Medical-Surgical Nursing practice questions

Question: Client admitted with pneumonia. Reassessment shows SpO₂ 78% on 2L O₂. What’s the first action?

Answer Choices:
A. Notify provider
B. Increase IV fluids
C. Increase O₂ to achieve >90%
D. Consult respiratory therapy

Answer: C. Increase O₂ to achieve >90%

Question: Which client is in appropriate precautions?

Answer Choices:
A. Airborne for bacterial pneumonia
B. Droplet for measles
C. Contact for C. difficile
D. Contact for influenza

Answer: C. Contact for C. difficile

Question: The nurse is caring for a client who was admitted with endocarditis. Which additional finding is most consistent with endocarditis?

Answer Choices:
A. History of IV drug use
B. Negative blood cultures
C. ST elevation on ECG
D. Chest pain worse on inspiration

Answer: A. History of IV drug use

Question: Client with suspected Guillain-Barré post-LP now has weak grips, hard to arouse, RR 10. Which problem is priority?

Answer Choices:
A. Cerebral perfusion
B. Cognition
C. Mobility
D. Nutrition

Answer: A. Cerebral perfusion

Question: Client admitted with SOB and fatigue. What intake question best indicates risk for respiratory acidosis?

Answer Choices:
A. “How many flights of stairs…”
B. “What color is your sputum?”
C. “How anxious do you become…”
D. “Do you have chronic lung disease…”

Answer: D. “Do you have chronic lung disease…”

Question: The charge nurse on a medical surgical unit is making staff assignments. Understanding the principles of infection control, which client would not be assigned to the same nurse to minimize risk of transmissions.

Answer Choices:
A. 55-year-old client with carbapenem-resistant Enterobacter (CRE)
B. 62-year-old female with VRE UTI
C. 43-year-old with influenza and pneumonia
D. 68-year-old with diabetic foot ulcer and MRSA

Answer: B. 62-year-old female with VRE UTI

Question: A client with impaired gas exchange is breathing shallow and fast. Nurse encourages pursed-lip breathing. What acid-base imbalance may occur if uncorrected?

Answer Choices:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis

Answer: D. Respiratory acidosis

Question: The nurse is caring for a 17-year-old client post-lumbar puncture for suspected meningitis. Client becomes hard to arouse, RR 10, weak hand grips. Which problem is priority to assess?

Answer Choices:
A. Cerebral perfusion
B. Cognition
C. Mobility
D. Nutrition

Answer: A. Cerebral perfusion

Question: Which one is the best choice from the two conditions: Tuberculosis or Bacterial pneumonia?

Answer Choices:
(Details not provided; explained TB is best match based on symptoms, weight loss, sputum, AFB test, and airborne precautions)

Answer: Tuberculosis

Question: Client in ER with chest pressure 6/10, nausea, sweating. History of diabetes and pulmonary hypertension. Which history is most concerning before nitroglycerin?

Answer Choices:
A. Taking sildenafil
B. History of migraines
C. When the client last ate
D. Allergy to morphine

Answer: A. Taking sildenafil

Question: Which client would the nurse be most concerned about?

Answer Choices:
A. 49-year-old with RSV, SpO₂ 95%
B. 62-year-old post-UTI, now with abdominal pain and watery stool
C. 70-year-old with toe wound, MRSA, no fever
D. 80-year-old confused, on antibiotics for UTI

Answer: B. 62-year-old with abdominal pain and watery stool (suspected C. diff)

Question: Client with COPD on 2L O₂ complains of SOB. SpO₂ is 90%. What action is taken first?

Answer Choices:
A. Increase O₂ to 4L
B. Draw ABGs
C. Contact respiratory therapy
D. Ensure high-Fowler’s position

Answer: D. Ensure high-Fowler’s position

Question: Client with cough and fever, had positive influenza swab 5 days ago. What test is anticipated?

Answer Choices:
A. Repeat influenza swab
B. TB skin test
C. Chest X-ray
D. ECG

Answer: C. Chest X-ray

Question: Which immediate action would the nurse take when a client presents with chest pain?

Answer Choices:
A. Obtain troponin levels
B. Obtain a 12-lead ECG
C. Obtain a chest x-ray
D. Obtain an 18-lead ECG

Answer: B. Obtain a 12-lead ECG

Question: Client with sepsis has platelets 20,000, lactic acid 21 mmol/L. What’s the priority intervention?

Answer Choices:
A. Platelet transfusion
B. Remove central line
C. Normal saline bolus
D. PRBC transfusion

Answer: A. Platelet transfusion

Question: Client with fatigue, orthopnea, new A-fib, history of rheumatic fever. Murmur heard at apex. Likely diagnosis?

Answer Choices:
A. Mitral stenosis
B. Aortic stenosis
C. COPD
D. Pericarditis

Answer: A. Mitral stenosis