NU 185
EXAM 2
3
NCLEX Style Questions w/ Rationales
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
This document contains NCLEX-style Exam
questions tailored to the NU 185 course at
Galen College of Nursing
It covers core topics assessed in the course
and reflects the actual exam format and question style.
Each question is followed by a correct answer and rationale
to support exam preparation.
,A client receiving long-term fentanyl therapy for
osteomyelitis pain asks why they can't just stop taking it
suddenly. What is the best response by the nurse?
A. "Stopping suddenly could cause liver damage."
B. "The medication could build up in your kidneys."
C. "You could develop withdrawal symptoms if stopped
abruptly."
D. "It will reduce the effectiveness of future antibiotics."
Correct Answer: C. "You could develop withdrawal symptoms if
stopped abruptly."
Rationale: Long-term use of narcotics like fentanyl can lead to
physical dependence, and sudden withdrawal can cause severe
symptoms.
A nurse is reviewing a patient's medication list for
osteomyelitis. Which of the following are appropriate
antibiotic options for treatment? (Select all that apply.)
A. Metronidazole
B. Cephalexin
C. Morphine
D. Erythromycin
E. Carbapenems
Correct Answers: A, B, D, E
Rationale: These are all antibiotics used to treat bacterial
infections. Morphine is not an antibiotic—it is an analgesic.
A nurse is caring for a client diagnosed with acute
osteomyelitis. Which finding requires immediate
intervention?
A. The client reports pain at the infection site
B. The client's WBC count is 15,000/mm³
,C. The client has difficulty hearing
D. The client is scheduled for incision and drainage
Correct Answer: C
Rationale: Difficulty hearing may indicate 8th cranial nerve
damage, a serious adverse effect of aminoglycosides. This
requires prompt action.
A nurse is administering IV gentamicin to a patient with
osteomyelitis. Which of the following should the nurse
monitor closely? (Select all that apply.)
A. Urine output
B. Creatinine levels
C. Heart rate
D. Hearing ability
E. Blood glucose
Correct Answers: A, B, D
Rationale: Gentamicin, an aminoglycoside, can cause
nephrotoxicity (monitored via urine output and creatinine) and
ototoxicity (hearing loss). Blood glucose and heart rate are not
directly affected.
Which of the following patients is most at risk for
developing osteomyelitis?
A. A teenager with a history of seasonal allergies
B. An adult recovering from laparoscopic appendectomy
C. A patient with a compound fracture of the tibia
D. A child being treated for strep throat
Correct Answer: C
Rationale: Compound fractures provide a direct pathway for
pathogens like Staph aureus to enter the bone.
The nurse is teaching a client with chronic osteomyelitis
about their upcoming treatment plan. Which statement
, indicates the need for further teaching?
A. "I may need IV antibiotics for several weeks."
B. "Surgery might be necessary to remove infected bone
tissue."
C. "I can stop antibiotics once my pain is gone."
D. "There's a chance I might need more than one surgery."
Correct Answer: C
Rationale: Patients must complete the full course of antibiotics
regardless of symptom relief to prevent recurrence or resistance.
Which nursing action is most appropriate before
administering IV streptomycin?
A. Monitor blood pressure in both arms
B. Assess for signs of confusion or delirium
C. Check baseline hearing and renal function
D. Test for allergies to penicillin
Correct Answer: C
Rationale: Streptomycin can cause ototoxicity and
nephrotoxicity, so baseline assessments are necessary before
starting therapy.
A nurse is administering IV vancomycin to a patient with a
MRSA infection. Which action is most important?
A. Administer the dose rapidly to minimize discomfort
B. Monitor the patient for signs of photosensitivity
C. Infuse the drug over at least 60 minutes
D. Administer with fruit juice to mask the taste
Correct Answer: C
Rationale: Vancomycin must be infused slowly (usually over at
least 60 minutes) to prevent Red Man Syndrome, a histamine
reaction that causes flushing and hypotension.
EXAM 2
3
NCLEX Style Questions w/ Rationales
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
This document contains NCLEX-style Exam
questions tailored to the NU 185 course at
Galen College of Nursing
It covers core topics assessed in the course
and reflects the actual exam format and question style.
Each question is followed by a correct answer and rationale
to support exam preparation.
,A client receiving long-term fentanyl therapy for
osteomyelitis pain asks why they can't just stop taking it
suddenly. What is the best response by the nurse?
A. "Stopping suddenly could cause liver damage."
B. "The medication could build up in your kidneys."
C. "You could develop withdrawal symptoms if stopped
abruptly."
D. "It will reduce the effectiveness of future antibiotics."
Correct Answer: C. "You could develop withdrawal symptoms if
stopped abruptly."
Rationale: Long-term use of narcotics like fentanyl can lead to
physical dependence, and sudden withdrawal can cause severe
symptoms.
A nurse is reviewing a patient's medication list for
osteomyelitis. Which of the following are appropriate
antibiotic options for treatment? (Select all that apply.)
A. Metronidazole
B. Cephalexin
C. Morphine
D. Erythromycin
E. Carbapenems
Correct Answers: A, B, D, E
Rationale: These are all antibiotics used to treat bacterial
infections. Morphine is not an antibiotic—it is an analgesic.
A nurse is caring for a client diagnosed with acute
osteomyelitis. Which finding requires immediate
intervention?
A. The client reports pain at the infection site
B. The client's WBC count is 15,000/mm³
,C. The client has difficulty hearing
D. The client is scheduled for incision and drainage
Correct Answer: C
Rationale: Difficulty hearing may indicate 8th cranial nerve
damage, a serious adverse effect of aminoglycosides. This
requires prompt action.
A nurse is administering IV gentamicin to a patient with
osteomyelitis. Which of the following should the nurse
monitor closely? (Select all that apply.)
A. Urine output
B. Creatinine levels
C. Heart rate
D. Hearing ability
E. Blood glucose
Correct Answers: A, B, D
Rationale: Gentamicin, an aminoglycoside, can cause
nephrotoxicity (monitored via urine output and creatinine) and
ototoxicity (hearing loss). Blood glucose and heart rate are not
directly affected.
Which of the following patients is most at risk for
developing osteomyelitis?
A. A teenager with a history of seasonal allergies
B. An adult recovering from laparoscopic appendectomy
C. A patient with a compound fracture of the tibia
D. A child being treated for strep throat
Correct Answer: C
Rationale: Compound fractures provide a direct pathway for
pathogens like Staph aureus to enter the bone.
The nurse is teaching a client with chronic osteomyelitis
about their upcoming treatment plan. Which statement
, indicates the need for further teaching?
A. "I may need IV antibiotics for several weeks."
B. "Surgery might be necessary to remove infected bone
tissue."
C. "I can stop antibiotics once my pain is gone."
D. "There's a chance I might need more than one surgery."
Correct Answer: C
Rationale: Patients must complete the full course of antibiotics
regardless of symptom relief to prevent recurrence or resistance.
Which nursing action is most appropriate before
administering IV streptomycin?
A. Monitor blood pressure in both arms
B. Assess for signs of confusion or delirium
C. Check baseline hearing and renal function
D. Test for allergies to penicillin
Correct Answer: C
Rationale: Streptomycin can cause ototoxicity and
nephrotoxicity, so baseline assessments are necessary before
starting therapy.
A nurse is administering IV vancomycin to a patient with a
MRSA infection. Which action is most important?
A. Administer the dose rapidly to minimize discomfort
B. Monitor the patient for signs of photosensitivity
C. Infuse the drug over at least 60 minutes
D. Administer with fruit juice to mask the taste
Correct Answer: C
Rationale: Vancomycin must be infused slowly (usually over at
least 60 minutes) to prevent Red Man Syndrome, a histamine
reaction that causes flushing and hypotension.
