Benchmark I Medical-Surgical Nursing Practice Test

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• What is the correct sequence of actions when a suspected blood transfusion reaction occurs?
• Based on a telemetry strip showing a stable rhythm, what is the most appropriate nursing action?
• A client tests positive for Hepatitis A. Which precaution should be included in discharge teaching?
• A client with a decubitus ulcer infected with MRSA has a laboratory value of glucose 250 mg/dL. This finding most likely indicates what?
• What laboratory findings indicate hepatocellular injury and how should nursing care respond?
• Which urinalysis result best supports a urinary tract infection diagnosis?
• In a facility where the RN receives new orders and delegates tasks, which action best reflects the RN's role?
• What is the initial treatment for atrial fibrillation with rapid ventricular response in acute care?
• After total knee replacement, pain management includes celecoxib and hydrocodone. Which observation most strongly indicates effective analgesia during rehabilitation?
• A patient is at risk for fluid volume overload. Which nursing action best supports monitoring fluid status?
• What is the mechanism of lactulose in hepatic encephalopathy and what nursing considerations accompany its use?
• What infection risks do leukemia patients face during chemotherapy and how can nurses mitigate?
• In a client with severe traumatic brain injury, which posturing indicates worsening intracranial pressure?
• When educating a client starting active tuberculosis treatment, which adverse effects should be reported to the health care provider?
• Which intervention is not typically part of acute management for a client with sickle cell disease in crisis?
• What are typical signs of left-sided heart failure?
• How is a hypertensive emergency managed in-hospital?
• During an interview about alcohol and other substances, which statement indicates a safety concern?
• A client with diabetic ketoacidosis (DKA) due to pneumonia presents with coma, glucose 500 mg/dL, blood pressure 90/50, heart rate 120, fever 102.0°F, and dry mucous membranes. After evaluation, which prescription should the nurse implement first?
• How should spinal precautions be applied in a trauma patient?
• A client on anti-tuberculosis therapy has mildly elevated liver enzymes. What is the most appropriate plan?
• In hepatic encephalopathy, which mechanism does lactulose primarily employ?
• In ostomy care, after removing the old ostomy bag, what is the next step?
• To prevent aspiration in a patient with a nasogastric feeding tube who has pneumonia, the head of the bed should be elevated to what degree?
• What is the Glasgow Coma Scale and how does it guide nursing actions?
• For a client with suspected appendicitis, which action best supports the plan for optimal imaging and assessment?
• Which of the following is an expected side effect of rifampin used in tuberculosis therapy?
• For best infection control in a client with an inflamed right eye and copious purulent drainage, which measure is most appropriate?
• What are typical treatments for iron deficiency anemia and nursing focus?
• What are potential adverse effects of ACE inhibitors besides hyperkalemia?
• How can delirium be prevented in hospitalized older adults?
• For a client receiving radiation therapy, which task would be most appropriate to delegate to a UAP?
• When providing discharge instructions for a client prescribed albuterol and montelukast, which directive is appropriate?
• When titrating IV nitroglycerin for chest pain in heart failure, which of the following BP readings indicates the rate may be too rapid and should be decreased?
• In patients on warfarin, INR monitoring primarily helps assess what?
• What is the recommended approach to address constipation risk in elderly postoperative patients?
• In COPD, what SpO2 target is appropriate and what risks affect oxygen therapy?
• How do you prevent and stage pressure ulcers and what is nursing care?
• Which action is NOT appropriate for suspected appendicitis?
• In adrenal crisis with volume depletion, which IV fluid is typically given first?
• Which intervention should the nurse anticipate implementing for a client with sickle cell disease experiencing an acute pain episode?
• Which finding best indicates a tension pneumothorax requiring urgent management?
• List the key nursing priorities in acute pancreatitis.
• A client with HIV and Pneumocystis pneumonia is being treated. Which intervention is appropriate?
• Which antibiotic should be avoided in a patient with a sulfa allergy when treating a urinary tract infection?
• In preoperative teaching, which step helps reduce risk of postoperative complications?
• In a UTIs prevention plan, which population should be the focus due to higher risk?
• A nurse caring for a client with coronary artery disease in suspected myocardial infarction discusses an order with the provider. Which order should be discussed before implementing?
• A 25-year-old woman with rheumatoid arthritis is started on leflunomide. Which precaution is essential before therapy and counseling?
• In planning care for an older adult at end of life, which action best supports the patient's psychosocial needs?
• When assessing a client for hemodialysis, which information is most important in determining the amount of ultrafiltration?
• A patient requires 3 mg IV morphine. If the morphine solution is 25 mg/mL, how many milliliters should be administered?
• How do you differentiate type 1 from type 2 diabetes and what are key nursing considerations?
• In a skilled nursing facility, when reviewing urinary tract infection surveillance data, which action best aligns with reducing UTIs?
• Which statement correctly describes ARDS ventilation strategy?
• Which is a potential side effect of opioid analgesics used after knee replacement?
• In a patient with benign prostatic hyperplasia and urinary retention, which parameter should be monitored most closely?
• A patient with gastroesophageal reflux disease who had open anti-reflux surgery should receive which essential nursing intervention?
• Which measurement is used to determine the ultrafiltration target in hemodialysis?
• How should a patient experiencing anaphylaxis be treated and monitored?
• Which statement about myocardial infarction and troponin elevation is correct?
• Which strategies constitute key prophylaxis for venous thromboembolism in hospitalized patients?
• Which statement best aligns with appropriate urinary catheter use in a facility policy?
• Which ABG interpretation best differentiates metabolic acidosis from metabolic alkalosis?
• A patient presents with mid-epigastric pain radiating to the back, accompanied by nausea, vomiting, and hematemesis. Which condition is most likely?
• A client with ulcerative colitis should receive which dietary intervention during a flare?
• Which diagnosis is most consistent with the described adrenal crisis scenario?
• A client suspected of sleep-disordered breathing has several findings. Which assessment would be most concerning?
• Which is not a recommended component of venous thromboembolism prophylaxis for hospitalized patients?
• Which clinical features characterize pneumonia and what should be nursing priorities on presentation?
• Which of the following are important considerations for patients on warfarin?
• Which statement best defines ARDS and its key nursing management strategies?
• Which statement indicates a good understanding of hypertension?
• How should you manage hypoglycemia in a patient with diabetes who is awake vs unconscious?
• When witnessing a seizure, which action is most appropriate?
• When reviewing a facility policy on perineal hygiene, which action is appropriate to include?
• What ECG changes are seen with hyperkalemia and what is the emergent treatment?
• In the ostomy care sequence, which step is not part of the standard procedure?
• For NSTEMI, how is management typically approached?
• What are common signs of a GI bleed and the initial nursing priorities?
• Which statement best describes the rationale for prone positioning in ARDS?
• In suspected bacterial meningitis, when should dexamethasone be given relative to antibiotics?
• Which nutritional intervention is emphasized to support wound healing in surgical patients?
• Which of the following indicates hyponatremia symptoms and the safe correction approach?
• Post-mastectomy, which health promotion need should be addressed?
• For meningitis precautions, which isolation is typically implemented?
• For macrocytic anemia due to B12 or folate deficiency, what nursing focus is most appropriate?
• In STEMI, what is the target door-to-balloon time for PCI?
• In the ICU after a myocardial infarction, which finding would be most concerning?
• In ostomy care, which is the final step in changing the ostomy appliance?
• What are typical signs of liver failure and how do you manage hepatic encephalopathy?
• What are key considerations for ACE inhibitors regarding kidney function and potassium?
• A patient with a history of chronic steroid use recently missed several days of medications and now presents with weakness, nausea, dry mucous membranes, hypotension, and electrolyte abnormalities consistent with an adrenal crisis. Which action should the nurse take first?
• A patient with a subdural hematoma is being treated. Which statement would be accurate regarding early treatment response?
• During diabetic ketoacidosis treatment, which electrolyte is most closely monitored for rapid shifts after starting insulin therapy?
• A Native American client in preoperative teaching says, 'I'm afraid the surgery will not go well unless my shaman is there to keep me well.' What is the nurse's best action?
• A client with suspected contact dermatitis. What is the priority nursing action?
• Pneumocystis pneumonia most commonly occurs in which patient population?
• Which medication order would be appropriate to manage pain in a patient with an AND order?
• A client with suspected colon cancer presents with pain and diarrhea on palpation and a palpable mass. What is the most likely location of the cancer?
• Which route and dose is appropriate for initial treatment of a suspected anaphylactic reaction to an IV infusion?
• Which statement indicates a need for further teaching about decongestant use in a patient with asthma and hypertension who is taking albuterol and montelukast?
• The nurse reviews the intake and output for a patient with a feeding tube. Which action is the best initial step?
• What are the initial steps in sepsis management and the rationale for early antibiotics?
• A client with chronic obstructive pulmonary disease (COPD) is admitted with respiratory acidosis. What is the target oxygen saturation for this client?
• Which lab value is most appropriate to monitor to assess hepatic encephalopathy therapy effectiveness when using lactulose?
• What are common signs of DKA and HHNK and the corresponding nursing priorities?
• Which statement best reflects management of a patient with asthma and hypertension who is prescribed albuterol and montelukast?
• A client with spina bifida is suspected of having a latex allergy. Which action should be the priority?
• Why is confirming NPO status important in preoperative assessment?
• Which statement correctly describes oxygen management in COPD to avoid CO2 retention?
• A client with severe hyperkalemia (potassium 7.0 mEq/L) has been treated with sodium polystyrene. Which data would best indicate the client's condition has improved?
• What is the primary nursing focus when caring for a patient with meningitis?
• A client with a small-bowel obstruction is restless and in pain. The client is at highest risk for which complication?
• In atrial fibrillation with rapid ventricular response, what should be assessed regarding anticoagulation?
• Which statement best distinguishes HHNK from DKA?
• Which condition is not a contraindication to kidney transplantation?
• A client with a chronic decubitus ulcer infection has a glucose level of 250 mg/dL. This finding most likely indicates what about glycemic control?
• After completing prescribed antibiotics for a UTI, which signs indicate improvement?
• A large pneumothorax is suspected when a patient presents with which findings, and what is the primary nursing action?
• How do isolation precautions work and why are they important in infection control?
• After initiating an IV antibiotic 20 minutes ago, a client develops wheezing and itching all over. What is the most appropriate initial action?
• MRSA wound care for a patient with an infected decubitus ulcer emphasizes which precaution?
• How do macrocytic and microcytic anemias differ and what nursing actions apply?
• During a post-bariatric surgery clinic visit, which statement indicates a potential pregnancy plan?
• A patient is prescribed amoxicillin suspension 750 mg by mouth every 8 hours. The suspension concentration is 125 mg per 5 mL. How many milliliters are required for each dose?
• During a seizure, which action should the nurse perform that protects the client from injury?
• Which tuberculosis medication is commonly associated with liver enzyme elevation?
• Which of the following is a hallmark of early cardiogenic shock requiring prompt action?
• What are best practices for opioid analgesia safety in postoperative patients?
• In a patient with diabetic ketoacidosis, dehydration is suspected. Which finding would best indicate dehydration?
• Which statement best describes endoscopy readiness in a patient with GI bleeding?
• After shift report, which patient should the nurse see first?
• In planning preoperative teaching to promote health and reduce complications, which information should the nurse discuss?
• How do troponin levels behave after myocardial infarction?
• Why is initiating broad-spectrum antibiotics within the first hour critical in sepsis management?
• An elderly patient with pneumonia and a sulfa allergy presents with urinary symptoms. Which finding would be most concerning for a concurrent urinary tract infection?
• Imaging of an embolic stroke shows an embolism in the anterior cerebral artery (ACA). Which signs are most likely to be present?
• How is hepatic encephalopathy diagnosed and managed in the hospital setting?
• Which goals should be included when planning a diabetes self-management workshop?
• Which clinical finding is most important to monitor to assess intracranial pressure in a brain-injured patient?
• What are typical ECG changes in hypokalemia and nursing interventions?
• After administering morphine sulfate to a client with severe burns and severe pain, which indicator best reflects that the pain is under control?
• In COPD management, maintaining an oxygen saturation of 90-92% is primarily to prevent which complication?
• Which measure should the nurse implement to decrease infection risk for a client with a clean wound?
• In suspected colon cancer, diarrhea is a symptom along with a palpable mass. The cancer is most likely located in which segment of the colon?
• What are typical signs of right-sided heart failure?
• Which initial management steps are included in MONA for suspected acute coronary syndrome?
• In suspected bacterial meningitis, which intervention should the nurse implement first to maintain safety and improve outcome?
• What are the main steps in the initial management of diabetic ketoacidosis?
• For a patient with an Allow Natural Death (AND) order, which medication order would be appropriate to manage nausea?
• A 67-year-old male presents to the ED with urinary symptoms. Which condition is a potential diagnosis?
• Which action best supports meeting a patient’s spiritual needs in end-of-life care?
• Which dysrhythmias are considered life-threatening after myocardial infarction?
• Why is knowing the CKD stage important for drug dosing?
• Which assessment finding is most indicative of hepatitis?
• When interpreting arterial blood gas results, what is the first step to identify the primary disturbance and compensation?
• In managing a client with chlamydia, which actions are appropriate?
• What are the indications and contraindications for thrombolysis in acute ischemic stroke?
• Which factors increase delirium risk in older hospitalized patients?
• What is a common adverse effect of oral iron therapy that patients should be educated about?
• Which of the following is a correction for ulcerative colitis nonpharmacologic management (stress-related)?
• Which steps are essential in preoperative assessment and consent considerations?
• What is the first step in managing a suspected spinal injury in trauma?
• Which instruction should be included when teaching hand hygiene for staff members?
• What is the first step the LPN/LVN should take when performing ostomy care?
• Which symptom would be least expected in a patient with acute pyelonephritis?
• A newly admitted patient presents with acute pyelonephritis. Which initial diagnostic test should be obtained?
• In counseling a client diagnosed with basal cell carcinoma, which statement is most accurate?
• A client with venous thromboembolism is being treated. Which finding would indicate improvement in the affected leg?
• How do STEMI and NSTEMI differ in urgency and reperfusion strategies?
• Following a provider's order for trimethoprim-sulfamethoxazole to complete the full course of therapy, the nurse should:
• What hand hygiene instruction should be included when teaching unlicensed assistive personnel?
• How can you clinically distinguish stable angina from unstable angina?
• Which urinalysis finding is most consistent with a urinary tract infection?
• What are early signs of cardiogenic shock and what nursing actions are essential?
• In a client with adrenal crisis and suspected hyperkalemia, which ECG finding would you expect to see?
• Which statement correctly identifies a common cause of constipation in postoperative patients and its management?