College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

98

Questions

13

Categories

Categories

Subcategories

QUESTION #1
Medical-Surgical Exam 3 Med-Surg
An older adult client presents with shortness of breath, bilateral ankle swelling, an irregular pulse, and a blood pressure of 150/90 mm Hg. Based on these findings, which condition should the nurse most strongly suspect?
A Heart failure
B Myocardial infarction
C Atrial fibrillation
D Hypertension

Explanations

A
Heart failure causes dyspnea and edema, but the key distinguishing assessment finding in this question is the irregular pulse.
B
Myocardial infarction usually presents with acute chest pain, diaphoresis, and hemodynamic instability rather than primarily pulse irregularity.
C
Atrial fibrillation is characterized by an irregularly irregular pulse and can lead to decreased cardiac output, causing shortness of breath and peripheral edema.
D
Hypertension explains the elevated BP but does not account for the irregular pulse or fluid retention.
QUESTION #2
Medical-Surgical Exam 3 Med-Surg
An older adult client presents to the clinic after sustaining a wrist fracture from a minor fall. A scan reveals significantly decreased bone mineral density. Which condition best explains this finding?
A Osteomalacia
B Osteomyelitis
C Osteoporosis
D Rheumatoid arthritis

Explanations

A
Osteomalacia involves softening of bones from vitamin D deficiency, not primarily decreased bone density on scan.
B
Osteomyelitis is a bone infection that causes localized inflammation rather than generalized low bone mass.
C
Osteoporosis is defined by decreased bone mineral density and increased fracture risk, especially after minor trauma in older adults.
D
Rheumatoid arthritis is an autoimmune joint disease and does not primarily cause reduced bone density.
QUESTION #3
Medical-Surgical Exam 3 Med-Surg
Which condition is classically characterized by symptoms that are most severe in the morning and improve as the day progresses?
A Osteoarthritis
B Gout
C Pancytopenia
D Rheumatoid arthritis

Explanations

A
Osteoarthritis pain typically worsens with activity during the day and improves with rest, not with morning stiffness lasting hours.
B
Gout causes sudden severe joint pain often at night, especially in the big toe, but it is not defined by prolonged morning stiffness that improves with movement.
C
Pancytopenia is a blood disorder involving low blood cell counts and does not cause joint stiffness patterns.
D
Rheumatoid arthritis causes prolonged morning stiffness that improves with activity due to inflammatory joint disease.
QUESTION #4
Medical-Surgical Exam 3 Med-Surg
An elderly client who worked in a crochet factory for 50 years is at greatest risk for which condition?
A Osteomalacia
B Osteoporosis
C Osteoarthritis
D Rheumatoid arthritis

Explanations

A
Osteomalacia is caused by vitamin D deficiency and is not related to repetitive joint use.
B
Osteoporosis is related to bone density loss, aging, and hormones, not repetitive occupational stress.
C
Osteoarthritis results from long term wear and tear on joints, so repetitive hand movements like crocheting increase risk.
D
Rheumatoid arthritis is an autoimmune disease not caused by occupational joint use.
QUESTION #5
Medical-Surgical Exam 3 Med-Surg
The nurse cares for a client who is prescribed skeletal traction. Which intervention should the nurse include in this plan of care to decrease the client’s risk for infection?
A Wash the traction lines and sockets once a day
B Release traction tension for 30 minutes twice a day
C Do not place the traction weights on the floor
D Schedule for skincare to be provided every shift

Explanations

A
Cleaning equipment is helpful but does not directly prevent infection at the client’s skin and pin sites.
B
Traction must remain continuous, and releasing it can cause loss of alignment.
C
This ensures proper traction but does not reduce infection risk.
D
Frequent skin care keeps pin sites and surrounding skin clean and dry, reducing infection risk and preventing complications like osteomyelitis.
QUESTION #6
Medical-Surgical Exam 3 Med-Surg
The nurse cares for a client who had a long leg cast applied last week. The client states, “I cannot seem to catch my breath and I feel a bit light-headed.” Which action should the nurse take next?
A Auscultate the client’s lung fields anteriorly and posteriorly
B Administer oxygen to keep the oxygen saturation level above 92%
C Check the client’s blood glucose level
D Ask the client to take deep breaths

Explanations

A
Assessment is important, but ABC priority is to treat suspected hypoxia first.
B
Sudden shortness of breath after immobilization suggests possible pulmonary embolism, so oxygen should be given immediately.
C
Light headedness can relate to glucose, but dyspnea after a leg cast is more concerning for embolism.
D
This may help anxiety but does not address a potentially life threatening cause of dyspnea.
QUESTION #7
Medical-Surgical Exam 3 Med-Surg
The nurse cares for an older adult client with multiple fractures. Which action should the nurse take to manage the client’s pain?
A Meperidine (Demerol) injections every 4 hours around the clock
B Patient-controlled analgesia (PCA) with morphine sulfate
C Ibuprofen (Motrin) 600 mg orally every 4 hours PRN for pain
D Morphine 4 mg IV push every 2 hours PRN for pain

Explanations

A
Meperidine is avoided in older adults because its metabolite can cause confusion seizures and delirium.
B
PCA allows the client to self administer safe doses for consistent pain control while reducing overdose risk with proper monitoring.
C
High dose NSAIDs increase risk of GI bleeding and kidney injury in older adults.
D
Intermittent IV pushes can cause peaks and sedation, while PCA offers more controlled pain management.
QUESTION #8
Medical-Surgical Exam 3 Med-Surg
The nurse cares for a client with a fractured tibia. Which assessment should alert the nurse to take immediate action?
A Complaint of pain level 4 on a scale of 0 to 10
B Complaint of numbness in the extremity
C Swollen extremity at the injury site
D Complaint of feeling cold while lying in bed

Explanations

A
Mild to moderate pain is expected with fractures and does not necessarily indicate an emergency.
B
Numbness suggests nerve compression or impaired circulation and may indicate compartment syndrome, which requires immediate action.
C
Some swelling is expected after a fracture and should be monitored but is not immediately alarming unless severe with neurovascular changes.
D
This is nonspecific and not directly related to fracture complications.
QUESTION #9
Medical-Surgical Exam 3 Med-Surg
A nurse cares for a client in skeletal traction. The nurse notes the skin around the client’s pin sites is swollen, red, and crusty with dry drainage. Which action should the nurse take first?
A Request a prescription to decrease the traction rate
B Apply an antibiotic ointment and a clean dressing
C Cleanse the area, making sure to scrub the crusty areas
D Obtain a prescription to culture the drainage

Explanations

A
Traction settings are unrelated to signs of infection at pin sites.
B
Medication should not be applied without identifying the organism and obtaining an order.
C
Aggressive scrubbing can worsen tissue injury and is not appropriate when infection is suspected.
D
Red swollen crusty pin sites suggest infection, and culturing identifies the organism so appropriate treatment can be started and complications like osteomyelitis can be prevented.
QUESTION #10
Medical-Surgical Exam 3 Med-Surg
The nurse assesses a client with a pelvic fracture. Which assessment finding should the nurse identify as a complication of this injury?
A Hypertension
B Constipation
C Infection
D Hematuria

Explanations

A
Elevated blood pressure is not a typical direct complication of pelvic fractures.
B
Constipation may occur with immobility or opioids but is not a specific complication of the pelvic fracture itself.
C
Infection can occur with any injury, but it is not the most characteristic complication of pelvic fractures.
D
Blood in the urine suggests bladder or urethral injury, which commonly occurs with pelvic fractures due to proximity to urinary structures.
×