Clinicals Med-Surg

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Sample questions from Clinicals Med-Surg

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

1. 1.A nurse is caring for a client admitted with acute heart failure who suddenly develops severe dyspnea, crackles, and an oxygen saturation of 82%. Which action should the nurse take first?

   • A.Place the client in high-Fowler position and apply oxygen
   • B.Obtain a daily weight
   • C.Encourage oral fluids
   • D.Prepare the client for discharge teaching

   Rationale: High-Fowler positioning and oxygen support ventilation and oxygenation during acute pulmonary congestion. Obtaining a daily weight is useful for ongoing fluid assessment but does not address the immediate respiratory emergency. Encouraging fluids can worsen volume overload. Discharge teaching is inappropriate while the client is unstable.

2. 2.A client with type 1 diabetes is diaphoretic, tremulous, and confused; the blood glucose is 48 mg/dL, and the client can swallow safely. What should the nurse do?

   • A.Give 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes
   • B.Administer the scheduled rapid-acting insulin
   • C.Give a high-fat snack and recheck glucose in 1 hour
   • D.Withhold all treatment until the next glucose check

   Rationale: A conscious client with hypoglycemia should receive about 15 g of rapid-acting carbohydrate, followed by a glucose recheck in 15 minutes. Giving rapid-acting insulin would further lower the glucose. Fat slows carbohydrate absorption and is not the best initial treatment. Delaying treatment risks worsening neuroglycopenia and loss of consciousness.

3. 3.A client with COPD has an oxygen saturation of 84%, increased work of breathing, and new confusion. Which nursing action is most appropriate?

   • A.Apply prescribed oxygen and promptly reassess respiratory status
   • B.Withhold oxygen because it may suppress the client's respiratory drive
   • C.Place the client flat and encourage rest
   • D.Wait for an arterial blood gas result before intervening

   Rationale: Hypoxemia with new confusion requires prompt oxygen support and reassessment, titrated to the prescribed target. Concern about carbon dioxide retention does not justify withholding oxygen from a hypoxemic client. Lying flat can worsen respiratory effort. An arterial blood gas may guide care but should not delay initial treatment of significant hypoxemia.

4. 4.A client with suspected acute stroke arrives in the emergency department. Which action is essential before administering aspirin?

   • A.Obtain a noncontrast head CT
   • B.Begin oral fluids
   • C.Lower the blood pressure to a normal range immediately
   • D.Assess the client's ability to walk

   Answer and rationale are in the full material.

5. 5.A client with chronic kidney disease has a potassium level of 6.4 mEq/L and peaked T waves. Which prescribed intervention should the nurse anticipate as an immediate priority?

   • A.Intravenous calcium gluconate
   • B.Oral potassium chloride
   • C.A high-potassium diet
   • D.A loop diuretic as the only treatment

   Answer and rationale are in the full material.