ADN Week 7 Quiz | Med-Surg Prioritization & Case Studies 2026/2027
UPDATE
1. A nurse is assigned to four clients. Which client should the nurse assess first?
A. A client with a history of heart failure reporting 2+ pitting edema in the ankles.
B. A client with a new-onset productive cough and shortness of breath following a thyroidectomy.
C. A client with chronic obstructive pulmonary disease (COPD) and an SpO2 of 91% on room air.
D. A client who is 2 days post-appendectomy and has a temperature of 100.2 F.
Answer: B
Rationale: Airway and breathing take priority. Post-thyroidectomy respiratory distress
may indicate airway obstruction from bleeding or laryngeal edema, which is an emergency.
2. Which task is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Evaluating the effectiveness of a pain medication administered 30 minutes ago.
B. Assisting a stable client with ambulation for the first time after surgery.
C. Calculating a client’s 24-hour intake and output totals.
D. Providing discharge instructions regarding wound care to a client.
Answer: C
Rationale: UAPs can perform routine tasks like calculating I&O. Evaluation, initial
ambulation (requiring assessment), and teaching are nursing responsibilities.
,3. A nurse receives a report on four clients. Which client should the nurse visit
first?
A. A client with diabetes mellitus whose blood glucose is 150 mg/dL.
B. A client with a stage III pressure injury requiring a dressing change.
C. A client receiving physical therapy for a fractured hip.
D. A client who has just been admitted with suspected bacterial meningitis.
Answer: D
Rationale: Bacterial meningitis is a medical emergency requiring immediate isolation and
antibiotic therapy to prevent neurological damage or death.
4. An RN is caring for a client with a potassium level of 6.2 mEq/L. Which action
should the nurse take first?
A. Call the physician to report the lab result.
B. Obtain an electrocardiogram (ECG).
C. Administer sodium polystyrene sulfonate orally.
D. Check the client’s urine output.
Answer: B
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias. An ECG is the
priority to assess the heart’s electrical activity.
5. Which client should the nurse see first after the shift report?
A. A client with Crohn’s disease reporting five loose stools in the last 12 hours.
B. A client with deep vein thrombosis (DVT) reporting sudden chest pain and shortness of breath.
C. A client with a urinary tract infection reporting burning during urination.
D. A client scheduled for an elective cholecystectomy in 4 hours.
Answer: B
Rationale: Sudden chest pain and shortness of breath in a DVT patient suggest a
pulmonary embolism, which is a life-threatening complication.
, 6. A client is admitted with Diabetic Ketoacidosis (DKA). Which intervention is
the priority?
A. Administering 10 units of regular insulin IV bolus.
B. Educating the client on the importance of insulin compliance.
C. Checking the client’s potassium level.
D. Initiating an intravenous infusion of 0.9% normal saline.
Answer: D
Rationale: Fluid resuscitation is the initial priority in DKA to treat dehydration and restore
circulatory volume before insulin and electrolyte management.
7. The nurse is assessing a client 1 hour after a cardiac catheterization. Which
finding requires immediate intervention?
A. A 2+ pedal pulse in the affected extremity.
B. A small hematoma at the insertion site.
C. The insertion site dressing is saturated with bright red blood.
D. The client reporting a warm sensation during dye injection.
Answer: C
Rationale: Saturated bright red blood indicates active arterial bleeding, which is a critical
post-procedural complication.
8. A client with a hip fracture is in Buck’s traction. Which finding should the
nurse prioritize?
A. The client reports pain at a level 6 out of 10.
B. The client’s toes are cool to the touch and have a cap refill of 5 seconds.
C. The weights are resting on the floor.
D. There is a small amount of redness over the client’s heel.
Answer: B
Rationale: Cool extremities and delayed capillary refill indicate neurovascular impairment,
which can lead to permanent damage if not addressed immediately.
UPDATE
1. A nurse is assigned to four clients. Which client should the nurse assess first?
A. A client with a history of heart failure reporting 2+ pitting edema in the ankles.
B. A client with a new-onset productive cough and shortness of breath following a thyroidectomy.
C. A client with chronic obstructive pulmonary disease (COPD) and an SpO2 of 91% on room air.
D. A client who is 2 days post-appendectomy and has a temperature of 100.2 F.
Answer: B
Rationale: Airway and breathing take priority. Post-thyroidectomy respiratory distress
may indicate airway obstruction from bleeding or laryngeal edema, which is an emergency.
2. Which task is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Evaluating the effectiveness of a pain medication administered 30 minutes ago.
B. Assisting a stable client with ambulation for the first time after surgery.
C. Calculating a client’s 24-hour intake and output totals.
D. Providing discharge instructions regarding wound care to a client.
Answer: C
Rationale: UAPs can perform routine tasks like calculating I&O. Evaluation, initial
ambulation (requiring assessment), and teaching are nursing responsibilities.
,3. A nurse receives a report on four clients. Which client should the nurse visit
first?
A. A client with diabetes mellitus whose blood glucose is 150 mg/dL.
B. A client with a stage III pressure injury requiring a dressing change.
C. A client receiving physical therapy for a fractured hip.
D. A client who has just been admitted with suspected bacterial meningitis.
Answer: D
Rationale: Bacterial meningitis is a medical emergency requiring immediate isolation and
antibiotic therapy to prevent neurological damage or death.
4. An RN is caring for a client with a potassium level of 6.2 mEq/L. Which action
should the nurse take first?
A. Call the physician to report the lab result.
B. Obtain an electrocardiogram (ECG).
C. Administer sodium polystyrene sulfonate orally.
D. Check the client’s urine output.
Answer: B
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias. An ECG is the
priority to assess the heart’s electrical activity.
5. Which client should the nurse see first after the shift report?
A. A client with Crohn’s disease reporting five loose stools in the last 12 hours.
B. A client with deep vein thrombosis (DVT) reporting sudden chest pain and shortness of breath.
C. A client with a urinary tract infection reporting burning during urination.
D. A client scheduled for an elective cholecystectomy in 4 hours.
Answer: B
Rationale: Sudden chest pain and shortness of breath in a DVT patient suggest a
pulmonary embolism, which is a life-threatening complication.
, 6. A client is admitted with Diabetic Ketoacidosis (DKA). Which intervention is
the priority?
A. Administering 10 units of regular insulin IV bolus.
B. Educating the client on the importance of insulin compliance.
C. Checking the client’s potassium level.
D. Initiating an intravenous infusion of 0.9% normal saline.
Answer: D
Rationale: Fluid resuscitation is the initial priority in DKA to treat dehydration and restore
circulatory volume before insulin and electrolyte management.
7. The nurse is assessing a client 1 hour after a cardiac catheterization. Which
finding requires immediate intervention?
A. A 2+ pedal pulse in the affected extremity.
B. A small hematoma at the insertion site.
C. The insertion site dressing is saturated with bright red blood.
D. The client reporting a warm sensation during dye injection.
Answer: C
Rationale: Saturated bright red blood indicates active arterial bleeding, which is a critical
post-procedural complication.
8. A client with a hip fracture is in Buck’s traction. Which finding should the
nurse prioritize?
A. The client reports pain at a level 6 out of 10.
B. The client’s toes are cool to the touch and have a cap refill of 5 seconds.
C. The weights are resting on the floor.
D. There is a small amount of redness over the client’s heel.
Answer: B
Rationale: Cool extremities and delayed capillary refill indicate neurovascular impairment,
which can lead to permanent damage if not addressed immediately.
