College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

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QUESTION #1
Medical-Surgical Exam 4 Med-Surg
A nurse is assessing a client who reports unintentional weight loss and brittle hair. Which of the following conditions is most likely responsible for these findings?
A Crohn’s disease
B Diverticulosis
C Gastroenteritis
D Diverticulitis

Explanations

A
Crohn’s disease causes chronic intestinal inflammation that leads to malabsorption of nutrients, resulting in weight loss, fatigue, and signs of malnutrition such as brittle hair.
B
Diverticulosis involves the formation of pouches in the colon and is often asymptomatic unless complications occur.
C
Gastroenteritis typically causes acute symptoms such as nausea, vomiting, and diarrhea, rather than chronic malnutrition.
D
Diverticulitis commonly presents with left lower quadrant abdominal pain, fever, and constipation, not chronic nutritional deficiencies.
QUESTION #2
Medical-Surgical Exam 4 Med-Surg
A nurse is reviewing the plan of care for a client receiving total parenteral nutrition (TPN). Which of the following nursing interventions should the nurse question?
A Change the TPN bag every 24 hours.
B Administer D10W while waiting for the next TPN bag.
C Weigh the client daily.
D Monitor the client’s blood glucose level three times a day.

Explanations

A
TPN solution bags are typically changed every 24 hours to reduce the risk of contamination and infection.
B
If TPN is temporarily unavailable, D10W may be administered to prevent hypoglycemia caused by the sudden interruption of TPN.
C
Daily weight monitoring is important to evaluate nutritional status and fluid balance in clients receiving TPN.
D
Blood glucose should be monitored more frequently (often every 4–6 hours) due to the high glucose content of TPN.
QUESTION #3
Medical-Surgical Exam 4 Med-Surg
A nurse is assessing several clients who report abdominal discomfort. Which of the following conditions is most commonly associated with right lower quadrant (RLQ) abdominal pain?
A Diverticulitis
B Appendicitis
C Irritable bowel syndrome
D Small bowel obstruction

Explanations

A
Diverticulitis typically causes left lower quadrant (LLQ) abdominal pain because it commonly affects the sigmoid colon.
B
Appendicitis usually begins with periumbilical pain that later localizes to the right lower quadrant at McBurney’s point.
C
IBS usually causes diffuse abdominal cramping and changes in bowel habits, rather than localized RLQ pain.
D
Small bowel obstruction generally presents with abdominal distention, cramping pain, vomiting, and inability to pass stool or gas.
QUESTION #4
Medical-Surgical Exam 4 Med-Surg
A nurse is providing dietary education to a client diagnosed with acute glomerulonephritis. Which statement by the client indicates a need for further teaching?
A “I will eat a high-calorie diet.”
B “I will decrease salt in every meal.”
C “I will decrease calcium in my diet.”
D “I will eat a low potassium diet.”

Explanations

A
Clients with acute glomerulonephritis often require adequate calories to prevent protein breakdown and support healing.
B
Sodium restriction helps control edema and hypertension, which are common complications of glomerulonephritis.
C
Calcium restriction is not typically required in acute glomerulonephritis, making this statement incorrect.
D
Potassium may need to be limited if kidney function is impaired and potassium levels become elevated.
QUESTION #5
Medical-Surgical Exam 4 Med-Surg
A nurse is assessing several clients to determine which individual is at the greatest risk for developing a pressure injury. Which of the following clients should the nurse identify as being at highest risk?
A A 50-year-old client with benign prostatic hyperplasia (BPH) and hypotension.
B A 45-year-old client with a stroke who is repositioned every 2 hours.
C A 65-year-old client who is incontinent and reports poor appetite (anorexia).
D An 85-year-old client with diabetes and hyperglycemia.

Explanations

A
Although hypotension may affect tissue perfusion, this client does not demonstrate the strongest risk factors for skin breakdown.
B
Regular repositioning significantly reduces the risk of pressure injuries in immobile clients.
C
Moisture from incontinence and poor nutritional status increase skin breakdown risk and impair wound healing.
D
Diabetes increases risk for skin complications, but the combination of incontinence and poor nutrition poses a greater immediate risk for pressure injury.
QUESTION #6
Medical-Surgical Exam 4 Med-Surg
A nurse is monitoring the drainage from a client’s postoperative surgical wound. Which type of wound drainage should the nurse report immediately to the primary health care provider (PHCP)?
A Serous drainage
B Purulent drainage
C Serosanguineous drainage
D Sanguineous drainage

Explanations

A
Serous drainage is thin, watery, and clear or pale yellow, and is commonly seen during normal wound healing.
B
Purulent drainage is thick, yellow, green, or brown and indicates the presence of infection, requiring immediate provider notification.
C
This type of drainage contains both serum and small amounts of blood and is commonly seen during the early stages of wound healing.
D
Sanguineous drainage is primarily blood and may occur shortly after surgery but should gradually decrease as healing progresses.
QUESTION #7
Medical-Surgical Exam 4 Med-Surg
A nurse is assessing several clients with urinary disorders. Which of the following conditions is most commonly associated with frequent urination during the night?
A Acute glomerulonephritis
B Urolithiasis
C Acute pyelonephritis
D Cystitis

Explanations

A
This condition typically presents with hematuria, edema, hypertension, and decreased urine output, rather than nocturia.
B
Kidney stones commonly cause severe flank pain, hematuria, nausea, and vomiting, not frequent nighttime urination.
C
Acute pyelonephritis often causes urinary frequency, urgency, dysuria, and nocturia, along with fever and flank pain.
D
Cystitis causes urinary frequency and dysuria, but nocturia is less commonly emphasized compared to pyelonephritis in exam scenarios.
QUESTION #8
Medical-Surgical Exam 4 Med-Surg
A nurse is preparing the room for a client who has been diagnosed with Clostridioides difficile infection. Which of the following infection control measures should the nurse implement to prevent transmission to other clients and healthcare staff?
A Place the client in airborne isolation with a negative-pressure room.
B Implement contact precautions, including the use of gloves and gowns.
C Require staff to wear surgical masks when entering the client’s room.
D Follow only standard precautions during client care.

Explanations

A
Airborne precautions are used for diseases such as tuberculosis, measles, and varicella, not C. difficile.
B
C. difficile spreads through spores via contaminated hands, surfaces, and equipment, requiring strict contact precautions.
C
Masks are used for droplet precautions and are not necessary for C. difficile transmission.
D
Standard precautions alone are not sufficient because C. difficile spores are highly transmissible and resistant.
QUESTION #9
Medical-Surgical Exam 4 Med-Surg
A nurse is determining the appropriate transmission-based precautions for a client diagnosed with diphtheria. Which of the following precautions should the nurse implement?
A Standard precautions
B Droplet precautions
C Airborne precautions
D Contact precautions

Explanations

A
Standard precautions are used for all clients but are not sufficient alone for infections transmitted through respiratory droplets.
B
Diphtheria spreads through respiratory droplets, so droplet precautions such as wearing a surgical mask and placing the client in a private room are required.
C
Airborne precautions are used for diseases such as tuberculosis, measles, and varicella, which spread through smaller airborne particles.
D
Contact precautions are used for infections spread through direct or indirect contact, such as MRSA or Clostridioides difficile.
QUESTION #10
Medical-Surgical Exam 4 Med-Surg
A nurse is assigning transmission-based precautions for a client diagnosed with varicella. Which of the following precautions should the nurse implement?
A Airborne precautions
B Droplet precautions
C Contact precautions
D Standard precautions

Explanations

A
Varicella (chickenpox) is transmitted through airborne droplets and requires placement in a negative pressure room with use of an N95 respirator.
B
Droplet precautions are used for infections such as influenza or meningitis, which spread through larger respiratory droplets.
C
Contact precautions are used for infections spread by direct contact, such as MRSA or Clostridioides difficile.
D
Standard precautions are used for all clients but are insufficient alone for highly contagious airborne diseases like varicella.
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