NR 1720 MED SURGE FINAL EXAM QUESTIONS AND CORRECT ANSWERS 2023A+, Exams of Nursing

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- Pain

1. The nurse who is a member of the palliative care team is assessing a patient. The patient indicates that he has been saving his PRN analgesics until the pain is intense because his pain control has been inadequate. What teaching should the nurse do with this patient? a. Medication should be taken when pain levels are low, so the pain is easier to reduce.
2. You are the nurse in a pain clinic caring for an 88-year-old man who is suffering from long-term, intractable pain. At this point, the pain team feels that first-line pharmacological and nonpharmacological methods of pain relief have been ineffective. What recommendation should guide this patients subsequent care? a. The patient may benefit from referral to a neurologist or neurosurgeon to discuss pain- management options.
3. You are the emergency department (ED) nurse caring for an adult patient who was in a motor vehicle accident. Radiography reveals an ulnar fracture. What type of pain are you addressing when you provide care for this patient? a. Acute
4. Which medication given for pain irreversibly inhibits the aggregation of platelets necessary for blood clot formation? a. Acetaminophen b. Aspirin c. Naproxen Sodium d. Morphine
5. Which patients should be careful when using opioid analgesics because of the effect histamine may have on the bronchioles of the lungs? a. Congestive heart failure b. Hypertension c. Diabetes d. Asthma

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6. Nonopioid analgesics include SATA a. Morphine b. Acetaminophen c. Ketoprofen d. Hydromorphone e. Nonsteroidal anti-inflammatory drugs (NSAIDS)
7. The patient has pain in the lower back that radiates down the leg as the result of a herniated disk compressing the sciatic nerve that began four months ago. When documenting this patient’s pain, which term will the nurse use? a. Acute somatic pain b. Acute visceral pain c. Acute neuropathic pain d. Chronic neuropathic pain
8. The nurse is caring for a patient who is experiencing acute chest pain that is rated 9 on a 0- pain scale. Based on this data, which medication does the nurse plan to administer? a. Morphine
9. What physiological signs indicate the presence of inflammation? a. Swelling and redness, pain and warmth, loss of function, (all of the above)
10. Which of the following is an accurate statement about opioid analgesics? a. It is held that opioids can relieve virtually any type of pain
11. What reason would the nurse have to administer ibuprofen over acetaminophen when providing patient pain management? a. Anti-inflammatory effects

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12. You are the nurse in a pain clinic caring for an 88-year-old man who is suffering from long term intractable pain. At this point. The pain team feels that first-line pharmacological and non- pharmacological methods of pain relief have been ineffective. what recommendation should guide this patient’s subsequent care? a. The patient may benefit from referral to a neurologist or neurosurgeon to discuss pain management options. Fluid/Electrolyte/Acid Base
13. You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance? a. Hypovolemia
14. You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand, and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect? a. HYPOcalcemia
15. A nurse is planning care for a nephrology patient with a new nursing graduate. The nurse states, A patient in renal failure partially loses the ability to regulate changes in pH. What is the cause of this partial inability? a. The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH.
16. One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acute-care nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following? a. Help distinguish reduced renal flow from decreased

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5. A client presents with shortness of breath and confusion and is subsequently diagnosed with COPD exacerbation. Arterial blood gases are as follows: pH 7.29, pCO2 64, HCO3 31, pO2 74. Which accurately describes the client’s condition? a. Uncompensated respiratory acidosis
6. A client is admitted with severe pneumonia, hypotension, confusion, and leukocytosis. Septic shock is expected. Arterial blood gases are as follows: pH 7.30, pCO2 28, HCO3 12, pO2 51. Which best describes the client’s condition? a. Uncompensated metabolic acidosis
7. What are the primary intracellular electrolytes? a. Potassium, Phosphate, and Magnesium
8. The nurse is caring for a client admitted to the medical unit 72 hours ago with pyloric stenosis. A nasogastric tube is placed upon admission and has been on low intermittent suction ever since. Upon review of the morning’s blood work, the nurse notices that the client’s potassium level is below reference range. The nurse should assess for s/s of what imbalance? a. Metabolic Alkalosis
9. A client presents to the emergency department with shortness of breath, bibasilar crackles in the lungs and severe edema to bilateral lower extremities. The client’s labs are as follows: serum sodium 131 mEq/L, serum potassium 3.2 mEq/L, blood urea nitrogen 57 mg/Dl and creatinine 2.2 mg/dL. Which lab values is suggestive of volume overload in the chambers of the heart as caused by congestive heart failure? a. Increased urine osmolality b. Decreased WBC count c. Increased B-type Natriuretic Peptide d. Decreased platelet count

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10. Hyperkalemia in patients with adequate renal function is oftentimes associated with which of the following conditions? a. Acute confusion b. Myocardial infarction c. Excessive flatulence d. Acidosis
11. The nurse is caring for a client with a serum sodium level of 118 mEq/L. The client has been non- responsive and is beginning to show signs of seizure like activity. The nurse anticipates which of the following orders? a. 3% hypertonic saline infusion b. Normal saline infusion c. Albumin infusion d. 1 ampule sodium bicarbonate
12. The nurse is caring for a patient with hypervolemia secondary to congestive heart failure. In addition to a fluid restriction, the nurse should expect that the physician will order which dietary restriction? a. Low sodium b. Low carbohydrates c. Low protein d. Low residue
13. Which is not an appropriate intervention for a client with a potassium of 2.9 mEq/L? a. Assess serum magnesium level b. Monitor for EKG changes c. Administer potassium chloride IV at 100 mL/hr. d. Administer a potassium chloride bolus
14. When planning the care of a patient with a fluid imbalance, the nurse states understand fat in the human body water and electrolytes move from the arterial capillary bed to the intestinal fluid.

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What causes this to occur? a. Hydrostatic pressure resulting from the pumping action to the heart

15. The nurse is called to a client’s room by a family member with a concern about the client’s status, on assessment, the nurse finds the client tachypneic, lethargic, weak, and exhibiting a diminished cognitive ability. The nurse identifies 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this clients’ signs and symptoms? a. HYPERchloremia
16. A nurse is evaluating a patients fluid balance by monitoring the patient’s I/O’s. which much the nurse understands about the ratio of the output? a. Intake should be slightly more than the output
17. For an individual experiencing an intracellular fluid deficit, an appropriate nursing intervention would be to? a. Observe for an increase in temperature
18. Sensible fluid loss includes? SATA a. Urine b. Feces c. Wound
19. A patient who had a recent surgery has been vomiting and becomes dizzy while standing up. After assisting the patient back to bed, the nurse notes that the patients BP is 55/30 and pulse is 140bpm. Which IV fluid would be most effective in correcting the situation? a. 0.9 NS
20. The nurse is providing care for a patient with chronic obstructive pulmonary disease. When describing the process of respiration, the nurse explains how oxygen and carbon dioxide are exchanged between the pulmonary capillaries and alveoli. The nurse is describing what process? a. Diffusion

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21. You are the nurse evaluating a newly admitted patients laboratory results, which includes several values that are outside the reference ranges. Which of the following would cause the release of anti- diuretic hormone (ADH)? a. Increased Serum Sodium
22. When are Baroreceptors Activated? a. When the Blood Pressure is Elevated.
23. The nurse is caring for a client who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. The client reports a new onset of weakness with abdominal pain and further assessment suggests that the client likely has a fluid volume deficit. The nurse should recognize that this client may be experiencing what electrolyte imbalance? a. HYPERcalcemia
24. A medical nurse educator is reviewing a patient's recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of kidneys in metabolic acidosis? a. The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. Respiratory
25. A patient postoperative day #1 after his endoscopic retrograde cholangiopancreatography (ERCO) procedure. The nurse is educating the patient on first-line measures to prevent post-op complications. Which statement by the patient indicates successful teaching? a. I’ll use the incentive spirometer as often as I can. It might be harder to suck in and hold my breath very long at first.
26. A nurse is counseling a patient with COPD on the use of purse-lip breathing. The patient asks the nurse about the purpose of this type of breathing. What is the nurse’s best response? a. Pursed-lip breathing slows breaths, prolongs expiration, and prevents collapse of small airways.
27. The nurse is caring for a client with COPD who is admitted with an exacerbation. He does not

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wear oxygen at home. The nurse sees an order for oxygen via nasal cannula a 4L/min. What should the nurse be monitoring for during the first hour of oxygen therapy? a. Hypoventilation

4. A patient asked the nurse why an infection in his upper respiratory system is affecting the clarity of a speech. Which structure serves as the patient’s resonating chamber in speech? a. Paranasal Sinuses.
5. A perioperative nurse is caring for a postoperative patient. The patient has shallow respiration patterns and is reluctant to cough or begin mobilizing. The nurse should address the patient's increased risk. For what complication? a. Atelectasis
6. A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate? a. Preparing to assist with intubating the client
7. The decision has been made to discharge a ventilator dependent patient home. The nurse is developing a teaching plan for this patient and his family. What would be the most important to include in this teaching plan? a. Signs of pulmonary infection.
8. The nurse is assessing a patient for tracheal displacement. She knows that the tracheal will deviate toward the: a. Contralateral side of the hemothorax - UNEFFECTED SIDE
9. On auscultation which finding suggest pulmonary congestion? a. Bilateral inspiratory and expiratory crackles.
10. The healthcare provider prescribed albuterol sulfate pro ventilatory patient with newly diagnosed asthma. When teaching the patient about this drug, the nurse should explain that it may cause all of the following EXCEPT:

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a. Lethargy

11. The patient has idiopathic pulmonary fibrosis. What respiratory pattern would the nurse expect to see in this patient? a. Shallow, Rapid Respirations
12. A drowning victim is brought in from the community pool with SA 02 79%, heart rate 130 in pulmonary edema progressing to acute respiratory distress syndrome ARDS. The nurse can immediately expect to carry out which of the following interventions as a part of the client’s care? a. Administer corticosteroids such as solumedrol, antibiotics, and turn to encourage coughing in deep breathing.
13. a nurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma? a. Anti-inflammatory drugs.
14. As an older patient with respiratory problems tells the nurse that she doesn’t need the influenza vaccine because she had the flu shot last year. She asked if the current influenza shot vaccines against the same free viruses as last year. What is the nurse’s best response? a. The influenza vaccine from last year is only effective for about six months, so you should take the vaccine again this year.
15. A postoperative patient with obstructive lung disease is receiving oxygen at 2L per minute via nasal cannula. The clients spouse reports feeling? She asked the nurse to increase the oxygen intake to help the client breathe easier. Which response by the nurse is most appropriate? a. Explain to the spouse that the high concentrated oxygen may depress breathing.
16. While the nurse is changing the dressing and ties on a tracheostomy tube, the patient coughs and dislodges the tube. The nurse should first: a. Grab the retention sutures to spread the opening and reinsert the tube.
17. A student was rushed to the hospital due to vomiting and decreased level of consciousness. The patient displays slow and deep (Kussmauls Breathing), and he is lethargic and irritable in response to

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stimulation. He appears to be dehydrated- and his eyes are sunken and mucous membranes are dry, they have a 2-week Hx of polydipsia, polyuria, and weight loss. Measurement of atrial blood gas shows pH 7.0, PaO2 90mm, PaCO2 23mm, and HCO2 12 mmol/L; Other results are Na+ 126, K+ 5, and Cl 95, Glucose 543. What is your assessment? a. Metabolic Acidosis.

18. A patient has the following arterial blood gases: HCO3 36, pH 7.52, PaCO2 54. Which of the following signs may this patient exhibit as a compensatory mechanism? a. Hypoventilation (Bradypnea)
19. A 12-year-old is admitted to the ER with diagnosis of status asthmatics. What are the nurses first action? a. Give supplemental oxygen and start IV line so that IV bronchodilators and corticosteroids can be given.
20. Roger, a lung cancer patient is being cared for after a left pneumonectomy. He has a chest tube in place for drainage. In giving care for this patient the nurse must: a. Encourage coughing and deep breathing
21. What is a priority assessment for the patient who has undergone posterior nasal packing one hour ago for a posterior nosebleed? a. Assessing adequacy of the patient’s airway.
22. A patient has been diagnosed with pulmonary hypertension, in which the capillaries in the alveoli are squeezed tightly. The nurse should recognize a disturbance. In what aspect of normal respiratory function? a. Perfusion
23. A college student falls and hits her head on the ground. “911” is called because the student is unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid base balance is the patient at risk for if medical attention is not provided?

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a. Respiratory Acidosis

24. A patient with moderately severe asthma has been told to stop taking her beta-blocker which she has been on for five years. Another medication is to be prescribed for her hypertension. She asks why this is being done. What is the best explanation the nurse can provide? a. Beta receptors on your lungs can cause your airway to relax. If these receptors are blocked, the airways can constrict.
25. Your patient is an obese male. When you auscultate the lungs, you hear friction rub. What symptoms might you expect the patient to report? a. Pain in the area of friction rub, especially with deep inspiration.
26. A 35-year-old recent immigrant is being seen in the clinic for complaints of cough that is associated with rust colored sputum, low grade afternoon fever, and night sweats for the past two months. The nurse preliminary analysis, based on history, is that the patient may be suffering from: a. Tuberculosis
27. A 21-year-old colleague student is brought to the emergency department with an open sucking stab wound to the chest. What should the nurse due immediately to prevent a tension pneumothorax from forming? a. Apply a dressing over the wound and tape it on three sides.
28. When assessing for substances that are known to harm workers lungs, the Occupational Health Nurse should assess their potential exposure to which of the following? a. Asbestos.
29. This School nurse is presenting a class on smoking cessation at the local high school. A participant in the class as a nurse about the risks of lung cancer and those who smoke. What response related to risk for lung cancer in smokers is most accurate? a. The younger you are when you start smoking, the higher your risk of lung cancer.
30. Question about delegation to the NAP a. CAN NOT provide info on trach care after procedure
31. A patient with a severe exacerbation of COPD requires reliable and precise oxygen delivery. Which

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mask will the nurse expect the physician to order? a. Venturi Mask

32. The nurse is assessing a patient who has a chest tube in place for the treatment of a pneumothorax. The nurse observes that the water level in the water seal rises and falls in rhythm with the patient’s respirations. How should the nurse best respond to this assessment finding? a. Document that the chest drainage system is operating as it is intended
33. Question about comparing thorax sounds? a. You compare SIDE to SIDE
34. A patient is having a pulmonary function. Studies performed. the patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding? a. obstructive lung disease
35. Which of the following statements is true regarding the impact of the lungs on fluid volume balance? a. The average size adult loses approximately 100mL of fluid from coughing up phlegm b. The average size adult has approximately 300-500mL of insensible fluid loss per day via the respiratory system c. Air from breathing dries the pharynx, contributing to the sensation of thirst

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d. Certain breathing patterns indicate that the client needs to continue more alkaline water

36. The nurse is caring for a patient who has just returned to the unit after a colon resection. The patient. Is showing signs of hypoxia. The nurse knows that this is probably caused by what? a. Shunting
37. While setting the patient, the nurse observes constant bubbling in the water seal Chamber of the patient's closed chest drainage system. What should the nurse conclude? a. The system has an air leak.
38. When preparing to wean, a patient from the ventilator, what assessment parameter is most important for the nurse to assess? a. Baseline arterial blood gas (ABG) levels
39. The Home Care nurse is assessing a patient requires home oxygen therapy. What criterion indicates that an oxygen concentration will best meet the needs of the patient in the home environment? a. the patient desires are portable oxygen delivery system that can deliver 2L/min.
40. The clinic nurse is caring for a patient who has been diagnosed with emphysema and who has just had a pulmonary function test ordered. The patient asks what exactly is this test for? What would be the nurse’s best response? a. A PFT measures how much air moves in and out of your lungs when you breathe.

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41. A patient is scheduled to have excess pleural fluid aspirated with a needle in order to relieve her dyspnea. The patient inquires about normal function of pleural fluid. What should the nurse describe? a. it lubricates the movement of the thorax and lungs
42. The nurse is assessing the respiratory status of a patient who is experiencing an exacerbation of her emphysema symptoms. When preparing to auscultate. What breath sounds should the nurse anticipate? a. Faint breath sounds with prolonged expiration.
43. The nurse is admitted a patient who is scheduled for a thoracic resection. The nurse is providing pre op teaching and is discussing several diagnostic studies will be required prior to surgery. Which study will be performed to determine whether the planning resection will leave sufficient functioning lung tissue? a. Pulmonary function test.
44. A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in the patient teaching? a. Cough and oral thrush.

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45. A patient is exhibiting signs of pneumothorax following tracheostomy. The surgeon inserts a chest tube into the anterior chest wall. What should the nurse tell the family is the primary purpose of this chest tube? a. To remove air from the pleural space. Cardiovascular (HTN/PVD/PAD)
46. Which medication order would the nurse question with the patient on an ACE Inhibitor for hypertension? a. Furosemide 40mg orally every day b. Potassium supplements 20 mEq orally every morning c. Hydrochlorothiazide 12.5 mg orally every day d. Magnesium 400 mg orally every night
47. The category of antihypertensive medications that work by blocking the conversion of angiotensin 1 to angiotensin II halting vasoconstriction are: A. Beta Blockers B. ACE Inhibitors C. Calcium channel blockers D. Vasodilators
48. The nurse is assessing the patient diagnosed with long-term arterial occlusive disease. Which assessment data supports the diagnosis? a. Hairless skin on the legs
49. A patient has been prescribed losartan 50mg daily. Which nursing intervention is most appropriate? a. Instruct patient to change position slowly
50. In preparation for discharge of a client with arterial insufficiency and Raynaud’s disease, client teaching should include:

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a. Keeping the heat up so that the environment is warm

6. Identify the priority medical assessment for a patient with a 10-year history of HTN? a. Fundoscopic examination of the retina
7. What is the rational for using active and passive ROM exercises? a. To treat lymphedema
8. A nurse is developing a plan of care for a patient receiving anticoagulation medicine. The nurse identifies which priority nursing dx is best for this patient? a. Risk of injury
9. Which assessment data would warrant immediate intervention by the nurse? a. The patient dx w/ a DVT and pain upon inspiration
10. During a physical assessment, a 60-year-old male patient with atherosclerosis the nurse hears a swishing sound over the left carotid artery. What is the nurse’s best action at this time? a. Hyperactive bowel sounds in that area
11. The most important factor in regulating the caliber of blood vessels, which determines resistance to flow is: a. Sympathetic nervous system
12. A client who has been receiving heparin therapy also is started on warfarin sodium (Coumadin). The client asks the nurse why both medications are being administered. In formulating a response, the nurse incorporated the understanding that warfarin sodium: a. Inhibits synthesis of specific clotting factors in the liver, and it takes 3-4 days for this medication to exert an anticoagulation effect.
13. A patient is prescribed atorvastatin. The nurse instructs the patient to watch for a report which side effect? a. Muscle cramps

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14. A 32-year-old patient with diabetes reports a sudden onset of headaches, blurred vision, and dyspnea. The pts BP is normally 120/74, but today is 200/130. What condition does the nurse suspect? a. Malignant hypertension
15. What is the recommended therapeutic range for the INR that is done alone with prothrombin time in a patient receiving warfarin sodium? a. 2-3 or 10-12 seconds
16. Which of the following is likely to occur if D5W is given continuously and oral intake is limited to ice chips? a. Intracellular fluid volume excess
17. A nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is: Normal because of the increased blood flow through the leg
18. The nurse is working with the patients at the health fair. Which teaching takes priority to reduce the risk of atherosclerosis? a. Instructing a diabetic patient not to smoke or use any tobacco
19. The most important factor in regulating the caliber of blood vessels, which determines resistance to flow is: a. The sympathetic nervous system
20. A patient who underwent peripheral arterial bypass surgery 16 hours ago complains of increase pain in the surgical leg at rest, which worsens with movement and is accompanied by paresthesia. Which action should the nurse take? a. Notify the physician
21. What is the rationale for using active and passive ROM exercises for lymphedema? a. Assist in moving lymphatic fluid into the blood stream
22. A 43-year-old construction worker has a history of hypertension. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. His

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current concern is calf pain during minimal exercise that decreased with rest. The nurse assesses Mike’s symptoms as being associated with peripheral arterial occlusive disease. The nursing dx is probably: A. Alteration in tissue perfusion r/t compromised circulation

23. What assessment data would the nurse expect to find in the patient diagnosed with chronic venous insufficiency? a. Brown discolored skin
24. The nurse is consulting with the registered dietician about the diet for a patient with chronic venous stasis ulcers. What are the dietary recommendations to help this pt promote wound healing? a. High protein foods
25. A patient is receiving thrombolytic therapy. How does the nurse monitor for the most serious complication from thrombolytic therapy? a. Performing neurologic checks and monitoring for level of consciousness
26. In preparation for discharge of a client with arterial insufficiency and Raynaud’s disease, client teaching instructions should include: a. Walking several times each day as an exercise program b. Keeping the heat up so that the environment is warm c. Wearing TED hose during the day d. Using hydrotherapy for increasing oxygenation
27. For a client experiencing fluid volume deficit, which would be an appropriate nursing intervention? a. Restrict fluids b. Contact the physician and ask for an order for diuretics c. Encourage PO fluid intake d. Position the client on their left side

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28. The nurse is caring for a patient with a large venous leg ulcer. What intervention should the nurse implement to promote healing and prevent infection? a. Provide a high calorie, high protein diet.
29. the triage nurse in the emergency department is assessing a patient who has presented with of swelling in her right lower leg. The patient's pain became much worse last night and appeared, along with fever, chills, and sweating. The patient states I hit my leg on the car door four or five days ago and it has been sore ever since. The patient has a history of chronic venous insufficiency. What intervention should the nurse anticipate for this patient? a. Antibiotics to treat Cellulitis.
30. The nurse is preparing to administer warfarin to a patient with a deep vein thrombosis. Which laboratory value would most clearly indicate that the patient’s warfarin is that a therapeutic level? a. International normalized ratio between two and three. Renal/Metabolic/Endocrine
31. Which food item should the nurse avoid giving to a client with renal disease? b. Stuffed mushrooms
32. 1kg of weight = 1L of fluid
33. Glomerular filtration rate (GFR) helps the nurse to identify: b. BUN and creatinine status c. Presence of urinary tract infection d. Functional status of the kidney e. The number of functional glomeruli in the nephron
34. A client being placed on macrodantin (a nitrofurantoin) for prophylactic treatment of a urinary tract

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infection. Which statement by the client indicates the need for further teaching? a. “Nausea is a common side effect. It is OK for me to take an antacid for that” b. “My urine may turn brown or rust colored” c. “Nausea is a common side effect. It is OK for me to take this with food or milk” d. “I should continue to drink cranberry juice to increase the acidity of my urine”

5. A patient is being treated for a newly diagnosed UTI. The patient asks the nurse if there is anything that she can do to prevent a recurrence. What would the nurse teach the patient? SATA a. Urinate after sexual intercourse b. Wipe from front to back c. Wear satin or nylon underclothing d. Drink caffeinated beverages e. Do not hold urine past the urge to void
6. What is the recommended therapeutic range for the prothrombin time (PT) that is done along with the international normalized ratio (INR) in a patient receiving warfarin sodium? b. 0.5-1. c. 1.0-1. d. 1.5-2. e. 2.0-2.
7. The nurses note states that the patient’s urine was concentrated. This finding may cause concern that the client may have what condition a. Dehydration
8. A patient with type one diabetes is told the nurse that his most recent urine test for ketones was positive. What are the nurses most possible conclusion based on this assessment finding? a. The patient's insulin levels are inadequate.
9. An adult client has a total of 300mL of urinary output in a 24-hour period. What would the nurse document this finding as? a. Oliguria

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10. A patient has just been diagnosed with type 2 diabetes. The physician is prescribing oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the position prescribed to his patient? a. A Biguanide
11. The nurse is caring for a patient with a diagnosis of deficient fluid volume. The nurse’s assessment reveals a BP of 98 / 52 mm Hg. The nurse should recognize that the patient's kidneys will compensate by secreting what substance? a. Renin
12. A patient most recent laboratory findings indicate glomerular filtration rate (GFR) of 58 mL/min. The nurse should recognize what implication of this diagnostic finding? a. the patient is likely to have increased serum creatinine levels
13. The nurse is proving care to a patient with less than 100mL of urine output in 24 hours. What term should the nurse use when documenting this finding? a. Anuria
14. Glomerular filtration rate (GFR) helps the nurse identify? a. Fluid volume excess
15. The nurse is providing discharge instructions to a client receiving trimethoprim sulfamethazine. Which instruction should be included in the list? a. Drink 8-10 glasses of water per day
16. Specific gravity of urine helps the nurse to determine if the patient’s kidney’s: a. Are able to concentrate urine adequately
17. Urine incontinence has many contributory causes. The nurse knows that caring for a patient with urinary incontinence involves: a. assessing the patient for isolation, loneliness, and depression
18. One day after the client is admitted to the medical unit the nurse determines the client is oliguric. The nurse notifies the acute care nurse practitioner who prescribes a fluid challenge of 200 mL of NS over 15 mins. This intervention will achieve what goal? a. Help distinguish renal blood flow from decreased renal function

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19. A client is being placed on macrodantin for prophylactic treatment of a urinary tract infection. Which statement by the client indicates need for further testing? a. Nausea is a common side effect; it is OK for me to take with food or milk.
20. The nurse is caring for a patient with cystitis. Which diagnostic test does the nurse anticipate will be ordered for this patient? a. Urinalysis
21. Which is a true statement in regard to daily weights? a. 1kg body weight is the equivalent of 1L of fluid b. 1 lbs. body weight is the equivalent of 1L of fluid c. The ideal time for the weight to be measured is after the client eats lunch d. Weight loss is always a positive change in the client’s condition, whether they are trying to lose weight or not
22. Which urinalysis results are indicative of cystitis? a. WBC 10-15
23. A nurse cares for a patient who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At what time should the nurse assess the patient for potential problems related to the NPH insulin? a. 1600
24. A nurse assesses a patient who has diabetes mellitus and notes the patient is awake and alert, but shaky, diaphoretic, and weak. 5 minutes after administering a 1/2 Cup of orange juice, the patient's clinical manifestations have not changed. Which action should the nurse take next? a. Administer another half Cup of orange juice

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25. A nurse assesses a patient with diabetes mellitus and notices the patient only responds to a sternal rub by moaning, has capillary blood glucose of 33 and an intravenous line that is infiltrated with 0.45 normal sailing. Which action should the nurse take first? a. Administer 1 milligram of intramuscular Glucagon
26. After teaching a patient with type 2 diabetes mellitus who is prescribed nateglinide, the nurse assesses the patient's understanding. Which statement made by the patient indicates a correct understanding of the prescribed therapy? a. I will take this medication immediately before I eat
27. The patient with diabetes asks the nurse why it is necessary to maintain blood glucose levels no lower than 65. Which is the nurse’s best response? a. Your brain needs a constant supply of glucose because it cannot store it
28. The nurse is caring for a patient with type 2 diabetes mellitus. Why should the nurse assess capillary refill in this patient? a. Assess for microvascular complications
29. A patient with type 2 diabetes mellitus is being evaluated for hyperosmolar hypoglycemic state (HHS). Which finding would be consistent with this medical diagnosis? a. Serum bicarb 28 mEq/L
30. Which statement best describes the pathophysiology of type 2 diabetes mellitus? a. The cells resist glucose from entering
31. A nurse cares for a patient who has a family history of diabetes mellitus. This patient states, “My father has type 1 diabetes mellitus. Will I develop this disease as well?” How should the nurse respond? a. Your risk of diabetes is higher than the general population, but it may not occur.”
32. A geriatric nurse is performing an assessment of body systems on an 85-year-old patient. The nurse should be aware of what age-related change affecting the renal or urinary system? a. Decrease glomerular Filtration rate.
33. A diabetes nurse educator is teaching a group of patients with type one diabetes about sick day rules.

AND CORRECT ANSWERS 2023A+

What guideline applies to periods of illness in a diabetic patient? a. Do not eliminate insulin when nauseated and vomiting.

34. A newly admitted patient with type one diabetes asked centers what caused her diabetes. When the nurses explain to the patient the etiology of type one diabetes, what process should the nurse describe? a. Destruction of special cells in the pancreas cause a decrease in insulin production. Glucose levels rise because insulin normally breaks it down. Male Reproduction
35. The parents of a newborn child within undescended testicle understanding of the teaching provided when they state? a. He will need to have surgery if the testicle does not descend by one year of age.
36. A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention? a. Increased Blood Urea Nitrogen (BUN)
37. The nurse is assessing a patient who has undergone a transurethral resection of the prostate (TURP). Which assessment finding requires immediate action by the nurse? a. Having bright red drainage with multiple clots
38. A 62-year-old male has been diagnosed with epididymitis. The most likely cause of this infection is: a. E. Coli UTI that has spread to the epididymis.
39. Erectile Disfunction is caused or worsened by lifestyle choices. Identify lifestyle changes that can help prevent erectile disfunction. (Select all that apply): a. Limit or eliminate alcohol consumption

AND CORRECT ANSWERS 2023A+

b. Stop Smoking c. Reduce Stress and anxiety d. Exercise Regularly.

6. Which assessment data during a health history will be most helpful in determining a client’s risk for testicular cancer? a. History of cryptorchidism
7. The nurse is providing care to a patient who is diagnosed with prostate cancer. Which items in the patients’ health history may have contributed to this diagnosis. (Select all that apply.) a. 70 years of age b. Diet that is high in meats and fats c. African American d. PSA 8ng/mL
8. Which intervention or activity should the nurse suggest to the client with chronic prostatitis to decrease the reservoir of microorganisms in the prostate and prevent spread of infection to other areas in the urinary tract? a. Try to have a masturbate session or have intercourse at least twice a week.
9. A nurse is teaching a client about a new drug prescribed to him, finasteride (Proscar). Which if the following instructions would be accurate? a. Finasteride works by decreasing the number of secretions from the prostate gland
10. For which client is a scrotal support indicated? a. A client who had a hydrocele surgically removed three weeks ago
11. A nurse is caring for a patient who is prescribed a selective phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction. The nurse should include which statement when educating the patient regarding this medication? a. You should take one an hour prior to sexual activity
12. Which male client should seek medical treatment? a. A client who had a sudden onset of testicular pain and edema