RN Adult Medical Surgical ACTUAL EXAM 2 WITH 90
QUESTIONS AND ANSWERS WITH RATIONALES|AGRADE
2023-2024 LATEST UPDATE
A nurse is assessing for compartment syndrome in a client who has a short leg cast.
Which of the following findings should the nurse identify as a manifestation of this
condition?-ANSWER-Pain that increases with passive movement results from a
decrease in blood flow in the extremity caused by a decrease in the muscle
compartment size due to a cast that is too tight.
A nurse is providing teaching to a client who has a severe form of stage II Lyme
disease. Which of the following statements made by the client reflects an understanding
of the teaching?-ANSWER-My joints ache because I have Lyme disease
A nurse is preparing to administer phenytoin 600 mg PO daily to a client. The amount
available is oral solution 125 mg/5 mL. How many mL should the nurse administer?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not
use a trailing zero.)-ANSWER-24
A nurse is caring for a client who has an arterial line. Which of the following actions
should the nurse take?-ANSWER-place a pressure bag around the flush solution
because the pressure from an artery is greater than that of the line.
A nurse is updating the plan of care for a client who is receiving chemotherapy. Which
of the following findings should the nurse identify as the priority?-ANSWER-Report of
sore throat which could be a manifestation of an infection. The client is at risk for
neutropenia due to myelosuppression; therefore, an infection could lead to
sepsis.
A nurse is reviewing the medical record of a client who has systemic lupus
erythematosus (SLE). Which of the following findings should the nurse expect?-
ANSWER-Facial butterfly rash
A nurse is planning care for a client who is postoperative following a parathyroidectomy.
Which of the following actions should the nurse identify as the priority?-ANSWER-Place
tach tray at the bedside
in case of airway obstruction
A nurse is assessing a client who has diabetes insipidus. Which of the following findings
should the nurse expect?-ANSWER-Low urine specific gravity
Decreased water reabsorption by the renal tubules is caused by an alteration in
antidiuretic hormone release or the kidneys' responsiveness to the hormone.
, RN Adult Medical Surgical ACTUAL EXAM 2 WITH 90
QUESTIONS AND ANSWERS WITH RATIONALES|AGRADE
2023-2024 LATEST UPDATE
A nurse is providing teaching to a client who has stage II cervical cancer and is
scheduled for brachytherapy. Which of the following instructions should the nurse
include?-ANSWER-You will need to stay still in the bed during each treatment
session.
limited movement because excessive movement can cause the radioactive
source to become dislodged.
A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the
following interventions should the nurse include in the plan?-ANSWER-Encourage the
client to take deep breaths after the procedure
A nurse is caring for a client who is receiving a blood transfusion. The client becomes
restless, dyspneic, and has crackles noted to the lung bases. Which of the following
actions should the nurse anticipate taking?-ANSWER-Slow the infusion rate
circulatory overload. The nurse should slow or stop the infusion to improve the
client's ability to breathe, place the client in an upright position, and notify the
provider. The provider might prescribe a diuretic to alleviate the fluid overload.
A nurse is providing teaching to a client who has end-stage kidney disease and is
waiting for a kidney transplant. Which of the following information should the nurse
provide?-ANSWER-Hemodialys is something required following surgery
When a kidney comes from a deceased donor, it might not function immediately,
requiring the recipient to continue hemodialysis postoperatively.
A nurse is caring for a client who has hypothyroidism. Which of the following
manifestations should the nurse expect?-ANSWER-Constipation
decrease in the client's metabolism, resulting in slow motility of the gastrointestinal tract.
A nurse is providing preoperative teaching for a client who is scheduled for a
mastectomy. Which of the following statements should the nurse make?-ANSWER-I will
refer you to community resources that can provide support
A nurse is caring for a client who had a nephrostomy tube inserted 12 hr ago. Which of
the following findings should the nurse report to the provider?-ANSWER-Client reports
back pain indicate that the nephrostomy tube is dislodged or clogged.
A nurse is teaching a family about the care of a parent who has a new diagnosis of
Alzheimer's disease. Which of the following information should the nurse include in the
teaching?-ANSWER-Create complete outfits and allow the client to select one each day
A nurse is caring for a client who has breast cancer and tells the nurse that they would
like to have acupuncture because it provides greater relief than pain medication. Which
QUESTIONS AND ANSWERS WITH RATIONALES|AGRADE
2023-2024 LATEST UPDATE
A nurse is assessing for compartment syndrome in a client who has a short leg cast.
Which of the following findings should the nurse identify as a manifestation of this
condition?-ANSWER-Pain that increases with passive movement results from a
decrease in blood flow in the extremity caused by a decrease in the muscle
compartment size due to a cast that is too tight.
A nurse is providing teaching to a client who has a severe form of stage II Lyme
disease. Which of the following statements made by the client reflects an understanding
of the teaching?-ANSWER-My joints ache because I have Lyme disease
A nurse is preparing to administer phenytoin 600 mg PO daily to a client. The amount
available is oral solution 125 mg/5 mL. How many mL should the nurse administer?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not
use a trailing zero.)-ANSWER-24
A nurse is caring for a client who has an arterial line. Which of the following actions
should the nurse take?-ANSWER-place a pressure bag around the flush solution
because the pressure from an artery is greater than that of the line.
A nurse is updating the plan of care for a client who is receiving chemotherapy. Which
of the following findings should the nurse identify as the priority?-ANSWER-Report of
sore throat which could be a manifestation of an infection. The client is at risk for
neutropenia due to myelosuppression; therefore, an infection could lead to
sepsis.
A nurse is reviewing the medical record of a client who has systemic lupus
erythematosus (SLE). Which of the following findings should the nurse expect?-
ANSWER-Facial butterfly rash
A nurse is planning care for a client who is postoperative following a parathyroidectomy.
Which of the following actions should the nurse identify as the priority?-ANSWER-Place
tach tray at the bedside
in case of airway obstruction
A nurse is assessing a client who has diabetes insipidus. Which of the following findings
should the nurse expect?-ANSWER-Low urine specific gravity
Decreased water reabsorption by the renal tubules is caused by an alteration in
antidiuretic hormone release or the kidneys' responsiveness to the hormone.
, RN Adult Medical Surgical ACTUAL EXAM 2 WITH 90
QUESTIONS AND ANSWERS WITH RATIONALES|AGRADE
2023-2024 LATEST UPDATE
A nurse is providing teaching to a client who has stage II cervical cancer and is
scheduled for brachytherapy. Which of the following instructions should the nurse
include?-ANSWER-You will need to stay still in the bed during each treatment
session.
limited movement because excessive movement can cause the radioactive
source to become dislodged.
A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the
following interventions should the nurse include in the plan?-ANSWER-Encourage the
client to take deep breaths after the procedure
A nurse is caring for a client who is receiving a blood transfusion. The client becomes
restless, dyspneic, and has crackles noted to the lung bases. Which of the following
actions should the nurse anticipate taking?-ANSWER-Slow the infusion rate
circulatory overload. The nurse should slow or stop the infusion to improve the
client's ability to breathe, place the client in an upright position, and notify the
provider. The provider might prescribe a diuretic to alleviate the fluid overload.
A nurse is providing teaching to a client who has end-stage kidney disease and is
waiting for a kidney transplant. Which of the following information should the nurse
provide?-ANSWER-Hemodialys is something required following surgery
When a kidney comes from a deceased donor, it might not function immediately,
requiring the recipient to continue hemodialysis postoperatively.
A nurse is caring for a client who has hypothyroidism. Which of the following
manifestations should the nurse expect?-ANSWER-Constipation
decrease in the client's metabolism, resulting in slow motility of the gastrointestinal tract.
A nurse is providing preoperative teaching for a client who is scheduled for a
mastectomy. Which of the following statements should the nurse make?-ANSWER-I will
refer you to community resources that can provide support
A nurse is caring for a client who had a nephrostomy tube inserted 12 hr ago. Which of
the following findings should the nurse report to the provider?-ANSWER-Client reports
back pain indicate that the nephrostomy tube is dislodged or clogged.
A nurse is teaching a family about the care of a parent who has a new diagnosis of
Alzheimer's disease. Which of the following information should the nurse include in the
teaching?-ANSWER-Create complete outfits and allow the client to select one each day
A nurse is caring for a client who has breast cancer and tells the nurse that they would
like to have acupuncture because it provides greater relief than pain medication. Which
