Medical-Surgical Practice Exam with
Complete Solutions
Which client should the practical nurse question a PRN prescription for sumatriptan
(Imitrex) for migraine headaches? - ANS-C. 50-year-old with Prinzmetal's angina.
The practical nurse (PN) is reinforcing information to a older male client with a history of
coronary artery disease about his prescribed daily medication regimen. Which
medication is most likely to reduce the client's risk factors? - ANS-D. A low-dose aspirin
given daily.
An adult client with otitis media has thick, yellow drainage from the right ear canal. What
additional findings should the practical nurse (PN) expect to identify? - ANS-A. Pain
relief after ear drainage begins.
The practical nurse is caring for a client who is admitted with signs of possible acute
brain attack (Stroke) three hours ago. The client's blood pressure is 170/96, regular
radial pulse 76 beats/minute, respirations are nonlabored at 11 breaths/minute, and a
Sp02 of 99%. What action is most important for the PN to implement? - ANS-C.
Continue to monitor client's blood pressure.
A client who was hit in the head with a baseball is admitted to the hospital for
observation. Which finding requires the practical nurse (PN) to follow-up with further
assessment? - ANS-D. Reports the hospital room is an office.
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? - ANS-D. It is a combination of wear and tear and
calcium loss that causes the change.
A practical nurse (PN) is coordinating the care of four clients on an oncology unit. Which
neutrophil count should the PN identify as a risk for a life-threatening infection in one of
the clients? - ANS-A. 500/mm3.
An older client who has had a cataract in the right eye for several years tells the
practical nurse (PN), "Now I have lost the sight in my right eye because I waited too
long for treatment." What information should the PN provide? - ANS-C. Surgery can
restore vision with corrective lens implants or glasses.
The practical nurse (PN) is visiting a male client with diabetes who has a new cast on
his arm. The client's fingers are pale, cool, slightly swollen, and the radial pulse is
, strong. What should the PN do first? - ANS-D. Elevate the arm above the level of the
heart.
A client with epilepsy is having bilateral rhythmic jerking movements of all extremities.
After calling for help, which action should the practical nurse (PN) do next? - ANS-1.
Maintain the client's airway
2. Apply pads to the bedside rails.
3. Avoid stimulation during post-ictal phase.
4. Observe the client for incontinence.
The practical nurse (PN) should place a client in which position for a thoracentesis? -
ANS-B. Sitting upright in a tripod position leaning on an overbed table.
Which action should the practical nurse take when handling a sample of cerebrospinal
fluid (CSF) collected for diagnostic testing from a client? - ANS-A. Implement standard
precautions with the CSF specimen.
Which instruction should the practical nurse (PN) reinforce with a female client about
skin care after her first radiotherapy treatment? - ANS-C. Avoid using ice packs on the
exposed area.
A client with heart failure (HF) takes a daily tablet of furosemide (Lasix) and lisinopril
(Zestril). Which finding during the clinic visit should indicate to the practical nurse that
the client's condition is worsening? - ANS-D. Sleeps with two additional pillows.
A client who is 3 days postoperative after a laminectomy is coughing up thick green
sputum and wheezing. What action is most important for the practical nurse (PN) to
implement? - ANS-D. Report the change in condition to the healthcare provider.
A male client who had a stroke is incontinent of urine. Which action should the practical
nurse (PN) implement in providing bladder training? - ANS-B. Offer the client the
commode or urinal every two hours.
Which action should the practical nurse (PN) implement to reduce the risk of infection
for a client who is receiving total parenteral nutrition (TPN)? - ANS-C. Change the
transparent dressing every 72 hours.
Which finding should the practical nurse (PN) identify as typical for a client who is
hypoxic? - ANS-B. Hemoglobin of 10 grams/dl
Which finding for a client who is 1-day postoperative for a partial thyroidectomy requires
immediate follow-up by the practical nurse (PN)? - ANS-A. High pitched expiratory
sound.
Which findings should the practical nurse identify in a client with anemia due to a
vitamin B12 deficiency? (Select all) - ANS-B. Smooth, beefy-red oral cavity.
Complete Solutions
Which client should the practical nurse question a PRN prescription for sumatriptan
(Imitrex) for migraine headaches? - ANS-C. 50-year-old with Prinzmetal's angina.
The practical nurse (PN) is reinforcing information to a older male client with a history of
coronary artery disease about his prescribed daily medication regimen. Which
medication is most likely to reduce the client's risk factors? - ANS-D. A low-dose aspirin
given daily.
An adult client with otitis media has thick, yellow drainage from the right ear canal. What
additional findings should the practical nurse (PN) expect to identify? - ANS-A. Pain
relief after ear drainage begins.
The practical nurse is caring for a client who is admitted with signs of possible acute
brain attack (Stroke) three hours ago. The client's blood pressure is 170/96, regular
radial pulse 76 beats/minute, respirations are nonlabored at 11 breaths/minute, and a
Sp02 of 99%. What action is most important for the PN to implement? - ANS-C.
Continue to monitor client's blood pressure.
A client who was hit in the head with a baseball is admitted to the hospital for
observation. Which finding requires the practical nurse (PN) to follow-up with further
assessment? - ANS-D. Reports the hospital room is an office.
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? - ANS-D. It is a combination of wear and tear and
calcium loss that causes the change.
A practical nurse (PN) is coordinating the care of four clients on an oncology unit. Which
neutrophil count should the PN identify as a risk for a life-threatening infection in one of
the clients? - ANS-A. 500/mm3.
An older client who has had a cataract in the right eye for several years tells the
practical nurse (PN), "Now I have lost the sight in my right eye because I waited too
long for treatment." What information should the PN provide? - ANS-C. Surgery can
restore vision with corrective lens implants or glasses.
The practical nurse (PN) is visiting a male client with diabetes who has a new cast on
his arm. The client's fingers are pale, cool, slightly swollen, and the radial pulse is
, strong. What should the PN do first? - ANS-D. Elevate the arm above the level of the
heart.
A client with epilepsy is having bilateral rhythmic jerking movements of all extremities.
After calling for help, which action should the practical nurse (PN) do next? - ANS-1.
Maintain the client's airway
2. Apply pads to the bedside rails.
3. Avoid stimulation during post-ictal phase.
4. Observe the client for incontinence.
The practical nurse (PN) should place a client in which position for a thoracentesis? -
ANS-B. Sitting upright in a tripod position leaning on an overbed table.
Which action should the practical nurse take when handling a sample of cerebrospinal
fluid (CSF) collected for diagnostic testing from a client? - ANS-A. Implement standard
precautions with the CSF specimen.
Which instruction should the practical nurse (PN) reinforce with a female client about
skin care after her first radiotherapy treatment? - ANS-C. Avoid using ice packs on the
exposed area.
A client with heart failure (HF) takes a daily tablet of furosemide (Lasix) and lisinopril
(Zestril). Which finding during the clinic visit should indicate to the practical nurse that
the client's condition is worsening? - ANS-D. Sleeps with two additional pillows.
A client who is 3 days postoperative after a laminectomy is coughing up thick green
sputum and wheezing. What action is most important for the practical nurse (PN) to
implement? - ANS-D. Report the change in condition to the healthcare provider.
A male client who had a stroke is incontinent of urine. Which action should the practical
nurse (PN) implement in providing bladder training? - ANS-B. Offer the client the
commode or urinal every two hours.
Which action should the practical nurse (PN) implement to reduce the risk of infection
for a client who is receiving total parenteral nutrition (TPN)? - ANS-C. Change the
transparent dressing every 72 hours.
Which finding should the practical nurse (PN) identify as typical for a client who is
hypoxic? - ANS-B. Hemoglobin of 10 grams/dl
Which finding for a client who is 1-day postoperative for a partial thyroidectomy requires
immediate follow-up by the practical nurse (PN)? - ANS-A. High pitched expiratory
sound.
Which findings should the practical nurse identify in a client with anemia due to a
vitamin B12 deficiency? (Select all) - ANS-B. Smooth, beefy-red oral cavity.
