Herzing Med-Surg

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Sample questions from Herzing Med-Surg

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

1. 1.During a home visit, a client recovering from a mild stroke says, "I want to practice making my own breakfast, but my family does everything for me." Which response best demonstrates patient-centered care?

   • A.Tell the family to stop helping so the client can regain independence.
   • B.Tell the client that the care plan cannot change until the next provider visit.
   • C.Ask the client which breakfast tasks they feel ready to try and collaborate on a safe plan.
   • D.Explain that the family should continue doing all meal preparation until recovery is complete.

   Rationale: Asking about the client's goals and readiness supports autonomy and makes the plan responsive to individual abilities and preferences. Telling the family to stop helping ignores safety, while having them do everything may unnecessarily limit independence. The nurse can revise nursing interventions collaboratively without waiting for a provider visit when the change is within nursing scope.

2. 2.Which action best reflects the purpose of the evaluation phase of the nursing process?

   • A.Comparing the client's current outcomes with expected outcomes and revising the plan as needed
   • B.Identifying the client's responses to health problems that nursing care can address
   • C.Selecting interventions before determining the client's goals
   • D.Collecting subjective and objective information about the client's current condition

   Rationale: Evaluation compares observed client outcomes with the measurable outcomes established in the plan and guides whether care should continue or change. Collecting information is assessment, and identifying nursing-addressable responses is analysis and nursing diagnosis. Selecting interventions before setting goals reverses the planning sequence.

3. 3.At change of shift, a nurse receives report on four clients. Which clients should the nurse assess first? Select all that apply.

   • A.A client with new facial drooping and difficulty speaking
   • B.A client requesting help to walk to the bathroom, with a steady gait documented earlier
   • C.A client who is newly confused and has an oxygen saturation of 88% on room air
   • D.A client reporting pain of 6 out of 10 one hour after receiving an analgesic, with stable vital signs
   • E.A client whose surgical dressing has a rapidly enlarging area of bright-red drainage

   Rationale: New confusion with an oxygen saturation of 88% requires prompt assessment for hypoxemia, and rapidly increasing bright-red drainage may indicate active bleeding. New facial drooping and difficulty speaking are time-sensitive neurologic changes that also require immediate assessment. Pain with stable vital signs and a routine toileting request remain important but are less urgent than threats to oxygenation, circulation, or neurologic function.

4. 4.In a medical-surgical unit, a registered nurse is delegating tasks to a nursing assistant. Which task is appropriate to delegate?

   • A.Assessing a newly admitted client's breath sounds
   • B.Evaluating whether a prescribed intervention relieved nausea
   • C.Teaching a client how to use a walker safely
   • D.Obtaining routine vital signs for a stable client

   Answer and rationale are in the full material.

5. 5.Which action best supports evidence-based practice when the nurse is considering a change to a routine wound-care approach?

   • A.Continue the existing method because familiar practice is safest.
   • B.Combine current research evidence with clinical expertise and the client's preferences.
   • C.Use the newest published study as the sole basis for changing care.
   • D.Adopt the method most frequently used by colleagues without further review.

   Answer and rationale are in the full material.