MEDICAL-SURGICAL NURSING 1 EXAM
2025-2026 GRADED A+
The nurse is caring for a patient who has a calcium level of 12.1
mg/dL. Which action would the nurse include in the plan of care?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Encourage fluid intake up to 4000 mL daily.
d. Monitor for Trousseau's and Chvostek's signs. Correct Answer
Encourage fluid intake up to 4000 mL daily.
A patient with renal failure is on a low phosphate diet. Which food
would the nurse remove from the patient's food tray?
a. Skim milk
b. Grape juice
c. Mixed green salad
d. Fried chicken breast Correct Answer Skim milk
A patient has a magnesium level of 1.3 mg/dL. Which information
from the patient's health history would help the nurse identify a
likely cause of this value?
a. Daily alcohol intake
,b. Dietary protein intake
c. Daily multivitamin use
d. Occasional laxative use Correct Answer Daily alcohol intake
A patient asks the nurse why a peripherally inserted central
catheter is needed to begin receiving parenteral nutrition with
25% dextrose. Which response by the nurse is accurate?
a. The prescribed infusion can be given more rapidly when there
is a central line.
b. The hypertonic solution is more rapidly diluted when given
through a central line.
c. There is a decreased risk for infection when 25% dextrose is
infused through a central line.
d. The required blood glucose monitoring is based on samples
obtained from a central line. Correct Answer The hypertonic
solution is more rapidly diluted when given through a central line.
Which action would the nurse take when caring for a patient who
has a central venous access device (CVAD)?
a. Avoid using friction when cleaning around the CVAD insertion
site.
b. Use the push-pause method to flush the CVAD after giving
medications.
c. Position the patient's face toward the CVAD during injection cap
changes.
,d. Obtain a prescription from the health care provider to change
CVAD dressing. Correct Answer Use the push-pause method to
flush the CVAD after giving medications.
An older adult patient receiving iso-osmolar continuous enteral
nutrition develops restlessness, agitation, and weakness. Which
laboratory result would the nurse report to the health care
provider immediately?
a. K+ 3.4 mEq/L (3.4 mmol/L)
b. Ca+2 7.8 mg/dL (1.95 mmol/L)
c. Na+ 154 mEq/L (154 mmol/L)
d. PO4-3 4.8 mg/dL (1.55 mmol/L) Correct Answer Na+ 154
mEq/L (154 mmol/L)
A patient who has been hospitalized for 2 days has a nasogastric
tube to low suction and is receiving normal saline IV at 100 mL/hr.
Which assessment finding would be a priority for the nurse to
report to the health care provider?
a. Oral temperature increased to 100.1F
b. Decreased alertness since admission
c. Weight gain of 2 pounds (1 kg) over 2 days
d. Serum sodium level of 138 mEq/L (138 mmol/L) Correct
Answer Decreased alertness since admission
, A nurse is assessing a newly admitted patient with chronic heart
failure who forgot to take prescribed medications. The patient
seems confused and short of breath with peripheral edema.
Which assessment would the nurse complete first?
a. Skin turgor
b. Heart sounds
c. Mental status
d. Capillary refill Correct Answer Mental status
A patient with renal failure who arrives for outpatient hemodialysis
is unresponsive to questions and has decreased deep tendon
reflexes. Family members report that the patient has been taking
aluminum hydroxide/magnesium hydroxide suspension (Maalox)
at home for indigestion. Which action would the nurse take first?
a. Notify the patient's health care provider.
b. Obtain an order to draw a potassium level.
c. Review the history of gastrointestinal upset on the chart.
d. Teach the patient about magnesium-containing antacids.
Correct Answer Notify the patient's health care provider.
A patient who had a transverse colectomy for diverticulosis 18
hours ago has nasogastric suction. The patient reports anxiety
and incisional pain. The patient's respiratory rate is 32
breaths/min, and the arterial blood gases (ABGs) indicate
respiratory alkalosis with a normal arterial oxygen level. Which
action would the nurse take first?
2025-2026 GRADED A+
The nurse is caring for a patient who has a calcium level of 12.1
mg/dL. Which action would the nurse include in the plan of care?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Encourage fluid intake up to 4000 mL daily.
d. Monitor for Trousseau's and Chvostek's signs. Correct Answer
Encourage fluid intake up to 4000 mL daily.
A patient with renal failure is on a low phosphate diet. Which food
would the nurse remove from the patient's food tray?
a. Skim milk
b. Grape juice
c. Mixed green salad
d. Fried chicken breast Correct Answer Skim milk
A patient has a magnesium level of 1.3 mg/dL. Which information
from the patient's health history would help the nurse identify a
likely cause of this value?
a. Daily alcohol intake
,b. Dietary protein intake
c. Daily multivitamin use
d. Occasional laxative use Correct Answer Daily alcohol intake
A patient asks the nurse why a peripherally inserted central
catheter is needed to begin receiving parenteral nutrition with
25% dextrose. Which response by the nurse is accurate?
a. The prescribed infusion can be given more rapidly when there
is a central line.
b. The hypertonic solution is more rapidly diluted when given
through a central line.
c. There is a decreased risk for infection when 25% dextrose is
infused through a central line.
d. The required blood glucose monitoring is based on samples
obtained from a central line. Correct Answer The hypertonic
solution is more rapidly diluted when given through a central line.
Which action would the nurse take when caring for a patient who
has a central venous access device (CVAD)?
a. Avoid using friction when cleaning around the CVAD insertion
site.
b. Use the push-pause method to flush the CVAD after giving
medications.
c. Position the patient's face toward the CVAD during injection cap
changes.
,d. Obtain a prescription from the health care provider to change
CVAD dressing. Correct Answer Use the push-pause method to
flush the CVAD after giving medications.
An older adult patient receiving iso-osmolar continuous enteral
nutrition develops restlessness, agitation, and weakness. Which
laboratory result would the nurse report to the health care
provider immediately?
a. K+ 3.4 mEq/L (3.4 mmol/L)
b. Ca+2 7.8 mg/dL (1.95 mmol/L)
c. Na+ 154 mEq/L (154 mmol/L)
d. PO4-3 4.8 mg/dL (1.55 mmol/L) Correct Answer Na+ 154
mEq/L (154 mmol/L)
A patient who has been hospitalized for 2 days has a nasogastric
tube to low suction and is receiving normal saline IV at 100 mL/hr.
Which assessment finding would be a priority for the nurse to
report to the health care provider?
a. Oral temperature increased to 100.1F
b. Decreased alertness since admission
c. Weight gain of 2 pounds (1 kg) over 2 days
d. Serum sodium level of 138 mEq/L (138 mmol/L) Correct
Answer Decreased alertness since admission
, A nurse is assessing a newly admitted patient with chronic heart
failure who forgot to take prescribed medications. The patient
seems confused and short of breath with peripheral edema.
Which assessment would the nurse complete first?
a. Skin turgor
b. Heart sounds
c. Mental status
d. Capillary refill Correct Answer Mental status
A patient with renal failure who arrives for outpatient hemodialysis
is unresponsive to questions and has decreased deep tendon
reflexes. Family members report that the patient has been taking
aluminum hydroxide/magnesium hydroxide suspension (Maalox)
at home for indigestion. Which action would the nurse take first?
a. Notify the patient's health care provider.
b. Obtain an order to draw a potassium level.
c. Review the history of gastrointestinal upset on the chart.
d. Teach the patient about magnesium-containing antacids.
Correct Answer Notify the patient's health care provider.
A patient who had a transverse colectomy for diverticulosis 18
hours ago has nasogastric suction. The patient reports anxiety
and incisional pain. The patient's respiratory rate is 32
breaths/min, and the arterial blood gases (ABGs) indicate
respiratory alkalosis with a normal arterial oxygen level. Which
action would the nurse take first?
