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Medical -Surgical Exam Questions And Rationale
Comprehensive 2026 Questions Exam Latest Version
Solved Questions & Answers Verified 100 %
1. A client with heart failure is prescribed digoxin 0.125 mg PO. The client's
apical heart rate is70 beats per minute, blood pressure is 125/75 mmHg, and
respirations are 18 breaths per minute. Which action should the nurse
implement next?
a. Administer the medication.
b. Inform the healthcare provider.
c. Review the vital sign flowsheet.
d. Reassess the apical heart rate.
a. Administer the medication.
Obtaining the apical heart rate is a common parameter prior to administering digoxin,
which may indicate early digoxin toxicity if the heart rate is less than 60 beats per
minute, so the dose should be administered since the client is not demonstrating any
signs of toxicity.
2. When teaching a client with breast cancer about the prescribed radiation
therapy for treatment, what information is important to include?
a. Dry, itchy skin changes may occur.
b. There is a possibility of long bone pain.
c. Permanent pigment changes to the breast may result.
d. A low-residue diet may be prescribed to reduce the likelihood of diarrhea.
a. Dry, itchy skin changes may occur.
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Side effects from radiation to the breast most often include temporary skin changes
such as dryness, tenderness, redness, swelling, and pruritus.
3. A client with chest pain, dizziness, and vomiting for the last 2 hours is
admitted for evaluation for Acute Coronary Syndrome (ACS). Which cardiac
biomarker should the registered nurse (RN) anticipate to be elevated if the
client experienced myocardial damage?
a. Creatine Kinase (CK-MB).
b. Serum troponin.
c. Myoglobin.
d. Ischemia modified albumin
b. Serum troponin.
Troponin is the most sensitive and specific test for myocardial damage. Troponin
elevation is more specific than CK-MB
4. A nurse is preparing a teaching plan for a client who is postmenopausal.
Which measure is most important for the nurse to include to prevent
osteoporosis?
a. Take a multivitamin daily.
b. Use only low fat milk products.
c. Perform weight resistance exercises.
d. Bicycle for at least 3 miles every day.
c. Perform weight resistance exercises.
Weight bearing on the skeletal system stimulates bone formation, so recommending
weight resistance exercises is most important in the prevention of osteoporosis in
postmenopausal clients.
5. A client is recently diagnosed with systemic lupus erythematosus (SLE) and
the registered nurse (RN) is assessing for common complications. Which
symptom should the RN instruct the client to report immediately?
a. Fever related to infection.
b. Weight loss and anorexia.
c. Depressed mood.
d. Break in tissue integrity.
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a. Fever related to infection.
Secondary infections are a major concern with SLE clients due to the use of
corticosteroids and chemotherapeutic agents, which suppresses the immune
system, so reporting fever and infections should be reported immediately.
6. A client arrives at the emergency department for treatment of injuries
sustained in a motor vehicle collision. The nurse notes asymmetrical
expansion of the chest wall during respiration. Which action should the nurse
implement next?
a. Auscultate the lungs bilaterally.
b. Inspect the overall skin color.
c. Palpate for tactile fremitus.
d. Percuss the chest for resonance.
a. Auscultate the lungs bilaterally.
Chest trauma may result in the development of pneumothorax. After noting
asymmetric expansion of the chest wall, the nurse should auscultate the lungs to
determine if the client can move air through all of the lung fields.
7. The nurse is preparing an adult client for an upper gastrointestinal (UGI)
series. Which information should the nurse include in the teaching plan?
a. The xray procedure may last for several hours.
b. A nasogastric tube (NGT) is inserted to instill the barium.
c. Enemas are given to empty the bowel after the procedure.
d. Nothing by mouth is allowed for 6 to 8 hours before the study.
d. Nothing by mouth is allowed for 6 to 8 hours before the study.
The client should be NPO, to include smoking or chewing gum for at least 6 hours
before the UGI study.
8. What is the primary nursing problem for a client with asymptomatic primary
syphilis?
a. Acute pain.
b. Risk for injury.
c. Sexual dysfunction.
d. Deficient knowledge.
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d. Deficient knowledge.
An asymptomatic client with primary syphilis is most likely unaware of this disease,
so to prevent transmission to others and recurrence in the client, the priority nursing
diagnosis is deficient knowledge of the disease pathophysiology.
9. A client who is admitted to the emergency department with a possible
tension pneumothorax after a motor vehicle collision is having multiple
diagnostic tests. Which finding requires immediate action by the nurse?
a. Serum amylase of 132 units/L.
b. Serum sodium of 134 mEq/L.
c. Chest x-ray indicating a mediastinal shift.
d. Abdominal x-ray air throughout intestines.
c. Chest x-ray indicating a mediastinal shift.
Immediate action is required for findings of a mediastinal shift, which can precipitate
life-threatening cardiovascular collapse as the great cardiac vessels become kinked
and compressed due to the tension pneumothorax.
10. The nurse is caring for a client receiving tamoxifen for the treatment of
breast cancer. Which action should the nurse include in the client's plan of
care?
a. Increase fluid intake.
b. Monitor sodium chloride intake.
c. Assist the client in coping with hot flashes.
d. Encourage milk products to increase calcium intake.
c. Assist the client in coping with hot flashes.
Tamoxifen, an estrogen receptor blocking agent, can cause hot flashes, so client
education regarding menopausal-like symptoms should be included in the plan of
care.
11. The nurse is caring for a client who is admitted with a hemorrhagic stroke.
Which nursing action should be included in the plan of care? a. Perform active
range of motion three times daily.
b. Monitor for Battle's sign every four hours.
Medical -Surgical Exam Questions And Rationale
Comprehensive 2026 Questions Exam Latest Version
Solved Questions & Answers Verified 100 %
1. A client with heart failure is prescribed digoxin 0.125 mg PO. The client's
apical heart rate is70 beats per minute, blood pressure is 125/75 mmHg, and
respirations are 18 breaths per minute. Which action should the nurse
implement next?
a. Administer the medication.
b. Inform the healthcare provider.
c. Review the vital sign flowsheet.
d. Reassess the apical heart rate.
a. Administer the medication.
Obtaining the apical heart rate is a common parameter prior to administering digoxin,
which may indicate early digoxin toxicity if the heart rate is less than 60 beats per
minute, so the dose should be administered since the client is not demonstrating any
signs of toxicity.
2. When teaching a client with breast cancer about the prescribed radiation
therapy for treatment, what information is important to include?
a. Dry, itchy skin changes may occur.
b. There is a possibility of long bone pain.
c. Permanent pigment changes to the breast may result.
d. A low-residue diet may be prescribed to reduce the likelihood of diarrhea.
a. Dry, itchy skin changes may occur.
, Page 2 of 139
Side effects from radiation to the breast most often include temporary skin changes
such as dryness, tenderness, redness, swelling, and pruritus.
3. A client with chest pain, dizziness, and vomiting for the last 2 hours is
admitted for evaluation for Acute Coronary Syndrome (ACS). Which cardiac
biomarker should the registered nurse (RN) anticipate to be elevated if the
client experienced myocardial damage?
a. Creatine Kinase (CK-MB).
b. Serum troponin.
c. Myoglobin.
d. Ischemia modified albumin
b. Serum troponin.
Troponin is the most sensitive and specific test for myocardial damage. Troponin
elevation is more specific than CK-MB
4. A nurse is preparing a teaching plan for a client who is postmenopausal.
Which measure is most important for the nurse to include to prevent
osteoporosis?
a. Take a multivitamin daily.
b. Use only low fat milk products.
c. Perform weight resistance exercises.
d. Bicycle for at least 3 miles every day.
c. Perform weight resistance exercises.
Weight bearing on the skeletal system stimulates bone formation, so recommending
weight resistance exercises is most important in the prevention of osteoporosis in
postmenopausal clients.
5. A client is recently diagnosed with systemic lupus erythematosus (SLE) and
the registered nurse (RN) is assessing for common complications. Which
symptom should the RN instruct the client to report immediately?
a. Fever related to infection.
b. Weight loss and anorexia.
c. Depressed mood.
d. Break in tissue integrity.
, Page 3 of 139
a. Fever related to infection.
Secondary infections are a major concern with SLE clients due to the use of
corticosteroids and chemotherapeutic agents, which suppresses the immune
system, so reporting fever and infections should be reported immediately.
6. A client arrives at the emergency department for treatment of injuries
sustained in a motor vehicle collision. The nurse notes asymmetrical
expansion of the chest wall during respiration. Which action should the nurse
implement next?
a. Auscultate the lungs bilaterally.
b. Inspect the overall skin color.
c. Palpate for tactile fremitus.
d. Percuss the chest for resonance.
a. Auscultate the lungs bilaterally.
Chest trauma may result in the development of pneumothorax. After noting
asymmetric expansion of the chest wall, the nurse should auscultate the lungs to
determine if the client can move air through all of the lung fields.
7. The nurse is preparing an adult client for an upper gastrointestinal (UGI)
series. Which information should the nurse include in the teaching plan?
a. The xray procedure may last for several hours.
b. A nasogastric tube (NGT) is inserted to instill the barium.
c. Enemas are given to empty the bowel after the procedure.
d. Nothing by mouth is allowed for 6 to 8 hours before the study.
d. Nothing by mouth is allowed for 6 to 8 hours before the study.
The client should be NPO, to include smoking or chewing gum for at least 6 hours
before the UGI study.
8. What is the primary nursing problem for a client with asymptomatic primary
syphilis?
a. Acute pain.
b. Risk for injury.
c. Sexual dysfunction.
d. Deficient knowledge.
, Page 4 of 139
d. Deficient knowledge.
An asymptomatic client with primary syphilis is most likely unaware of this disease,
so to prevent transmission to others and recurrence in the client, the priority nursing
diagnosis is deficient knowledge of the disease pathophysiology.
9. A client who is admitted to the emergency department with a possible
tension pneumothorax after a motor vehicle collision is having multiple
diagnostic tests. Which finding requires immediate action by the nurse?
a. Serum amylase of 132 units/L.
b. Serum sodium of 134 mEq/L.
c. Chest x-ray indicating a mediastinal shift.
d. Abdominal x-ray air throughout intestines.
c. Chest x-ray indicating a mediastinal shift.
Immediate action is required for findings of a mediastinal shift, which can precipitate
life-threatening cardiovascular collapse as the great cardiac vessels become kinked
and compressed due to the tension pneumothorax.
10. The nurse is caring for a client receiving tamoxifen for the treatment of
breast cancer. Which action should the nurse include in the client's plan of
care?
a. Increase fluid intake.
b. Monitor sodium chloride intake.
c. Assist the client in coping with hot flashes.
d. Encourage milk products to increase calcium intake.
c. Assist the client in coping with hot flashes.
Tamoxifen, an estrogen receptor blocking agent, can cause hot flashes, so client
education regarding menopausal-like symptoms should be included in the plan of
care.
11. The nurse is caring for a client who is admitted with a hemorrhagic stroke.
Which nursing action should be included in the plan of care? a. Perform active
range of motion three times daily.
b. Monitor for Battle's sign every four hours.
