Med Surg Final UPDATED Actual Exam
Questions and CORRECT Answers
A nurse is planning dietary teaching for a client who has diabetes mellitus. Which of the
following actions should the nurse plan to take first? - CORRECT ANSWER✔✔- Ask the
client to identify the types of foods she prefers.
A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose
reading of 48 mg/dL. Which of the following findings should the nurse expect? - CORRECT
ANSWER✔✔- Diaphoresis
A nurse is caring for a client who is 72 hr postoperative following an above-the-knee
amputation. Which of the following actions should the nurse take? - CORRECT
ANSWER✔✔- Assist the client to a prone position every 4 hr.
A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to
prevent future uric acid stones. Which of the following suggestions should the nurse make?
(Select all that apply.) - CORRECT ANSWER✔✔- Take allopurinol as prescribed.
Exercise several times a week.
Limit intake of foods high in purine.
A nurse in an emergency department is assessing a client who sustained a fall off of a roof.
Which of the following findings should the nurse identify as an indication of a basilar skull
fracture? - CORRECT ANSWER✔✔- Clear fluid coming from the nares
A nurse is teaching a client how to perform a breast self exam (BSE). The nurse should
identify which of the following findings as an indication of breast cancer? - CORRECT
ANSWER✔✔- A nontender, hard lump that is palpated in one breast
A nurse is providing discharge teaching about improving gas exchange to a client who has
emphysema. Which of the following instructions should the nurse include in the teaching? -
CORRECT ANSWER✔✔- Use pursed-lip breathing during periods of dyspnea.
A nurse is caring for a client who has an upper gastrointestinal bleed and a hematocrit of
24%. Prior to initiating a transfusion of packed red blood cells (RBCs), which of the
,following actions should the nurse take? (Select all that apply.) - CORRECT ANSWER✔✔-
Assess and document the client's vital signs.
Verify with another nurse the blood type and Rh of the packed RBCs.
Change IV tubing to a set that has a filter.
A nurse is preparing to change the bed linens of a client who has AIDS and is incontinent of
stool. Which of the following personal protective equipment (PPE) should the nurse don prior
to providing client care? (Select all that apply.) - CORRECT ANSWER✔✔- Gown
Gloves
A nurse is caring for a client who begins having a tonic-clonic seizure while sitting in a chair
at the bedside. Which of the following actions should the nurse take first? - CORRECT
ANSWER✔✔- Lower the client to the floor.
A nurse is caring for a client following a hip arthroplasty. The nurse places an abduction
pillow on the client for which of the following purposes? - CORRECT ANSWER✔✔-
Preventing dislocation of the hip during position changes or movement
A nurse in the emergency department is caring for a client who has fruity breath odor, dry
mouth, and extreme thirst. Which of the following assessments should the nurse make? -
CORRECT ANSWER✔✔- Blood glucose level
A nurse is caring for a client who has a stage III pressure ulcer on the heel. When preparing to
irrigate the wound, which of the following actions should the nurse take first? - CORRECT
ANSWER✔✔- Check the client's pain level.
A nurse is providing postoperative care for a client who has two chest tubes in place
following a lobectomy. The client asks the nurse the reason for having two chest tubes. The
nurse should inform the client that the lower chest tube is placed for which of the following
reasons? - CORRECT ANSWER✔✔- Draining blood and fluid from the pleural space
A nurse is providing teaching to a client who has stomatitis due to chemotherapy and
radiation therapy. Which of the following statements by the client indicates a need for further
teaching? - CORRECT ANSWER✔✔- "I will use lemon and glycerine swabs after meals."
, A nurse is providing discharge teaching to a client who has a new permanent pacemaker.
Which of the following statements by the client indicates an understanding of the teaching? -
CORRECT ANSWER✔✔- "I should check my heart rate at the same time each day."
A nurse is reviewing a client's laboratory report. The client's ABG levels are pH 7.5, PaCO2
32 mm HG, and HCO3- 24 mEq/L. The nurse should determine that the client has which of
the following acid-base imbalances? - CORRECT ANSWER✔✔- Respiratory alkalosis
A nurse is preparing to care for a group of clients after receiving change-of-shift report.
Which of the following clients should the nurse assess first? - CORRECT ANSWER✔✔- A
client who has emphysema and reports dyspnea
A nurse is obtaining a weekly weight for a client who has obesity and osteoarthritis and is on
a weight management program. The nurse determines that the client gained 1.36 kg (3 lb) in
the past week. Which of the following statements should the nurse make? - CORRECT
ANSWER✔✔- "Were there any issues last week that kept you from focusing on your diet?"
A nurse is caring for a client who is receiving intermittent peritoneal dialysis. The nurse
observes that the peritoneal fluid is not adequately draining. Which of the following actions
should the nurse take? - CORRECT ANSWER✔✔- Turn the client from side to side.
A nurse is providing teaching to a client who has tuberculosis (TB) and a prescription for
isoniazid. Which of the following instructions should the nurse include? - CORRECT
ANSWER✔✔- "You should take this medication on an empty stomach."
A nurse is caring for a client who has continuous bladder irrigation following a transurethral
resection of the prostate (TURP). Which of the following findings should the nurse report to
the provider? - CORRECT ANSWER✔✔- Viscous urinary output with clots
A nurse is providing discharge teaching to an adult female client who has infective
endocarditis about how to prevent recurrence. Which of the following statements by the client
indicates understanding of the teaching? - CORRECT ANSWER✔✔- "I will notify my
doctor before I have dental procedures."
A nurse is providing teaching about antiretroviral medication therapy to a client who has a
new diagnosis of AIDS. Which of the following statements should the nurse include in the
Questions and CORRECT Answers
A nurse is planning dietary teaching for a client who has diabetes mellitus. Which of the
following actions should the nurse plan to take first? - CORRECT ANSWER✔✔- Ask the
client to identify the types of foods she prefers.
A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose
reading of 48 mg/dL. Which of the following findings should the nurse expect? - CORRECT
ANSWER✔✔- Diaphoresis
A nurse is caring for a client who is 72 hr postoperative following an above-the-knee
amputation. Which of the following actions should the nurse take? - CORRECT
ANSWER✔✔- Assist the client to a prone position every 4 hr.
A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to
prevent future uric acid stones. Which of the following suggestions should the nurse make?
(Select all that apply.) - CORRECT ANSWER✔✔- Take allopurinol as prescribed.
Exercise several times a week.
Limit intake of foods high in purine.
A nurse in an emergency department is assessing a client who sustained a fall off of a roof.
Which of the following findings should the nurse identify as an indication of a basilar skull
fracture? - CORRECT ANSWER✔✔- Clear fluid coming from the nares
A nurse is teaching a client how to perform a breast self exam (BSE). The nurse should
identify which of the following findings as an indication of breast cancer? - CORRECT
ANSWER✔✔- A nontender, hard lump that is palpated in one breast
A nurse is providing discharge teaching about improving gas exchange to a client who has
emphysema. Which of the following instructions should the nurse include in the teaching? -
CORRECT ANSWER✔✔- Use pursed-lip breathing during periods of dyspnea.
A nurse is caring for a client who has an upper gastrointestinal bleed and a hematocrit of
24%. Prior to initiating a transfusion of packed red blood cells (RBCs), which of the
,following actions should the nurse take? (Select all that apply.) - CORRECT ANSWER✔✔-
Assess and document the client's vital signs.
Verify with another nurse the blood type and Rh of the packed RBCs.
Change IV tubing to a set that has a filter.
A nurse is preparing to change the bed linens of a client who has AIDS and is incontinent of
stool. Which of the following personal protective equipment (PPE) should the nurse don prior
to providing client care? (Select all that apply.) - CORRECT ANSWER✔✔- Gown
Gloves
A nurse is caring for a client who begins having a tonic-clonic seizure while sitting in a chair
at the bedside. Which of the following actions should the nurse take first? - CORRECT
ANSWER✔✔- Lower the client to the floor.
A nurse is caring for a client following a hip arthroplasty. The nurse places an abduction
pillow on the client for which of the following purposes? - CORRECT ANSWER✔✔-
Preventing dislocation of the hip during position changes or movement
A nurse in the emergency department is caring for a client who has fruity breath odor, dry
mouth, and extreme thirst. Which of the following assessments should the nurse make? -
CORRECT ANSWER✔✔- Blood glucose level
A nurse is caring for a client who has a stage III pressure ulcer on the heel. When preparing to
irrigate the wound, which of the following actions should the nurse take first? - CORRECT
ANSWER✔✔- Check the client's pain level.
A nurse is providing postoperative care for a client who has two chest tubes in place
following a lobectomy. The client asks the nurse the reason for having two chest tubes. The
nurse should inform the client that the lower chest tube is placed for which of the following
reasons? - CORRECT ANSWER✔✔- Draining blood and fluid from the pleural space
A nurse is providing teaching to a client who has stomatitis due to chemotherapy and
radiation therapy. Which of the following statements by the client indicates a need for further
teaching? - CORRECT ANSWER✔✔- "I will use lemon and glycerine swabs after meals."
, A nurse is providing discharge teaching to a client who has a new permanent pacemaker.
Which of the following statements by the client indicates an understanding of the teaching? -
CORRECT ANSWER✔✔- "I should check my heart rate at the same time each day."
A nurse is reviewing a client's laboratory report. The client's ABG levels are pH 7.5, PaCO2
32 mm HG, and HCO3- 24 mEq/L. The nurse should determine that the client has which of
the following acid-base imbalances? - CORRECT ANSWER✔✔- Respiratory alkalosis
A nurse is preparing to care for a group of clients after receiving change-of-shift report.
Which of the following clients should the nurse assess first? - CORRECT ANSWER✔✔- A
client who has emphysema and reports dyspnea
A nurse is obtaining a weekly weight for a client who has obesity and osteoarthritis and is on
a weight management program. The nurse determines that the client gained 1.36 kg (3 lb) in
the past week. Which of the following statements should the nurse make? - CORRECT
ANSWER✔✔- "Were there any issues last week that kept you from focusing on your diet?"
A nurse is caring for a client who is receiving intermittent peritoneal dialysis. The nurse
observes that the peritoneal fluid is not adequately draining. Which of the following actions
should the nurse take? - CORRECT ANSWER✔✔- Turn the client from side to side.
A nurse is providing teaching to a client who has tuberculosis (TB) and a prescription for
isoniazid. Which of the following instructions should the nurse include? - CORRECT
ANSWER✔✔- "You should take this medication on an empty stomach."
A nurse is caring for a client who has continuous bladder irrigation following a transurethral
resection of the prostate (TURP). Which of the following findings should the nurse report to
the provider? - CORRECT ANSWER✔✔- Viscous urinary output with clots
A nurse is providing discharge teaching to an adult female client who has infective
endocarditis about how to prevent recurrence. Which of the following statements by the client
indicates understanding of the teaching? - CORRECT ANSWER✔✔- "I will notify my
doctor before I have dental procedures."
A nurse is providing teaching about antiretroviral medication therapy to a client who has a
new diagnosis of AIDS. Which of the following statements should the nurse include in the
