KAPLAN MEDICAL SURGICAL INTEGRATED
ACTUAL EXAM TEST BANK 1000 QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
BEST DOCUMENT FOR FINAL EXAM PREP |
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION 2026/2027
Question 1
A client is diagnosed with HTN. The client says, "I have trouble remembering to
take my medications, but I am now only smoking 5 cigarettes a day instead of 2
packs." Which response by the nurse is best?
a. "Ask your spouse to help you remember the medications. The smoking needs to
be reduced even more."
b. "It is good that your smoking has decreased. Let's talk about ways to remember
the medication."
c. "You must take the medication, and the smoking habit needs to stop very soon."
d. "It sounds like you are trying to adhere to the plan. Tell me about your current
diet."
Correct Answer: B
,Expert Rationale
The priority nursing approach is therapeutic communication combined with
positive reinforcement and problem-solving support. The client demonstrates
partial behavioral improvement by reducing smoking, which should be
acknowledged to promote continued motivation. At the same time, the nurse
should address the more immediate safety issue of medication nonadherence in a
collaborative and nonjudgmental manner.
Option B is correct because it validates the client’s progress (smoking reduction)
while shifting focus toward improving medication adherence through problem-
solving strategies. This supports patient-centered care and increases likelihood of
behavioral change.
Option A is incorrect because it gives directive advice and introduces judgment
about smoking reduction, which may decrease therapeutic rapport.
Option C is inappropriate because it is authoritarian, nontherapeutic, and may
increase resistance.
Option D shifts focus away from the priority issue (medication adherence) and
does not address the immediate safety concern.
NCLEX Focus: Therapeutic communication, medication adherence, behavioral
change support
DIF: Application
REF: Mental Health / Therapeutic Communication Principles
OBJ: Select appropriate nurse response promoting adherence
TOP: Psychosocial Integrity
Question 2
,A client is diagnosed with myasthenia gravis. The client says, "I am tired all the
time and I don't want to live any more. If I stop taking my medication, I can stop
breathing." Which is the nurse's best response?
a. Ask client about feelings of hopelessness
b. Give client information about a myasthenia gravis group
c. Place client on suicide watch
d. Teach client about the new medication
Correct Answer: A
Expert Rationale
The client’s statement indicates possible suicidal ideation with a passive death
wish, which requires immediate therapeutic assessment before any intervention
or teaching. The nurse’s priority is to explore the client’s emotional state and
assess the severity of suicidal thoughts.
Option A is correct because it opens communication and allows further
assessment of hopelessness, suicidal intent, and safety risk, which is the priority in
mental health nursing.
Option C may become necessary later if suicide risk is confirmed, but the nurse
must first assess intent and plan before initiating safety precautions.
Option B is premature because support group referral does not address
immediate risk of self-harm.
Option D is inappropriate because teaching is not a priority during a potential
mental health crisis.
NCLEX Focus: Suicide risk assessment, therapeutic communication, psychosocial
priority
DIF: Analysis
REF: Mental Health / Suicide Risk Assessment
OBJ: Identify priority nursing response to suicidal ideation
TOP: Psychosocial Integrity
, Question 3
The nurse suctions a client's tracheostomy. Which technique does the nurse use?
(select all)
a. Routinely instills sterile normal saline before suctioning
b. Applies suction when inserting the catheter
c. Suctions the client every hour
d. Uses sterile technique when suctioning
e. Rotates the catheter when withdrawing
f. Uses intermittent suctioning
Correct Answer: D, E, F
Expert Rationale
Tracheostomy suctioning is a sterile procedure that requires techniques to
minimize mucosal trauma and maintain oxygenation.
Option D is correct because sterile technique is required to prevent introduction
of pathogens into the lower airway.
Option E is correct because rotating the catheter during withdrawal helps remove
secretions more effectively while reducing trauma to the tracheal mucosa.
Option F is correct because suction should be applied intermittently and only
while withdrawing the catheter to prevent hypoxia and tissue damage.
Option A is incorrect because routine instillation of normal saline is no longer
recommended; it can reduce oxygenation and dislodge bacteria deeper into the
lungs.
Option B is incorrect because suction should NOT be applied during insertion, as
this can cause mucosal injury and hypoxemia.
Option C is incorrect because suctioning should be performed based on clinical
indication, not on a fixed schedule.
ACTUAL EXAM TEST BANK 1000 QUESTIONS
AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+
BEST DOCUMENT FOR FINAL EXAM PREP |
(VERIFIED ANSWERS) |ALREADY GRADED
A+||NEWEST VERSION 2026/2027
Question 1
A client is diagnosed with HTN. The client says, "I have trouble remembering to
take my medications, but I am now only smoking 5 cigarettes a day instead of 2
packs." Which response by the nurse is best?
a. "Ask your spouse to help you remember the medications. The smoking needs to
be reduced even more."
b. "It is good that your smoking has decreased. Let's talk about ways to remember
the medication."
c. "You must take the medication, and the smoking habit needs to stop very soon."
d. "It sounds like you are trying to adhere to the plan. Tell me about your current
diet."
Correct Answer: B
,Expert Rationale
The priority nursing approach is therapeutic communication combined with
positive reinforcement and problem-solving support. The client demonstrates
partial behavioral improvement by reducing smoking, which should be
acknowledged to promote continued motivation. At the same time, the nurse
should address the more immediate safety issue of medication nonadherence in a
collaborative and nonjudgmental manner.
Option B is correct because it validates the client’s progress (smoking reduction)
while shifting focus toward improving medication adherence through problem-
solving strategies. This supports patient-centered care and increases likelihood of
behavioral change.
Option A is incorrect because it gives directive advice and introduces judgment
about smoking reduction, which may decrease therapeutic rapport.
Option C is inappropriate because it is authoritarian, nontherapeutic, and may
increase resistance.
Option D shifts focus away from the priority issue (medication adherence) and
does not address the immediate safety concern.
NCLEX Focus: Therapeutic communication, medication adherence, behavioral
change support
DIF: Application
REF: Mental Health / Therapeutic Communication Principles
OBJ: Select appropriate nurse response promoting adherence
TOP: Psychosocial Integrity
Question 2
,A client is diagnosed with myasthenia gravis. The client says, "I am tired all the
time and I don't want to live any more. If I stop taking my medication, I can stop
breathing." Which is the nurse's best response?
a. Ask client about feelings of hopelessness
b. Give client information about a myasthenia gravis group
c. Place client on suicide watch
d. Teach client about the new medication
Correct Answer: A
Expert Rationale
The client’s statement indicates possible suicidal ideation with a passive death
wish, which requires immediate therapeutic assessment before any intervention
or teaching. The nurse’s priority is to explore the client’s emotional state and
assess the severity of suicidal thoughts.
Option A is correct because it opens communication and allows further
assessment of hopelessness, suicidal intent, and safety risk, which is the priority in
mental health nursing.
Option C may become necessary later if suicide risk is confirmed, but the nurse
must first assess intent and plan before initiating safety precautions.
Option B is premature because support group referral does not address
immediate risk of self-harm.
Option D is inappropriate because teaching is not a priority during a potential
mental health crisis.
NCLEX Focus: Suicide risk assessment, therapeutic communication, psychosocial
priority
DIF: Analysis
REF: Mental Health / Suicide Risk Assessment
OBJ: Identify priority nursing response to suicidal ideation
TOP: Psychosocial Integrity
, Question 3
The nurse suctions a client's tracheostomy. Which technique does the nurse use?
(select all)
a. Routinely instills sterile normal saline before suctioning
b. Applies suction when inserting the catheter
c. Suctions the client every hour
d. Uses sterile technique when suctioning
e. Rotates the catheter when withdrawing
f. Uses intermittent suctioning
Correct Answer: D, E, F
Expert Rationale
Tracheostomy suctioning is a sterile procedure that requires techniques to
minimize mucosal trauma and maintain oxygenation.
Option D is correct because sterile technique is required to prevent introduction
of pathogens into the lower airway.
Option E is correct because rotating the catheter during withdrawal helps remove
secretions more effectively while reducing trauma to the tracheal mucosa.
Option F is correct because suction should be applied intermittently and only
while withdrawing the catheter to prevent hypoxia and tissue damage.
Option A is incorrect because routine instillation of normal saline is no longer
recommended; it can reduce oxygenation and dislodge bacteria deeper into the
lungs.
Option B is incorrect because suction should NOT be applied during insertion, as
this can cause mucosal injury and hypoxemia.
Option C is incorrect because suctioning should be performed based on clinical
indication, not on a fixed schedule.
