NUR1211 Medical Surgical Final Exam Practice Tests-with 100% verified solutions-2024-2025., Exams of Nursing

Download NUR1211 Medical Surgical Final Exam Practice Tests-with 100% verified solutions-2024-2025. and more Exams Nursing in PDF only on Docsity! NUR1211 Medical Surgical Final Exam Practice Tests-with 100% verified solutions-2024-2025 The nurse is admitting a patient with the diagnosis of advanced renal carcinoma. Based upon this diagnosis, the nurse will expect to find which of the following as the "classic triad" of presenting symptoms occurring in patients with renal cancer? A. Fever, chills, flank pain B. Hematuria, flank pain, palpable mass C. Hematuria, proteinuria, palpable mass D. Flank pain, palpable abdominal mass, and proteinuria B. Hematuria, flank pain, palpable mass Which of the following nursing interventions is appropriate in providing care for an adult patient with newly diagnosed adult onset polycystic kidney disease (PKD)? A. Help the patient cope with the rapid progression of the disease. B. Suggest genetic counseling resources for the children of the patient. C. Expect the patient to have polyuria and poor concentration ability of the kidneys. D. Implement appropriate measures for the patient's deafness and blindness in addition to the renal problems. B. Suggest genetic counseling resources for the children of the patient. An elderly male patient visits his primary care provider because of burning on urination and production of urine that he describes as "foul smelling." The health care provider should assess the patient for which of the following factors that may dispose him to urinary tract infections (UTIs)? A. High-purine diet B. Sedentary lifestyle C. Benign prostatic hyperplasia (BPH) D. Recent use of broad-spectrum antibiotics C. Benign prostatic hyperplasia (BPH) The nurse is providing care for a patient who has been admitted to the hospital for the treatment of nephrotic syndrome. Which of the following is a priority nursing assessment in the care of this patient? A. Assessment of pain and level of consciousness B. Assessment of serum calcium and phosphorus levels C. Blood pressure and assessment for orthostatic hypotension D. Daily weights and measurement of the patient's abdominal girth D. Daily weights and measurement of the patient's abdominal girth Which of the following nursing diagnoses is a priority in the care of a patient with renal calculi? A. Acute pain B. Deficient fluid volume C. Risk for constipation D. Risk for powerlessness A. Acute pain Eight months after the delivery of her first child, a 31-year-old woman has sought care because of occasional incontinence that she experiences when sneezing or laughing. Which of the following measures should the nurse first recommend in an attempt to resolve the woman's incontinence? A. Kegel exercises B. Use of adult incontinence pads C. Intermittent self-catheterization D. Dietary changes including fluid restriction A. Kegel exercise The nurse preparing to administer a dose of PhosLo to a patient with chronic kidney disease would interpret that this medication should have a beneficial effect on which of the following laboratory values of the patient? A. Sodium B. Potassium C. Magnesium D. Phosphorus D. Phosphorus When caring for a patient during the oliguric phase of acute kidney injury, which of the following would be an appropriate nursing intervention? A. Weigh patient three times weekly. B. Increase dietary sodium and potassium. C. Provide a low-protein, high-carbohydrate diet. D. Restrict fluids according to previous daily loss. D. Restrict fluids according to previous daily loss. Which of the following statements by the nurse regarding continuous ambulatory peritoneal dialysis (CAPD) would be of highest priority when teaching a patient new to this procedure? A. "It is essential that you maintain aseptic technique to prevent peritonitis." B. "You will be allowed a more liberal protein diet once you complete CAPD." C. "It is important for you to maintain a daily written record of blood pressure and weight." D. "You will need to continue regular medical and nursing follow-up visits while performing CAPD." A. "It is essential that you maintain aseptic technique to prevent peritonitis." A patient with a history of end-stage renal disease secondary to diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which of the following assessments should the nurse prioritize before, during, and after his treatment? A patient is admitted with diabetes mellitus, has a glucose level of 380 mg/dl, and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which of the following respiratory patterns would the nurse expect to find? A. Central apnea B. Hypoventilation C. Kussmaul respirations D. Cheyne-Stokes respirations C. Kussmaul respirations The nurse is assisting a diabetic patient to learn dietary planning as part of initial management of diabetes. The nurse would encourage the patient to limit intake of which of the following foods to help reduce the percent of fat in the diet? A. Cheese B. Broccoli C. Chicken D. Oranges A. Cheese Lab results are back for a 54-year-old patient with a 15-year history of diabetes. Which of the following lab results follows the expected pattern accompanying macrovascular disease as a complication of diabetes? A. Increased triglyceride levels B. Decreased low-density lipoproteins C. Increased high-density lipoproteins D. Decreased very-low-density lipoproteins A. Increased triglyceride levels The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes which of the following statements? A. "I should only walk barefoot in nice dry weather." B. "I should look at the condition of my feet every day." C. "I am lucky my shoes fit so nice and tight because they give me firm support." D. "When I am allowed up out of bed, I should check the shower water with my toes." B. "I should look at the condition of my feet every day." A patient is admitted with diabetes mellitus, malnutrition, and cellulitis. The patient's potassium level is 5.6 mEq/L. The nurse considers that which of the following could be a contributing factor for this lab result (select all that apply)? A. The level may be increased as a result of dehydration that accompanies hyperglycemia. B. The patient may be excreting extra sodium and retaining potassium because of malnutrition. C. The level is consistent with renal insufficiency that can develop with renal nephropathy. D. tThe level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia. A. The level may be increased as a result of dehydration that accompanies hyperglycemia. C. The level is consistent with renal insufficiency that can develop with renal nephropathy. D. The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia. The patient received regular insulin 10 units subcutaneously at 8:30 pm for a blood glucose level of 253 mg/dl. The nurse plans to monitor this patient for signs of hypoglycemia at which of the following peak action times? A. 9:00 pm to 10:30 pm B. 10:30 pm to 11:30 pm C. 12:30 am to 1:30 am D. 2:30 am to 4:30 am B. 10:30 pm to 11:30 pm When computing a heart rate from the ECG tracing, the nurse counts 15 of the small blocks between the R waves of a patient whose rhythm is regular. From these data, the nurse calculates the patient's heart rate to be which of the following? A. 60 Beats/min B. 75 Beats/min C. 100 Beats/min D. 150 Beats/min C. 100 Beats/min Which of the following statements best describes the electrical activity of the heart represented by measuring the PR interval on the ECG? A. The length of time it takes to depolarize the atrium B. The length of time it takes for the atria to depolarize and repolarize C. The length of time for the electrical impulse to travel from the SA node to the Purkinje fibers D. The length of time it takes for the electrical impulse to travel from the SA node to the AV node C. The length of time for the electrical impulse to travel from the SA node to the Purkinje fibers The nurse obtains a 6-second rhythm strip and charts the following analysis: atrial rate 70, regular; ventricular rate 40, regular; QRS 0.04 sec; no relationship between P waves and QRS complexes; atria and ventricles beating independently of each other. Which of the following would be a correct interpretation of this rhythm strip? A. Sinus dysrhythmias B. Third-degree heart block C. Wenckebach phenomenon D. Premature ventricular contractions B. Third-degree heart block The nurse is caring for a patient who is 24 hours postpacemaker insertion. Which of the following nursing interventions is most appropriate at this time? A. Reinforcing the pressure dressing as needed B. Encouraging range-of-motion exercises of the involved arm C. Assessing the incision for any redness, swelling, or discharge D. Applying wet-to-dry dressings every 4 hours to the insertion site C. Assessing the incision for any redness, swelling, or discharge The nurse is watching the cardiac monitor, and a patient's rhythm suddenly changes. There are no P waves. Instead there are fine, wavy lines between the QRS complexes. The QRS complexes measure 0.08 sec (narrow), but they occur irregularly with a rate of 120 beats/min. The nurse correctly interprets that this rhythm is which of the following? A. Sinus tachycardia B. Atrial fibrillation C. Ventricular fibrillation D. Ventricular tachycardia B. Atrial fibrillation A patient has sought care following a syncopal episode of unknown etiology. Which of the following nursing actions should the nurse prioritize in the patient's subsequent diagnostic workup? A. Preparing to assist with a head-up tilt-test B. Assessing the patient's knowledge of pacemakers C. Preparing an intravenous dose of a B-adrenergic blocker D. Teaching the patient about the role of antiplatelet aggregators A. Preparing to assist with a head-up tilt-test For which of the following dysrhythmias is defibrillation primarily indicated? A. Ventricular fibrillation B. Third-degree AV block C. Uncontrolled atrial fibrillation D. Ventricular tachycardia with a pulse A. Ventricular fibrillation A patient in asystole is likely to receive which of the following drug treatments? A. Atropine and epinephrine B. Lidocaine and amiodarone C. Digoxin and procainamide D. β-Adrenergic blockers and dopamine A. Atropine and epinephrine Which of the following ECG characteristics is consistent with a diagnosis of ventricular tachycardia (VT)? A. Unmeasurable rate and rhythm B. Rate 150 beats/min; inverted P wave C. Rate 200 beats/min; P wave not visible D. Rate 125 beats/min; normal QRS complex C. Rate 200 beats/min; P wave not visible Five minutes after receiving a preoperative sedative medication by IV injection, a patient asks to get up to go to the bathroom to urinate. Which of the following is the most appropriate action for the nurse to take? A. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. B. Assist the patient to the bathroom and stay next to the door to assist patient back to bed when done. C. Allow the patient to go to the bathroom since the onset of the medication will be more than 5 minutes. D. Ask the patient to hold the A. Offer the patient to use the urinal/bedpan after explaining the need to maintain safety. Which of the following is the primary reason for accurately recording the patient's current medications during a preoperative assessment? A. Some medications may alter the patient's perceptions about surgery. B. Many anesthetics alter renal and hepatic function, causing toxicity of other drugs. C. Some medications may interact with anesthetics, altering the potency and effect of the drugs. D. Routine medications are withheld the day of surgery, requiring dosage and schedule adjustments after surgery. B. Induction and maintenance of anesthesia. C. Analgesia and prevention of intraoperative vomiting. D. Relaxation of skeletal muscles and facilitation of endotracheal intubation. A. Monitored anesthesia care and amnesia. Unless contraindicated by the surgical procedure, which of the following positions is preferred for the unconscious patient immediately postoperative? A. Supine B. Lateral C. Semi-Fowler's D. High-Fowler's B. Lateral A postoperative patient is transferred from the postanesthesia unit to the medical- surgical nursing floor. The nurse notes that the patient has an order for D5½ NS to infuse at 125 ml/hr. Until an IV pump is available, the nurse regulates the IV flow rate at which of the following drops (gtts)/min, noting that the tubing has a drop factor of 10 drops/ml? A. 13 gtts/min B. 31 gtts/min C. 25 gtts/min D. 21 gtts/min D. 21 gtts/min The nurse is preparing to administer cefazolin (Ancef) 2 gm in 100 ml of normal saline to a postoperative patient. Which of the following IV rates will infuse this medication over 20 minutes? A. 100 ml/hr B. 150 ml/hr C. 200 ml/hr D. 300 ml/hr D. 300 ml/hr The nurse is working on a surgical floor and is preparing to receive a postoperative patient from the postanesthesia unit. Which of the following should be the nurse's initial action upon the patient's arrival? A. Assess the patient's pain. B. Assess the patient's vital signs. C. Check the rate of the IV infusion. D. Check the physician's postoperative orders. B. Assess the patient's vital signs. When assessing a patient's surgical dressing on the first postoperative day, the nurse notes new, bright-red drainage about 5 cm in diameter. In response to this finding, the nurse should do which of the following? A. Recheck in 1 hour for increased drainage. B. Notify the surgeon of a potential hemorrhage. C. Assess the patient's blood pressure and heart rate. D. Remove the dressing and assess the surgical incision. C. Assess the patient's blood pressure and heart rate. In planning postoperative interventions to promote ambulation, coughing, deep breathing, and turning, the nurse recognizes that which of the following actions will best enable the patient to achieve the desired outcomes? A. Administering adequate analgesics to promote relief or control of pain B. Asking the patient to demonstrate the postoperative exercises every 1 hour C. Giving the patient positive feedback when the activities are performed correctly D. Warning the patient about possible complications if the activities are not performed A. Administering adequate analgesics to promote relief or control of pain Bronchial obstruction by retained secretions has contributed to a postoperative patient's recent pulse oximetry reading of 87%. Which of the following health problems is the patient experiencing? A. Atelectasis B. Bronchospasm C. Hypoventilation D. Pulmonary embolism A. Atelectasis The nurse would be alerted to the occurrence of malignant hyperthermia when the patient demonstrates A. Hypocapnia. B. Muscle rigidity. C. Decreased body temperature. D. Confusion upon arousal from anesthesia. B. Muscle rigidity.