PN MEDICAL- ADULT MEDICAL SURGICAL EXAM
Q&A 2025
A Nurse Is Caring For A Client Who Has A History Of Cirrhosis And Is Admitted With Manifestations Of
Hepatic Encephalopathy. The Nurse Should Anticipate A Prescription For Which Of The Following
Laboratory Tests To Determine The Possibility Of Recent Excessive Alcohol Use?
A. Gamma-Gluramyl Transferase ( GGT )
B. Alkaline Phosphatase ( ALP )
C. Serum Bilirubin
D.Alanine Aminotransferase (ALT] - CORRECT ANSWER A. CORRECT: The GGT Laboratory Test Is Specific
To The Hepatobiliary System In Which Levels Can Be Raised By Alcohol And Hepatotoxic Drugs.
Therefore, It Is Useful For Monitoring Drug Toxicity And Excessive Alcohol Use.
B. ALP Is Elevated In Biliary Obstruction And Most Forms Of Liver Dysfunction. It Does Not
Differentiate Between Alcohol And Other Causative Factors For Liver Disease.
C. The Serum Bilirubin Test Is Used To Detect The Function Of The Liver And Its Ability To
Excrete Bilirubin. Elevated Levels Can Determine Liver Disease Or Biliary Tract Disease.
D.The Largest Concentration Of The Enzyme ALT Is Found In Liver Tissue. However. It Is Also Present In
Kidney, Heart. And Skeletal Muscle Tissues. Because It Is Elevated In Various Toes Of Tissue Damage. It
Is Not Helpful In Identifying Excessive Alcohol Use.
A Nurse Is Providing Dietary Teaching To A Client Who Has Diverticulitis About Preventing Acute Attacks.
Which Of The Following Foods Should The Nurse Recommend?
A. Foods High In Vitamin C
B. Foods Low In Fat
C. Foods High In Fiber
D.Foods Low In Calories - CORRECT ANSWER A. Vitamin C Functions As An Antioxidant As Well As A
Coenzyme. It Can Be Associated With Prevention Of Cancer Of The Stomach. Esophagus And Colon.
However, It Does Not Improve Or Prevent Acute Diverticulitis Attacks.
B. Low-Fat Foods Do Not Improve Or Prevent Acute Diverticulitis Attacks.
,PN MEDICAL- ADULT MEDICAL SURGICAL EXAM
Q&A
C. CORRECT: The Result Of Long-Term, Low-Fiber Eating Habits Along With Increased
Intracolonic Pressure Lead To Straining During Bowel Movements, Causing The Development Of
Diverticula. High-Fiber Foods Help Strengthen And Maintain Active Motility Of The Gastrointestinal Tract.
D.Low-Calorie Foods Do Not Improve Or Prevent Acute Diverticulitis Attacks.
A Nurse Is Caring For A Client Who Is 4 Hr Postoperative Following A Laparoscopic
Cholecystectomy. Which Of The Following Findings Should The Nurse Expect?
A. Right Shoulder Pain
B. Urine Output 20 Ml/Hr
C. Temperature 38.4 Degrees C (101.1 Degrees F)
D.Oxygen Saturation 92% - CORRECT ANSWER A. CORRECT: The Client Can Experience Pain In The Right
Upper Shoulder Due To Gas (Carbon Dioxide) Injected Into The Abdominal Cavity During The
Laparoscopic Procedure, Which Can Irritate The Diaphragm And Cause Referred Pain In The Shoulder
Area. The Pain Disappears In 12 Days. Mild Analgesics And A Recumbent Position Can Help With Client
Comfort.
B. Urine Output Following Surgery Should Be At Least 30 Ml/Hr. Less Than This Amount Can Indicate
Hypovolemia Or Renal Complications And Should Be Reported To The Provider Immediately.
C. A Temperature Greater Than 38.4. C (101.1 F) Can Indicate Infection And Should Be Reported To
The Provider Immediately.
D.An Oxygen Saturation Of Less Than 95% Can Indicate An Impaired Gas Exchange Following Surgery
And Should Be Reported To The Provider Immediately.
A Nurse In The Emergency Dependent Is Caring For A Client Who Has Bleeding Esophageal Varies. The
Nurse Should Anticipate A Prescription For Which Of The Following Medications?
A. Famotidine
B. Esomeprazole
C. Vasopressin
D.Omeprazole - CORRECT ANSWER A. Famotidine Is An H2 Receptor Antagonist Used To Treat Stress
Ulcers.
B. Esomeprazole Is A Proton Pump Inhibitor Used To Treat Gastrointestinal Reflux Disease.
,C. CORRECT: Vasopressin Constricts The Splanchnic Bed And Decreases Portal Pressure. Vasopressin Also
Constricts The Distal Esophageal And Proximal Gastric Veins, Which Reduces Inflow Into The Portal
System And Is Used To Treat Bleeding Varies.
D.Omeprazole Is A Proton Pump Inhibitor Used To Treat Duodenal And Gastric Ulcers.
A Nurse Is Assessing A Client Who Is In The Early Stages Of Hepatitis A. Which Of The Following
Manifestations Should The Nurse Expect?
A
A. Jaundice
B. Dark Urine
D.Pale Feces - CORRECT ANSWER A. Jaundice Is A Late Manifestation Of Hepatitis A.
B. CORRECT: Anorexia Is An Early Manifestation Of Hepatitis A And Is Often Severe. It Is Thought To
Result From The Release Of A Toxin By The Damaged Liver Or By The Failure Of The Damaged Liver
Cells To Detoxify An Abnormal Product. C. Dark Urine Is A Late Manifestation Of Hepatitis A.
D.Pale Feces Is A Late Manifestation Of Hepatitis A.
A Nurse Is Caring For A Client Who Has Acute Pancreatitis. Which Of The Following Serum Laboratory
Values Should The Nurse Anticipate Returning To The Expected Reference Range Within 72 Hr After
Treatment Begins?
A. Aldolase
B. Lipase
C. Amylase
D.Lactic Dehydrogenase - CORRECT ANSWER A. Elevated Aldolase Levels Are Caused By Inflammation Of
The Muscles, Also Known As Myositis. The Levels Of Aldolase Are Not Affected By Pancreatic Disorders.
B. Lipase Levels In Clients Who Have Pancreatitis Increase After A Rise In Serum Amylase And
Stay Elevated For Up To 14 Days Longer Than Amylase.
C. CORRECT: Pancreatitis Is The Most Common Diagnosis For Marked Elevations In Serum
Amylase. Serum Amylase Begins To Increase About 3 To 6 Hr Following The Onset Of Acute
Pancreatitis. The Amylase Level Peaks In 20 To 30 Hr And Returns To The Expected Reference
Range Within 2 To 3 Days.
D.Lactic Dehydrogenase (LDH) Increases Are Typically Seen In Clients Who Have Anemia,
Leukemia, Or Liver Damage.
, PN MEDICAL- ADULT MEDICAL SURGICAL EXAM
Q&A
A Nurse Is Caring For A Client Who Is 2 Days Postoperative Following A Gastric Bypass. The Nurse Notes
That Bowel Sounds Are Present. Which Of The Following Foods Should The Nurse Provide At The Initial
Feeding?
A. Vanilla Pudding
B. Apple Juice
C. Diet Ginger Ale
D.Clear Liquids - CORRECT ANSWER A. Vanilla Pudding Contains Sugar, Which Can Cause Diarrhea
Due To Hyperosmolarity. Clear Liquids Should Be Given As The First Oral Feeding.
B. The Sugar Content Of Apple Juice Can Cause Diarrhea Due To Hyperosmolarity. Clear
Liquids Should Be Given As The First Oral Feeding.
C. The Client Should Avoid Carbonated Beverages Because They Can Distend The Stomach.
Causing Pressure On The Internal Sutures Or Staples. Pressure Can Cause Leaking Into The
Peritoneum Resulting In Peritonitis.
D.CORRECT: Clear Liquids. Such As Water Or Broth. Can Be Given For The First Oral Feedings. But Should
Be Limited To Only 30 Ml (1 Oz) Per Feeding. Water Does Not Contain Sugar. Which Could Cause
Diarrhea Due To Hyperosmolarity.
A Nurse Is Completing A History And Physical Assessment For A Client Who Has Chronic Pancreatitis.
Which Of The Following Findings Should The Nurse Identify As A Likely Cause Of The Client's Condition?
A. High-Calorie Diet
B. Prior Gastrointestinal Illnesses
C. Tobacco Use
D.Alcohol Use - CORRECT ANSWER A. A High-Calorie Diet Can Contribute To Heart Disease And Obesity
But It Does Not Cause Chronic Pancreatitis.
B. A Prior Gastrointestinal Illness Does Not Cause Or Contribute To Chronic Pancreatitis.
C. Tobacco Use Can Contribute To Heart Disease And Increases The Risk Of Cancer Development. But It
Does Not Cause Chronic Pancreatitis.
D.CORRECT: Alcohol Consumption Is One Of The Major Causes Of Chronic Pancreatitis In The
U.S. Long-Term Alcohol Use Disorder Produces Hyper Secretion Of Protein In Pancreatic Secretions. The
Result Is Protein Plugs And Calculi Within The Pancreatic Ducts. Alcohol Also Has A Direct Toxic Effect On
Q&A 2025
A Nurse Is Caring For A Client Who Has A History Of Cirrhosis And Is Admitted With Manifestations Of
Hepatic Encephalopathy. The Nurse Should Anticipate A Prescription For Which Of The Following
Laboratory Tests To Determine The Possibility Of Recent Excessive Alcohol Use?
A. Gamma-Gluramyl Transferase ( GGT )
B. Alkaline Phosphatase ( ALP )
C. Serum Bilirubin
D.Alanine Aminotransferase (ALT] - CORRECT ANSWER A. CORRECT: The GGT Laboratory Test Is Specific
To The Hepatobiliary System In Which Levels Can Be Raised By Alcohol And Hepatotoxic Drugs.
Therefore, It Is Useful For Monitoring Drug Toxicity And Excessive Alcohol Use.
B. ALP Is Elevated In Biliary Obstruction And Most Forms Of Liver Dysfunction. It Does Not
Differentiate Between Alcohol And Other Causative Factors For Liver Disease.
C. The Serum Bilirubin Test Is Used To Detect The Function Of The Liver And Its Ability To
Excrete Bilirubin. Elevated Levels Can Determine Liver Disease Or Biliary Tract Disease.
D.The Largest Concentration Of The Enzyme ALT Is Found In Liver Tissue. However. It Is Also Present In
Kidney, Heart. And Skeletal Muscle Tissues. Because It Is Elevated In Various Toes Of Tissue Damage. It
Is Not Helpful In Identifying Excessive Alcohol Use.
A Nurse Is Providing Dietary Teaching To A Client Who Has Diverticulitis About Preventing Acute Attacks.
Which Of The Following Foods Should The Nurse Recommend?
A. Foods High In Vitamin C
B. Foods Low In Fat
C. Foods High In Fiber
D.Foods Low In Calories - CORRECT ANSWER A. Vitamin C Functions As An Antioxidant As Well As A
Coenzyme. It Can Be Associated With Prevention Of Cancer Of The Stomach. Esophagus And Colon.
However, It Does Not Improve Or Prevent Acute Diverticulitis Attacks.
B. Low-Fat Foods Do Not Improve Or Prevent Acute Diverticulitis Attacks.
,PN MEDICAL- ADULT MEDICAL SURGICAL EXAM
Q&A
C. CORRECT: The Result Of Long-Term, Low-Fiber Eating Habits Along With Increased
Intracolonic Pressure Lead To Straining During Bowel Movements, Causing The Development Of
Diverticula. High-Fiber Foods Help Strengthen And Maintain Active Motility Of The Gastrointestinal Tract.
D.Low-Calorie Foods Do Not Improve Or Prevent Acute Diverticulitis Attacks.
A Nurse Is Caring For A Client Who Is 4 Hr Postoperative Following A Laparoscopic
Cholecystectomy. Which Of The Following Findings Should The Nurse Expect?
A. Right Shoulder Pain
B. Urine Output 20 Ml/Hr
C. Temperature 38.4 Degrees C (101.1 Degrees F)
D.Oxygen Saturation 92% - CORRECT ANSWER A. CORRECT: The Client Can Experience Pain In The Right
Upper Shoulder Due To Gas (Carbon Dioxide) Injected Into The Abdominal Cavity During The
Laparoscopic Procedure, Which Can Irritate The Diaphragm And Cause Referred Pain In The Shoulder
Area. The Pain Disappears In 12 Days. Mild Analgesics And A Recumbent Position Can Help With Client
Comfort.
B. Urine Output Following Surgery Should Be At Least 30 Ml/Hr. Less Than This Amount Can Indicate
Hypovolemia Or Renal Complications And Should Be Reported To The Provider Immediately.
C. A Temperature Greater Than 38.4. C (101.1 F) Can Indicate Infection And Should Be Reported To
The Provider Immediately.
D.An Oxygen Saturation Of Less Than 95% Can Indicate An Impaired Gas Exchange Following Surgery
And Should Be Reported To The Provider Immediately.
A Nurse In The Emergency Dependent Is Caring For A Client Who Has Bleeding Esophageal Varies. The
Nurse Should Anticipate A Prescription For Which Of The Following Medications?
A. Famotidine
B. Esomeprazole
C. Vasopressin
D.Omeprazole - CORRECT ANSWER A. Famotidine Is An H2 Receptor Antagonist Used To Treat Stress
Ulcers.
B. Esomeprazole Is A Proton Pump Inhibitor Used To Treat Gastrointestinal Reflux Disease.
,C. CORRECT: Vasopressin Constricts The Splanchnic Bed And Decreases Portal Pressure. Vasopressin Also
Constricts The Distal Esophageal And Proximal Gastric Veins, Which Reduces Inflow Into The Portal
System And Is Used To Treat Bleeding Varies.
D.Omeprazole Is A Proton Pump Inhibitor Used To Treat Duodenal And Gastric Ulcers.
A Nurse Is Assessing A Client Who Is In The Early Stages Of Hepatitis A. Which Of The Following
Manifestations Should The Nurse Expect?
A
A. Jaundice
B. Dark Urine
D.Pale Feces - CORRECT ANSWER A. Jaundice Is A Late Manifestation Of Hepatitis A.
B. CORRECT: Anorexia Is An Early Manifestation Of Hepatitis A And Is Often Severe. It Is Thought To
Result From The Release Of A Toxin By The Damaged Liver Or By The Failure Of The Damaged Liver
Cells To Detoxify An Abnormal Product. C. Dark Urine Is A Late Manifestation Of Hepatitis A.
D.Pale Feces Is A Late Manifestation Of Hepatitis A.
A Nurse Is Caring For A Client Who Has Acute Pancreatitis. Which Of The Following Serum Laboratory
Values Should The Nurse Anticipate Returning To The Expected Reference Range Within 72 Hr After
Treatment Begins?
A. Aldolase
B. Lipase
C. Amylase
D.Lactic Dehydrogenase - CORRECT ANSWER A. Elevated Aldolase Levels Are Caused By Inflammation Of
The Muscles, Also Known As Myositis. The Levels Of Aldolase Are Not Affected By Pancreatic Disorders.
B. Lipase Levels In Clients Who Have Pancreatitis Increase After A Rise In Serum Amylase And
Stay Elevated For Up To 14 Days Longer Than Amylase.
C. CORRECT: Pancreatitis Is The Most Common Diagnosis For Marked Elevations In Serum
Amylase. Serum Amylase Begins To Increase About 3 To 6 Hr Following The Onset Of Acute
Pancreatitis. The Amylase Level Peaks In 20 To 30 Hr And Returns To The Expected Reference
Range Within 2 To 3 Days.
D.Lactic Dehydrogenase (LDH) Increases Are Typically Seen In Clients Who Have Anemia,
Leukemia, Or Liver Damage.
, PN MEDICAL- ADULT MEDICAL SURGICAL EXAM
Q&A
A Nurse Is Caring For A Client Who Is 2 Days Postoperative Following A Gastric Bypass. The Nurse Notes
That Bowel Sounds Are Present. Which Of The Following Foods Should The Nurse Provide At The Initial
Feeding?
A. Vanilla Pudding
B. Apple Juice
C. Diet Ginger Ale
D.Clear Liquids - CORRECT ANSWER A. Vanilla Pudding Contains Sugar, Which Can Cause Diarrhea
Due To Hyperosmolarity. Clear Liquids Should Be Given As The First Oral Feeding.
B. The Sugar Content Of Apple Juice Can Cause Diarrhea Due To Hyperosmolarity. Clear
Liquids Should Be Given As The First Oral Feeding.
C. The Client Should Avoid Carbonated Beverages Because They Can Distend The Stomach.
Causing Pressure On The Internal Sutures Or Staples. Pressure Can Cause Leaking Into The
Peritoneum Resulting In Peritonitis.
D.CORRECT: Clear Liquids. Such As Water Or Broth. Can Be Given For The First Oral Feedings. But Should
Be Limited To Only 30 Ml (1 Oz) Per Feeding. Water Does Not Contain Sugar. Which Could Cause
Diarrhea Due To Hyperosmolarity.
A Nurse Is Completing A History And Physical Assessment For A Client Who Has Chronic Pancreatitis.
Which Of The Following Findings Should The Nurse Identify As A Likely Cause Of The Client's Condition?
A. High-Calorie Diet
B. Prior Gastrointestinal Illnesses
C. Tobacco Use
D.Alcohol Use - CORRECT ANSWER A. A High-Calorie Diet Can Contribute To Heart Disease And Obesity
But It Does Not Cause Chronic Pancreatitis.
B. A Prior Gastrointestinal Illness Does Not Cause Or Contribute To Chronic Pancreatitis.
C. Tobacco Use Can Contribute To Heart Disease And Increases The Risk Of Cancer Development. But It
Does Not Cause Chronic Pancreatitis.
D.CORRECT: Alcohol Consumption Is One Of The Major Causes Of Chronic Pancreatitis In The
U.S. Long-Term Alcohol Use Disorder Produces Hyper Secretion Of Protein In Pancreatic Secretions. The
Result Is Protein Plugs And Calculi Within The Pancreatic Ducts. Alcohol Also Has A Direct Toxic Effect On
