NR325 EXAM 2 MEDICAL-SURGICAL NURSING ADVANCED
CONCEPTS COMPLETE EXAM QUESTIONS WIT CORRECT
ANSWERS
Question 1
A client with a platelet count of 20,000 mm3 is receiving chemotherapy.
What action should the nurse implement based on this finding?
A) Remove fresh flowers from the client's room
B) Remove the rectal thermometer from the client's room
C) Instruct family members to wear a mask when entering the client's
room
D) Call the dietary department to report a low-bacteria diet
Correct Answer: B) Remove the rectal thermometer from the client's
room
Explanation: A platelet count of 20,000 indicates severe
thrombocytopenia and high bleeding risk. Rectal temperatures could
cause trauma to delicate rectal membranes and lead to bleeding. The
other options relate to infection risk (low white blood cell count), not
bleeding risk.
Question 2
A client with acute pancreatitis is admitted with severe, piercing
abdominal pain and elevated serum amylase. Which additional
information is the client most likely to report?
,A) Abdominal pain decreases when lying supine
B) Pain lasts an hour and leaves the abdomen tender
C) Right upper quadrant pain refers to right scapula
D) Drinks alcohol until intoxicated at least twice weekly
Correct Answer: D) Drinks alcohol until intoxicated at least twice
weekly
Explanation: Alcohol use is a leading cause of acute pancreatitis. The
pain of pancreatitis is typically worse when supine and may be relieved
by leaning forward (not supine). Pain lasting an hour is not typical of
pancreatitis.
Question 3
A child newly diagnosed with sickle cell anemia (SCA) is being
discharged. Which information is most important to provide the
parents?
A) Instructions about how much fluid the child should drink daily
B) Signs of addiction to opioid pain medications
C) Information about non-pharmaceutical pain relief measures
D) Referral for social services for the child and family
Correct Answer: A) Instructions about how much fluid the child should
drink daily
Explanation: Hydration is critical in SCA to prevent sickling and vaso-
occlusive crises. Dehydration increases blood viscosity and promotes
sickling. This is the most important discharge teaching for prevention of
complications.
Question 4
To auscultate for a carotid bruit, where should the nurse place the
,stethoscope?
A) Over the apex of the heart
B) Over the base of the neck on each side
C) Over the left anterior chest
D) Over the mid-abdomen
Correct Answer: B) Over the base of the neck on each side
Explanation: Carotid bruits are auscultated over the carotid arteries in
the neck. The bell of the stethoscope is used. The nurse should listen to
each carotid separately, asking the patient to hold their breath.
Question 5
After receiving report on an inpatient acute care unit, which client
should the nurse assess first?
A) Client with obstruction of the large intestine with abdominal
distention
B) Client who had surgery yesterday with paralytic ileus and absent
bowel sounds
C) Client with small bowel obstruction with NGT draining greenish fluid
D) Client with bowel obstruction due to volvulus with abdominal rigidity
Correct Answer: D) Client with bowel obstruction due to volvulus with
abdominal rigidity
Explanation: Abdominal rigidity with volvulus indicates peritonitis or
strangulation, which is a surgical emergency. This client requires
immediate assessment and likely surgical intervention.
Question 6
A teenager presents to the ED with palpitations after vaping at a party.
The client is anxious, fearful, and hyperventilating. Which acid-base
, imbalance is anticipated?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: D) Respiratory alkalosis
Explanation: Hyperventilation causes excessive exhalation of CO2,
leading to respiratory alkalosis. Symptoms include palpitations, anxiety,
and paresthesias. Treatment includes reassurance and rebreathing
techniques.
Question 7
A client with dyspnea is being admitted to the medical unit. To best
prepare for the client's arrival, the nurse should ensure the bed is in
which position?
A) Supine
B) Supine with feet elevated
C) Supine with head elevated
D) Fowler's
Correct Answer: D) Fowler's
Explanation: A client with dyspnea should be placed in Fowler's position
(head of bed elevated 45-90 degrees) to maximize lung expansion and
ease breathing. Supine position would worsen respiratory distress.
Question 8
The nurse is taking the blood pressure of a client with Parkinson's
disease. Which assessment findings are relevant to the plan for taking
BP? (Select all that apply)
CONCEPTS COMPLETE EXAM QUESTIONS WIT CORRECT
ANSWERS
Question 1
A client with a platelet count of 20,000 mm3 is receiving chemotherapy.
What action should the nurse implement based on this finding?
A) Remove fresh flowers from the client's room
B) Remove the rectal thermometer from the client's room
C) Instruct family members to wear a mask when entering the client's
room
D) Call the dietary department to report a low-bacteria diet
Correct Answer: B) Remove the rectal thermometer from the client's
room
Explanation: A platelet count of 20,000 indicates severe
thrombocytopenia and high bleeding risk. Rectal temperatures could
cause trauma to delicate rectal membranes and lead to bleeding. The
other options relate to infection risk (low white blood cell count), not
bleeding risk.
Question 2
A client with acute pancreatitis is admitted with severe, piercing
abdominal pain and elevated serum amylase. Which additional
information is the client most likely to report?
,A) Abdominal pain decreases when lying supine
B) Pain lasts an hour and leaves the abdomen tender
C) Right upper quadrant pain refers to right scapula
D) Drinks alcohol until intoxicated at least twice weekly
Correct Answer: D) Drinks alcohol until intoxicated at least twice
weekly
Explanation: Alcohol use is a leading cause of acute pancreatitis. The
pain of pancreatitis is typically worse when supine and may be relieved
by leaning forward (not supine). Pain lasting an hour is not typical of
pancreatitis.
Question 3
A child newly diagnosed with sickle cell anemia (SCA) is being
discharged. Which information is most important to provide the
parents?
A) Instructions about how much fluid the child should drink daily
B) Signs of addiction to opioid pain medications
C) Information about non-pharmaceutical pain relief measures
D) Referral for social services for the child and family
Correct Answer: A) Instructions about how much fluid the child should
drink daily
Explanation: Hydration is critical in SCA to prevent sickling and vaso-
occlusive crises. Dehydration increases blood viscosity and promotes
sickling. This is the most important discharge teaching for prevention of
complications.
Question 4
To auscultate for a carotid bruit, where should the nurse place the
,stethoscope?
A) Over the apex of the heart
B) Over the base of the neck on each side
C) Over the left anterior chest
D) Over the mid-abdomen
Correct Answer: B) Over the base of the neck on each side
Explanation: Carotid bruits are auscultated over the carotid arteries in
the neck. The bell of the stethoscope is used. The nurse should listen to
each carotid separately, asking the patient to hold their breath.
Question 5
After receiving report on an inpatient acute care unit, which client
should the nurse assess first?
A) Client with obstruction of the large intestine with abdominal
distention
B) Client who had surgery yesterday with paralytic ileus and absent
bowel sounds
C) Client with small bowel obstruction with NGT draining greenish fluid
D) Client with bowel obstruction due to volvulus with abdominal rigidity
Correct Answer: D) Client with bowel obstruction due to volvulus with
abdominal rigidity
Explanation: Abdominal rigidity with volvulus indicates peritonitis or
strangulation, which is a surgical emergency. This client requires
immediate assessment and likely surgical intervention.
Question 6
A teenager presents to the ED with palpitations after vaping at a party.
The client is anxious, fearful, and hyperventilating. Which acid-base
, imbalance is anticipated?
A) Respiratory acidosis
B) Metabolic alkalosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: D) Respiratory alkalosis
Explanation: Hyperventilation causes excessive exhalation of CO2,
leading to respiratory alkalosis. Symptoms include palpitations, anxiety,
and paresthesias. Treatment includes reassurance and rebreathing
techniques.
Question 7
A client with dyspnea is being admitted to the medical unit. To best
prepare for the client's arrival, the nurse should ensure the bed is in
which position?
A) Supine
B) Supine with feet elevated
C) Supine with head elevated
D) Fowler's
Correct Answer: D) Fowler's
Explanation: A client with dyspnea should be placed in Fowler's position
(head of bed elevated 45-90 degrees) to maximize lung expansion and
ease breathing. Supine position would worsen respiratory distress.
Question 8
The nurse is taking the blood pressure of a client with Parkinson's
disease. Which assessment findings are relevant to the plan for taking
BP? (Select all that apply)
