Medical-Surgical Nursing Exam 1: Questions and Answers, Exams of Medicine

Download Medical-Surgical Nursing Exam 1: Questions and Answers and more Exams Medicine in PDF only on Docsity!

Medical-Surgical Nursing Exam 1

questions and answers

The nurse is caring for a client who has as a son with a streptococcus throat infection. Which nurse recommendation would be best to advise the client to do in order to prevent acquiring the infection? - ANSWER>>Frequently wash her hands and surfaces of the home.

The nurse is caring for a client infected with Rocky Mountain spotted fever. The nurse should ask if the client has experienced which of the following? - ANSWER>>Was bitten by a tick

The nurse is caring for a client with a protozoa infection. Which is the most likely mode of transmission? - ANSWER>>Ingestion of contaminated food or water

The nurse is caring for a client who is recovering from an allergic reaction. Which leukocyte level would the nurse expect to be the most elevated? - ANSWER>>Eosinophils

The nurse is caring for a client who has an infected wound on the great toe that is red with a purulent exudate. The nurse expects that this client has which type of infection? - ANSWER>>Localized

The client experienced a fall. Nursing assessment reveals that the client is experiencing tachycardia, hypotension, confusion, tachypnea, and flat jugular veins. What should be the nurse's first response? - ANSWER>>Administer oxygen.

The family wants to know why the nurse is putting a urinary catheter in a client experiencing shock. What is the nurse's best response? - ANSWER>>"It will help monitor how much urine the kidneys are able to produce."

A client experiencing shock has had a urinary output of 250 mL in the last 10 hours. What is the nurse's most appropriate response? - ANSWER>>Notify the physician.

Which client is most likely to be experiencing hypovolemic shock? - ANSWER>>A client who had surgery 24 hours ago and who also has a nasogastric tube

The physician has ordered arterial blood gases for a client experiencing shock. The nurse knows that which value indicates shock? - ANSWER>>pH 7.

A 63-year-old Arab American male states his left leg is "hot." What is the nurse's best first response? - ANSWER>>Assess for pain

The client is complaining of excruciating pain in a foot that has been amputated. The family tells the nurse that the client is just addicted to pain medications. What is the nurse's best response? - ANSWER>>"He is experiencing phantom limb pain."

A client has had abdominal surgery and has orders to be ambulated three times a day. Oral pain medication has been ordered for the client. What should the nurse do to facilitate ambulation?

• ANSWER>>Mediate 1 hour prior to ambulating the client.

The client reports frequent use of acetaminophen. How should the nurse best respond? - ANSWER>>"Do you drink alcohol?"

A client with chronic pain has been admitted with a fever. The nursing assessment reveals that the client has a decreased level of consciousness. What should the nurse ask the family about? - ANSWER>>What medications the client has taken

The practical nurse is reviewing the social history from a client diagnosed with small cell carcinoma of the lung. Which information is significant for this disease? - ANSWER>>The client has smoked two (2) packs of cigarettes a day for 20 years

The practical nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients on a medical unit. Which information provided by the UAP warrants immediate intervention by the practical nurse? - ANSWER>>The client receiving Procrit (epoetin alfa) has a T 99.2˚F, P 68, R 24, and BP of 198/

The client diagnosed with lung cancer has been told the cancer has metastasized to the brain. Which intervention should the practical nurse expect to implement? - ANSWER>>Discuss implementing an advance directive

The client diagnosed with lung cancer is being discharged. Which statement made by the client indicates a reiteration of information is required? - ANSWER>>"It doesn't matter if I smoke now. I already have cancer."

Elevated blood pressure

A patient is diagnosed with an infection that has spread to the blood stream. Which term should the nurse use to document this patient's health problem? - ANSWER>>Sepsis

The nurse learns that a patient is being admitted with an infectious disease that is transmited through the air. For which health problems should the nurse prepare to provide care?

Select all that apply. - ANSWER>>Measles Tuberculosis Chickenpox

A patient is diagnosed with Rocky Mountain spotted fever. What should the nurse explain as the method by which this disease was transmitted to the patient? - ANSWER>>Ticks

A patient returning from the recovery room following abdominal surgery to drain an abscess has a nonsuction-type drain placed in the wound bed to allow drainage. Which drain should the nurse expect to see? - ANSWER>>Penrose drain

A patient has an epidural catheter placed for pain control. Which medications should the nurse question before providing them to the patient during routine medication administration?

Select all that apply. - ANSWER>>Aspirin 325 mg by mouth once a day

Warfarin (Coumadin) 2.5 mg by mouth every evening

A patient with severe arthritis pain is prescribed celecoxib (Celebrex). What should the nurse instruct the patient about this medication? - ANSWER>>Take with food.

The nurse is caring for a patient exposed to a toxin. Which is the most potent lethal toxin? - ANSWER>>Botulinum

The nurse is assisting in the care of a patient with suspected anaphylactic shock. Which orders should the nurse question?

Select all that apply. - ANSWER>>Morphine 2 mg intravenous (IV) now

Transfuse with 1 unit of packed red blood cells over 1 hour

The nurse is preparing to assess a patient receiving chemotherapy and radiation for adverse effects of the treatments. In which order (1-5) should the nurse assess the patient for these adverse effects? Place the effects in the order in which they should be assessed. - ANSWER>>Emesis Infection Bleeding Tiredness Skin changes

The nurse is caring for a patient who has just returned from an endoscopic examination of the esophagus. Which is the most important observation the nurse should make before offering the patient food and water? - ANSWER>>Test for an intact gag reflex.

A patient is experiencing a drop in blood pressure. What should the nurse expect to assess in this patient?

Select all that apply. - ANSWER>>Epinephrine is released.

The heart beats faster and stronger.

The body retains sodium and water.

Blood is shunted away from the skin, intestines, and kidneys.

The nurse is evaluating care provided to a patient with a fractured humerus. Which observations indicate that nursing care has been effective?

Select all that apply. - ANSWER>>Palpable pulses

Normal skin color

Capillary refill time 2 seconds

Pain level 2 on a scale of 1 to 10

A patient is diagnosed with conjunctivitis. The nurse should explain that the patient was infected via which mechanism? - ANSWER>>Vehicle-borne

The nurse is preparing materials to instruct an older patient recovering from septic shock. What should the nurse keep in mind when teaching this patient?

Select all that apply. - ANSWER>>Speak slowly and clearly.

Speak in a low-pitched tone.

Provide materials in large print.

Involve family members in teaching.

During the primary survey, the nurse has determined that the airway is unobstructed, but the patient is not breathing. What action should take priority? - ANSWER>>Ventilate the patient immediately

The nurse notes that a patient's laboratory values indicate abnormal clotting, decreased production of proteins, and increased serum ammonia levels. Which organ should the nurse suspect is damaged in this patient? - ANSWER>>Liver

The nurse is preparing to administer an opioid analgesic. Which assessment findings should be evaluated and documented prior to administering the medication? - ANSWER>>Pain level and respiratory rate

A patient is diagnosed with an illness caused by a prion. The nurse should plan patient care for which diseases process? - ANSWER>>Creutzfeldt-Jakob syndrome

A patient is prescribed an antibiotic to treat a lung infection. What should the nurse emphasize to the patient about this medication?

Select all that apply. - ANSWER>>Take all of the medication as prescribed.

Report evidence of side effects to the HCP.

A patient who was impaled on a piece of pipe is brought to the emergency department with a piece of metal rod protruding from the lower chest area. Which action should the nurse take first? - ANSWER>>Apply a bulky dressing around the impaled object.

A patient is having a regional block where a tourniquet is placed on an extremity to reduce the blood in the extremity and then have a local agent injected into the extremity. What type of block should the nurse document? - ANSWER>>Bier block

The nurse is reviewing cancer statistics prior to obtaining morning report for a group of oncology patients. Which cancer does the nurse realize is associated with the highest mortality rate? - ANSWER>>Lung cancer

A patient has been receiving 10 mg morphine IV every 4 to 6 hours for postoperative pain. At discharge, the patient rates the pain as a 4 on a 0-10 scale. On a prescription to be given to the patient at discharge, the physician has written morphine 10 mg by mouth four times a day as needed. What should the nurse do first? - ANSWER>>Contact the physician regarding the prescription.

A patient is experiencing moderate-to-severe pain. Which pain medication should the nurse expect to be prescribed for this patient? - ANSWER>>Morphine

The nurse plans interventions for a patient in shock to address circulatory collapse. What is the goal for this patient's care? - ANSWER>>Prevent organ damage

The nurse is caring for a patient with preexisting liver dysfunction experiencing shock. Which acid-base imbalance should the nurse anticipate this patient developing? - ANSWER>>Metabolic acidosis

An older patient receiving antibiotics for an abdominal wound infection develops a fever and diarrhea. What treatment should the nurse prepare to provide to this patient?

Select all that apply. - ANSWER>>Provide metronidazole (Flagyl) if prescribed.

Provide vancomycin (Vanocin) if prescribed.

Use hand washing with soap and water after all patient care.

Stop the administration of the currently prescribed antibiotic.

Eliminate foods containing lactose from the diet.

Incorporate apples, strawberries, and citrus foods with each meal.

A patient is prescribed to receive an NSAID and an opioid medication at the same time. What should the nurse do when preparing these medications for the patient? - ANSWER>>Provide the medication together as prescribed.

The nurse is providing information for a patient who wishes to limit analgesic use and instead utilize alternative or complementary therapies. Which cognitive-behavioral methods for treating pain should the nurse include in the teaching?

Select all that apply. - ANSWER>>Distraction Biofeedback Guided imagery Relaxation exercises

A family member of a patient in shock says that being in shock should not be that critical because it can be treated. What should the nurse explain about the major body damage caused by shock? - ANSWER>>Inadequate oxygen delivered to cells

A patient with extracardiac obstructive shock is diagnosed with a condition that causes blood to fill the sac around the heart, compressing it and limiting its filling capacity. For which health problem should the nurse plan interventions for this patient? - ANSWER>>Pericardial tamponade

The nurse is reviewing the process of pain perception and control. In which group of chemical substances should the nurse find prostaglandins and substance P? - ANSWER>>Neurotransmitters

During a home visit, the nurse is collecting data from a patient recovering from spinal surgery conducted 3 weeks ago. Which wound finding should the nurse expect in the patient? - ANSWER>>Raised scar

The nurse is assisting in the care of a patient admitted with suspected carbon monoxide poisoning. Which laboratory value should the nurse evaluate first? - ANSWER>>Carboxyhemoglobin

Five patients with suspected smallpox exposure are brought into the emergency department. What actions should the nurse take to prevent exposure to other patients and health care personnel?

Select all that apply. - ANSWER>>Cleanse room surfaces with ammonia.

Apply surgical masks to each of the patients.

Place the patients' laundry and linens in biohazard bags.

Staff should wear fit-tested N95 respirators if not vaccinated against smallpox.

The nurse is planning interventions for a patient with shock. On which body organ should the nurse focus interventions first? - ANSWER>>Kidneys

During morning report, the nurse caring for a patient experiencing chronic pain doubts the patient is in pain and does not want to provide any pain medication all shift. What myths about pain should the nurse manager review with the nurse?

Select all that apply. - ANSWER>>Pain is often overtreated

A patient who is talking on the phone and laughing is not really in pain.

Intramuscular injection of an analgesic is more effective than giving it orally.

Addiction to opioids given to relieve pain is common, especially in teenagers.

Morphine has a ceiling effect; therefore, its use should be reserved for severe pain.

A patient is diagnosed with distributive shock. What should the nurse explain to the family as the cause of this type of shock? - ANSWER>>Excessive dilation of venules and arterioles

A college student is brought into the emergency department with possible frostbite of both feet after losing consciousness in a snow drift while walking home from a party. What actions should the nurse take at this time?

Select all that apply. - ANSWER>>Handle the feet gently.

A patient is experiencing blurred vision, dysphagia, dysphonia, dysarthria, diplopia, and descending flaccid paralysis. For which type of poisoning should the nurse plan care for this patient? - ANSWER>>Botulism

A patient suffered a head injury in a boating accident. Upon admission, the patient is conscious and responsive to questions. About 2 hours later, the patient reports headache, nausea, and drowsiness and has slurred speech. Which of the following nursing actions is best? - ANSWER>>Raise head of bed.

The transmission of genetic information in the cell involves several steps. Place the following steps in order (1-5) as they occur. - ANSWER>>DNA replicates, forming mRNA.

mRNA attaches to a ribosome.

tRNA carries amino acids to the ribosome.

mRNA leaves the nucleus of the cell.

Peptide bonds form between amino acids.

A patient is diagnosed with shingles. What organism should the nurse explain as causing this health problem in the patient? - ANSWER>>Varicella zoster

A patient is being treated for anaphylactic shock caused by a hornet sting. What should the nurse ensure occurs before the patient is discharged? - ANSWER>>Receive a prescription for epinephrine auto-injector.

The nurse is reviewing risk factors for the development of lung cancer. What percentage of lung cancer is related to smoking in men? - ANSWER>>90%

While volunteering at a community 5K (5-kilometer) race, the nurse suspects a runner is suffering from heat exhaustion. What manifestations did the nurse assess in this runner?

Select all that apply. - ANSWER>>Dizziness Vomiting Irritability Temperature 100.5°F

A patient is scheduled for a diagnostic test used to outline tissue density and masses within the pelvis and breast. Which diagnostic test is this patient having? - ANSWER>>Ultrasound

A patient is diagnosed with the Epstein-Barr virus. Epstein-Barr put the patient at increased risk for which type of cancer? - ANSWER>>Lymphoma

A patient with chronic renal failure has been diagnosed with a foot wound. What should the nurse expect when antibiotic orders are written by the health care provider (HCP)? - ANSWER>>Prescribed dose will be lower than recommended.

A patient rates a pain level of 5 on a scale of 0 to 10. Which type of analgesic should the nurse prepare to provide the patient? - ANSWER>>Low-dose opioid

In the perianesthesia care unit, the nurse monitors the patient's temperature, pulse rate, respiration rate, blood pressure, and pain level. What additional bodily function should the nurse monitor in this patient? - ANSWER>>Oxygen saturation

The nurse is reviewing pain control approaches in preparation for a patient care conference. Which theory of pain developed in the mid-1960s should the nurse realize is most likely being used for patient pain control today? - ANSWER>>Gate

A patient is diagnosed with a type of cancer that affects the skin and urinary system. What term should the nurse use to describe this type of cancer? - ANSWER>>Carcinoma

During pre-admission, the data collection for a 24-year-old woman scheduled for a cholecystectomy includes a complete blood count and chest radiograph based on her age and medical history. What other test should the nurse anticipate being ordered? - ANSWER>>Pregnancy test

A 2-day postoperative patient is receiving 1000 mL normal saline over 10 hours. The patient has an intake of 4 ounces of orange juice, one 8-ounce cup of coffee, 3 cups of water, and 1 cup of tea. This patient has a total intake of _________ mL over the 12-hour period. - ANSWER>>

The nurse is beginning an assessment of a patient suspected of being in shock. What should the nurse do first? - ANSWER>>Determine if the airway is patent.

While reviewing laboratory results the nurse suspects that a patient receiving chemotherapy for cancer has reached the nadir. What action(s) should the nurse take at this time?

Select all that apply. - ANSWER>>Maximize infection control practices.

Closely examine the skin and mucous membranes for bleeding.

A patient diagnosed with hypovolemic shock has an estimated blood loss of 500 mL, 250 mL of emesis, and 250 mL of insensible water losses. The health care provider prescribes the patient to receive 3 mL of 0.9% normal saline via IV infusion to replace each mL of fluid loss to be infused over 24 hours. How many mL of the fluid should the patient receive each hour? Calculate to the nearest whole number. - ANSWER>>

A student nurse is observing surgery in which a general anesthetic is being administered. After the intravenous (IV) induction agent is given, what action should the nurse anticipate the anesthesia provider will take next? - ANSWER>>Use an endotracheal tube to intubate the patient.

A patient is prescribed a dose of ondansetron (Zofran) before surgery. What should the nurse explain to the patient about the purpose of this medication? - ANSWER>>Reduces emesis

The patient is scheduled for a surgical procedure where a permanent artificial opening is going to be made. Which suffix should the nurse use when documenting this patient's surgery? - ANSWER>>-ostomy

The nurse is explaining cancer to a group of community members. Which should the nurse use as the best definition of cancer? - ANSWER>>A cluster of disorganized cells that grow out of control

A patient is having procedural sedation and analgesia for a short surgical procedure. How often should the nurse monitor the patient's vital signs? - ANSWER>>Every 5 minutes

A patient receiving amifostine (Ethyol) as a cytoprotectant asks, "Is that the medication that prevents vomiting?" What should the nurse respond to the patient? - ANSWER>>"No, this medication is given to prevent kidney damage by the chemotherapy agents."

The nurse is working on a medical surgical unit that has recently noticed an increase in the incidence of vancomycin-resistant enterococci infections. Which patients are at increased risk for vancomycin-resistant enterococci?

Select all that apply. - ANSWER>>An 84-year-old man with pneumonia who is receiving intravenous (IV) vancomycin

A 92-year-old woman with a cerebrovascular attack who has an indwelling catheter

A 74-year-old woman with lymphoma receiving chemotherapy via an implanted port

A patient is experiencing respiratory depression, constipation, nausea and vomiting, and hypotension after receiving pain medication. Which class of analgesics is this patient most likely receiving? - ANSWER>>Opioid analgesics

The nurse is doing discharge teaching with a chemotheray patient who has developed leukopenia. Which statement by the patient to the nurse indicates that additional teaching is needed? - ANSWER>>"I should report bleeding or bruising."

A patient is diagnosed with the most common type of distributive shock. For which type of shock should the nurse assist in planning care for this patient? - ANSWER>>Septic shock

Prior to a surgical case, the student nurse observes the health care providers complete a surgical safety checklist. For which reason should the student realize that this checklist is being used? - ANSWER>>Reduces errors and patient complications

A patient with botulism is admitted to the hospital for treatment. What actions should the nurse take to prevent the exposure of others?

Select all that apply. - ANSWER>>Decontaminate surfaces with bleach.

Shower with soap and water after exposure.

A community is experiencing an epidemic of chickenpox within school age children. The nurse should realize that which of the following factors results in a more than 80% infection rate among those exposed? - ANSWER>>The causative virus has three modes of transmission.