A client is admitted on the day of surgery for an arthroscopy of the l

NCLEX RN Medical Surgical Questions

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Question 1 of 5.

A client is admitted on the day of surgery for an arthroscopy of the left knee. Which nursing activities should be completed to avoid wrong-site surgery? Select all that apply.

A. Ask the surgeon preoperatively to mark with a permanent marker the correct knee for the surgical site.

B. Verbally ask the client to state his name, surgical site, and procedure.

C. Verify the correct client with the correct operative site by medical records and radiographic diagnostic reports.

D. Call a 'time-out'Â in the operating room to have the surgeon verify the correct knee before making the incision.

E. Show the client an anatomic model of the surgery site.

Explanation: To prevent wrong-site surgery, the surgeon marks the site (A), the client verifies identity and procedure (B), records are checked (C), and a time-out confirms the site (D). Showing a model (E) is educational but not a standard safety measure.

Question 2 of 5.

The nurse notices that a client's heart rate decreases from 63 to 50 beats per minute on the monitor. The nurse should first:

A. Administer Atropine 0.5 mg I.V. push.

B. Auscultate for abnormal heart sounds.

C. Prepare for transcutaneous pacing.

D. Take the client's blood pressure.

Explanation: A heart rate of 50 bpm may indicate bradycardia. Taking the blood pressure first assesses hemodynamic stability, guiding whether immediate intervention (e.g., atropine or pacing) is needed.

Question 3 of 5.

The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?

A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.

B. A 43-year-old male with a family history of CAD and cholesterol level of 158.

C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).

D. A 65-year-old female who is obese with an LDL of 188.

Explanation: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.

Question 4 of 5.

The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains to the client that this procedure is being used in this specific case to:

A. Open and dilate blocked coronary arteries.

B. Assess the extent of arterial blockage.

C. Bypass obstructed vessels.

D. Assess the functional adequacy of the valves and heart muscle.

Explanation: Cardiac catheterization in unstable angina assesses the extent of coronary artery blockage to guide interventions like angioplasty or bypass surgery.

Question 5 of 5.

The nurse finds the apical impulse below the fifth intercostal space. The nurse suspects:

A. Left atrial enlargement.

B. Left ventricular enlargement.

C. Right atrial enlargement.

D. Right ventricular enlargement.

Explanation: An apical impulse below the fifth intercostal space suggests left ventricular enlargement, common in heart failure due to ventricular dilation.