FOCUS ON ADULT HEALTH MEDICAL
SURGICAL NURSING PRACTICE TEST PAPER
2026 SOLVED QUESTIONS REVIEW
◉ A nurse is providing dietary instructions to a client with chronic
obstructive pulmonary disease (COPD) who is experiencing a loss of
appetite and complains of feeling "too full to eat." What does the
nurse encourage the client to do? Select all that apply. Answer: Avoid
drinking fluids before and during meals
Select foods that are easy to chew and are not gas forming
Rationale: COPD is a progressive and irreversible condition
characterized by diminished inspiratory and expiratory capacity of
the lungs. Instruct the client who complains of feeling too full to eat,
to avoid drinking fluids before and during the meal. Dry foods such
as crackers stimulate coughing; foods such as milk and chocolate
may increase the thickness of saliva and secretions. Cheese is
constipating and should also be avoided by the client. The nurse
should also teach the client about foods that are easy to chew and do
not encourage the formation of gas; for this reason, broccoli, which
is a gas-forming food, should be avoided.
◉ A tuberculin skin test (TST) is administered to a client with a
diagnosis of HIV infection. Forty-eight hours after administration,
the nurse checks the test site (see image). Answer: Positive
,Rationale: The tuberculin, or TST, test is a reliable determinant of
tuberculosis (TB) infection. A reaction measuring 5 mm or more in
diameter is considered positive in a client with HIV infection. A
reaction measuring 10 mm or more in diameter is considered
positive in a non-immunosuppressed client. In this instance, the area
of induration measures 9 mm, indicating a positive reaction. A
positive reaction does not mean that active disease is present, but it
does indicate exposure to TB or the presence of inactive (dormant)
disease.
◉ A nurse is interpreting a central venous pressure (CVP) reading
from a client in whom right ventricular failure has been diagnosed.
From this diagnosis, the nurse would expect that the most likely
result is a pressure of Answer: 14 cm H2O
Rationale: CVP measurements are used to monitor blood volume
and the adequacy of venous return to the heart. The CVP measures
pressures from the right atrium or central veins. The normal CVP is
7 to 12 cm H2O. An increased CVP reading may indicate right
ventricular failure. A low CVP reading may indicate hypovolemia. A
reading of 4 cm H2O is low. Readings of 8 and 11 cm H2O are
normal. A reading of 14 cm H2O is increased.
◉ A nurse is caring for a client who has just undergone
thyroidectomy. Which technique is the best way for the nurse to
assess the surgical site for bleeding? Answer: Checking for moisture
on the back of the dressing over the client's neck and shoulders
,Rationale: Thyroid surgery may be complicated by hemorrhage,
respiratory distress, parathyroid gland injury (resulting in
hypocalcemia and tetany), damage to the laryngeal nerves, and
thyroid storm. Hemorrhage is most likely during the 24 hours after
surgery. If the client is bleeding after surgery, gravity will cause the
blood to seep down the sides of the dressing and drain onto the
underlying bed linens even as the top of the dressing remains clean
and dry. Asking the client whether the dressing feels wet and
replacing the dry sterile dressing every 2 hours are not the best
actions. Replacing the dressing frequently when it is not warranted
could also increase the risk of infection.
◉ A client who sustained a major burn injury is beginning to take an
oral diet again. Which between-meal menu selections meet the
client's needs for wound healing and tissue repair? Select all that
apply. Answer: Whole-milk shake and granola
Baked potato topped with cheese
Cheese and whole-wheat crackers
Rationale: To facilitate healing and meet continued high metabolic
needs, the client with a major burn should eat a diet high in calories,
protein, and carbohydrates. This type of diet also keeps the client in
positive nitrogen balance. Foods such as milkshakes, granola, cheese,
and whole-wheat products are acceptable choices. Though fresh
fruits and vegetables and skim milk are high in nutrients, higher-
calorie foods, including versions of dairy products prepared with
whole milk, are preferable in this situation.
, ◉ A client is found to have hypoparathyroidism. Which nutritional
supplement does the nurse, teaching the client about measures to
manage the disorder, tell the client to take on a daily basis? Answer:
Calcium carbonate with vitamin D
Rationale: Hypoparathyroidism is an endocrine disorder in which
parathyroid function is decreased. The client with
hypoparathyroidism is likely to have low calcium and high
phosphate levels and should consume a diet high in calcium but low
in phosphorus. Additionally, the generally used treatment is calcium
supplementation (either as calcium carbonate or calcium citrate)
coupled with vitamin D supplementation. Vitamin C
supplementation is not a treatment measure for this disorder. Beta-
carotene is incorrect, because a client with hypoparathyroidism
typically has an increased phosphorus level
◉ A nurse participating in a free health screening at the local mall
obtains a random blood glucose level of 190 mg/dL (10.6 mmol/L)
and a total cholesterol level of 210 mg/dL (5.4 mmol/L) in an
otherwise healthy client. What should the nurse tell the client to do
next? Answer: Call his health care provider to have these values
rechecked as soon as possible
Rationale: Adult diabetes mellitus may be diagnosed on the basis of
symptoms (e.g., polydipsia, polyuria, polyphagia) or laboratory
values. An abnormal glucose tolerance test, a random plasma
glucose level greater than 200 mg/dL (11.1 mmol/L), and a fasting
plasma glucose level greater than 140 mg/dL (7.8 mmol/L) on two
separate occasions are all diagnostic of diabetes mellitus. The total
cholesterol should be less than 200 mg/dL (5.2 mmol/L).
SURGICAL NURSING PRACTICE TEST PAPER
2026 SOLVED QUESTIONS REVIEW
◉ A nurse is providing dietary instructions to a client with chronic
obstructive pulmonary disease (COPD) who is experiencing a loss of
appetite and complains of feeling "too full to eat." What does the
nurse encourage the client to do? Select all that apply. Answer: Avoid
drinking fluids before and during meals
Select foods that are easy to chew and are not gas forming
Rationale: COPD is a progressive and irreversible condition
characterized by diminished inspiratory and expiratory capacity of
the lungs. Instruct the client who complains of feeling too full to eat,
to avoid drinking fluids before and during the meal. Dry foods such
as crackers stimulate coughing; foods such as milk and chocolate
may increase the thickness of saliva and secretions. Cheese is
constipating and should also be avoided by the client. The nurse
should also teach the client about foods that are easy to chew and do
not encourage the formation of gas; for this reason, broccoli, which
is a gas-forming food, should be avoided.
◉ A tuberculin skin test (TST) is administered to a client with a
diagnosis of HIV infection. Forty-eight hours after administration,
the nurse checks the test site (see image). Answer: Positive
,Rationale: The tuberculin, or TST, test is a reliable determinant of
tuberculosis (TB) infection. A reaction measuring 5 mm or more in
diameter is considered positive in a client with HIV infection. A
reaction measuring 10 mm or more in diameter is considered
positive in a non-immunosuppressed client. In this instance, the area
of induration measures 9 mm, indicating a positive reaction. A
positive reaction does not mean that active disease is present, but it
does indicate exposure to TB or the presence of inactive (dormant)
disease.
◉ A nurse is interpreting a central venous pressure (CVP) reading
from a client in whom right ventricular failure has been diagnosed.
From this diagnosis, the nurse would expect that the most likely
result is a pressure of Answer: 14 cm H2O
Rationale: CVP measurements are used to monitor blood volume
and the adequacy of venous return to the heart. The CVP measures
pressures from the right atrium or central veins. The normal CVP is
7 to 12 cm H2O. An increased CVP reading may indicate right
ventricular failure. A low CVP reading may indicate hypovolemia. A
reading of 4 cm H2O is low. Readings of 8 and 11 cm H2O are
normal. A reading of 14 cm H2O is increased.
◉ A nurse is caring for a client who has just undergone
thyroidectomy. Which technique is the best way for the nurse to
assess the surgical site for bleeding? Answer: Checking for moisture
on the back of the dressing over the client's neck and shoulders
,Rationale: Thyroid surgery may be complicated by hemorrhage,
respiratory distress, parathyroid gland injury (resulting in
hypocalcemia and tetany), damage to the laryngeal nerves, and
thyroid storm. Hemorrhage is most likely during the 24 hours after
surgery. If the client is bleeding after surgery, gravity will cause the
blood to seep down the sides of the dressing and drain onto the
underlying bed linens even as the top of the dressing remains clean
and dry. Asking the client whether the dressing feels wet and
replacing the dry sterile dressing every 2 hours are not the best
actions. Replacing the dressing frequently when it is not warranted
could also increase the risk of infection.
◉ A client who sustained a major burn injury is beginning to take an
oral diet again. Which between-meal menu selections meet the
client's needs for wound healing and tissue repair? Select all that
apply. Answer: Whole-milk shake and granola
Baked potato topped with cheese
Cheese and whole-wheat crackers
Rationale: To facilitate healing and meet continued high metabolic
needs, the client with a major burn should eat a diet high in calories,
protein, and carbohydrates. This type of diet also keeps the client in
positive nitrogen balance. Foods such as milkshakes, granola, cheese,
and whole-wheat products are acceptable choices. Though fresh
fruits and vegetables and skim milk are high in nutrients, higher-
calorie foods, including versions of dairy products prepared with
whole milk, are preferable in this situation.
, ◉ A client is found to have hypoparathyroidism. Which nutritional
supplement does the nurse, teaching the client about measures to
manage the disorder, tell the client to take on a daily basis? Answer:
Calcium carbonate with vitamin D
Rationale: Hypoparathyroidism is an endocrine disorder in which
parathyroid function is decreased. The client with
hypoparathyroidism is likely to have low calcium and high
phosphate levels and should consume a diet high in calcium but low
in phosphorus. Additionally, the generally used treatment is calcium
supplementation (either as calcium carbonate or calcium citrate)
coupled with vitamin D supplementation. Vitamin C
supplementation is not a treatment measure for this disorder. Beta-
carotene is incorrect, because a client with hypoparathyroidism
typically has an increased phosphorus level
◉ A nurse participating in a free health screening at the local mall
obtains a random blood glucose level of 190 mg/dL (10.6 mmol/L)
and a total cholesterol level of 210 mg/dL (5.4 mmol/L) in an
otherwise healthy client. What should the nurse tell the client to do
next? Answer: Call his health care provider to have these values
rechecked as soon as possible
Rationale: Adult diabetes mellitus may be diagnosed on the basis of
symptoms (e.g., polydipsia, polyuria, polyphagia) or laboratory
values. An abnormal glucose tolerance test, a random plasma
glucose level greater than 200 mg/dL (11.1 mmol/L), and a fasting
plasma glucose level greater than 140 mg/dL (7.8 mmol/L) on two
separate occasions are all diagnostic of diabetes mellitus. The total
cholesterol should be less than 200 mg/dL (5.2 mmol/L).
