PN Med-Surg
See correct answers immediately with detailed explanations after each question.
Answer all questions, then review your results with feedback at the end.
Timed simulation that mimics real exam conditions. No feedback until completion.
Below are sample questions from this exam to help you understand the content and format.
Q1: A nurse is preparing to begin a 24-hour urine collection for a client. Which of the following actions should the nurse take?
Answer Choices:
To ensure accurate timing of a 24-hour urine collection, the nurse should discard the first voided urine and begin timing from that point. All urine passed afterward should be collected for the next 24 hours.
Option 2: The urine should be stored in a refrigerated or ice-cooled container, not at room temperature, to prevent bacterial growth and preserve the sample.
Option 3: All urine must be collected—if any is missed, the test is invalid. The test would need to be restarted, not simply documented.
Option 4: A notice is appropriate, but it should be placed in a discreet location, such as the bathroom, not on the client's door, to maintain privacy.
Q2: A nurse is contributing to the plan of care for a client who has urolithiasis. Which of the following interventions should the nurse include in the plan?
Answer Choices:
or a client with urolithiasis (urinary stones), increasing fluid intake to at least 3 L/day helps flush the urinary system, promotes stone passage, and prevents new stone formation by diluting the urine.
Option 1: Bed rest is not recommended; activity helps move the stone through the urinary tract unless contraindicated by pain or medical condition.
Option 2: A high-protein diet can increase the risk of certain types of stones (e.g., uric acid stones), so it's generally not advised.
Option 4: A decrease in urine output may indicate obstruction or worsening condition and is not expected—it should be reported immediately.
Q3: Which of the following nursing interventions is appropriate for managing urinary incontinence?
Answer Choices:
Option 3: Kegel exercises strengthen the pelvic floor muscles, which is especially beneficial for clients with stress or urge incontinence.
Incorrect Options:
Option 1: While hydration is important, excessive fluid intake can worsen incontinence in some cases. Fluid intake should be balanced, not necessarily increased for this purpose.
Option 4: Limiting access to the restroom can lead to accidents and worsen the problem. It is not a therapeutic intervention.
Option 2 (Providing frequent reminders) is helpful, especially for cognitively impaired clients, but it is more of a compensatory strategy, not a corrective one.
Q4: A nurse is caring for a client who is receiving hemodialysis. Which of the following client measurements should the nurse compare before and after dialysis treatment to determine fluid losses?
Answer Choices:
Body weight is the most accurate indicator of fluid loss during hemodialysis. The difference between the client's pre- and post-dialysis weight reflects the amount of fluid removed during the treatment.
Option 2: Blood pressure may change with fluid removal but is not a reliable measurement of total fluid loss.
Option 3: Neck vein distention can indicate fluid overload but is subjective and not precise for measuring loss.
Option 4: Abdominal girth is used for ascites, not routine fluid status during dialysis.
Q5: A charge nurse overhears a newly licensed nurse providing instructions to a female client on the proper steps to collect a midstream urine specimen. Which of the following statements made by the newly licensed nurse requires the charge nurse to intervene?
Answer Choices:
Option 3 requires intervention because cleansing the perineal area should be done using a front-to-back motion (from the urethra toward the anus) to prevent introducing bacteria from the rectal area into the urinary tract. A back-and-forth motion increases the risk of contamination and urinary tract infection (UTI).
Option 1: Correct — Starting the stream first allows contaminants to be flushed away before collecting the sample.
Option 2: Correct — Removing the container before the stream stops prevents contamination from residual urine.
Option 4: Correct — Using the non-dominant hand to spread the labia helps keep the area exposed while collecting the specimen with the dominant hand.
