Medical-Surgical II

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Sample questions from Medical-Surgical II

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, a charge nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 8 hours after hip replacement who reports pain of 7 on a 0-to-10 scale
   • B.A client 1 day after thyroidectomy who has new inspiratory stridor
   • C.A client with chronic heart failure who has 2+ ankle edema and asks for a diuretic
   • D.A client with diabetes whose premeal glucose is 198 mg/dL

   Rationale: New inspiratory stridor after thyroidectomy can indicate airway obstruction from edema or hematoma and requires immediate assessment and intervention. Edema, postoperative pain, and a glucose of 198 mg/dL require follow-up but do not take priority over a threatened airway. Use airway, breathing, and circulation priorities when setting the order of care.

2. 2.In the emergency department, a 68-year-old client with a history of heart failure reports worsening shortness of breath. Refer to the client's chart. Which action should the nurse take first?

   • A.Administer the scheduled oral furosemide
   • B.Teach the client to limit sodium
   • C.Obtain a daily weight
   • D.Apply oxygen and position the client upright

   Rationale: The client has acute respiratory distress, with SpO2 falling from 91% to 86%, RR rising to 30/min, and new crackles; oxygen and upright positioning address breathing immediately. Oral diuretic administration may be needed, but it does not replace initial respiratory support. Daily weights and sodium teaching are important for ongoing management, not the immediate deterioration.

3. 3.A unit manager is planning care for a client with a new tracheostomy who requires frequent suctioning. Which assignment is appropriate for an experienced practical nurse (PN)?

   • A.Assess the new tracheostomy and revise the nursing plan
   • B.Evaluate a newly admitted client's respiratory status
   • C.Suction the tracheostomy of a stable client with an established care plan
   • D.Provide initial teaching about home tracheostomy management

   Rationale: An experienced PN may provide suctioning for a stable client when the procedure and plan of care are established. Initial assessment, care planning, initial teaching, and evaluation of a newly admitted client require RN judgment. Delegation must match the client's stability, the task, and the staff member's competence.

4. 4.During rounds on a medical-surgical unit, a 56-year-old client with acute pancreatitis is being prepared for transfer to a higher level of care. Which actions should the nurse take before the transfer? Select all that apply.

   • A.Send the client's current medication list and relevant records
   • B.Leave the client unattended while locating transport equipment
   • C.Give a concise handoff that includes recent changes and pending tests
   • D.Reassess vital signs and respiratory status immediately before departure
   • E.Confirm that the receiving unit has accepted the client

   Answer and rationale are in the full material.

5. 5.A client states, "I do not understand why I need another surgery, and I am not signing this form." The client is scheduled for an elective procedure in 1 hour. What should the nurse do?

   • A.Notify the surgeon that the client has questions and has not consented
   • B.Administer the prescribed sedative so the client can relax
   • C.Ask the client's spouse to sign instead
   • D.Explain the surgical risks and obtain the signature

   Answer and rationale are in the full material.