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Medical-Surgical RN A Prophecy Relias – 2024/2025: Practice Questions and Answers, Exams of Public Health

A series of multiple-choice questions and answers related to medical-surgical nursing. It covers a wide range of topics, including tuberculosis, dehydration, hepatitis b, medication side effects, pain management, venous thromboembolism, diabetes, tracheostomy, infection control, post-operative care, anemia, diverticulitis, and more. The questions are designed to test knowledge and understanding of essential nursing concepts and procedures.

Typology: Exams

2024/2025

Available from 11/04/2024

profsmith
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Download Medical-Surgical RN A Prophecy Relias – 2024/2025: Practice Questions and Answers and more Exams Public Health in PDF only on Docsity! Medical-Surgical RN A Prophecy Relias – 2024/2025 1. A patient is having a reaction to a skin test for tuberculosis (TB). What size induration would indicate a positive test? A. 1 mm B. 3 mm C. 5 mm D. 10 mm Answer: D. 10 mm 2. You are assessing a patient for signs of dehydration. Which of the following findings would you expect? A. Increased urine output B. Moist mucous membranes C. Decreased skin turgor D. Bradycardia Answer: C. Decreased skin turgor 3. A nurse caring for a patient with hepatitis B must follow which standard precaution? A. Gloves, gown, mask B. Droplet precautions C. Airborne precautions D. Standard precautions Answer: D. Standard precautions 4. The healthcare provider prescribes methylprednisolone for a patient with an autoimmune disease. What is a common side effect of this medication? A. Weight loss B. Hypoglycemia C. Fluid retention D. Bradycardia Answer: C. Fluid retention 5. Which assessment finding should the nurse monitor for a patient who is taking a calcium channel blocker? A. Decreased heart rate B. Decreased blood pressure C. Increased respiratory rate D. Increased blood glucose Answer: B. Decreased blood pressure 6. A patient with chronic pain is started on a pain management regimen that includes opioids. What is a common concern that should be addressed with this patient? A. Decreased appetite B. Risk for dependency C. Increased activity level D. Enhanced mood Answer: B. Risk for dependency 7. Your patient is at high risk for developing venous thromboembolism (VTE). What preventive measure should you prioritize? A. Ambulation B. Bed rest C. High-protein diet D. Restrict all activities Answer: A. Ambulation 8. A patient newly diagnosed with diabetes asks the nurse how often they should check their blood glucose levels. What is the most appropriate response? A. "Once a day is sufficient." B. "Check it after every meal." C. "It depends on your treatment plan." D. "Only when feeling symptoms." Answer: C. "It depends on your treatment plan." 9. A nurse is caring for a patient with a tracheostomy. What is the priority nursing intervention? A. Suctioning the tracheostomy regularly B. Ensuring the tracheostomy is properly secured C. Keeping the patient positioned at 30 degrees D. Performing daily dressing changes Answer: A. Suctioning the tracheostomy regularly 10. Your patient is under isolation precautions for a bacterial infection. What is an essential part of the nurse's role? A. Provide education on infection control measures B. Avoiding hand hygiene before exiting the room C. Decreasing the frequency of assessments D. Disregarding health care worker recommendations Answer: A. Provide education on infection control measures 11. A post-operative patient is being treated for nausea. Which medication class is commonly used to manage this side effect? A. Antihypertensives B. Antiemetics C. Antipyretics D. Antibiotics Answer: B. Antiemetics 12. A patient has a prescription for clopidogrel. What is the primary reason this medication is used? A. To lower blood pressure B. To prevent platelet aggregation C. To dissolve blood clots D. Frequent urination Answer: B. Numbness or tingling in the feet 25. A patient with a history of heart failure and a low sodium diet is also diabetic. What intervention is essential for this patient? A. Restricting fluid intake even more B. Monitoring blood glucose levels closely C. Offering high-sodium snacks D. Discouraging weight checks Answer: B. Monitoring blood glucose levels closely 26. A client has been diagnosed with hyperthyroidism and is being treated with methimazole. What is the priority teaching for this client? A. "You will need to limit your cold exposure." B. "This medication will cause early weight gain." C. "Monitor for signs of hypothyroidism such as fatigue." D. "You can stop taking this medication when you feel better." Answer: C. "Monitor for signs of hypothyroidism such as fatigue." 27. 1.2 milligrams is equal to how many micrograms? A. 1200 mcg B. 120 mcg C. 12,000 mcg D. 1,200,000 mcg Answer: A. 1200 mcg 28. Your post-op patient has a Jackson-Pratt (JP) drain in place. How do you ensure effective drain function? A. Keep the drain open B. Compress the drain, then plug the bulb to establish suction C. Leave the bulb disconnected D. Change the bulb every hour Answer: B. Compress the drain, then plug the bulb to establish suction 29. Your male patient complains of discomfort while inflating the balloon during insertion of an indwelling urinary catheter. What would be the MOST appropriate action? A. Deflate the balloon, advance the catheter further, then reinflate the balloon B. Inflate the balloon more C. Remove the catheter and let him rest D. Call the physician Answer: A. Deflate the balloon, advance the catheter further, then reinflate the balloon 30. Your patient has symptomatic anemia but is refusing a blood transfusion for religious reasons. What is an appropriate response? A. Persuade him to take the transfusion B. Respect his wishes and notify the provider C. Ignore his choice D. Document refusal only Answer: B. Respect his wishes and notify the provider 31. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? A. Clear liquids B. Broth, jello, soft fruit no skin C. Full solid diet D. High fiber diet Answer: B. Broth, jello, soft fruit no skin 32. You were hired to work the medical unit, and when you arrive at work the charge nurse has assigned you to the post-surgical unit since they are understaffed. Which is the MOST appropriate action? A. Refuse to go B. Report to the post-surgical unit C. Wait for another assignment D. Ask for training on the medical unit Answer: B. Report to the post-surgical unit 33. What is a proton pump inhibitor, such as pantoprazole (Protonix), used for? A. Blood pressure regulation B. Acid reduction C. Pain relief D. Cholesterol management Answer: B. Acid reduction 34. Which adaptive equipment would be MOST appropriate to use for a severely contracted patient who is unable to bear weight when transferring from the bed to the chair? A. Walker B. Patient lift (e.g., Hoyer) C. Bed rails D. Wheelchair ramp Answer: B. Patient lift (e.g., Hoyer) 35. Which tool should you use to assess pain in your 80-year-old patient with severe dementia? A. Numeric scale B. FACES scale C. PAINAD scale D. Wong-Baker scale Answer: C. PAINAD scale 36. Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to his coccyx. You were told in report that he lives at home with family members. What should you do? A. Notify the charge nurse and social worker of your concerns B. Document your findings C. Wait for further orders D. Discuss with the family Answer: A. Notify the charge nurse and social worker of your concerns 37. Your 85-year-old patient with atrial fibrillation fell at home 3 days ago. You notice she has been having several episodes of acute confusion since being admitted to your unit. What is the MOST important order you should anticipate from the provider? A. Routine blood work B. Stat CT of head C. MRI of the brain D. X-ray of the pelvis Answer: B. Stat CT of head 38. Your patient has a temp of 102.3 F, HR 122, and has had 15 mL of urine from the indwelling urinary catheter in the last 2 hours. What is your patient MOST likely experiencing? A. Dehydration B. Heart failure C. Sepsis D. Fever Answer: C. Sepsis 39. What type of personal protective equipment (PPE) is applied prior to entering a room for a patient with C. diff? A. Mask and gloves B. Gown and gloves C. Face shield and goggles D. No PPE required Answer: B. Gown and gloves 40. Your patient continues to pull at their IV site located in their left forearm despite verbal reminders and increased observation. The nursing assistant recommends using soft mitt restraints on the patient. What is your recommendation? A. Request an order for soft mitts as they are the least restrictive B. Use hard restraints C. Ignore the recommendation D. Allow the patient to pull at their IV Answer: A. Request an order for soft mitts as they are the least restrictive 41. Your patient was admitted for a hypertensive crisis and has a history of HTN, Parkinson's disease, depression, and alcohol use. On his second hospitalized day, you notice he is more anxious and restless than his baseline. What would be your FIRST nursing intervention? A. Ask the patient when his last drink of alcohol was B. Administer anxiety medication C. Call the psychiatrist 53. What is the EARLIEST sign indicating increased intracranial pressure (ICP)? A. Severe headache B. Level of consciousness C. Vomiting D. Pupillary signs Answer: B. Level of consciousness 54. In addition to pain, pallor, and pulselessness, a neurovascular assessment also includes checking for: A. Swelling B. Paresthesia and paralysis C. Warmth D. Capillary refill Answer: B. Paresthesia and paralysis 55. You received a report on a patient that sustained a right hemisphere CVA 48 hours ago. What do you expect the patient to exhibit? A. Right-sided weakness of the leg, arm, and face B. Left-sided weakness of the leg, arm, and face C. No weakness D. Unilateral vision loss Answer: B. Left-sided weakness of the leg, arm, and face 56. You are ordered to give digoxin (Lanoxin). Your patient's vital signs are: BP 130/70, Temp 97.9F, HR 52, RR 16, O2 Sat 100% on room air. What should you do NEXT? A. Hold digoxin (Lanoxin) and call the provider B. Administer the medication C. Check a potassium level D. Document the patient's status Answer: A. Hold digoxin (Lanoxin) and call the provider 57. Upon entry to your patient's room, you find her sitting in High Fowler's position and complaining of shortness of breath. Her respiratory rate is 34 breaths/min and O2 sat is 84%. Which mode of oxygen delivery would MOST likely reverse these symptoms? A. Nasal cannula B. CPAP C. Non-rebreather mask D. Venturi mask Answer: C. Non-rebreather mask 58. Your patient is on contact precautions for active MRSA. What proper PPE should you use before entering the room? A. Surgical mask B. Gown and gloves C. N95 mask D. No PPE necessary Answer: B. Gown and gloves 59. Your patient recently had a G-tube placed and intermittent enteral feedings have been initiated. What symptoms may indicate intolerance to the feedings? A. Constipation B. Vomiting and diarrhea C. Weight gain D. Abdominal cramps Answer: B. Vomiting and diarrhea 60. Upon entering your patient's room, you note that they are having a seizure. What is your FIRST action? A. Call for help B. Position the patient on their side to maintain the airway C. Restrain the patient D. Document the event Answer: B. Position the patient on their side to maintain the airway 61. Your 18-year-old female patient was admitted with dehydration secondary to anorexia nervosa. During your assessment, you note she has a flat affect and says, "I just want to die. I'm tired of my life." What should be your FIRST intervention? A. Stay with the patient and ask if she has a plan to carry out this wish B. Notify the physician immediately C. Document the statement D. Refer to a psychiatrist Answer: A. Stay with the patient and ask if she has a plan to carry out this wish 62. Your patient has a non-productive cough and presence of secretions in his tracheostomy. Prior to suctioning the patient, what should you do FIRST? A. Suction the tracheostomy B. Hyperoxygenate patient C. Raise the head of the bed D. Call the physician Answer: B. Hyperoxygenate patient 63. Your patient takes 5 mg of warfarin (Coumadin/Jantoven) daily and reports having black colored stool today. What do you most likely suspect? A. Gastrointestinal bleeding B. Iron supplementation C. Hemorrhoids D. Food intolerance Answer: A. Gastrointestinal bleeding 64. Your new patient was admitted with blunt force trauma to the abdomen following a motor vehicle accident (MVA). An NG tube is in place for decompression; however, you note during the assessment that the stomach is rigid and hard during palpation. What condition do you suspect? A. Pneumonia B. Bowel obstruction C. Hemorrhage D. Gastritis Answer: C. Hemorrhage 65. Which of the following nursing diagnoses is MOST important for a patient with chronic obstructive pulmonary disease (COPD)? A. Impaired gas exchange B. Risk for falls C. Knowledge deficit D. Ineffective tissue perfusion Answer: A. Impaired gas exchange 66. You have a patient going for dialysis. Their medications include lisinopril (Prinivil), ondansetron (Zofran), famotidine (Pepcid), and atorvastatin (Lipitor). Which medication would you possibly hold and seek clarification? A. Lisinopril (Prinivil) B. Ondansetron (Zofran) C. Famotidine (Pepcid) D. Atorvastatin (Lipitor) Answer: C. Famotidine (Pepcid) 67. What is an early symptom that the patient is developing a complication of heart failure? A. Dyspnea on exertion B. Chest pain C. Palpitations D. Edema in the legs and feet Answer: D. Edema in the legs and feet 68. Black and tarry colored stools are CLASSIC symptoms of what condition? A. Diverticulitis B. Gastrointestinal bleeding C. Constipation D. Hemorrhoids Answer: B. Gastrointestinal bleeding 69. You have 4 patients who have high-priority needs. One needs to go to surgery, one needs STAT lab draws from a PICC line, another has chest pain rated 8/10, and another needs toileting. Which patient should you tend to FIRST? A. The patient who needs to go to surgery B. The patient with chest pain C. The patient needs lab draws D. The patient who needs toileting Answer: B. The patient with chest pain 70. Your patient with hepatitis C exhibits signs of jaundice and a distended abdomen. What procedure would you anticipate being performed by the provider at the bedside for this patient? A. ERCP 82. Your patient's morning labs revealed a hemoglobin level of 6.3 and hematocrit of 18. What blood product do you expect to administer? A. Platelets B. Fresh frozen plasma C. PRBCs D. Whole blood Answer: C. PRBCs 83. Your 68-year-old patient is a Type 1 diabetic with a history of schizophrenia and exhibits signs and symptoms of tardive dyskinesia. What long-term medication is associated with signs and symptoms of tardive dyskinesia? A. Risperidone B. Levothyroxine C. Metformin D. Amlodipine Answer: A. Risperidone 84. Your 80-year-old patient is being discharged home post-CVA. She lives alone, yet still requires assistance with ADLs. What referral is MOST appropriate to ensure her needs are met? A. Case Manager B. Social Worker C. Physical Therapy D. Occupational Therapy Answer: A. Case Manager 85. Central Telemetry calls and tells you your patient is experiencing bradycardia. What is the first thing you should do after entering the room? A. Prepare to administer medications B. Assess the patient and take vital signs C. Document your findings D. Call the physician Answer: B. Assess the patient and take vital signs 86. Your patient is currently under 1:1 observation for suicide precautions. He states he needs to have a bowel movement and would like some privacy to use the bathroom. What is the MOST appropriate response? A. "I can leave the room." B. "I must be within an arm's length view of you at all times for your safety." C. "You can wait until afterward." D. "Go ahead; I will be outside." Answer: B. "I must be within an arm's length view of you at all times for your safety." 87. A female patient requests a female nurse to provide care for her based on her religious beliefs. What is the MOST appropriate action to take? A. Accommodate her request if possible B. Deny the request C. Ask another staff member to assist D. Document the request Answer: A. Accommodate her request if possible 88. Your patient is a 40-year-old female with a recent history of hair loss, extremely dry skin, and a 20-point weight loss in the last 3 weeks. She also exhibits occasional episodes of tremors in her upper extremities. What condition do these symptoms MOST likely indicate? A. Hypothyroidism B. Hyperthyroidism C. Diabetes D. Anemia Answer: B. Hyperthyroidism 89. Insulin lispro (Humalog) is ordered via sliding scale a.c. for your patient with diabetes. When is the best time to administer insulin lispro (Humalog)? A. 30 minutes after meals B. Immediately after meals C. 15 minutes before the meal arrives D. 1 hour before meals Answer: C. 15 minutes before the meal arrives 90. Which of the following would be used as part of the preop procedure to prevent infection? A. Prophylactic antibiotics B. Preoperative checklist C. Informed consent D. Patient education Answer: A. Prophylactic antibiotics 91. Two days after surgery, your 72-year-old patient is showing signs of agitation and confusion, which is not his baseline. The severity fluctuates throughout the day. His medications include hydromorphone (Dilaudid), amlodipine (Norvasc), alprazolam (Xanax), and carbidopa-levodopa (Sinemet). What condition do you MOST likely suspect? A. Dementia B. Delirium C. Stroke D. Sedation Answer: B. Delirium 92. What is the proper technique when suctioning a tracheostomy? A. Suction continuously while inserting the catheter B. Suction in a circular motion while the catheter is being pulled out C. Suction only while inserting the catheter D. Have the patient take a deep breath before suctioning Answer: B. Suction in a circular motion while the catheter is being pulled out 93. Your new patient admitted for cholecystitis expresses she has a history of anxiety disorder. She is feeling panicked and does not think she can handle staying in the hospital for her surgery. What action is MOST appropriate for you to take? A. Call security B. Sit calmly next to her and offer her compassion and a sense of security C. Prescribe anti-anxiety medication D. Discuss with the surgeon Answer: B. Sit calmly next to her and offer her compassion and a sense of security 94. The provider orders an IV infusion of D5W 1000 mL to infuse over the next 6 hours. How many mLs per hour should the IV pump be set to? A. 100 mL/hr B. 156 mL/hr C. 167 mL/hr D. 250 mL/hr Answer: C. 167 mL/hr 95. You are assigned a new admission and note a Braden score of 11 after completing your assessment. Which interventions would be MOST appropriate based on your assessment? A. Turn q 2 hours, request nutrition consult, request low air loss mattress B. Increase mobility and hydration C. Ambulate every hour D. Only document findings Answer: A. Turn q 2hours, request nutrition consult, request low air loss mattress 96. Your patient may have tuberculosis (TB) and is placed in airborne precautions. What test would you expect to be ordered? A. Sputum culture B. Acid-fast bacilli sputum C. Chest X-ray D. PPD test Answer: B. Acid-fast bacilli sputum 97. Your patient starts to complain of difficulty breathing while laying down, and states that he has been coughing up pink sputum. While performing your assessment, you notice jugular vein distention and coarse crackles in both lungs on auscultation. What diagnosis do you suspect? A. Pulmonary embolism B. Congestive heart failure C. Pneumonia D. COPD exacerbation Answer: B. Congestive heart failure 98. You received a patient post-op transurethral resection of the prostate (TURP). Which of the following symptoms would cause you the MOST concern? A. Bright red urine B. Low-grade fever C. Abdominal pain D. Urgency to urinate Answer: A. Bright red urine A. Right upper quadrant B. Left upper quadrant C. Left lower quadrant D. Right lower quadrant Answer: C. Left lower quadrant 111. Which of the following is MOST important in preventing a catheter-associated urinary tract infection (CAUTI)? A. Using sterile technique when inserting the catheter B. Daily cleaning of the external catheter C. Changing the catheter every week D. Collecting urine samples less frequently Answer: A. Using sterile technique when inserting the catheter 112. The provider orders a Heparin infusion of 900 units/hr. Your IV medication on hand has 25,000 units of Heparin in 500 mL of D5W. How many mL/hr will you infuse? A. 40 mL/hr B. 18 mL/hr C. 32 mL/hr D. 72 mL/hr Answer: B. 18 mL/hr 113. Your patient has developed a productive cough and fever. The provider is suspecting influenza. Which actions should you take FIRST? A. Administer antipyretics B. Initiate droplet precautions C. Check vital signs D. Start antiviral medication Answer: B. Initiate droplet precautions 114. What medication would you anticipate being ordered for a patient who has an LDL > 200 mg/dL? A. Antihypertensives B. Statin C. Anticoagulant D. Diuretic Answer: B. Statin 115. Fifteen minutes after starting a blood transfusion, the patient complains of lower back pain, shortness of breath, and chills. What is your FIRST action? A. Stop the transfusion B. Call the physician C. Monitor vital signs D. Document the event Answer: A. Stop the transfusion 116. Your patient had a transurethral resection of the prostate (TURP) 24 hours ago. What signs require further intervention? A. Bright red urine B. Low-grade fever C. Abdominal pain D. Increased urination Answer: A. Bright red urine 117. What condition (not medication related) might cause an elevation in the patient’s PT/INR level? A. Kidney disease B. Liver disease C. Infection D. Diabetes Answer: B. Liver disease 118. Your patient admitted for small bowel obstruction has been vomiting for the last 3 days. What electrolyte imbalance would you expect to be associated with this patient? A. Hypercalcemia B. Hyperkalemia C. Hypokalemia D. Hyponatremia Answer: C. Hypokalemia 119. Digoxin (Lanoxin) 125 mcg is equivalent to how many mg? A. 0.125 mg B. 0.0125 mg C. 1.25 mg D. 0.025 mg Answer: A. 0.125 mg 120. As you are walking down the hallway you overhear your colleague discussing her personal family issues with a patient. What would be the MOST appropriate response? A. Join the conversation B. Remind her later of her responsibility for establishing and maintaining professional boundaries with patients C. Report her to HR D. Ignore the situation Answer: B. Remind her later of her responsibility for establishing and maintaining professional boundaries with patients 121. Your patient, who has soft wrist restraints for safety (non-violent), is working with the occupational therapist at the bedside. The nursing assistant enters and says, "The patient is not allowed to have his restraints untied." How do you respond? A. "Restraints can be temporarily off while directly working with staff. Let me know when the therapy session is finished and I will re-apply them." B. "Keep the restraints on at all times." C. "You are right; we cannot take them off." D. "Let me consult the nurse manager first." Answer: A. "Restraints can be temporarily off while directly working with staff. Let me know when the therapy session is finished and I will re-apply them." 122. Your patient suddenly develops signs and symptoms of shortness of breath, restlessness, tachypnea, hemoptysis, and decreased oxygen saturation despite being on 2L/min of O2 by nasal cannula. What do you expect is happening? A. Pneumothorax B. Heart failure C. Pulmonary embolism D. Asthma attack Answer: C. Pulmonary embolism 123. The dosage of which drug must be tapered down slowly to prevent acute adrenal insufficiency? A. Ibuprofen B. Prednisone C. Loratadine D. Metformin Answer: B. Prednisone 124. Your patient with CHF states, "I can still eat the same food, I just have to weigh myself every day." Based on this statement, which nursing diagnosis would be appropriate? A. Knowledge Deficit B. Effective coping C. Imbalanced nutrition D. Risk for fluid volume overload Answer: A. Knowledge Deficit 125. A patient arrives on the unit. You do an assessment and notice lice in her hair. What is your first action? A. Discuss treatment options B. Secure a private room C. Notify the physician D. Give the patient shampoo Answer: B. Secure a private room 126. A patient presents with dusky pallor and pulseless. What is your first action? A. Initiate facility code procedure B. Call for help C. Start CPR D. Check for a pulse Answer: A. Initiate facility code procedure 127. Your patient is experiencing severe chest pain, and an EKG shows ST elevation in leads II, III, and aVF. What is the most likely diagnosis? B. Pre-medicate with steroids and antihistamines C. Cancel the CT scan altogether D. Notify the physician and request an order for a different imaging study Answer: B. Pre-medicate with steroids and antihistamines 140. Which of the following is a critical finding in a patient with appendicitis? A. Nausea and vomiting B. Pain relief after defecation C. Rebound tenderness in the right lower quadrant D. Chronic indigestion Answer: C. Rebound tenderness in the right lower quadrant 141. Your newly admitted patient is on anticoagulants. Which nursing intervention is essential? A. Monitor vital signs every 4 hours B. Assess for signs of bleeding C. Perform daily weight checks D. Limit sodium intake Answer: B. Assess for signs of bleeding 142. A patient with heart failure has gained 3 pounds in two days. What is the MOST appropriate nursing action? A. Document the findings B. Encourage fluid intake C. Notify the physician D. Increase diuretics Answer: C. Notify the physician 143. You suspect your patient may be experiencing suicidal thoughts. What is the most appropriate initial question to ask? A. "Why do you feel this way?" B. "Have you thought about harming yourself?" C. "Are you having a bad day?" D. "Do you have a support system?" Answer: B. "Have you thought about harming yourself?" 144. Your patient is receiving a blood transfusion and develops an acute headache. What should you do first? A. Call the physician B. Assess the patient's vital signs C. Stop the transfusion D. Administer pain medication Answer: C. Stop the transfusion 145. What type of exercise is most important in the rehabilitation of a patient who has suffered a stroke? A. Resistance training B. Aerobic exercise C. Flexibility exercises D. Balance training Answer: D. Balance training 146. A patient with diabetes has a blood glucose level of 45 mg/dL. What is the first action the nurse should take? A. Administer insulin B. Provide a quick source of sugar C. Check for ketones D. Notify the physician Answer: B. Provide a quick source of sugar 147. A patient with a history of chronic obstructive pulmonary disease (COPD) has difficulty breathing and is wheezing. Which medication would you expect to be administered? A. Bronchodilator B. Steroid C. Diuretic D. Antihistamine Answer: A. Bronchodilator 148. Which finding is most concerning in a patient with diabetes? A. Respiratory rate of 22 B. Serum glucose level of 65 mg/dL C. Rapid weight gain D. Cool, clammy skin Answer: C. Rapid weight gain 149. Your patient is on a ventilator and develops a high fever, increased respiratory rate, and purulent secretions. What complication should you suspect? A. Pneumothorax B. Ventilator-associated pneumonia C. Pulmonary embolism D. Barotrauma Answer: B. Ventilator-associated pneumonia 150. A patient with liver cirrhosis is prescribed lactulose. What is the primary purpose of this medication? A. To decrease blood pressure B. To prevent infection C. To decrease ammonia levels D. To improve appetite Answer: C. To decrease ammonia levels 151. Which of the following assessments is MOST critical for a patient who is post-op abdominal surgery? A. Bowel sounds B. Drain output C. Pain level D. Incision appearance Answer: A. Bowel sounds 152. A nurse is caring for a patient who has just had a stroke. What is the priority nursing diagnosis? A. Risk for impaired skin integrity B. Impaired physical mobility C. Ineffective airway clearance D. Risk for falls Answer: C. Ineffective airway clearance 153. Which of the following is a common adverse effect of corticosteroids? A. Hypoglycemia B. Weight loss C. Osteoporosis D. Increased blood pressure Answer: C. Osteoporosis 154. Your patient is prescribed metoprolol for hypertension. What is the nursing priority when administering this medication? A. Monitor heart rate B. Assess for edema C. Check blood glucose D. Monitor kidney function Answer: A. Monitor heart rate 155. In which situation would a nurse apply the use of a more restrictive restraint? A. Patient attempts to leave a facility B. Patient is verbally aggressive but not physically threatening C. Patient is a danger to self or others D. Patient is confused and disoriented Answer: C. Patient is a danger to self or others 156. A patient with sickle cell disease is experiencing a vaso-occlusive crisis. What is the priority nursing intervention? A. Schedule a blood transfusion B. Administer hydration C. Provide oxygen therapy D. Control pain Answer: D. Control pain 157. A patient with a new diagnosis of heart failure is receiving digoxin. What should the nurse monitor to prevent toxicity? A. Blood pressure B. Serum potassium levels B. Thyroid function C. Kidney function D. Liver function Answer: B. Thyroid function 170. A patient newly diagnosed with hypertension asks why they need to limit their sodium intake. What is your best response? A. "Sodium has no effect on blood pressure." B. "Sodium can cause the body to retain fluid and increase blood pressure." C. "High sodium levels help lower blood pressure." D. "There are no dietary restrictions with hypertension." Answer: B. "Sodium can cause the body to retain fluid and increase blood pressure." 171. Your patient with a hip replacement is at risk for deep vein thrombosis (DVT). What is a crucial nursing intervention? A. Keep the patient on total bed rest B. Administer anticoagulants as prescribed C. Elevate the legs above the heart D. Apply heat to the affected limb Answer: B. Administer anticoagulants as prescribed 172. A patient with a history of asthma is experiencing wheezing and shortness of breath. What medication should be administered immediately? A. Corticosteroids B. Long-acting beta-agonist (LABA) C. Short-acting beta-agonist (SABA) D. Anticholinergic Answer: C. Short-acting beta-agonist (SABA) 173. A patient scheduled for surgery presents with a fever and elevated white blood cell count. What action should the nurse take? A. Continue with the surgery as planned B. Notify the surgeon and hold the surgery C. Administer antipyretics D. Document findings for post-op care Answer: B. Notify the surgeon and hold the surgery 174. Your patient develops a pressure injury while hospitalized. Which intervention is most effective in reducing the risk of further pressure injuries? A. Reposition the patient every 4 hours B. Assess skin every shift C. Use a pressure-relieving mattress D. Keep the patient in bed Answer: C. Use a pressure-relieving mattress 175. In planning discharge for a patient with heart failure, what information should be emphasized? A. Avoid checking weight B. Monitor daily weights and report significant changes C. Encourage increased sodium intake D. Limit fluid intake completely Answer: B. Monitor daily weights and report significant changes 176. Which lifestyle change should a nurse encourage to help prevent hypertension? A. Increase sodium intake B. Increase physical activity C. Limit fruits and vegetables D. Avoid all fats Answer: B. Increase physical activity 177. A nurse is assessing a patient with bronchitis. What is a common symptom to expect? A. Dry cough B. Productive cough with mucus C. Chest pain D. Wheezing only Answer: B. Productive cough with mucus 178. A patient receiving chemotherapy presents with mouth sores. Which intervention should the nurse consider first? A. Administering acetaminophen B. Assessing the pain level C. Providing oral care instructions D. Documenting the symptoms Answer: C. Providing oral care instructions 179. A nurse is educating a patient about signs of hyperglycemia. Which symptom should the nurse include? A. Sweating B. Dizziness C. Frequent urination D. Bradycardia Answer: C. Frequent urination 180. A patient with bipolar disorder is expressing feelings of grandiosity and overconfidence. What is your priority nursing diagnosis? A. Anxiety B. Risk for self-harm C. Ineffective coping D. Impaired social interaction Answer: B. Risk for self-harm 181. The healthcare provider prescribes atorvastatin for a patient with high cholesterol. What should the nurse teach the patient about this medication? A. "You should take it on an empty stomach." B. "Avoid grapefruit juice while taking this medication." C. "It's safe to take during pregnancy." D. "No side effects are expected." Answer: B. "Avoid grapefruit juice while taking this medication." 182. A nurse is monitoring a patient’s INR levels who is on warfarin therapy. What level is considered therapeutic? A. 1-2 B. 2-3 C. 3-4 D. 4-5 Answer: B. 2-3 183. A patient scheduled for a colonoscopy needs medication for sedation. Which medication would be administered? A. Aspirin B. Midazolam C. Ibuprofen D. Metoprolol Answer: B. Midazolam 184. A patient with pneumonia is prescribed albuterol. What is the expected outcome of this medication? A. Decrease the cough reflex B. Open the airways C. Increase mucus production D. Reduce fever Answer: B. Open the airways 185. What should the nurse prioritize when caring for a patient with a diagnosis of pancreatitis? A. Administering pain medication B. Evaluating nutritional intake C. Monitoring blood glucose levels D. Encouraging oral fluids Answer: A. Administering pain medication 186. When assessing a patient with a head injury, which symptom is most concerning? A. Nausea B. Confusion C. Dizziness D. Slow heart rate Answer: B. Confusion 187. A patient complains of a dry cough while taking an ACE inhibitor. How should the nurse respond? A. "This is a serious side effect; you need to stop taking it."