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Medical Surgical Nursing NCLEX RN Questions Questions

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Question 1 of 5

A 38-year-old female client with a history of breast-conserving surgery, axillary node dissection, and radiation therapy reports that her arm is red, warm to touch, and slightly swollen. Which of the following actions should the nurse suggest?

Correct Answer: C

Rationale: Redness, warmth, and swelling suggest cellulitis, a serious infection in a client with a history of axillary node dissection, requiring immediate medical evaluation.

Question 2 of 5

Which of the following is normal for a client during the icteric phase of viral hepatitis?

Correct Answer: B

Rationale: The icteric phase involves jaundice, causing yellowed sclera (
B) due to bilirubin buildup. Tarry stools (
A) indicate bleeding, not typical. Shortness of breath (
C) and frothy urine (
D) are unrelated.

Question 3 of 5

Upon assessment of third degree heart block on the monitor, the nurse should first:

Correct Answer: C

Rationale: Third-degree heart block may require pacing. Having transcutaneous pacing ready is the first step to manage symptomatic bradycardia.

Question 4 of 5

The nurse should instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?

Correct Answer: C

Rationale: Vitamin B12 is primarily found in animal products, such as meats and dairy products, making them the best dietary sources. Whole grains, green leafy vegetables, broccoli, and brussels sprouts contain little to no vitamin B12. Clients with B12 deficiency, such as those with pernicious anemia, should be encouraged to consume meats and dairy to meet their B12 needs.

Question 5 of 5

The nurse's discharge teaching plan for the client with heart failure should stress the importance of which of the following?

Correct Answer: C

Rationale: Daily weights at the same time detect fluid retention early, a key strategy to prevent heart failure exacerbations.

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