RN ADULT MEDICAL SURGICAL 2023 WITH NGN ACTUAL
EXAM 180 QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) A+ GRADE
A nurse is admitting a client who has active tuberculosis. Which of the following types of
transmission precautions should the nurse initiate?
ANSW-Airborne
A nurse is reviewing the medical record of a client who has osteomyelitis and a
prescription for gentamicin. Which of the following findings from the client's medical
record should indicate to the nurse the need to withhold the medication and notify the
provider? (Click on the "Exhibit" button for additional information about the client. There
are three tabs that contain separate categories of data.)
ANSW-Serum creatinine
A nurse is providing teaching to a client who is perimenopausal and has a prescription
for hormone replacement therapy. For which of the following adverse effects should the
nurse instruct the client to notify the provider? (Select all that apply.)
ANSW-Calf pain
Numbness in the arms
Intense headache
A nurse is planning discharge teaching for a client who has an external fixation device
for a fracture of the lower extremity. Which of the following instructions should the nurse
include in the plan of care?
ANSW-Use crutches with rubber tips.
A nurse is teaching a group of newly licensed nurses about pain management for older
adult clients. Which of the following statements by a newly licensed nurse indicates an
understanding of the teaching?
ANSW-"Ibuprofen can cause gastrointestinal bleeding in older adult clients."
A nurse is caring for a client who has a cervical spinal cord injury sustained 1 month
ago. Which of the following manifestations indicates that the client is experiencing
autonomic dysreflexia (AD)?
ANSW-Heart rate 52/min
,A nurse is assessing a client who has advanced lung cancer and is receiving palliative
care. The client has just undergone thoracentesis. The nurse should expect a reduction
in which of the following common manifestations of advanced cancer?
ANSW-Dyspnea
A nurse is providing teaching to a client who takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?
ANSW-"Ginkgo biloba can cause an increased risk for bleeding."
A nurse on a medical-surgical unit is reviewing the medical record of an older adult
client who is receiving IV fluid therapy. Which of the following client information should
indicate to the nurse that the client requires re-evaluation of the IV therapy prescription?
(Click on the "Exhibit" button for additional information about the client. There are three
tabs that contain separate categories of data.)
ANSW-EXHIBIT BUN
A nurse is receiving report on a client who is postoperative following an open repair of
Zenker's diverticulum. The nurse should anticipate the surgical incision to be in which of
the following locations? (You will find hot spots to select in the artwork below. Select
only the hot spot that corresponds to your answer.)
ANSW-A )Neck
A nurse is obtaining a medication history from a client who is scheduled to undergo
cataract surgery. The nurse should recognize that which of the following client
medications is a contraindication for the surgery and notify the provider?
ANSW-Warfarin
A nurse is assessing a client who has peripheral arterial disease. Which of the following
findings should the nurse expect?
ANSW-Hair loss on the lower legs
A home health nurse is providing teaching to a client who has a stage 1 pressure injury
on the greater trochanter of his left hip. Which of the following instructions should the
nurse include in the teaching?
ANSW-Change position every hour.
A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the
following nonpharmacological interventions should the nurse suggest to the client to
reduce pain?
ANSW-Alternate application of heat and cold to the affected joints.
A nurse is assessing a client following the completion of hemodialysis. Which of the
following findings is the nurse's priority to report to the provider?
ANSW-Restlessness
, A nurse is caring for a client who is 4 hr postoperative following an open reduction
internal fixation of the right ankle. Which of the following assessment findings should the
nurse report to the provider?
ANSW-Extremity cool upon palpation
A nurse is assessing a client who is postoperative following a thyroidectomy. Which of
the following findings is the nurse's priority?
ANSW-Temperature 38.9° C (102° F)
A nurse is planning care for a client who is having a modified radical mastectomy of the
right breast. Which of the following interventions should the nurse include in the plan of
care?
ANSW-Instruct the client that the drain will be removed when there is 25 mL of output
or less over a 24-hr period.
A nurse is teaching a client about the use of transcutaneous electrical nerve stimulation
(TENS) for the management of bone cancer pain. The nurse should explain that
applying a TENS unit to the painful area has which of the following effects?
ANSW-A tingling sensation replacing the pain
A nurse is providing teaching to a client who has a recent diagnosis of constipation-
predominant irritable bowel syndrome. Which of the following instructions should the
nurse include in the teaching?
ANSW-Consume at least 30 g of fiber daily.
A nurse is providing teaching to a client who has AIDS. Which of the following
statements by the client indicates an understanding of the teaching?
ANSW-"I will take my temperature once a day."
A nurse is reviewing the medical record of a client who is taking warfarin for chronic
atrial fibrillation. Which of the following values should the nurse identify as a desired
outcome for this therapy?
ANSW-INR 2.5
A nurse is caring for a newly admitted client who has a gastric hemorrhage and is going
into shock. Identify the sequence of actions the nurse should take. (Move the steps into
the box on the right, placing them in the selected order of performance. Use all the
steps.)
ANSW-AdminiSTER o2
Initiate IV therapy
Insert an NG tube
Administer ranitidine
A nurse is assessing heart sounds of a client who reports substernal precordial pain.
Identify which of the following sounds the nurse should document in the client's medical
EXAM 180 QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) A+ GRADE
A nurse is admitting a client who has active tuberculosis. Which of the following types of
transmission precautions should the nurse initiate?
ANSW-Airborne
A nurse is reviewing the medical record of a client who has osteomyelitis and a
prescription for gentamicin. Which of the following findings from the client's medical
record should indicate to the nurse the need to withhold the medication and notify the
provider? (Click on the "Exhibit" button for additional information about the client. There
are three tabs that contain separate categories of data.)
ANSW-Serum creatinine
A nurse is providing teaching to a client who is perimenopausal and has a prescription
for hormone replacement therapy. For which of the following adverse effects should the
nurse instruct the client to notify the provider? (Select all that apply.)
ANSW-Calf pain
Numbness in the arms
Intense headache
A nurse is planning discharge teaching for a client who has an external fixation device
for a fracture of the lower extremity. Which of the following instructions should the nurse
include in the plan of care?
ANSW-Use crutches with rubber tips.
A nurse is teaching a group of newly licensed nurses about pain management for older
adult clients. Which of the following statements by a newly licensed nurse indicates an
understanding of the teaching?
ANSW-"Ibuprofen can cause gastrointestinal bleeding in older adult clients."
A nurse is caring for a client who has a cervical spinal cord injury sustained 1 month
ago. Which of the following manifestations indicates that the client is experiencing
autonomic dysreflexia (AD)?
ANSW-Heart rate 52/min
,A nurse is assessing a client who has advanced lung cancer and is receiving palliative
care. The client has just undergone thoracentesis. The nurse should expect a reduction
in which of the following common manifestations of advanced cancer?
ANSW-Dyspnea
A nurse is providing teaching to a client who takes ginkgo biloba as an herbal
supplement. Which of the following statements should the nurse make?
ANSW-"Ginkgo biloba can cause an increased risk for bleeding."
A nurse on a medical-surgical unit is reviewing the medical record of an older adult
client who is receiving IV fluid therapy. Which of the following client information should
indicate to the nurse that the client requires re-evaluation of the IV therapy prescription?
(Click on the "Exhibit" button for additional information about the client. There are three
tabs that contain separate categories of data.)
ANSW-EXHIBIT BUN
A nurse is receiving report on a client who is postoperative following an open repair of
Zenker's diverticulum. The nurse should anticipate the surgical incision to be in which of
the following locations? (You will find hot spots to select in the artwork below. Select
only the hot spot that corresponds to your answer.)
ANSW-A )Neck
A nurse is obtaining a medication history from a client who is scheduled to undergo
cataract surgery. The nurse should recognize that which of the following client
medications is a contraindication for the surgery and notify the provider?
ANSW-Warfarin
A nurse is assessing a client who has peripheral arterial disease. Which of the following
findings should the nurse expect?
ANSW-Hair loss on the lower legs
A home health nurse is providing teaching to a client who has a stage 1 pressure injury
on the greater trochanter of his left hip. Which of the following instructions should the
nurse include in the teaching?
ANSW-Change position every hour.
A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the
following nonpharmacological interventions should the nurse suggest to the client to
reduce pain?
ANSW-Alternate application of heat and cold to the affected joints.
A nurse is assessing a client following the completion of hemodialysis. Which of the
following findings is the nurse's priority to report to the provider?
ANSW-Restlessness
, A nurse is caring for a client who is 4 hr postoperative following an open reduction
internal fixation of the right ankle. Which of the following assessment findings should the
nurse report to the provider?
ANSW-Extremity cool upon palpation
A nurse is assessing a client who is postoperative following a thyroidectomy. Which of
the following findings is the nurse's priority?
ANSW-Temperature 38.9° C (102° F)
A nurse is planning care for a client who is having a modified radical mastectomy of the
right breast. Which of the following interventions should the nurse include in the plan of
care?
ANSW-Instruct the client that the drain will be removed when there is 25 mL of output
or less over a 24-hr period.
A nurse is teaching a client about the use of transcutaneous electrical nerve stimulation
(TENS) for the management of bone cancer pain. The nurse should explain that
applying a TENS unit to the painful area has which of the following effects?
ANSW-A tingling sensation replacing the pain
A nurse is providing teaching to a client who has a recent diagnosis of constipation-
predominant irritable bowel syndrome. Which of the following instructions should the
nurse include in the teaching?
ANSW-Consume at least 30 g of fiber daily.
A nurse is providing teaching to a client who has AIDS. Which of the following
statements by the client indicates an understanding of the teaching?
ANSW-"I will take my temperature once a day."
A nurse is reviewing the medical record of a client who is taking warfarin for chronic
atrial fibrillation. Which of the following values should the nurse identify as a desired
outcome for this therapy?
ANSW-INR 2.5
A nurse is caring for a newly admitted client who has a gastric hemorrhage and is going
into shock. Identify the sequence of actions the nurse should take. (Move the steps into
the box on the right, placing them in the selected order of performance. Use all the
steps.)
ANSW-AdminiSTER o2
Initiate IV therapy
Insert an NG tube
Administer ranitidine
A nurse is assessing heart sounds of a client who reports substernal precordial pain.
Identify which of the following sounds the nurse should document in the client's medical
