Clinical Medical-Surgical Practice Exam

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• Which factor MOST increases a client's risk for falls?
• Which of the following is NOT a modifiable risk factor for cardiovascular disease?
• The term 'point of maximal impulse' refers to the location of the apical impulse.
• Which agent is the first-line anticonvulsant in the emergency department for a generalized tonic-clonic seizure?
• In ACS, what distinguishes STEMI from NSTEMI on ECG?
• Which PPE removal error places the nurse at the highest risk for contamination during doffing?
• Which patient profile is most commonly associated with hyperosmolar hyperglycemic state?
• Which action is appropriate for a client on contact precautions for C. diff?
• A CNA reports a change in a client's condition. What should the nurse do FIRST?
• Which combination of symptoms is most characteristic of hypothyroidism?
• Which biomarker is most specific for myocardial injury and used to diagnose MI?
• In prerenal AKI due to decreased renal perfusion, which laboratory finding is most characteristic?
• A patient has low blood pressure and the provider wants to promote venous return. Which position should the nurse use?
• Which two measurements are required to calculate a client’s BMI?
• Antibiotics are indicated in COPD exacerbation if there is suspicion of which coexisting condition?
• Which statement best differentiates diabetic ketoacidosis from hyperosmolar hyperglycemic state in terms of glucose levels, ketones, and typical age group?
• Which findings are typical of meningitis and require immediate evaluation?
• During NG tube feeding, the nurse checks a gastric residual of 150 mL. What should the nurse do?
• In ARDS, which ventilator setting is prioritized to minimize barotrauma?
• A nurse suspects a client is being financially abused by a family member. What is the nurse's FIRST responsibility?
• Before transferring a patient from bed to chair, which action should the nurse take FIRST?
• Which client is the HIGHEST priority for fall-risk precautions?
• Which statement about wound healing nutrition is true?
• Which option represents the last resort in constipation management?
• A client is at high risk for aspiration. In what position should the nurse administer oral medications?
• Before administering a scheduled medication through an NG tube, what should the nurse do?
• Place the following constipation interventions in order from least to most invasive.
• Which spirometry pattern is characteristic of restrictive lung disease?
• What is the appropriate dialysis-indication criterion in acute kidney injury?
• Which imaging feature most suggests postoperative ileus?
• Which client statement indicates a need for further teaching about advance directives?
• Which action would be appropriate when a client reports a dressing feeling tight during education?
• Which nursing action best reflects proper resource management on a busy unit?
• Which principle should guide delegation decisions at the start of a shift?
• Which items would you expect on a routine prescription list for a healthy older adult?
• Which of the following pairs correctly lists two signs and two symptoms commonly seen in acute decompensated heart failure?
• Which ECG change is most characteristic of a STEMI in the anterior wall?
• Powdered latex gloves are contraindicated for latex-allergic patients because they contain latex. Which glove type should be avoided?
• What is the critical time window for intravenous thrombolysis in acute ischemic stroke?
• When gastric residual is within normal limits, the nurse should do which before initiating the feeding?
• In a patient with a latex allergy who requires an invasive procedure, which gloves should be used?
• Adrenal crisis presents with which features?
• Standard precautions apply to the care of all clients, regardless of diagnosis. True or False?
• ST-segment elevation indicating anterior wall involvement is seen in which leads?
• What is the correct sequence of techniques for assessing the thorax?
• NG tube care is an example of which type of technique?
• Identify the doffing error most likely to increase contamination risk.
• As the charge nurse, what is the BEST initial action when two CNAs are arguing over patient assignments?
• When evaluating a client for fluid imbalance, which finding is the priority?
• In ARDS, what ventilator strategy best reduces ventilator-induced lung injury?
• Which statement best describes prerenal acute kidney injury in terms of pathophysiology?
• What is a common cause of pleural effusion that would require therapeutic thoracentesis?
• Why is left ventricular ejection fraction important in heart disease management?
• Which action is the single most fundamental principle of infection control?
• Which of the following is a late sign of compartment syndrome?
• If a dressing feels too tight during wound care, what is the appropriate action?
• A nurse is asked to perform a procedure they have never done before. What is the nurse's legal responsibility?
• Which statement best reflects honoring patient autonomy in care decisions?
• A nurse is asked to perform a procedure they have never done before. What is the nurse's legal responsibility?
• What is the main indication for therapeutic thoracentesis in pleural effusion?
• In atrial fibrillation with rapid ventricular response, which agent is commonly used for rate control?
• Which action demonstrates appropriate privacy when sharing patient information with a family member?
• Which statement best differentiates osteoarthritis from rheumatoid arthritis regarding morning stiffness?
• In neutropenia, which statement best describes the recommended precautions and management?
• Name two common complications following an acute MI requiring rapid nursing assessment.
• Which statement about updating advance directives is true?
• Which position is least effective at promoting venous return in a hypotensive patient?
• When providing a therapeutic massage to a client's back, which technique is appropriate?
• Which symptom is more indicative of alarm features of peptic ulcer disease than typical GERD symptoms?
• Which condition is a contraindication to pharmacologic DVT prophylaxis?
• During donning PPE, which item should be worn second?
• After a family member learns of a death, which action best supports the bereaved?
• What is the role of PEEP in ARDS management?
• Which statement about cardiovascular risk reduction would indicate understanding?
• A confused client keeps attempting to climb out of bed. Which intervention should the nurse try BEFORE applying restraints?
• Which enzyme pattern is most suggestive of alcoholic hepatitis?
• When there is suspected elder financial abuse, what is the appropriate reporting process?
• Which client education point supports optimal wound healing?
• What is the primary endocrine emergency characterized by sudden adrenal insufficiency?
• What is the priority nursing action during a seizure?
• Which assessment finding is the PRIORITY when evaluating a client for fluid imbalance?
• A post-surgical client is prescribed enoxaparin (Lovenox) after hip surgery. How is this medication administered?
• Is a standard fixed NG tube length appropriate for all adult clients?
• Which of the following is a presenting feature of leukemia aside from fatigue?
• In diastolic heart failure, which echocardiographic finding indicates elevated LV filling pressures?
• A client has urge incontinence. Which intervention is appropriate?
• Postrenal acute kidney injury is caused by which mechanism?
• Which option correctly lists two management strategies for suspected increased intracranial pressure?
• Which statement best describes the classic presentation of pancreatitis?
• Which statement best describes DVT prophylaxis in hospitalized medical-surgical patients and when it is contraindicated?
• Stage I pressure ulcer criterion includes which finding?
• What is a recommended initial positioning for suspected increased intracranial pressure?
• Which statement accurately reflects standard precautions in nursing practice?
• Which of the following is a common stressor for an adolescent (age 12-20)?
• Which of the following is a major contraindication to thrombolysis in acute ischemic stroke?
• Which finding best differentiates myocardial infarction from unstable angina?
• Which action demonstrates maintaining client confidentiality per HIPAA?
• When caring for a patient with a documented latex allergy, which glove option is appropriate?
• Before repositioning a client with limited mobility who reports pain, what should the nurse do FIRST?
• Which task is MOST appropriate to delegate to a CNA?
• Which statement correctly contrasts osteoarthritis with rheumatoid arthritis in terms of symmetry and morning stiffness duration?
• Which item should be removed last during doffing PPE?
• What is the recommended daily sodium intake restriction for most patients with heart failure?
• Which combination of signs is most characteristic of hypothyroidism?
• Which statement correctly distinguishes medical asepsis from surgical asepsis?
• Why does abdominal assessment follow a different sequence (inspection, auscultation, percussion, palpation) than other body systems?
• To assess the apical pulse, the clinician should auscultate at which location?
• During wound healing education, a client reports that a dressing is tight. The nurse should respond by?
• Which item is NOT typically required when setting up for NG tube insertion?
• Which lab values are most relevant to monitor when assessing electrolyte balance?
• Which client scenario represents the highest fall risk due to combination of age, medication, and history?
• Which is the appropriate action after checking gastric residual within normal limits?
• Which medication would the nurse anticipate as a routine prescription for a healthy 65-year-old client?
• A client with a known fall risk is found attempting to get out of bed alone. What is the PRIORITY nursing action?
• During a seizure, which action best promotes safety?
• What are two classic signs of left-sided heart failure?
• Which two conditions are common etiologies of microcytic anemia?
• Name one criterion for Stage I pressure ulcer and a key prevention strategy.
• What is the priority nursing assessment when a sequential compression device (SCD) is applied?
• Which approach best reflects resource management on a busy unit?
• Which finding is consistent with a Stage 1 pressure injury?
• Systolic heart failure and diastolic heart failure are distinguished by two diagnostic indicators each. Which combination correctly describes them?
• Which nursing behavior demonstrates active/therapeutic listening?
• A client uses a cane for mobility due to right-sided weakness. Which instruction is correct?
• Decompensated heart failure requiring hospitalization is best indicated by which presentation?
• In fat malabsorption syndromes, which vitamin deficiency is most associated with neuromuscular symptoms?
• Which personal protective equipment is required for contact precautions when caring for a patient with C. diff?
• Which presentation and laboratory finding is most characteristic of pancreatitis?
• Immediately following a client's death, what should the nurse do regarding personal belongings?
• Differentiating obstructive from restrictive lung disease using spirometry, which key ratio is used?
• In ACS, what is a first-line pharmacologic treatment for chest pain and what caution must be observed?
• Intrinsic AKI is best described as which of the following?
• Which of the following are common signs of compartment syndrome?
• When removing PPE, which item should be removed FIRST?
• To prevent latex exposure, which of the following is essential when caring for a latex-allergic patient?
• Standard precautions apply to the care of all patients, regardless of infection status.
• How should the nurse assess the apical pulse?
• Why should nephrotoxic medications be avoided or dosed carefully in kidney impairment?
• If a gastric residual is 120 mL, what should the nurse do?
• Which finding is expected in a client receiving palliative/end-of-life care?
• How should the nurse assess a client's balance?
• A nurse is teaching a client about reducing cardiovascular disease risk. Which statement indicates understanding?
• Teach-back is used to verify which aspect of informed consent?
• What is the normal left ventricular ejection fraction range, and why is it clinically important?
• In a stable patient with suspected spinal cord injury, what is the preferred initial management step?
• Which statement best describes latex allergy precautions for patient care?
• A living will specifically outlines which of the following?
• Before performing tracheostomy care, what must the nurse confirm?
• In an abdominal examination, which action should be performed first?
• When donning PPE, which item should be put on FIRST?
• A patient with acute pulmonary edema develops worsening hypoxemia. What ventilatory strategy is typically used in the ICU?
• Which is an expected age-related change in a 68-year-old client?
• What is the typical management approach to a suspected vertebral fracture in an elderly patient?
• A client with a latex allergy is scheduled for a procedure. What is the most important precaution the nurse should take?
• What imaging finding best distinguishes postoperative ileus from small bowel obstruction?
• A family member has just been told their loved one has passed away. What is the nurse's BEST response?
• What is the most common cause of prerenal AKI in hospitalized patients?
• Among doffing actions, which step is most likely to contribute to contamination if performed incorrectly?
• What ABG pattern would you expect in acute respiratory alkalosis?
• A nurse suspects a client has an electrolyte imbalance. Which lab values should the nurse review?
• When a patient consistently refuses a prescribed medication, what is the nurse's FIRST step?
• Which scenario is an indication for urgent cardiac catheterization in acute coronary conditions?
• What is rhabdomyolysis and what urine finding is typical?
• A nurse realizes she just administered the wrong medication to a client. What is the nurse's FIRST action?
• Active immunization is best described as:
• Which response demonstrates therapeutic communication when a patient expresses fear about a procedure?
• What is the first-line pharmacologic therapy for COPD exacerbation in the ED?
• Following an acute myocardial infarction, which arrhythmia is a common complication requiring rapid nursing assessment?
• What is the range of the Glasgow Coma Scale and what do low scores indicate?
• In patients with neutropenia, which infection risk is most increased and how is it managed in the hospital?
• Name two risk factors for COPD exacerbation.
• Which statement about end-of-life symptoms is NOT typical?
• How should you measure the correct length for NG tube insertion?
• Which of the following represents typical presenting features of leukemia?
• A residual gastric content checked before a scheduled tube feeding is within normal limits. What should the nurse do?
• A nurse is caring for a client who follows Orthodox Judaism. Which meal-planning consideration is MOST relevant?
• Which action is essential to confirm before a client signs an informed consent form?
• Which is a MODIFIABLE risk factor for cardiovascular disease?