RN Adult Medical Surgical Online Practice 2024\2025 A NGN Questions And Answers, Exams of Medicine

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Practice 2024\2025 A NGN Questions

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NGN

1000:

Client is alert and oriented and reports not feeling well for a few days. Client is on continuous ambulatory peritoneal dialysis (CAPD) and reports dialysate appeared cloudy this morning. Reports abdominal pain as 4 on a scale of 0 to 10. Bowel sounds active in all quadrants. Peritoneal dialysis access site red, warm to touch, with a small amount of purulent drainage noted on dressing.1300: Client is lying in bed with the knees flexed, guarding the abdomen. Abdomen is slightly distended, hypoactive bowel sounds. Client reports nausea. Reports pain as 6 on a scale of 0 to 10. Provider notified and updated with client condition and diagnostic results. - correct answer The client is experiencing manifestations of peritonitis due to x-ray results . NGN Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal

Practice 2024\2025 A NGN Questions

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pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. - correct answer Insert a large-gauge IV. Initiate a fluid challenge. Hypovolemia Urine output Blood pressure A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following assessment findings should the nurse expect? - correct answer Hypoactive Bowel Sounds NGN 0900: Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10. Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus. Febrile, oriented to person, place, and time.

Practice 2024\2025 A NGN Questions

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Tachypnea with diminished breath sounds. Sinus tachycardia. Client voids 300 mL of clear, amber urine. 0930: Client vomited 100 mL brown liquid. - correct answer The client is experiencing manifestations of pancreatitis as evidenced by the amylase and lipase . 0530: Client is awake and alert. Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Lung sounds clear upon auscultation; client denies shortness of breath. No peripheral edema noted; capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses. AVF access prepared and cannulated twice with no difficulty. Lines are taped and secured; treatment is initiated.0600: Client is reading a book. Access is visible, and lines are secure. Client reports no discomfort or pain.0630:

Practice 2024\2025 A NGN Questions

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Client reports feeling warm, nauseated, and lightheaded; appears restless and slightly confused. - correct answer Perform a 12-lead ECG is not indicated. Place the client in Trendelenburg position is indicated. Administer a 0.9% sodium chloride 200 mL IV bolus is indicated. Apply oxygen at 2 L/min via nasal cannula is indicated Notify the provider immediately is indicated Obtain the client's blood glucose level is not indicated. 1800: Emergency medical team removed client's shirt at the scene and initiated 18-gauge IV therapy in the right antecubital space. Client has full-thickness burns over the upper half of the chest and both forearms; partial-thickness burns are present on the client's face and neck. Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper extremities.

Practice 2024\2025 A NGN Questions

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Respirations even, labored with scattered rhonchi. Soot noted to the client's mouth and nose. Oxygen 40% via face tent applied. Hypoactive bowel sounds. 16 French indwelling urinary catheter inserted with return of 250 mL of yellow urine. Lactated Ringer's infusing to right antecubital. Provider preparing to insert right femoral central line catheter. 1830: Client's voice is becoming hoarse and reports difficulty swallowing. Wheezes present to upper lobes bilaterally. Provider notified. Client positioned upright, oxygen via face tent. Blood collected - correct answer During the emergent phase of burn care, the client is at risk for developing hypovolemia and respiratory failure . A nurse is teaching a class about client rights. Which of the following instructions should the nurse include? - correct answer A client should sign an informed consent before receiving a placebo during a research trial.

Practice 2024\2025 A NGN Questions

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A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit? - correct answer Heart rate 110/min A nurse is creating a plan of care for a client who has neutropenia as a result of chemotherapy. Which of the following interventions should the nurse include in the plan? - correct answer Monitor the client's temperature every 4 hr. A nurse in an emergency department is caring for a client who has full- thickness burns over 20% of their total body surface area. After ensuring a patent airway and administering oxygen, which of the following items should the nurse prepare to administer first? - correct answer IV fluids 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? - correct answer Extremity cool upon palpation A nurse is caring for a client who is 12 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? - correct answer Place a pillow between the client's legs.

Practice 2024\2025 A NGN Questions

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A nurse is assessing a client who has Graves' disease. Which of the following images should indicate to the nurse that the client has exophthalmos? - correct answer D- the lady looking eyes A nurse is providing teaching for a female client who has recurrent urinary tract infections. Which of the following information should the nurse include in the teaching? - correct answer Void before and after intercourse. A nurse is providing postoperative teaching for a client who had a total knee arthroplasty. Which of the following instructions should the nurse include? - correct answer Flex the foot every hour when awake A nurse is assessing a client who has had a suspected stroke. The nurse should place the priority on which of the following findings? - correct answer Dysphagia A nurse is administering packed RBCs to a client. Which of the following assessment findings indicates a hemolytic transfusion reaction? - correct answer Low back pain and apprehension

Practice 2024\2025 A NGN Questions

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A nurse in an emergency department is assessing an older adult client who has a fractured wrist following a fall. During the assessment, the client states, "Last week I crashed my car because my vision suddenly became blurry." Which of the following actions is the nurse's priority? - correct answer Check the client's neurologic status. A nurse is evaluating the plan of care for four clients after 2 days of hospitalization. The nurse should identify the need to revise the plan for which of the following clients? - correct answer A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed. A nurse is assessing a client who had extracorporeal shock wave lithotripsy (ESWL) 6 hr ago. Which of the following findings should the nurse expect? - correct answer Stone fragments in the urine A nurse is providing teaching to a client who has stage II cervical cancer and is scheduled for brachytherapy. Which of the following instructions should the nurse include? - correct answer "You will need to stay still in the bed during each treatment session." A nurse is caring for a client has who has chronic glomerulonephritis with oliguria. Which of the following findings should the nurse identify

Practice 2024\2025 A NGN Questions

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as a manifestation of chronic glomerulonephritis? - correct answer Hyperkalemia A nurse is admitting a client who has active tuberculosis. Which of the following types of transmission precautions should the nurse initiate? - correct answer Airborne A nurse is providing teaching to a client who is receiving chemotherapy and has a new prescription for epoetin alfa. Which of the following client statements indicates an understanding of the teaching? - correct answer "I will monitor my blood pressure while taking this medication." A nurse is caring for a client who has terminal cancer. The client tells the nurse, "I wish I could stop these treatments. I am ready to die." Which of the following statements should the nurse make? - correct answer Discontinuing with the treatments is your choice if it is your wish to do so. A nurse is caring for a client who has anorexia, low-grade fever, night sweats, and a productive cough. Which of the following actions should the nurse take first? - correct answer Initiate airborne precautions.

Practice 2024\2025 A NGN Questions

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A nurse is reviewing the laboratory results of a client who has aplastic anemia. Which of the following findings indicates a potential complication? - correct answer WBC count 2,000/mm NGN 2330: Report received from ambulance crew: Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - correct answer Client reports pain as 3 on a scale of 0 to 10 is correct. Client reports shortness of breath has decreased is correct. Client reports nausea, awaiting prescription for nausea is incorrect.

Practice 2024\2025 A NGN Questions

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Transfused 1 unit of packed RBCs, awaiting second unit is incorrect. Wound dressing is dry and intact is correct. Respiratory rate 24/min, blood pressure 108/74 mm Hg, and oxygen saturation 95% on 2 L/min via nasal cannula are correct. NGN 2330: Report received from ambulance crew: Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest.

Practice 2024\2025 A NGN Questions

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Bowel sounds are present in all 4 quadrants. - correct answer Place the client in high-Fowler's position is correct. Ensure there is continuous bubbling in the water seal chamber is incorrect. Monitor drainage every 30 min for the first hour is incorrect. Strip the drainage tubing to ensure it is patent is incorrect. Place two rubber-tipped hemostats in the client's room is correct. Palpate the chest tube insertion site for subcutaneous emphysema is correct. Ensure that all chest tube connections are securely attached is correct. NGN 2330: Report received from ambulance crew:

Practice 2024\2025 A NGN Questions

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Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - correct answer Transfuse packed RBCs is anticipated. Place the client in Trendelenburg position is contraindicated. Prepare the client for chest tube insertion is anticipated. Cover the client with a cooling blanket is contraindicated. Initiate NPO status is anticipated. NGN

Practice 2024\2025 A NGN Questions

And Answers

2330:

Report received from ambulance crew: Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - correct answer The nurse should first address the client's oxygenation followed by the client's blood pressure . NGN 2330: Report received from ambulance crew:

Practice 2024\2025 A NGN Questions

And Answers

Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted.2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. - correct answer The client is most likely experiencing a hemothorax as evidenced by the client's respiratory findings NGN 2330: Report received from ambulance crew: Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a

Practice 2024\2025 A NGN Questions

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scale of 0 to 10. Shortness of breath noted. - correct answer GCS score is incorrect. Temperature is incorrect. Oxygen saturation is correct. Pain level is correct. A nurse is planning care for a client who is postoperative following a laparotomy and has a closed-suction drain. Which of the following actions should the nurse take to manage the drain? - correct answer Compress the drain reservoir after emptying. A nurse is planning care to decrease psychosocial health issues for a client who is starting dialysis treatments for chronic kidney disease. Which of the following interventions should the nurse include in the plan? - correct answer Tell the client that it is possible to return to similar previous levels of activity. A nurse is planning care for a client who is undergoing brachytherapy via a sealed vaginal implant to treat endometrial cancer. Which of the

Practice 2024\2025 A NGN Questions

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following actions should the nurse include in the client's plan of care? - correct answer Wear a lead apron while providing care to the client. A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse include in the plan? - correct answer Encourage the client to take deep breaths after the procedure. A nurse in an acute care facility is caring for a client who is at risk for seizures. Which of the following precautions should the nurse implement? - correct answer Ensure that the client has a patent IV. A nurse is providing preoperative teaching for a client who is scheduled for an open cholecystectomy. Which of the following actions should the nurse take? - correct answer Demonstrate ways to deep breathe and cough. A nurse is caring for a client who has homonymous hemianopsia as a result of a stroke. To reduce the risk of falls when ambulating, the nurse should provide which of the following instructions to the client? - correct answer "Scan the environment by turning your head from side to side."

Practice 2024\2025 A NGN Questions

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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? - correct answer dyspnea A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not available when the current infusion is nearly completed. Which of the following actions should the nurse take? - correct answer Administer dextrose 10% in water until the new bag arrives. A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for omeprazole. The nurse should instruct the client that the medication provides relief by which of the following actions? - correct answer Suppressing gastric acid production A nurse is planning to irrigate and dress a clean, granulating wound for a client who has a pressure injury. Which of the following actions should the nurse take? - correct answer Use a 30-mL syringe. A nurse is providing teaching to a client who has cancer and a new prescription for an opioid analgesic for pain management. Which of the following information should the nurse include in the teaching? -

Practice 2024\2025 A NGN Questions

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correct answer "You should void every 4 hours to decrease the risk of urinary retention." A nurse in a provider's office is assessing a client who has hypertension and takes propranolol. Which of the following findings should indicate to the nurse that the client is experiencing an adverse reaction to this medication? - correct answer Report of a night cough 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? - correct answer "Ibuprofen can cause gastrointestinal bleeding in older adult clients." 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? - correct answer Restlessness A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings is the nurse's priority? - correct answer Temperature 38.9° C (102° F) A nurse is providing education to a client who has tuberculosis (TB) and their family. Which of the following information should the nurse

Practice 2024\2025 A NGN Questions

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include in the teaching? - correct answer Family members in the household should undergo TB testing. A nurse is providing discharge instructions to a client following an upper gastrointestinal series with barium contrast. Which of the following information should the nurse provide? - correct answer Increase fluid intake 1NGN 000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally.1300:Client reports pain as 2 on a scale of 0 to 10 and nausea has resolved.

Practice 2024\2025 A NGN Questions

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Provided client with discharge instructions regarding sumatriptan and migraine triggers. - correct answer "Foods that contain tyramine might trigger my headaches" is correct. "I will keep a food and headache diary" is correct. "I will place a cool cloth on my forehead when I experience a migraine" is correct. "I will take the sumatriptan once every day" is incorrect. "I should stay awake until my headache is gone" is incorrect. NGN 1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the

Practice 2024\2025 A NGN Questions

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lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - correct answer Following the administration of sumatriptan, the nurse should monitor for chest pain due to the risk of myocardial ischemia NGN 1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - correct answer Administer sumatriptan is correct.

Practice 2024\2025 A NGN Questions

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Dim the lights in the client's room is correct. Nurses' Notes 1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain.1045:Client states the flashing lights, numbness, and tingling in the lips have gone away. Client states they now have throbbing pain behind the left eye, photophobia, and nausea. Client is requesting medication for pain that is 7 on a scale of 0 to 10. Hand grasps are equal and strong bilaterally. - correct answer The nurse should identify that the client is most likely experiencing a migraine and the nurse should address the client's pain .

Practice 2024\2025 A NGN Questions

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1000:Client presents to the ED with visual disturbances, expressive aphasia, and numbness and tingling of the lips. Manifestations started about 30 min ago. Client reports flashing lights in their vision, especially on the right side. Client's partner states the client had some difficulty with finding words when speaking. Client is alert and oriented x 3 and appears anxious. No facial drooping noted. Right hand grasp is weaker than left. Client denies pain. - correct answer Hand grasps is consistent with migraine, stroke, and meningitis. Numbness is consistent with migraine and stroke. Aphasia is consistent with migraine and stroke. Visual changes are consistent with migraine, stroke, and meningitis. Family history is consistent with migraine and stroke. NGN

Practice 2024\2025 A NGN Questions

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1000:Temperature 36.8° C (98.4° F)Heart rate 98/minRespiratory rate 18/minBlood pressure 134/75 mm HgOxygen saturation 98% on room air - correct answer Visual disturbances is correct. Tingling of the lips is correct. Hand grasps is correct. Expressive aphasia is correct. 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.) - correct answer BUN A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the following results should the nurse expect? - correct answer PaCO2 56 mm Hg