PN Adult Medical Surgical
Online Practice
1. A nurse is caring for a client who has heart failure and is receiving furosemide.
Which finding is the priority to report to the provider?
A. Blood pressure 102/70 mmHg
B. Potassium 2.9 mEq/L
C. 1+ pitting edema in ankles
D. Blood glucose 120 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Rationale: A potassium level <3.5 mEq/L places the client at risk for life-threatening
dysrhythmias. This is the priority.
2. A client with COPD reports shortness of breath and has an oxygen saturation of
86% on room air. What action should the nurse take first?
A. Encourage fluids
B. Administer bronchodilator
C. Apply oxygen at 2 L/min via nasal cannula
D. Obtain a sputum culture
Correct Answer: C. Apply oxygen at 2 L/min via nasal cannula
,Rationale: Airway and oxygenation come first. COPD clients need low-flow oxygen to
avoid suppressing respiratory drive.
3. A client with diabetes mellitus is dizzy, sweaty, and shaky. Which action should the
nurse take?
A. Obtain a urine ketone test
B. Give 4 oz of orange juice
C. Call the rapid response team
D. Administer insulin lispro
Correct Answer: B. Give 4 oz of orange juice
Rationale: Symptoms indicate hypoglycemia, requiring immediate glucose.
4. A nurse is preparing to administer blood to a client. Which action should the nurse
take?
A. Use 22-gauge IV catheter
B. Hang the blood with lactated Ringer’s
C. Stay with the client for the first 15 minutes
D. Transfuse over 6 hours
Correct Answer: C. Stay with the client for the first 15 minutes
Rationale: Most transfusion reactions occur in the first 15 minutes; close monitoring
is essential.
5. A client is experiencing chest pain. What is the priority action?
A. Obtain a 12-lead ECG
B. Start an IV line
,C. Administer morphine
D. Ask the client to rate the pain
Correct Answer: A. Obtain a 12-lead ECG
Rationale: Rule out myocardial ischemia immediately. This guides all further
interventions.
6. A client newly diagnosed with hypertension is prescribed lisinopril. Which finding
is the nurse’s priority to monitor?
A. Dry cough
B. Serum sodium
C. Blood pressure
D. Facial swelling
Correct Answer: D. Facial swelling
Rationale: Facial swelling = angioedema, a life-threatening ACE inhibitor adverse
effect.
7. A nurse is caring for a client with pneumonia. Which finding indicates
improvement?
A. Respiratory rate 28/min
B. O2 saturation increases from 88% to 94%
C. WBC increased from 8,000 to 15,000
D. Temperature 38.3°C (101°F)
Correct Answer: B. O2 saturation increases from 88% to 94%
Rationale: Improved oxygenation indicates effective treatment.
, 8. A client with chronic kidney disease has lab results: K+ 6.1 mEq/L, BUN 40,
creatinine 4.0. What is the priority action?
A. Restrict intake of protein
B. Give sodium polystyrene sulfonate
C. Prepare for dialysis
D. Place the client on a cardiac monitor
Correct Answer: D. Place the client on a cardiac monitor
Rationale: Hyperkalemia causes fatal arrhythmias → cardiac monitoring is priority.
9. A client with a new tracheostomy suctioned twice in the last hour now has bloody
secretions. What should the nurse do?
A. Suction again immediately
B. Decrease suction pressure
C. Increase oxygen flow rate
D. Insert catheter deeper
Correct Answer: B. Decrease suction pressure
Rationale: Bloody secretions indicate trauma from excessive suction pressure.
10. A nurse is teaching a client with GERD about lifestyle changes. Which statement
indicates understanding?
A. “I should lie down after meals.”
B. “I should avoid chocolate and peppermint.”
C. “I will drink coffee instead of soda.”
D. “I will eat large meals.”
Online Practice
1. A nurse is caring for a client who has heart failure and is receiving furosemide.
Which finding is the priority to report to the provider?
A. Blood pressure 102/70 mmHg
B. Potassium 2.9 mEq/L
C. 1+ pitting edema in ankles
D. Blood glucose 120 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Rationale: A potassium level <3.5 mEq/L places the client at risk for life-threatening
dysrhythmias. This is the priority.
2. A client with COPD reports shortness of breath and has an oxygen saturation of
86% on room air. What action should the nurse take first?
A. Encourage fluids
B. Administer bronchodilator
C. Apply oxygen at 2 L/min via nasal cannula
D. Obtain a sputum culture
Correct Answer: C. Apply oxygen at 2 L/min via nasal cannula
,Rationale: Airway and oxygenation come first. COPD clients need low-flow oxygen to
avoid suppressing respiratory drive.
3. A client with diabetes mellitus is dizzy, sweaty, and shaky. Which action should the
nurse take?
A. Obtain a urine ketone test
B. Give 4 oz of orange juice
C. Call the rapid response team
D. Administer insulin lispro
Correct Answer: B. Give 4 oz of orange juice
Rationale: Symptoms indicate hypoglycemia, requiring immediate glucose.
4. A nurse is preparing to administer blood to a client. Which action should the nurse
take?
A. Use 22-gauge IV catheter
B. Hang the blood with lactated Ringer’s
C. Stay with the client for the first 15 minutes
D. Transfuse over 6 hours
Correct Answer: C. Stay with the client for the first 15 minutes
Rationale: Most transfusion reactions occur in the first 15 minutes; close monitoring
is essential.
5. A client is experiencing chest pain. What is the priority action?
A. Obtain a 12-lead ECG
B. Start an IV line
,C. Administer morphine
D. Ask the client to rate the pain
Correct Answer: A. Obtain a 12-lead ECG
Rationale: Rule out myocardial ischemia immediately. This guides all further
interventions.
6. A client newly diagnosed with hypertension is prescribed lisinopril. Which finding
is the nurse’s priority to monitor?
A. Dry cough
B. Serum sodium
C. Blood pressure
D. Facial swelling
Correct Answer: D. Facial swelling
Rationale: Facial swelling = angioedema, a life-threatening ACE inhibitor adverse
effect.
7. A nurse is caring for a client with pneumonia. Which finding indicates
improvement?
A. Respiratory rate 28/min
B. O2 saturation increases from 88% to 94%
C. WBC increased from 8,000 to 15,000
D. Temperature 38.3°C (101°F)
Correct Answer: B. O2 saturation increases from 88% to 94%
Rationale: Improved oxygenation indicates effective treatment.
, 8. A client with chronic kidney disease has lab results: K+ 6.1 mEq/L, BUN 40,
creatinine 4.0. What is the priority action?
A. Restrict intake of protein
B. Give sodium polystyrene sulfonate
C. Prepare for dialysis
D. Place the client on a cardiac monitor
Correct Answer: D. Place the client on a cardiac monitor
Rationale: Hyperkalemia causes fatal arrhythmias → cardiac monitoring is priority.
9. A client with a new tracheostomy suctioned twice in the last hour now has bloody
secretions. What should the nurse do?
A. Suction again immediately
B. Decrease suction pressure
C. Increase oxygen flow rate
D. Insert catheter deeper
Correct Answer: B. Decrease suction pressure
Rationale: Bloody secretions indicate trauma from excessive suction pressure.
10. A nurse is teaching a client with GERD about lifestyle changes. Which statement
indicates understanding?
A. “I should lie down after meals.”
B. “I should avoid chocolate and peppermint.”
C. “I will drink coffee instead of soda.”
D. “I will eat large meals.”
