Free NCLEX RN Questions for Med Surg
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Question 1 of 5.
On the second day following an abdominal perineal resection, the nurse notes that the wound edges aren't approximated and one half the incision has torn apart. The nurse should immediately take what action?
A. Flush the wound with sterile water.
B. Apply an abdominal binder.
C. Cover the wound with a sterile dressing moistened with normal saline.
D. Apply strips of tape.
Explanation: Covering the wound with a sterile dressing moistened with normal saline protects the open wound from infection and keeps it moist until further medical evaluation. Flushing, applying a binder, or using tape are inappropriate without addressing the dehiscence first. CN: Physiological adaptation; CL: Synthesize
Question 2 of 5.
The client has had hypertension for 20 years. The nurse should assess the client for?
A. Renal insufficiency and failure.
B. Valvular heart disease.
C. Endocarditis.
D. Peptic ulcer disease.
Explanation: Long-standing hypertension damages kidneys, leading to renal insufficiency or failure, a common complication requiring assessment.
Question 3 of 5.
During rescue breathing in cardiopulmonary resuscitation (CPR), the victim will exhale by:
A. Normal relaxation of the chest.
B. Gentle pressure of the rescuer's hand on the upper chest.
C. The pressure of cardiac compressions.
D. Turning the head to the side.
Explanation: Exhalation during CPR occurs naturally due to chest relaxation after the rescuer delivers a breath, allowing air to exit the lungs.
Question 4 of 5.
A common abnormal laboratory result associated with the development of peripheral vascular disease (PVD) is:
A. High serum calcium level
B. High serum lipid levels
C. Low serum lipid levels
D. Low serum calcium level
Explanation: High serum lipid levels, particularly elevated low-density lipoprotein (LDL) cholesterol, are a major risk factor for atherosclerosis, which underlies PVD. Lipid accumulation in arterial walls leads to plaque formation, narrowing vessels and reducing blood flow. Calcium levels are not directly associated with PVD, and low lipid levels are not a risk factor.
Question 5 of 5.
A 70-year-old male with the diagnosis of claudication has been hospitalized for an evaluation of his increasingly impaired mobility and complaints of pain. The client tells the nurse that he can no longer walk a block without having severe pain in his left calf and foot. Based on these data, which nursing diagnosis would be most appropriate for this client?
A. Activity intolerance related to decreased blood supply and pain
B. Self-care deficit related to increased leg pain
C. Ineffective coping related to chronic pain
D. Impaired skin integrity related to poor circulation
Explanation: Activity intolerance due to decreased blood supply and pain is the most appropriate nursing diagnosis, as claudication (pain during walking) directly results from inadequate arterial blood flow, limiting mobility. The other diagnoses may apply but are less specific to the described symptoms.