MED-SURG EXAM SCRIPT 2026 QUESTIONS
AND FULL ANSWERS GRADED A+
◉ 2. The client receiving dialysis is complaining of being dizzy and
light-headed. Which
action should the nurse implement first?
1. Place the client in the Trendelenburg position.
2. Turn off the dialysis machine immediately.
3. Bolus the client with 500 mL of normal saline.
4. Notify the health-care provider as soon as possible. Answer: 1.
The nurse should place the client's
chair with the head lower than the
body, which will shunt blood to the
brain; this is the Trendelenburg
position.
◉ 22. The nurse caring for a client diagnosed with CKD writes a
client problem of
"noncompliance with dietary restrictions." Which intervention
should be included in
the plan of care?
1. Teach the client the proper diet to eat while undergoing dialysis.
,2. Refer the client and significant other to the dietitian.
3. Explain the importance of eating the proper foods.
4. Determine the reason for the client not adhering to the diet.
Answer: 4. Noncompliance is a choice the client
has a right to make, but the nurse
should determine the reason for the
noncompliance and then take
appropriate actions based on the
client's rationale. For example, if the client has financial difficulties,
the
nurse may suggest how the client can
afford the proper foods along with
medications, or the nurse may be able
to refer the client to a social worker.
◉ 23. The client diagnosed with CKD is receiving peritoneal dialysis.
Which assessment
data warrant immediate intervention by the nurse?
1. Inability to auscultate a bruit over the fistula.
2. The client's abdomen is soft, is nontender, and has bowel sounds.
3. The dialysate being removed from the client's abdomen is clear.
4. The dialysate instilled was 1,500 mL and removed was 1,500 mL.
Answer: 4. Because the client is in ESRD, fluid
,must be removed from the body, so the
output should be more than the
amount instilled. These assessment
data require intervention by the nurse.
◉ 24. The client receiving hemodialysis is being discharged home
from the dialysis center.
Which instruction should the nurse teach the client?
1. Notify the HCP if oral temperature is 102˚F or greater.
2. Apply ice to the access site if it starts bleeding at home.
3. Keep fingernails short and try not to scratch the skin.
4. Encourage significant other to make decisions for the client.
Answer: 3. Uremic frost, which results when the
skin attempts to take over the function
of the kidneys, causes itching, which
can lead to scratching possibly
resulting in a break in the skin.
◉ 25. The client is admitted to a nursing unit from a long-term care
facility with a
hematocrit of 56% and a serum sodium level of 152 mEq/L. Which
condition is a
cause for these findings?
, 1. Overhydration.
2. Anemia.
3. Dehydration.
4. Renal failure. Answer: 3. Dehydration results in concentrated
serum, causing laboratory values to
increase because the blood has normal
constituents but not enough volume to
dilute the values to within normal
range or possibly lower.
◉ 26. The client who has undergone an exploratory laparotomy and
subsequent removal of
a large intestinal tumor has a nasogastric tube (NGT) in place and an
IV running at
150 mL/hr via an IV pump. Which data should be reported to the
HCP?
1. The pump keeps sounding an alarm indicating the high pressure
has been
reached.
2. Intake is 1,800 mL, NGT output is 550 mL, and Foley output is 950
mL.
3. On auscultation, crackles and rhonchi in all lung fields are noted.
AND FULL ANSWERS GRADED A+
◉ 2. The client receiving dialysis is complaining of being dizzy and
light-headed. Which
action should the nurse implement first?
1. Place the client in the Trendelenburg position.
2. Turn off the dialysis machine immediately.
3. Bolus the client with 500 mL of normal saline.
4. Notify the health-care provider as soon as possible. Answer: 1.
The nurse should place the client's
chair with the head lower than the
body, which will shunt blood to the
brain; this is the Trendelenburg
position.
◉ 22. The nurse caring for a client diagnosed with CKD writes a
client problem of
"noncompliance with dietary restrictions." Which intervention
should be included in
the plan of care?
1. Teach the client the proper diet to eat while undergoing dialysis.
,2. Refer the client and significant other to the dietitian.
3. Explain the importance of eating the proper foods.
4. Determine the reason for the client not adhering to the diet.
Answer: 4. Noncompliance is a choice the client
has a right to make, but the nurse
should determine the reason for the
noncompliance and then take
appropriate actions based on the
client's rationale. For example, if the client has financial difficulties,
the
nurse may suggest how the client can
afford the proper foods along with
medications, or the nurse may be able
to refer the client to a social worker.
◉ 23. The client diagnosed with CKD is receiving peritoneal dialysis.
Which assessment
data warrant immediate intervention by the nurse?
1. Inability to auscultate a bruit over the fistula.
2. The client's abdomen is soft, is nontender, and has bowel sounds.
3. The dialysate being removed from the client's abdomen is clear.
4. The dialysate instilled was 1,500 mL and removed was 1,500 mL.
Answer: 4. Because the client is in ESRD, fluid
,must be removed from the body, so the
output should be more than the
amount instilled. These assessment
data require intervention by the nurse.
◉ 24. The client receiving hemodialysis is being discharged home
from the dialysis center.
Which instruction should the nurse teach the client?
1. Notify the HCP if oral temperature is 102˚F or greater.
2. Apply ice to the access site if it starts bleeding at home.
3. Keep fingernails short and try not to scratch the skin.
4. Encourage significant other to make decisions for the client.
Answer: 3. Uremic frost, which results when the
skin attempts to take over the function
of the kidneys, causes itching, which
can lead to scratching possibly
resulting in a break in the skin.
◉ 25. The client is admitted to a nursing unit from a long-term care
facility with a
hematocrit of 56% and a serum sodium level of 152 mEq/L. Which
condition is a
cause for these findings?
, 1. Overhydration.
2. Anemia.
3. Dehydration.
4. Renal failure. Answer: 3. Dehydration results in concentrated
serum, causing laboratory values to
increase because the blood has normal
constituents but not enough volume to
dilute the values to within normal
range or possibly lower.
◉ 26. The client who has undergone an exploratory laparotomy and
subsequent removal of
a large intestinal tumor has a nasogastric tube (NGT) in place and an
IV running at
150 mL/hr via an IV pump. Which data should be reported to the
HCP?
1. The pump keeps sounding an alarm indicating the high pressure
has been
reached.
2. Intake is 1,800 mL, NGT output is 550 mL, and Foley output is 950
mL.
3. On auscultation, crackles and rhonchi in all lung fields are noted.
