who has a new prescription for nitroglycerin. The nurse should
monitor for which of the following adverse effects of the medication?
Nocturia
Increased saliva production
Flushing
Fever Answer: Flushing
Rationale:
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
ADULT MEDICAL SURGICAL 2023 EXAM PLUS PRACTICE
EXAM | FROM QUESTION TO PERFECTION| STUDY WITH
CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,TEST
A nurse is caring for a client who is taking lithium and reports persistent nausea and vomiting
for 2 days. Which of the following laboratory values should the nurse report to the provider?
a) Potassium 4.0 mEq/L
b) Lithium 0.9 mEq/L
c) BUN 12 mg/dL
d) Sodium 132 mEq/L Answer: D. Sodium 132 mEq/L
Rationale:
The nurse should identify that a sodium level of 132 mEq/L is not within the expected reference
range of 136 to 145 mEq/L. This finding indicates hyponatremia, which can lead to lithium
accumulation and places the client at risk for lithium toxicity. The nurse should report this
finding to the provider.
A nurse is caring for a client who has cancer and has a WBC count of 4,000/mm3. Which of the
following
actions should the nurse take?
a) Cleanse the client's toothbrush with hydrogen peroxide.
b) Instruct the client to use a disposable razor to shave.
c) Decrease the client's protein intake.
d) Encourage the client to eat unpasteurized dairy products. Answer: A. Cleanse the client's
toothbrush with hydrogen peroxide.
Rationale:
A WBC count of 4,000/mm3 is considered low and is known as leukopenia. A low WBC count
can be caused by cancer or cancer treatment. The nurse should instruct the client to cleanse their
toothbrush with hydrogen peroxide. People with leukemia or leukopenia should avoid using
disposable razors, which can cause cuts and bleeding that can lead to infections. Instead, they
recommend using an electric razor to reduce the risk of injury. Encouraging the client to eat
unpasteurized dairy products is not recommended as they can contain harmful bacteria that can
cause infections. Decreasing the client's protein intake is not recommended as protein is
important for wound healing and immune function
TEST
A nurse enters a client's room and sees smoke coming from the bathroom. Which of the
following actions should the nurse take first?
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
,a) Activate the fire alarm system.
b) Use a fire extinguisher at the source of the
smoke.
c) Assist the client to a nearby common area.
d) Close the doors to the room and to the
bathroom. Answer: C. Assist the client to a nearby common area.
Rationale:
use
Rescue
Alarm
Contain
Extinguish
TEST
A nurse is contributing to the plan of care for a client who reports difficulty eating due to
chronic arthritis. Which of the following interventions should the nurse include in the plan?
a) Apply foam handles to the client's eating utensils.
b) Obtain a referral for physical therapy.
c) Have an assistive personnel feed the client.
d) Ask the provider for a prescription for a pureed diet. Answer: A. Apply foam handles to the
client's eating utensils.
Rationale:
To help a client with chronic arthritis who experiences difficulty eating, applying foam handles
to the eating utensils can provide a larger, more comfortable grip and reduce strain on the joints.
Asking for a puree diet may not be necessary unless swallowing difficulties are present. Having
an assistive personnel feed the client may not promote independence. While obtaining a referral
for physical therapy may be beneficial for overall mobility, it does not directly address the
client's difficulty with eating.
A nurse is providing directions to an assistive personnel about moving a client up in bed.
a. "Place a pillow under the client's head prior to repositioning."
b. "Keep your feet close together while moving the client"
c "Face in the direction of the client's movement"
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
, d. "Move the client's arms to his sides prior to repositioning." Answer: C. "Face in the direction
of the client's movement."
Rational:
When moving a client up in bed, it is important for the nurse to face in the direction of the
client's movement to maintain proper body mechanics and ensure safe transfer.
1)Adjust the head of the bed to a flat position.
2)Remove all pillows from under the client.
3)Position the UAP on the side opposite the nurse.
4)Place a friction-reducing sheet under the client.
5)Ask the client to bend the legs and place the chin on the chest.
6)Grasp the sheet and move the client on the count of three.
A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for
chest discomfort with activity. Which of the following medications should the nurse instruct the
client to avoid taking within 24 hrs of using nitroglycerin?
a) Atorvastatin
b) Metformin
c) Sildenafil
d) Omeprazole Answer: C. Sildenafil
Rationale:
Sildenafil treats PAH (pulmonary arterial hypertension) by relaxing the blood vessels in the
lungs to allow blood to flow easily.
Same as, nitroglycerin is a vaso-dilator which is primarily to treat anginal chest pain and thereby
it reduces blood pressure.
Remaining drugs like omeprazole and atorvastatin can be given for patients with in 24hrs of
nitroglycerin administration.
A nurse is caring for a client who has a new prescription for nitroglycerin. The nurse should
monitor for which of the following adverse effects of the medication?
Nocturia
Increased saliva production
Flushing
Fever Answer: Flushing
Rationale:
APPHIA – Crafted with Care and Precision for Academic Excellence.
4
