Medical-Surgical Exam Study
Guide – Practice Questions with
Verified Answers with Rationales.
GRADED A+. Latest 2026/2027
Update
When making morning assessments, the practical nurse finds a client who is
exhibiting a new finding of right-sided facial drooping. Which assessment is
most important for the PN to implement first? - Answer✔✔-Test all four
extremities for movement and strength
Rationale:
Unilateral facial droop may be a symptom of an acute brain attack (stroke) or
Bell's Palsy. Unilateral motor deficits are the most obvious effects of a stroke (B)
and should be assessed for first. If ruled out, other assessments can be
performed for the possibility of Bell's Palsy (A, C and D).
An adult male presents in the Emergency Center with "tearing" chest pain that
has moved into his back. Which finding by the practical nurse in the client's
history is relevant to the client's chest pain? - Answer✔✔-Smokes three packs
of cigarettes a day
,Rationale:
Cigarette smoking (A) is the common risk factor associated with hypertension
that contributes to dissecting aneurysms of the aortic arch, which is manifested
by "tearing chest" that radiates to the back. Alcohol consumption (B) does not
have a direct correlation with dissecting aneurysms. Although (C) increases the
client's risk for diabetes, the most relevant client behavior that contributes to
arterial disease is cigarette smoking. (D) is not related to these symptoms.
A client who is positive for human immunodeficiency virus (HIV) comes to the
clinic for a routine check up. During the initial interview, the client's partner
tells the practical nurse (PN) that the client has had several occasions of mental
confusion. The PN should focus questions to determine if the client is
developing which opportunistic infection? - Answer✔✔-Toxoplasmosis.
Rationale:
Clients with HIV who have toxoplasmosis (C) of the brain are most likely to
manifest mental confusion, so questions should focus on this protozoan
infection that is hosted in cats and excreted in cat feces. Although Kaposi's
sarcoma has been associated as an AIDS-defining opportunistic infection, it is a
dermatological sarcoma associated with the herpes virus, not a neurological
complication. (B and D) are respiratory acquired opportunistic infections in
clients with acquired immunodeficiency syndrome (AIDS).
The practical nurse (PN) is monitoring a client with a comminuted fracture of
the left femur. Which finding should the PN report to the healthcare provider
immediately? - Answer✔✔-Leg pain of "10" unrelieved by opioids.
,Rationale:
Compartment syndrome, an emergency complication of circulatory
impairment, is manifested by severe pain unaffected by opioid analgesics (C),
which should be reported immediately. (A and B) are common findings
consistent with trauma. Although (D) should be reported, the presence of a
pulse point provides some oxygenation to distal tissues.
The practical nurse (PN) is caring for a group of clients on a telemetry unit.
Which client requires immediate follow-up by the PN? - Answer✔✔-A client
with multiple premature ventricular contractions (PVC)/minute after receiving
atropine.
Rationale:
A client who is experiencing multiple PVCs/minute (C) is at risk for ventricular
fibrillation (VF) and requires immediate follow-up and treatment. Digoxin slows
the heart rate by decreasing the rate impulse conduction through the AV node,
which is contraindicated in heart block (A), but the client who is at risk for
impending VF is the priority. The PN should continue monitoring (B and D) for
other side effects of glucocorticosteroids and epinephrine, such as trembling
(D), which are not life threatening.
The practical nurse (PN) is transferring a client to the in-patient dialysis unit for
hemodialysis scheduled for today. Which information is essential for the PN to
report to the receiving nurse? - Answer✔✔-Today's hemoglobin result of 8.0
grams.
Rationale:
, The PN should report the client's recent hemoglobin level (D), which is low and
is essential information in planning the client's care for hemodialysis. (A and B)
are standards of care for a client who is receiving dialysis. Although routine
antihypertensive drugs (C) are withheld before hemodialysis, the priority is the
client's need for possible blood transfusion during the next hemodialysis
session.
The practical nurse (PN) receives shift report about a client whose chest x-ray
reveals "free air under the right diaphragm." What action should the PN take? -
Answer✔✔-Maintain the client NPO.
Rationale:
"Free air under the diaphragm" on an upright chest x-ray is most often
indicative of a gastrointestinal perforation, and the client will probably need
surgery, so the client should be kept NPO (A) until that determination is made.
Since the air is outside the colon, hence the term "free air," it will not help to
position (B) or ambulate (C) the client. (D) is not indicated.
The practical nurse (PN) performs a Glasgow Coma Scale (GCS) assessment for
a client who experienced an acute brain attack (stroke) yesterday and obtains a
score of "12." What assessment should the PN do next? - Answer✔✔-
Comparison of GCS score with previous checks.
Rationale:
A key element in neurological assessments is the client's trends, which can be
subtle changes, so the PN should compare the client's present score to
Guide – Practice Questions with
Verified Answers with Rationales.
GRADED A+. Latest 2026/2027
Update
When making morning assessments, the practical nurse finds a client who is
exhibiting a new finding of right-sided facial drooping. Which assessment is
most important for the PN to implement first? - Answer✔✔-Test all four
extremities for movement and strength
Rationale:
Unilateral facial droop may be a symptom of an acute brain attack (stroke) or
Bell's Palsy. Unilateral motor deficits are the most obvious effects of a stroke (B)
and should be assessed for first. If ruled out, other assessments can be
performed for the possibility of Bell's Palsy (A, C and D).
An adult male presents in the Emergency Center with "tearing" chest pain that
has moved into his back. Which finding by the practical nurse in the client's
history is relevant to the client's chest pain? - Answer✔✔-Smokes three packs
of cigarettes a day
,Rationale:
Cigarette smoking (A) is the common risk factor associated with hypertension
that contributes to dissecting aneurysms of the aortic arch, which is manifested
by "tearing chest" that radiates to the back. Alcohol consumption (B) does not
have a direct correlation with dissecting aneurysms. Although (C) increases the
client's risk for diabetes, the most relevant client behavior that contributes to
arterial disease is cigarette smoking. (D) is not related to these symptoms.
A client who is positive for human immunodeficiency virus (HIV) comes to the
clinic for a routine check up. During the initial interview, the client's partner
tells the practical nurse (PN) that the client has had several occasions of mental
confusion. The PN should focus questions to determine if the client is
developing which opportunistic infection? - Answer✔✔-Toxoplasmosis.
Rationale:
Clients with HIV who have toxoplasmosis (C) of the brain are most likely to
manifest mental confusion, so questions should focus on this protozoan
infection that is hosted in cats and excreted in cat feces. Although Kaposi's
sarcoma has been associated as an AIDS-defining opportunistic infection, it is a
dermatological sarcoma associated with the herpes virus, not a neurological
complication. (B and D) are respiratory acquired opportunistic infections in
clients with acquired immunodeficiency syndrome (AIDS).
The practical nurse (PN) is monitoring a client with a comminuted fracture of
the left femur. Which finding should the PN report to the healthcare provider
immediately? - Answer✔✔-Leg pain of "10" unrelieved by opioids.
,Rationale:
Compartment syndrome, an emergency complication of circulatory
impairment, is manifested by severe pain unaffected by opioid analgesics (C),
which should be reported immediately. (A and B) are common findings
consistent with trauma. Although (D) should be reported, the presence of a
pulse point provides some oxygenation to distal tissues.
The practical nurse (PN) is caring for a group of clients on a telemetry unit.
Which client requires immediate follow-up by the PN? - Answer✔✔-A client
with multiple premature ventricular contractions (PVC)/minute after receiving
atropine.
Rationale:
A client who is experiencing multiple PVCs/minute (C) is at risk for ventricular
fibrillation (VF) and requires immediate follow-up and treatment. Digoxin slows
the heart rate by decreasing the rate impulse conduction through the AV node,
which is contraindicated in heart block (A), but the client who is at risk for
impending VF is the priority. The PN should continue monitoring (B and D) for
other side effects of glucocorticosteroids and epinephrine, such as trembling
(D), which are not life threatening.
The practical nurse (PN) is transferring a client to the in-patient dialysis unit for
hemodialysis scheduled for today. Which information is essential for the PN to
report to the receiving nurse? - Answer✔✔-Today's hemoglobin result of 8.0
grams.
Rationale:
, The PN should report the client's recent hemoglobin level (D), which is low and
is essential information in planning the client's care for hemodialysis. (A and B)
are standards of care for a client who is receiving dialysis. Although routine
antihypertensive drugs (C) are withheld before hemodialysis, the priority is the
client's need for possible blood transfusion during the next hemodialysis
session.
The practical nurse (PN) receives shift report about a client whose chest x-ray
reveals "free air under the right diaphragm." What action should the PN take? -
Answer✔✔-Maintain the client NPO.
Rationale:
"Free air under the diaphragm" on an upright chest x-ray is most often
indicative of a gastrointestinal perforation, and the client will probably need
surgery, so the client should be kept NPO (A) until that determination is made.
Since the air is outside the colon, hence the term "free air," it will not help to
position (B) or ambulate (C) the client. (D) is not indicated.
The practical nurse (PN) performs a Glasgow Coma Scale (GCS) assessment for
a client who experienced an acute brain attack (stroke) yesterday and obtains a
score of "12." What assessment should the PN do next? - Answer✔✔-
Comparison of GCS score with previous checks.
Rationale:
A key element in neurological assessments is the client's trends, which can be
subtle changes, so the PN should compare the client's present score to
