PN VATI Medical Surgical Re-
evaluation Assessment
A nurse is caring for a client who just had a endoscopic procedure. Which of the following is the
monitoring priority for this client?
A) Pain
B) Nausea
C) Gag reflex
D) Level of consciousness ANS: C) Gag reflex
A nurse is reinforcing discharge teaching for a client who has chronic pancreatitis. Which of the
following statements by the nurse is appropriate?
A)"You should decrease your caloric intake when abdominal pain is present."
B) "You should increase your daily protein intake."
C) "You should increase fat intake when experiencing loose stools."
D) "You should limit alcohol intake to 2-2 drinks per week." ANS: B) "You should increase your daily
protein intake."
A nurse collects data on a client who returned to the unit four hr ago following a partial colectomy.
Which of the following conditions should the nurse attend to first?
A) Change the moderately saturated dressing.
B) Administer analgesic medication for incisional pain.
C) Catheterize for a distended bladder.
D) Cough and deep breathe client. ANS: B) Administer analgesic medication for incisional pain.
,Rationale: Administer pain medication to establish comfort and then attend to the other reported
condition.
A nurse is reinforcing discharge teaching on actions that improve gas exchange to a client diagnosed
with emphysema. Which of the following instructions should be included in the teaching?
A) Resting in a supine position
B) Elevating arms while performing ADLs
C) Breathing in through the nose and out through pursed lips.
D) Increasing oxygen delivery to 5 L/min during times of distress. ANS: C) Breathing in through the nose
and out through pursed lips.
A nurse is assessing a client who is African-American and who is jaundice. Which of the following areas
are the most reliable for the nurse to inspect?
A) Palms of hands
B) Hard palate
C) Sclera
D) Nail beds ANS: Hard palate
A nurse is reinforcing teaching with a client who has ulcerative colitis and requires a low fiber diet. The
nurse should instruct the client to avoid which of the following foods?
A) Cooked carrots
B) Dried apricots
C) Ripe bananas
D) White rice ANS: B) Dried apricots
, A nurse is caring for a client who has a large wound that has a vacuum-assisted closure device placed
over it. Which of the following findings by the nurse indicated healing of the wound.
A) Granulation tussue on the surface of the wound
B) Musty odor from the foam dressing upon removal
C) Sanguineous drainage in the suction device.
D) Peeling of the edges of the transparent dressing ANS: A) Granulation tussue on the surface of the
wound
A nurse is caring for a toddler admitted to the hospital with acute gastroenteritis. Which of the following
findings has the highest priority?
A) Weightloss 3% of total body weight.
B) Blood glucose 150 mg/dL
C)Potassium 2.5 mEq/L
D) Urine specific gravity 1.035 ANS: C)Potassium 2.5 mEq/L
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy
with an older adult client who has diabetes mellitus. Which of the following actions is the most
important for the nurse to include in the teaching?
A) "Plan to have an eye examination once per year."
B) "Examine your feet carefully every day".
C) "Wear closed toed shoes daily."
D) "Maintain stable blood glucose levels." ANS: D) "Maintain stable blood glucose levels."
evaluation Assessment
A nurse is caring for a client who just had a endoscopic procedure. Which of the following is the
monitoring priority for this client?
A) Pain
B) Nausea
C) Gag reflex
D) Level of consciousness ANS: C) Gag reflex
A nurse is reinforcing discharge teaching for a client who has chronic pancreatitis. Which of the
following statements by the nurse is appropriate?
A)"You should decrease your caloric intake when abdominal pain is present."
B) "You should increase your daily protein intake."
C) "You should increase fat intake when experiencing loose stools."
D) "You should limit alcohol intake to 2-2 drinks per week." ANS: B) "You should increase your daily
protein intake."
A nurse collects data on a client who returned to the unit four hr ago following a partial colectomy.
Which of the following conditions should the nurse attend to first?
A) Change the moderately saturated dressing.
B) Administer analgesic medication for incisional pain.
C) Catheterize for a distended bladder.
D) Cough and deep breathe client. ANS: B) Administer analgesic medication for incisional pain.
,Rationale: Administer pain medication to establish comfort and then attend to the other reported
condition.
A nurse is reinforcing discharge teaching on actions that improve gas exchange to a client diagnosed
with emphysema. Which of the following instructions should be included in the teaching?
A) Resting in a supine position
B) Elevating arms while performing ADLs
C) Breathing in through the nose and out through pursed lips.
D) Increasing oxygen delivery to 5 L/min during times of distress. ANS: C) Breathing in through the nose
and out through pursed lips.
A nurse is assessing a client who is African-American and who is jaundice. Which of the following areas
are the most reliable for the nurse to inspect?
A) Palms of hands
B) Hard palate
C) Sclera
D) Nail beds ANS: Hard palate
A nurse is reinforcing teaching with a client who has ulcerative colitis and requires a low fiber diet. The
nurse should instruct the client to avoid which of the following foods?
A) Cooked carrots
B) Dried apricots
C) Ripe bananas
D) White rice ANS: B) Dried apricots
, A nurse is caring for a client who has a large wound that has a vacuum-assisted closure device placed
over it. Which of the following findings by the nurse indicated healing of the wound.
A) Granulation tussue on the surface of the wound
B) Musty odor from the foam dressing upon removal
C) Sanguineous drainage in the suction device.
D) Peeling of the edges of the transparent dressing ANS: A) Granulation tussue on the surface of the
wound
A nurse is caring for a toddler admitted to the hospital with acute gastroenteritis. Which of the following
findings has the highest priority?
A) Weightloss 3% of total body weight.
B) Blood glucose 150 mg/dL
C)Potassium 2.5 mEq/L
D) Urine specific gravity 1.035 ANS: C)Potassium 2.5 mEq/L
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy
with an older adult client who has diabetes mellitus. Which of the following actions is the most
important for the nurse to include in the teaching?
A) "Plan to have an eye examination once per year."
B) "Examine your feet carefully every day".
C) "Wear closed toed shoes daily."
D) "Maintain stable blood glucose levels." ANS: D) "Maintain stable blood glucose levels."
