Adults Med

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Sample questions from Adults Med

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

1. 1.At change of shift on a medical unit, a 68-year-old client with pneumonia has a temperature of 38.1 C, HR 104, RR 22, BP 118/70, and SpO2 93% on 2 L/min oxygen. Which client should the nurse assess first?

   • A.A client with heart failure who has unchanged 1+ ankle edema
   • B.A client scheduled for discharge who needs instructions about a new inhaler
   • C.A client with pneumonia who is newly confused and has an SpO2 of 86% on 2 L/min oxygen
   • D.A client with a urinary infection who reports burning during urination

   Rationale: New confusion with worsening hypoxemia can indicate impaired oxygenation and requires immediate assessment. Dysuria, stable edema, and routine discharge teaching are important but do not take priority over an acute change in respiratory status. Use airway and breathing findings to guide prioritization.

2. 2.In the medical intensive care unit, a 71-year-old client being treated for urosepsis has become less responsive. Refer to the client's chart. Which findings require immediate escalation of care? Select all that apply.

   • A.Urine output has declined to 15 mL/hr
   • B.The client reports mild discomfort at the peripheral IV site
   • C.The client is newly difficult to arouse at 1000
   • D.Blood pressure has fallen from 108/66 to 84/48 mm Hg
   • E.Temperature has decreased from 38.6 C to 38.1 C

   Rationale: New decreased responsiveness, a falling blood pressure, and urine output of 15 mL/hr suggest worsening perfusion and possible septic shock. The modest temperature decrease alone does not show the same immediate deterioration, and mild IV discomfort should be assessed but does not supersede these findings. Escalate promptly when mental status, hemodynamics, and renal perfusion worsen together.

3. 3.A provider prescribes a medication for a 54-year-old client who is receiving warfarin. The client reports taking an over-the-counter herbal supplement but cannot identify it. What should the nurse do first?

   • A.Ask the client to identify the supplement and notify the pharmacist or prescriber before administration
   • B.Administer the medication and document the supplement for the next visit
   • C.Tell the client to stop warfarin immediately
   • D.Ask a family member to decide whether the medication is safe

   Rationale: The nurse should identify the supplement and check for interactions before administering a medication to a client taking warfarin, which has significant interaction risks. Giving the medication without clarification may cause harm, and the nurse should not independently discontinue prescribed warfarin. A family member cannot replace medication reconciliation and consultation with the care team.

4. 4.At change of shift on a medical unit, a 62-year-old client with a new tracheostomy has thick secretions and a weak cough. Which task is appropriate for the RN to delegate to an experienced nursing assistant?

   • A.Assess the client's need for tracheostomy suctioning
   • B.Measure and record the client's oxygen saturation and report a reading below the ordered parameter
   • C.Change the tracheostomy ties
   • D.Teach the client how to use the call light when secretions increase

   Answer and rationale are in the full material.

5. 5.On a medical unit, a 57-year-old client with chronic kidney disease has potassium of 6.1 mEq/L and reports new muscle weakness. Refer to the client's chart. Which actions should the nurse take? Select all that apply.

   • A.Review the medication record for potassium-raising medications
   • B.Place the client on cardiac monitoring
   • C.Wait for the next routine laboratory draw before reporting the result
   • D.Notify the provider promptly of the potassium result and symptoms
   • E.Encourage a high-potassium snack

   Answer and rationale are in the full material.