Med-Surg HESI Final Practice Exam

Med-Surg HESI Final Practice Exam

 

Question 1:

A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with increased dyspnea and sputum production. The nurse understands that which factor is the most common cause of an acute exacerbation in COPD patients?

 

A. Smoking
B. Air pollution
C. Viral or bacterial infections
D. Noncompliance with medications

Answer: C. Viral or bacterial infections
Rationale: Respiratory infections are the most common cause of acute exacerbations in COPD patients, leading to increased airway inflammation and obstruction.

 

Question 2:

A nurse is caring for a client with a history of diabetes mellitus and reports symptoms of hypoglycemia. Which of the following findings should the nurse expect?

 

A. Polydipsia and dry mouth
B. Bradycardia and cool skin
C. Tremors and diaphoresis
D. Hyperventilation and fruity breath odor

Answer: C. Tremors and diaphoresis
Rationale: Symptoms of hypoglycemia include sweating, shaking, confusion, and rapid heartbeat, often associated with low blood glucose levels.

 

Question 3:

Which laboratory finding is most consistent with acute kidney injury (AKI)?

 

A. Decreased blood urea nitrogen (BUN) and creatinine levels
B. Elevated BUN and creatinine levels
C. Increased hemoglobin and hematocrit levels
D. Decreased serum potassium levels

 

Question 4:

A nurse is teaching a patient newly diagnosed with hypertension about lifestyle modifications. Which instruction is most appropriate?

 

A. Reduce sodium intake to less than 4,000 mg/day.
B. Perform high-intensity exercises daily.
C. Limit alcohol intake to 2 drinks per day for women.
D. Aim for a diet rich in fruits, vegetables, and low-fat dairy products.

 

Question 5:

What is the priority nursing intervention for a patient experiencing chest pain indicative of acute coronary syndrome?

 

A. Administer oxygen at 2-4 L/min via nasal cannula.
B. Prepare the patient for coronary angiography.
C. Administer sublingual nitroglycerin.
D. Obtain a 12-lead ECG.

 

Question 6:

A patient with heart failure is receiving furosemide (Lasix). Which of the following electrolyte imbalances is the patient most at risk for?

 

A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypochloremia

 

Question 7:

A patient with liver cirrhosis and ascites is prescribed spironolactone. The nurse understands that this medication works by:

 

A. Blocking the action of aldosterone.
B. Increasing sodium and water retention.
C. Enhancing renal function.
D. Lowering ammonia levels in the blood.

 

Question 8:

Which nursing diagnosis is the highest priority for a patient experiencing a myasthenic crisis?

 

A. Ineffective airway clearance
B. Impaired physical mobility
C. Anxiety related to disease process
D. Deficient knowledge about self-care

 

Question 9:

A nurse is preparing to administer a blood transfusion. What is the most important action prior to starting the transfusion?

 

A. Take the patient’s temperature.
B. Verify the blood product and recipient with another nurse.
C. Obtain the patient’s weight.
D. Administer antihistamines prophylactically.

 

Question 10:

A patient with a history of peptic ulcer disease presents with sudden severe abdominal pain, rigid abdomen, and absent bowel sounds. Which complication should the nurse suspect?

 

A. Gastric outlet obstruction
B. Perforation
C. Hemorrhage
D. Pyloric stenosis

 

Question 11:

Which clinical finding is most indicative of acute pancreatitis?

 

A. Pain that worsens with food intake
B. Bradycardia and hypotension
C. Jaundice and pruritus
D. Right upper quadrant pain radiating to the back

 

Question 12:

A patient with newly diagnosed rheumatoid arthritis is started on methotrexate. What is the most important teaching point for the nurse to provide?

 

A. Avoid high-potassium foods.
B. Report signs of infection promptly.
C. Take the medication with food to avoid stomach upset.
D. Expect increased energy levels after starting treatment.

 

Question 13:

A nurse is caring for a patient receiving total parenteral nutrition (TPN). What is the most critical assessment?

 

A. Daily weight measurement
B. Monitoring blood glucose levels
C. Checking electrolyte levels weekly
D. Monitoring intake and output every shift

 

Question 14:

Which sign or symptom is most concerning in a patient with sepsis?

 

A. Temperature of 101.4°F (38.6°C)
B. Blood pressure of 88/56 mmHg
C. Heart rate of 102 beats per minute
D. White blood cell count of 12,500/mm³

 

Question 15:

A nurse is monitoring a patient who had a thyroidectomy. Which finding is the most concerning and requires immediate action?

 

A. Hoarseness when speaking
B. Serum calcium level of 6.5 mg/dL
C. Mild difficulty swallowing
D. Redness at the surgical site

 

Question 16:

A patient with a suspected deep vein thrombosis (DVT) presents with a swollen, red, and painful left calf. What is the nurse’s priority action?

 

A. Apply a warm compress to the area.
B. Massage the affected leg to reduce pain.
C. Elevate the leg to decrease swelling.
D. Notify the healthcare provider immediately.

 

Question 17:

A nurse is caring for a patient with a traumatic brain injury. Which assessment finding is most concerning?

 

A. Blood pressure of 160/90 mmHg
B. Heart rate of 56 beats per minute
C. Glasgow Coma Scale (GCS) score decreasing from 13 to 10
D. Pupils equal and reactive to light

 

Question 18:

Which intervention is the priority for a patient in sickle cell crisis?

 

A. Administer IV fluids.
B. Apply ice packs to painful areas.
C. Restrict physical activity.
D. Provide high-protein meals.

 

Question 19:

A patient is receiving warfarin (Coumadin) therapy for atrial fibrillation. Which finding indicates the need for immediate intervention?

 

A. International normalized ratio (INR) of 4.8
B. Reports of mild bruising on the arms
C. Serum potassium level of 4.2 mEq/L
D. Heart rate of 88 beats per minute

 

Question 20:

A patient with chronic kidney disease (CKD) reports severe itching. What is the most likely cause of this symptom?

 

A. Hyperkalemia
B. Hypercalcemia
C. Hyperphosphatemia
D. Hyponatremia

 

Question 21:

A patient with cirrhosis is prescribed lactulose. What is the desired therapeutic effect of this medication?

 

A. Reduce portal hypertension
B. Lower serum ammonia levels
C. Improve clotting factors
D. Prevent esophageal varices

 

Question 22:

A nurse is assessing a patient with Guillain-Barré syndrome. Which finding requires immediate intervention?

 

A. Tingling sensation in the feet
B. Weakness in the legs
C. Respiratory rate of 10 breaths per minute
D. Loss of deep tendon reflexes

 

Question 23:

A patient with acute pyelonephritis is being treated with antibiotics. Which assessment finding indicates improvement?

 

A. Flank pain increases with movement.
B. Decreased frequency and burning during urination.
C. Increased protein in the urine.
D. Elevated white blood cell count.

 

Question 24:

Which sign indicates a potential complication in a patient with a newly created arteriovenous (AV) fistula for hemodialysis?

 

A. Bruit and thrill are present.
B. Coolness of the extremity distal to the fistula.
C. Slight swelling at the fistula site.
D. Blood pressure of 130/80 mmHg.

 

Question 25:

A patient with a total hip replacement is prescribed enoxaparin (Lovenox). What is the primary purpose of this medication?

 

A. Relieve postoperative pain
B. Promote wound healing
C. Prevent deep vein thrombosis (DVT)
D. Reduce inflammation at the surgical site

 

Question 26:

A nurse is assessing a patient with diabetes insipidus. Which laboratory finding is most consistent with this condition?

 

A. Serum sodium of 152 mEq/L
B. Serum potassium of 3.2 mEq/L
C. Serum glucose of 300 mg/dL
D. Serum calcium of 12 mg/dL

 

Question 27:

Which assessment finding suggests a positive response to treatment in a patient with pulmonary edema?

 

A. Crackles persist in both lung bases.
B. Respiratory rate decreases to 20 breaths per minute.
C. Oxygen saturation remains at 88%.
D. The patient reports increased dyspnea.

 

Question 28:

A nurse is caring for a patient with Addison’s disease. Which clinical manifestation requires immediate intervention?

 

A. Hyperpigmentation of the skin
B. Blood pressure of 78/48 mmHg
C. Weight loss of 5 pounds over 1 month
D. Fatigue lasting throughout the day

 

Question 29:

A patient is admitted with diabetic ketoacidosis (DKA). Which arterial blood gas (ABG) result is most consistent with this condition?

 

A. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 20 mEq/L
B. pH 7.25, PaCO₂ 28 mmHg, HCO₃⁻ 14 mEq/L
C. pH 7.40, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L
D. pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L

 

Question 30:

Which nursing intervention is most appropriate for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

 

A. Administer hypotonic IV fluids.
B. Encourage increased oral fluid intake.
C. Monitor for signs of fluid overload.
D. Restrict dietary sodium intake.

 

Question 31:

A patient recovering from a stroke has dysphagia. What is the nurse’s priority intervention during meals?

 

A. Encourage the patient to eat quickly to avoid fatigue.
B. Keep the patient in a high Fowler’s position during and after meals.
C. Administer liquids through a straw for easier swallowing.
D. Provide a regular diet to encourage normal chewing.

 

Question 32:

Which clinical finding indicates that a patient with hyperthyroidism is developing thyroid storm?

 

A. Bradycardia and cold intolerance
B. Fever and tachycardia
C. Weight gain and lethargy
D. Hypothermia and bradypnea

 

Question 33:

A patient with acute coronary syndrome is prescribed nitroglycerin. What is the nurse’s priority before administering this medication?

 

A. Assess the patient’s heart rate.
B. Check the patient’s potassium level.
C. Obtain a blood pressure reading.
D. Review the patient’s blood glucose level.

 

Question 34:

A patient with a history of hypertension reports a sudden severe headache, blurred vision, and nausea. The nurse should suspect:

 

A. Stroke.
B. Hypertensive crisis.
C. Migraine.
D. Transient ischemic attack (TIA).

 

Question 35:

A nurse is caring for a patient with newly diagnosed multiple sclerosis (MS). Which symptom is the most common early manifestation?

 

A. Incontinence
B. Fatigue and weakness
C. Dysphagia
D. Cognitive impairment

 

Question 46:

A patient with Cushing’s syndrome has developed hypertension. What is the primary cause of this complication?

 

A. Increased cortisol levels
B. Sodium depletion
C. Decreased aldosterone production
D. Low blood glucose levels

 

Question 47:

A nurse is monitoring a patient with sepsis. Which finding indicates the patient is developing septic shock?

 

A. Blood pressure of 80/50 mmHg despite fluid resuscitation
B. Heart rate of 92 beats per minute
C. Temperature of 98.6°F (37°C)
D. Urine output of 50 mL/hr

 

Question 48:

Which symptom would the nurse expect in a patient with pernicious anemia?

 

A. Bone pain
B. Numbness and tingling in extremities
C. Elevated bilirubin levels
D. Petechiae on the skin

 

Question 49:

A patient with a history of asthma is experiencing wheezing and shortness of breath. What is the nurse’s first action?

 

A. Administer a bronchodilator.
B. Obtain a peak flow reading.
C. Provide humidified oxygen.
D. Assess for cyanosis.

 

Question 50:

A nurse is caring for a patient with acute renal failure. Which laboratory result is most concerning?

 

A. Serum potassium of 6.5 mEq/L
B. Serum calcium of 9.0 mg/dL
C. Serum creatinine of 2.0 mg/dL
D. Blood urea nitrogen (BUN) of 25 mg/dL

 

Question 51:

Which intervention is the priority for a patient with status epilepticus?

 

A. Insert an oral airway.
B. Administer prescribed IV benzodiazepines.
C. Place the patient in a supine position.
D. Monitor the patient’s postictal state.

 

Question 52:

A patient with a newly diagnosed deep vein thrombosis (DVT) is started on heparin. Which laboratory test is used to monitor the effectiveness of this treatment?

 

A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count

 

Question 53:

Which dietary recommendation is most appropriate for a patient with chronic kidney disease (CKD)?

 

A. High-protein diet to promote healing
B. Low-phosphorus diet to prevent complications
C. High-potassium diet to support muscle function
D. Low-fat diet to reduce cardiovascular risks

 

Question 54:

A nurse is caring for a patient with myasthenia gravis who is experiencing a myasthenic crisis. What is the priority intervention?

 

A. Administer IV immunoglobulin (IVIG).
B. Assess respiratory status and provide ventilatory support if needed.
C. Perform plasmapheresis to remove antibodies.
D. Administer corticosteroids to reduce inflammation.

 

Question 55:

A nurse is caring for a patient with a central venous catheter. Which finding indicates a possible catheter-related infection?

 

A. A blood pressure reading of 130/80 mmHg
B. Redness and swelling at the insertion site
C. Decreased appetite and mild nausea
D. A temperature of 98.7°F (37°C)

 

Question 56:

Which clinical manifestation is most indicative of hyperkalemia?

 

A. Muscle weakness and paresthesia
B. Hyperreflexia and tetany
C. Constipation and bradycardia
D. Positive Trousseau’s sign

 

Question 57:

A nurse is assessing a patient with pericarditis. Which symptom is most characteristic of this condition?

 

A. Sharp chest pain that improves when sitting forward
B. Dull chest pain that worsens with deep inspiration
C. Radiating pain to the jaw and left arm
D. Crushing chest pain unrelieved by rest

 

Question 58:

A patient with cirrhosis develops ascites. Which intervention should the nurse prioritize?

 

A. Encourage high sodium intake.
B. Prepare the patient for a paracentesis.
C. Restrict fluid intake to 3 liters per day.
D. Place the patient in a supine position.

 

Question 59:

A patient is admitted with acute appendicitis. What is the priority nursing intervention?

 

A. Apply heat to the abdomen to relieve pain.
B. Administer prescribed IV antibiotics.
C. Encourage oral fluid intake.
D. Provide a high-fiber diet.

 

Question 60:

A patient receiving chemotherapy has a white blood cell count of 1,200/μL. Which nursing action is most appropriate?

 

A. Encourage a diet high in fresh fruits and vegetables.
B. Monitor for signs of infection and implement neutropenic precautions.
C. Administer iron supplements as prescribed.
D. Advise the patient to avoid ambulation to prevent injury.

 

Question 61:

Which symptom is most concerning in a patient with Guillain-Barré syndrome?

 

A. Tingling in the fingers and toes
B. Weakness in the lower extremities
C. Shortness of breath and decreased oxygen saturation
D. Pain in the back and legs

 

Question 62:

A patient with chronic liver disease is at risk for hepatic encephalopathy. Which clinical finding would indicate this complication?

 

A. Jaundice and pruritus
B. Confusion and asterixis
C. Bruising and petechiae
D. Ascites and peripheral edema

 

Question 63:

A patient is recovering from a thyroidectomy. Which assessment finding requires immediate attention?

 

A. Hoarseness and weak voice
B. Numbness around the mouth and fingers
C. Difficulty swallowing saliva
D. A heart rate of 84 beats per minute

 

Question 64:

Which assessment finding is most indicative of a tension pneumothorax?

 

A. Diminished breath sounds on the affected side
B. Deviated trachea away from the affected side
C. Crackles in the lower lobes
D. Bilateral chest wall expansion

 

Question 65:

A nurse is caring for a patient with ulcerative colitis. Which intervention is most appropriate during an acute exacerbation?

 

A. Encourage a diet high in fiber.
B. Administer prescribed corticosteroids.
C. Monitor the patient for signs of infection.
D. Provide a laxative to prevent constipation.

 

Question 66:

Which clinical finding is most indicative of right-sided heart failure?

 

A. Crackles in the lungs
B. Peripheral edema
C. Orthopnea
D. Decreased oxygen saturation

 

Question 67:

A nurse is assessing a patient with hyperthyroidism. Which symptom would the nurse expect to find?

 

A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Constipation

 

Question 68:

Which intervention is most appropriate for a patient with a new diagnosis of deep vein thrombosis (DVT)?

 

A. Apply a heating pad to the affected area.
B. Encourage frequent ambulation.
C. Administer prescribed anticoagulants.
D. Keep the affected leg elevated at all times.

 

Question 69:

A nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about oxygen therapy. Which statement indicates a need for further teaching?

 

A. “I will use my oxygen as prescribed, even during meals.”
B. “I should increase my oxygen flow rate if I feel short of breath.”
C. “I will check my oxygen equipment regularly for safety.”
D. “I should avoid using flammable materials near my oxygen.”

 

Question 70:

Which laboratory result would the nurse expect to see in a patient with diabetic ketoacidosis (DKA)?

 

A. Serum bicarbonate of 24 mEq/L
B. Blood glucose of 90 mg/dL
C. Serum potassium of 5.8 mEq/L
D. pH of 7.45

 

Question 71:

A patient with a gastric ulcer reports severe, sudden abdominal pain. What is the nurse’s priority action?

 

A. Administer prescribed antacids.
B. Place the patient in a semi-Fowler’s position.
C. Notify the healthcare provider immediately.
D. Obtain a sample for a stool guaiac test.

 

Question 72:

Which finding is most concerning in a patient with a new tracheostomy?

 

A. Small amounts of bleeding around the stoma
B. Difficulty passing a suction catheter through the tracheostomy tube
C. A respiratory rate of 20 breaths per minute
D. Clear secretions when suctioning the tracheostomy

 

Question 73:

Which symptom is most concerning in a patient with end-stage renal disease (ESRD)?

 

A. Fatigue
B. Pruritus
C. Kussmaul respirations
D. Peripheral edema

 

Question 74:

A patient with advanced liver disease has a platelet count of 50,000/μL. Which intervention is most appropriate?

 

A. Encourage frequent ambulation.
B. Administer prescribed acetaminophen for pain.
C. Monitor for signs of bleeding.
D. Administer fresh frozen plasma.

 

Question 75:

Which intervention is most appropriate for a patient experiencing autonomic dysreflexia?

 

A. Lower the head of the bed.
B. Check the patient for bladder distention.
C. Administer intravenous corticosteroids.
D. Encourage deep breathing exercises.

 

Question 76:

A nurse is caring for a patient with acute pancreatitis. Which laboratory finding is most concerning?

 

A. Serum lipase of 300 U/L
B. Serum amylase of 250 U/L
C. Serum calcium of 7.5 mg/dL
D. Blood glucose of 120 mg/dL

 

Question 77:

A nurse is teaching a patient with chronic venous insufficiency about self-care. Which statement indicates a need for further teaching?

 

A. “I will elevate my legs whenever I sit.”
B. “I should wear compression stockings daily.”
C. “I will avoid standing for long periods.”
D. “I can sit in a hot bath to relieve leg pain.”

 

Question 78:

Which symptom is most concerning in a patient with aortic stenosis?

 

A. Dizziness when standing
B. A systolic murmur heard at the second right intercostal space
C. Exertional chest pain and shortness of breath
D. Peripheral edema and weight gain

 

Question 79:

A patient is admitted with a suspected pulmonary embolism (PE). What is the nurse’s priority intervention?

 

A. Administer prescribed anticoagulants.
B. Apply compression stockings.
C. Elevate the patient’s legs.
D. Prepare the patient for a ventilation-perfusion (V/Q) scan.

 

Question 80:

A nurse is assessing a patient with Parkinson’s disease. Which symptom is most characteristic of this condition?

 

A. Rapid eye movement and confusion
B. Resting tremor and bradykinesia
C. Muscle weakness and fatigue
D. Difficulty with swallowing and speaking

 

Question 81:

A patient with type 1 diabetes is brought to the emergency department with confusion and rapid, deep respirations. Which laboratory result confirms diabetic ketoacidosis (DKA)?

 

A. Blood glucose of 600 mg/dL
B. Serum bicarbonate of 28 mEq/L
C. Serum pH of 7.50
D. Ketones present in the urine

 

Question 82:

A nurse is caring for a patient with a history of seizures who suddenly becomes unresponsive and begins to jerk rhythmically. What is the nurse’s priority action?

 

A. Restrain the patient to prevent injury.
B. Place the patient in a side-lying position.
C. Insert an oral airway to prevent choking.
D. Call for immediate medical assistance.

 

Question 83:

Which assessment finding is most concerning in a patient with a chest tube?

 

A. Continuous bubbling in the water seal chamber
B. Tidaling of fluid in the water seal chamber with respiration
C. Drainage of 50 mL/hour of serosanguineous fluid
D. Absence of drainage over the past hour

 

Question 84:

A nurse is caring for a patient with hypovolemic shock. Which intervention is the priority?

 

A. Administer oxygen therapy.
B. Initiate IV fluid resuscitation.
C. Position the patient in Trendelenburg.
D. Monitor urine output hourly.

 

Question 85:

Which finding indicates that a patient with a urinary tract infection (UTI) has developed pyelonephritis?

 

A. Dysuria and cloudy urine
B. Flank pain and fever
C. Hematuria and urgency
D. Suprapubic pain and foul-smelling urine

 

Question 86:

Which is a common symptom of chronic kidney disease (CKD)?

 

A. Increased energy levels
B. Hyperkalemia and acidosis
C. Hypoglycemia
D. Decreased creatinine levels

 

Question 87:

A nurse is caring for a patient who recently underwent a total hip replacement. Which intervention is most important to prevent complications?

 

A. Encourage the patient to cross their legs when sitting.
B. Instruct the patient to avoid weight-bearing on the affected leg.
C. Ensure the patient uses an elevated toilet seat.
D. Assist the patient with turning the affected leg inward.

 

Question 88:

A nurse is assessing a patient who is taking a beta-blocker. Which finding is a priority to report to the healthcare provider?

 

A. Heart rate of 68 bpm
B. Blood pressure of 112/70 mmHg
C. New onset of shortness of breath
D. Peripheral edema

 

Question 89:

A patient with diabetes insipidus (DI) is experiencing increased thirst and urination. Which intervention should the nurse implement first?

 

A. Restrict fluid intake to prevent further water loss.
B. Encourage the patient to consume foods high in sodium.
C. Monitor the patient’s daily weight and urine output.
D. Administer prescribed antidiuretic hormone (ADH).

 

Question 90:

Which assessment finding in a patient with chronic obstructive pulmonary disease (COPD) indicates a worsening condition?

 

A. Decreased respiratory rate
B. Decreased oxygen saturation with activity
C. Productive cough with yellow sputum
D. Increased use of accessory muscles for breathing

 

Question 91:

A patient is receiving a blood transfusion and reports chills and back pain. What should the nurse do first?

 

A. Continue the transfusion and monitor the patient.
B. Stop the transfusion and keep the IV line open with saline.
C. Administer antipyretics and observe for other symptoms.
D. Notify the healthcare provider and document the findings.

 

Question 92:

Which patient condition is most at risk for developing metabolic syndrome?

 

A. Patient with a BMI of 24 kg/m² and regular exercise
B. Patient with hypertension, elevated triglycerides, and abdominal obesity
C. Patient with chronic insomnia and mild depression
D. Patient who has been treated for hypothyroidism

 

Question 93:

Which finding in a patient post-laparoscopic cholecystectomy is most concerning?

 

A. Presence of shoulder pain
B. Minimal incision site drainage
C. Elevated temperature of 101°F (38.3°C)
D. Ability to ambulate without assistance

 

Question 94:

A nurse is assessing a patient with a history of congestive heart failure (CHF). Which finding requires immediate action?

A. 2+ pitting edema of the ankles
B. Weight gain of 2 lbs (0.9 kg) over 24 hours
C. Blood pressure of 140/90 mmHg
D. Occasional cough without sputum

 

Question 95:

A patient is receiving IV fluids and reports pain and swelling at the insertion site. Which action should the nurse take first?

 

A. Elevate the patient’s arm.
B. Discontinue the IV and apply a warm compress.
C. Assess for signs of phlebitis and document findings.
D. Change the IV site to the other arm.

 

Question 96:

Which intervention is most appropriate for a patient with a newly inserted nasogastric (NG) tube?

 

A. Ensure the tube is secured to the patient’s cheek with tape.
B. Encourage the patient to drink fluids frequently.
C. Place the patient in a low-Fowler’s position for feeding.
D. Check for proper tube placement by aspirating stomach contents.

 

Question 97:

A nurse is assessing a patient with suspected appendicitis. Which assessment finding is most suggestive of appendicitis?

 

A. Pain in the left lower quadrant
B. Pain in the right lower quadrant that worsens with movement
C. Pain relieved by deep breathing
D. Pain that radiates to the left shoulder

 

Question 98:

Which finding indicates that a patient is at risk for developing pressure ulcers?

 

A. Moisture on the skin from incontinence
B. Well-nourished with a BMI of 24 kg/m²
C. Good circulation with warm extremities
D. Regular ambulation and active range of motion exercises

 

Question 99:

A patient is on a low-sodium diet. Which food choice is most appropriate?

 

A. Processed cheese
B. Canned soup
C. Fresh spinach
D. Pickled herring

 

Question 100:

Which finding is most concerning for a patient who recently had a stroke?

 

A. Difficulty swallowing
B. Slurred speech
C. Occasional headache
D. Sudden loss of consciousness

 

Question 101:

A patient with a history of hypertension presents with severe headache, blurry vision, and a blood pressure of 220/120 mmHg. Which condition is most likely?

 

A. Hypertensive crisis
B. Orthostatic hypotension
C. Essential hypertension
D. Secondary hypertension

 

Question 102:

Which finding in a patient with cirrhosis is most concerning?

 

A. Jaundice
B. Ascites
C. Spontaneous bruising
D. Confusion and disorientation

 

Question 103:

A patient is receiving diuretic therapy for heart failure. Which electrolyte imbalance should the nurse monitor for?

 

A. Hypercalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypernatremia

 

Question 104:

A nurse is caring for a patient post-mastectomy who is experiencing lymphedema in the arm. Which intervention is most appropriate?

 

A. Keep the affected arm in a dependent position.
B. Apply a tourniquet to the arm to reduce swelling.
C. Encourage the patient to elevate the arm above heart level.
D. Restrict all movement of the affected arm.

 

Question 105:

A patient with peptic ulcer disease (PUD) is at risk for which complication?

 

A. Diarrhea
B. Perforation
C. Gallstones
D. Diverticulosis

 

Question 106:

What is the most appropriate action for a nurse caring for a patient with pneumonia and a history of COPD?

 

A. Administer high-flow oxygen to maintain oxygen saturation.
B. Encourage deep coughing and chest physiotherapy.
C. Keep the patient in a supine position to facilitate lung expansion.
D. Monitor for signs of hypercapnia and respiratory acidosis.

 

Question 107:

A nurse is caring for a patient who has just undergone a kidney transplant. Which finding should be reported immediately to the healthcare provider?

 

A. Urine output of 50 mL/hour
B. Blood pressure of 130/80 mmHg
C. Sudden decrease in urine output
D. Mild swelling around the surgical site

 

Question 108:

A nurse is caring for a patient with an ileostomy. Which statement by the patient indicates a need for further teaching?

 

A. “I should expect my stool to be loose and watery.”
B. “I will eat low-fiber foods to prevent blockage.”
C. “I can take a warm bath to clean my stoma.”
D. “I need to limit my fluid intake to avoid dehydration.”

 

Question 109:

Which lab result would be most concerning for a patient receiving chemotherapy?

 

A. Elevated white blood cell count
B. Decreased hemoglobin and hematocrit
C. Normal platelet count
D. Increased serum albumin

 

Question 110:

What is the most common cause of a pulmonary embolism?

 

A. Air embolism
B. Fat embolism
C. Deep vein thrombosis (DVT)
D. Tumor embolism

 

Question 111:

A patient with asthma is experiencing wheezing, coughing, and shortness of breath. What is the nurse’s priority action?

 

A. Encourage the patient to rest and relax.
B. Administer prescribed bronchodilators.
C. Perform chest physiotherapy.
D. Monitor for signs of dehydration.

 

Question 112:

A nurse is caring for a patient with a nasogastric (NG) tube who suddenly develops a fever and abdominal distention. What is the most likely complication?

 

A. Aspiration pneumonia
B. Gastric ulcer
C. Peritonitis
D. Bowel obstruction

 

Question 113:

A patient is scheduled for a cardiac catheterization. Which teaching point should the nurse include?

 

A. “You will be instructed to eat a light meal before the procedure.”
B. “You should avoid drinking fluids for 24 hours prior to the procedure.”
C. “You will need to stay on bed rest for several hours after the procedure.”
D. “You can resume normal activities immediately after the procedure.”

 

Question 114:

Which patient statement indicates that the nurse needs to provide more education regarding a newly diagnosed myocardial infarction (MI)?

 

A. “I will avoid lifting heavy objects for a few weeks.”
B. “I can continue to smoke, as long as I take my prescribed medication.”
C. “I should follow a low-sodium, heart-healthy diet.”
D. “I need to monitor my blood pressure regularly.”

 

Question 115:

A patient with a history of type 1 diabetes presents with confusion, sweating, and shakiness. What is the nurse’s priority action?

 

A. Administer insulin.
B. Give the patient a glass of orange juice.
C. Check the patient’s blood glucose level.
D. Place the patient on a cardiac monitor.

 

Question 116:

A patient who underwent a total knee replacement is at risk for which complication?

 

A. Anemia
B. Deep vein thrombosis (DVT)
C. Pulmonary edema
D. Hyperglycemia

 

Question 117:

What is the primary goal of treatment for a patient with stable angina?

 

A. Increase the heart rate to improve circulation
B. Reduce myocardial oxygen demand
C. Promote vasoconstriction to maintain blood pressure
D. Increase fluid intake to reduce blood viscosity

 

Question 118:

A nurse is teaching a patient about their new prescription for a beta-blocker. Which statement indicates that the patient understands the teaching?

 

A. “I should stop taking this medication if I start to feel better.”
B. “I will take my medication on an empty stomach for better absorption.”
C. “I should monitor my heart rate and report any significant changes.”
D. “This medication will prevent my blood pressure from getting too high.”

 

Question 119:

A patient with chronic heart failure (CHF) is experiencing weight gain, edema, and shortness of breath. What is the nurse’s priority intervention?

 

A. Administer prescribed diuretics as ordered.
B. Encourage increased fluid intake to prevent dehydration.
C. Recommend bed rest for 24 hours.
D. Decrease the patient’s sodium intake to prevent fluid retention.

 

Question 120:

A patient who underwent a myocardial infarction (MI) is prescribed ACE inhibitors. What is the primary benefit of this medication class for MI patients?

 

A. They lower cholesterol levels.
B. They prevent clot formation.
C. They reduce blood pressure and improve heart function.
D. They increase blood flow to the coronary arteries.

 

Question 121:

Which dietary recommendation is appropriate for a patient with chronic kidney disease (CKD)?

 

A. High-protein diet
B. Low-sodium, low-potassium diet
C. Low-carbohydrate diet
D. High-calcium diet

 

Question 122:

What is the priority action when caring for a patient with a chest tube who reports sudden shortness of breath?

 

A. Check the water seal chamber for proper fluid level.
B. Clamp the chest tube and assess for an air leak.
C. Encourage the patient to take deep breaths and cough.
D. Notify the healthcare provider immediately.

 

Question 123:

A nurse is caring for a patient with a history of hypoglycemia. Which snack is best for preventing an episode?

 

A. Fresh fruit and a handful of nuts
B. Granola bar and a diet soda
C. Popcorn and a cup of black coffee
D. Cheese and crackers

 

Question 124:

What is the most common symptom of deep vein thrombosis (DVT)?

 

A. Red, warm, and swollen leg
B. Severe leg pain while resting
C. Sudden shortness of breath
D. Bilateral leg swelling

 

Question 125:

Which sign indicates that a patient is developing an allergic reaction to a medication?

 

A. Decreased urine output
B. Bruising and petechiae
C. Rash and pruritus
D. Jaundice

 

Question 126:

A patient with cirrhosis is prescribed lactulose. What is the intended outcome of this medication?

 

A. Increase blood pressure
B. Prevent fluid retention
C. Reduce ammonia levels in the blood
D. Relieve pain associated with abdominal cramping

 

Question 127:

What is the most important intervention for a patient with acute pancreatitis?

A. Administering pain medications regularly
B. Keeping the patient NPO (nothing by mouth) to rest the pancreas
C. Encouraging high-protein, low-fat meals
D. Performing frequent abdominal assessments

 

Question 128:

A nurse is preparing to administer insulin to a patient with type 1 diabetes. Which action is most important?

A. Mix the insulin before drawing it into the syringe.
B. Administer insulin into a muscle for faster absorption.
C. Ensure the insulin is at room temperature before injection.
D. Rotate injection sites to prevent lipodystrophy.

 

Question 129:

A patient with a history of chronic obstructive pulmonary disease (COPD) is experiencing increased dyspnea. What is the priority intervention?

A. Increase oxygen therapy to high levels.
B. Encourage slow, deep breathing with pursed lips.
C. Administer a sedative to help the patient relax.
D. Place the patient in a supine position to promote lung expansion.

 

Question 130:

Which finding in a patient with a history of heart failure should be reported immediately to the healthcare provider?

A. Mild ankle swelling at the end of the day
B. Shortness of breath when lying down
C. Occasional mild cough
D. Decreased appetite

 

Question 131:

A patient is receiving chemotherapy and develops severe mouth sores. Which intervention should the nurse include in the care plan?

A. Recommend using alcohol-based mouthwash for oral hygiene.
B. Encourage the patient to avoid eating acidic or spicy foods.
C. Suggest brushing teeth with a hard-bristled toothbrush for better cleaning.
D. Advise the patient to limit fluid intake to prevent further irritation.

 

Question 132:

What is the primary concern for a patient receiving total parenteral nutrition (TPN)?

A. Hyperkalemia
B. Hyperglycemia
C. Hypothermia
D. Hypocalcemia

 

Question 133:

Which lab value should be closely monitored in a patient receiving warfarin therapy?

A. Platelet count
B. Hemoglobin and hematocrit
C. Prothrombin time (PT) and international normalized ratio (INR)
D. Serum albumin

 

Question 134:

A patient with type 2 diabetes is prescribed metformin. What is an important teaching point for the nurse to include?

A. “You should take this medication with a high-fat meal to improve absorption.”
B. “Avoid taking this medication with any other diabetic medications.”
C. “Do not take this medication if you have a history of kidney disease.”
D. “It is safe to take this medication even if you are pregnant.”

 

Question 135:

Which sign in a patient with a history of chronic liver disease is most indicative of hepatic encephalopathy?

A. Dark urine and pale stool
B. Jaundice and ascites
C. Confusion and asterixis (flapping tremor)
D. Edema and fatigue

 

Question 136:

What should the nurse instruct a patient to do when taking a corticosteroid for chronic inflammation?

A. Increase salt intake to prevent dehydration.
B. Take the medication with an empty stomach to maximize absorption.
C. Avoid sudden discontinuation of the medication to prevent adrenal insufficiency.
D. Limit fluid intake to reduce swelling.

 

Question 137:

A patient undergoing dialysis reports muscle cramps and fatigue. What should the nurse suspect?

A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypocalcemia

 

Question 138:

Which type of diet is most appropriate for a patient with chronic pancreatitis?

A. Low-protein, high-fat diet
B. Low-carbohydrate, high-protein diet
C. High-protein, low-fat diet
D. Low-fiber, low-protein diet

 

Question 139:

A patient with a history of myocardial infarction (MI) is prescribed a beta-blocker. Which symptom should the patient be educated to report to their healthcare provider?

A. Persistent cough
B. Increased appetite
C. Unexplained fatigue
D. A slight increase in blood pressure

 

Question 140:

What is a common complication of long-term use of corticosteroids?

A. Hypoglycemia
B. Osteoporosis
C. Hypotension
D. Hyperkalemia

 

Question 141:

A patient with a history of allergic rhinitis is using a nasal decongestant. What instruction should the nurse provide?

A. “Use this medication for more than 7 days for maximum effectiveness.”
B. “Take this medication with meals to prevent stomach upset.”
C. “Limit use to 3-4 days to prevent rebound congestion.”
D. “Take this medication only before bedtime to prevent insomnia.”

 

Question 142:

A patient with acute kidney injury (AKI) is at risk for which electrolyte imbalance?

A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypomagnesemia

 

Question 143:

Which nursing intervention is most appropriate for a patient with chronic obstructive pulmonary disease (COPD) who is experiencing a cough with sputum production?

A. Encourage the patient to rest and limit activity.
B. Provide humidified air and encourage effective coughing.
C. Instruct the patient to drink large amounts of water to thin secretions.
D. Administer antitussive medications to suppress the cough.

 

Question 144:

A patient who has undergone a mastectomy is at risk for which of the following complications related to lymphatic drainage?

A. Lymphedema
B. Hypertension
C. Phlebitis
D. Pulmonary embolism

 

Question 145:

A patient reports persistent thirst, polyuria, and weight loss. Which condition should the nurse suspect?

A. Hyperthyroidism
B. Diabetes insipidus
C. Cushing’s syndrome
D. Hypothyroidism

 

Question 146:

A patient is receiving IV fluids for dehydration. Which assessment finding indicates that the patient is at risk for fluid overload?

A. Increased skin turgor
B. Rapid, deep breathing
C. Edema in the lower extremities
D. Decreased urine output

 

Question 147:

A patient with a history of chronic alcoholism presents with confusion and ataxia. What condition should the nurse suspect?

A. Wernicke’s encephalopathy
B. Hepatic encephalopathy
C. Hypoglycemia
D. Stroke

 

Question 148:

A patient is admitted with suspected appendicitis. Which assessment finding would be most concerning for the nurse?

A. Mild, generalized abdominal pain
B. Pain localized to the right lower quadrant
C. Sudden relief of pain after severe abdominal pain
D. Presence of a low-grade fever

 

Question 149:

A patient with chronic kidney disease (CKD) is scheduled to start hemodialysis. What is the most important intervention for the nurse before initiating dialysis?

A. Ensure the patient has eaten a high-calorie meal.
B. Check the patency of the arteriovenous (AV) fistula.
C. Administer a sedative to relax the patient.
D. Place the patient on a low-sodium diet.

 

Question 150:

Which nursing intervention is most appropriate for a patient with heart failure and fluid retention?

A. Limit fluid intake to 500 mL per day.
B. Administer diuretics as ordered and monitor for electrolyte imbalances.
C. Encourage the patient to rest with the legs elevated for extended periods.
D. Advise the patient to avoid monitoring their weight to prevent anxiety.

 

Question 151:

A patient presents with a sudden loss of sensation and movement in the left leg following a fall. What is the priority assessment?

A. Check for a femoral pulse in the affected leg.
B. Elevate the leg to reduce swelling.
C. Apply a cold compress to the site of the injury.
D. Assess the level of consciousness.

 

Question 152:

A patient receiving anticoagulant therapy with heparin is found to have a platelet count of 30,000/mm³. What is the nurse’s priority action?

A. Administer the heparin as ordered.
B. Stop the heparin infusion and notify the healthcare provider.
C. Increase the heparin dose to maintain therapeutic levels.
D. Monitor the patient’s blood pressure closely.

 

Question 153:

A patient is receiving treatment for tuberculosis (TB) and complains of dark-colored urine. Which potential complication should the nurse be concerned about?

A. Renal failure
B. Hepatotoxicity
C. Hyperglycemia
D. Hyperkalemia

 

Question 154:

A patient with a history of stroke is at risk for which complication during physical therapy?

A. Hypothermia
B. Aspiration
C. Seizures
D. Deep vein thrombosis (DVT)

 

Question 155:

Which medication should the nurse expect to be prescribed for a patient with rheumatoid arthritis to reduce inflammation?

A. Acetaminophen
B. Methotrexate
C. Hydrochlorothiazide
D. Furosemide

 

Question 156:

A patient has been prescribed ciprofloxacin for a urinary tract infection. Which instruction should the nurse provide to avoid potential side effects?

A. “Avoid taking this medication with dairy products or antacids.”
B. “Take this medication with grapefruit juice to improve absorption.”
C. “Avoid sunlight while on this medication due to increased photosensitivity.”
D. “Ensure to take the medication only at night to prevent drowsiness.”

 

Question 157:

A patient with chronic obstructive pulmonary disease (COPD) is prescribed a bronchodilator. Which side effect should the nurse educate the patient to report?

A. Drowsiness
B. Increased heart rate
C. Decreased appetite
D. Constipation

 

Question 158:

A patient with a history of hyperthyroidism is at risk for which complication if untreated?

A. Hypoglycemia
B. Myxedema coma
C. Thyroid storm
D. Hypocalcemia

 

Question 160:

A nurse is caring for a patient with a history of peptic ulcer disease who is prescribed proton pump inhibitors (PPIs). Which teaching point should the nurse emphasize?

A. “Take this medication only when symptoms are severe.”
B. “Avoid taking this medication with antacids.”
C. “Take the medication with meals to enhance effectiveness.”
D. “Notify your healthcare provider if you experience black, tarry stools.”

 

Question 163:

A patient with chronic kidney disease (CKD) has been prescribed erythropoietin. Which potential side effect should the nurse monitor for?

A. Hypercalcemia
B. Thrombocytopenia
C. Hypertension
D. Hyperkalemia

 

Question 164:

Which statement indicates a patient with diabetes is experiencing hypoglycemia?

A. “I feel nervous, shaky, and sweaty.”
B. “My vision is blurry, and I feel sluggish.”
C. “I have a headache, and I feel very thirsty.”
D. “I’m feeling sleepy and disoriented, but I have no symptoms of sweating.”

 

Question 165:

A patient has a new diagnosis of deep vein thrombosis (DVT). Which statement by the patient indicates the need for further teaching?

A. “I should wear compression stockings to help prevent swelling.”
B. “I will elevate my leg above the level of my heart when resting.”
C. “I can take aspirin instead of my prescribed anticoagulant.”
D. “I should avoid crossing my legs to improve circulation.”

 

Question 166:

A patient undergoing chemotherapy is experiencing neutropenia. Which precaution should the nurse take?

A. Encourage the patient to exercise daily.
B. Advise the patient to avoid crowded places and sick people.
C. Recommend a diet high in raw vegetables and fruits.
D. Suggest that the patient take a daily multivitamin.

 

Question 167:

What is the priority intervention for a patient presenting with signs of compartment syndrome following a leg fracture?

A. Elevate the leg above the heart.
B. Apply ice to the site to reduce swelling.
C. Loosen any restrictive clothing or bandages.
D. Administer pain medication and monitor for increased discomfort.

 

Question 168:

A patient is receiving a beta-blocker for hypertension. Which side effect should the nurse monitor for?

A. Tachycardia
B. Bradycardia
C. Hyperthermia
D. Diarrhea

 

Question 169:

A patient who has been treated for tuberculosis is being monitored for potential side effects of the medication. Which sign would indicate a possible adverse reaction to rifampin?

A. Drowsiness
B. Red-orange colored urine
C. Weight gain
D. Photosensitivity

 

Question 170:

Which dietary change should the nurse recommend for a patient with chronic heart failure (CHF) to help manage symptoms?

A. Increase intake of high-sodium foods to boost energy.
B. Reduce fluid intake to prevent fluid overload.
C. Eat smaller, more frequent meals to avoid bloating.
D. Avoid all sources of dietary fiber to prevent bloating.

 

Question 171:

A patient with asthma is prescribed a leukotriene receptor antagonist. Which statement by the patient indicates that further teaching is needed?

A. “I will take this medication at bedtime.”
B. “I can stop taking this medication once my symptoms are under control.”
C. “I should not use this medication during an acute asthma attack.”
D. “I need to take this medication regularly, even if I feel fine.”

 

Question 172:

A patient is receiving a high dose of prednisone. What potential side effect should the nurse monitor for?

A. Hypotension
B. Hypoglycemia
C. Weight gain
D. Bradycardia

 

Question 173:

A patient with a history of GERD is taking an H2 receptor antagonist. Which food should the nurse instruct the patient to avoid to prevent exacerbation of symptoms?

A. Bananas
B. Oatmeal
C. Spicy foods
D. Low-fat yogurt

 

Question 174:

A patient receiving IV fluids complains of a sudden headache, nausea, and confusion. What is the most appropriate nursing action?

A. Slow the infusion rate and assess the patient’s vital signs.
B. Increase the infusion rate to prevent dehydration.
C. Apply a cold compress to the patient’s forehead.
D. Encourage the patient to drink more fluids.

 

Question 175:

Which intervention is most appropriate for a patient receiving continuous enteral tube feeding to reduce the risk of aspiration?

A. Position the patient flat in bed during feeding.
B. Elevate the head of the bed to 30-45 degrees during feeding.
C. Stop the feeding if the patient shows signs of nausea.
D. Change the tube feeding formula to a thicker consistency.

 

 

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