Medical Surgical In Nursing-1 P1 Exam (Part-1)

Which patient is most likely to be in the fibrous stage of development of coronary artery disease (CAD)? *

Age 40, thrombus adhered to the coronary artery wall

Age 50, rapid onset of disease with hypercholesterolemia
Age 32, thickened coronary arterial walls with narrowed vessel lumen
Age 19, elevated low-density lipoprotein (LDL) cholesterol, lipid-filled smooth muscle cells

Which serum lipid elevation, along with elevated LDL, is strongly associated with CAD? *

Apolipoproteins
Fasting triglycerides
Total serum cholesterol
High-density lipoprotein (HDL)

Which of the following measures to prevent pulmonary embolism after lower extremity surgery is the
BEST? *

early ambulation

frequent chest x-rays

increase fluid intake
frequent lower extremity scan

Controlling of hemorrhage after a motor vehicular accident is classified according to urgency as: *

Emergent
Urgent
Required
Elective

A 52-year-old man is admitted to the emergency department with severe chest pain. On what basis
would the nurse suspect an MI? *

He has pale, cool, clammy skin.

He reports nausea and vomited once at home.
He says he is anxious and has a feeling of impending doom.
He reports he has had no relief of the pain with rest or position change.

During an acute exacerbation of mild COPD, the patient is severely short of breath and the nurse
identifies a nursing diagnosis of ineffective breathing pattern related to obstruction of airflow and anxiety.
What is the best action by the nurse? *
 Prepare and administer routine bronchodilator medications.
Perform chest physiotherapy to promote removal of secretions.
Administer oxygen at 5 L/min until the shortness of breath is relieved.
Position the patient upright with the elbows resting on the over-the-bed table.

A nurse is assisting the health care provider who is intubating a client. The provider has been attempting
to intubate for 40 seconds. What action by the nurse takes priority? *

Ensure the client has adequate sedation.

Find another provider to intubate.
Interrupt the procedure to give oxygen.
Monitor the client’s oxygen saturation.

Which of the following interventions would be most appropriate when caring for a client experiencing an
acute exacerbation of asthma who is dyspneic and irritable? *

Administer an antitussive agent.

Withhold fluids to prevent aspiration.
Have the client breathe into a paper bag.
Elevate the head of the bed to ease breathing.

A nurse is providing diet teaching to a client with congestive heart failure (CHF). The nurse tells the client
to avoid: *

potatoes
apples
steak sauce
green leafy vegetables

Like any nursing interventions, counts should be documented. To whom does the scrub nurse report any
discrepancy of country so that immediate ‘and appropriate action is instituted? *

Anesthesiologist
Surgeon
OR nurse supervisor
Circulating nurse

What should the nurse emphasize when teaching a patient who is newly prescribed clonidine
(Catapres)? *

The drug should never be stopped abruptly.

The drug should be taken early in the day to prevent nocturia.
The first dose should be taken when the patient is in bed for the night.
Because aspirin will decrease the drug’s effectiveness, Tylenol should be used instead.
Which of the following should be given highest priority when receiving patient in the OR? *

Assess level of consciousness

Verify patient identification and informed consent
Assess vital signs
Check for jewelry, gown, manicure and dentures

Which of the following would be important to include in the discharge teaching plan for a client
diagnosed with pulmonary embolism? *

Maintain peripheral circulation with leg exercises.

Avoid bending when attempting to pick up objects.
Soak feet nightly in warm water to increase circulation.
Reduce walking to necessary activities around the house.

Mr. Alejandro is scheduled for a prostatectomy and the anesthesiologist plans to use a spinal
(subarachnoid) block during surgery. In the operating room, the nurse positions the client according to
the anesthesiologist's instructions. Why does the client require special positioning for this type of
anesthesia? *

To prevent confusion
To prevent seizures
To prevent cerebrospinal fluid (CSF) leakage
To prevent cardiac arrhythmias

Which of the following is included in the treatment of asthma? *

oxygen, corticosteroid, and anticholinergic

bronchodilator, oxygen, and corticosteroid
bronchodilator, corticosteroid, and sedative
sedative, anticholinergic, and bronchodilator

Which of the following medications is prescribed after a pulmonary embolism is diagnosed? *

Warfarin (Coumadin)
Urokinase
Heparin
Streptokinase

The Recovery Room nurse should monitor for the most common postoperative complication of: *

hemorrhage
endotracheal tube perforation
esopharyngeal edema
 Epiglottis

A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client’s
oxygen saturation has not significantly improved. What response by the nurse is best? *

Breathing so rapidly interferes with oxygenation.

Maybe the client has respiratory distress syndrome.
The blood clot interferes with perfusion in the lungs.
The client needs immediate intubation and mechanical ventilation.

Another nursing check that should not be missed before the induction of general anesthesia is: *

check for presence underwear

check for presence dentures
check patient’s blood studies
check baseline vital signs

The nurse is planning the care of a patient who is scheduled for a laryngectomy. The nurse should assign
the highest priority to which postoperative nursing diagnosis? *

Anxiety related to diagnosis of cancer

Altered nutrition related to swallowing difficulties
Ineffective airway clearance related to airway alterations
Impaired verbal communication related to removal of the larynx

The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed
time frame and deliver a standard patient outcome. White the surgeon performs the surgical procedure,
who monitors the status of the client like urine output, blood loss? *

Scrub nurse
Surgeon
Anesthesiologist
Circulating nurse

What is the most important postoperative instruction nurse Nikki must give to Mrs. Serrano who has just
returned from the operating room after receiving a subarachnoid block? *

"Avoid drinking liquids until the gag reflex returns."

"Avoid eating milk products for 24 hours."
"Notify a nurse if you experience blood in your urine."
"Remain supine for the time specified by the physician."

A preoperative client expresses anxiety to the nurse about the upcoming surgery. Which of the following
responses by the nurse is most likely to stimulate further discussion between the client and the nurse? *
 “I will be happy to explain the entire surgical procedure to you.”
“Let me tell you about the care you’ll receive after surgery and the amount of pain you can anticipate.”
“If it’s any help, everyone is nervous before surgery.”
“Can you share with me what you’ve been told about your surgery?”

Which individual is at high risk for a cobalamin (vitamin B12) deficiency anemia? *

A 47-year-old man who had a gastrectomy (removal of the stomach)

A 54-year-old man with a history of irritable bowel disease and ulcerative colitis
A 26-year-old woman who complains of heavy menstrual periods
A 15-year-old girl who is a vegetarian

For a client with history of angina, which of the following should the nurse teach the patient to do FIRST
should the client develop pain at home? *

Take the sublingual nitroglycerin (NTG) and lie down.

Take an extra- long-acting nitrate tablet immediately.
Perform mild breathing and range of motion exercises.
Sit down and relax, using guided imagery or distraction.

Which statements accurately describe heart failure (select all that apply)? *

A common cause of diastolic failure is left ventricular hypertrophy.

A primary risk factor for heart failure is coronary artery disease (CAD).
Systolic heart failure results in a normal left ventricular ejection fraction.
Systolic failure is characterized by abnormal resistance to ventricular filling.
Hypervolemia precipitates heart failure by decreasing cardiac output and increasing oxygen
consumption.

The acronym FACES is used to help educate patients to identify symptoms of heart failure. What does
this acronym mean? *

Frequent activity leads to cough in the elderly and swelling

Factors of risk: activity, cough, emotional upsets, salt intake
Follow activity plan, continue exercise, and know signs of problems
Fatigue, limitation of activities, chest congestion/cough, edema, shortness of breath

Priority Decision: A patient in the PACU has emergence delirium manifested by agitation and thrashing.
What should the nurse assess for first in the patient? *

Hypoxemia
Neurologic injury
Distended bladder
Cardiac dysrhythmias
Concerted work efforts among members of the surgical team is essential to the success of the surgical
procedure. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there
is a need for sterile supply which is not in the sterile field, who hands out these items by opening its outer
cover? *

Circulating nurse
Anesthesiologist
Surgeon
Nursing aide

Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the
client to use the drug when chest pain occurs? *

Take 1 tablet every 2 to 5 minutes until the pain stops.

Take 1 tablet and rest for 10 minutes. Call the physician if pain persists after 10 minutes.
Take 1 tablet. If pain persists after 5 minutes, take 2 tablets. If pain still persists 5 minutes later, call
the physician.
Take 1 tablet, then an additional tablet every 5 minutes for a total of 3 tablets. Call the physician if pain
persists after 3 tablets.
Option 5

The nurse performs discharge teaching with a client with emphysema. Which statement, if made by the
client, indicates that teaching was successful? *

“Cold weather will help my breathing problems.”

“I should eat three balanced meals but limit my fluid intake.”
“My outside activity should be limited when pollution levels are high.”
“An intensive exercise program is important in regaining my strength.”

Which of the following is the most common symptom of myocardial infarction (MI)? *

Chest pain
Dyspnea
Edema
Palpitations

Which initial physical assessment finding would the nurse expect to be present in a patient with acute
left-sided heart failure? *

Bubbling crackles and tachycardia

Hepatosplenomegaly and tachypnea
Peripheral edema and cool, diaphoretic skin
Frothy blood-tinged sputum and distended jugular veins
Which of the following ECG changes would be present in a myocardial attack? *

Inverted T wave, and inverted P wave

Inverted T wave, and elevated P wave
Inverted T wave, and elevated ST segment DILI SURE :>
Inverted T wave, and depressed QRS complex

To prevent airway obstruction in the postoperative patient who is unconscious or semiconscious, what
will the nurse do? *

Encourage deep breathing

Elevate the head of the bed
Administer oxygen per mask
Position the patient in a side-lying position

Which foods should you encourage patients with folic acid deficiency to include in their daily food intake
(select all that apply)? *

Ready-to-eat cereal
Wheat tortillas
Lentils
Strawberries
Potatoes

Which of the following methods is the best way to confirm the diagnosis of a pneumothorax? *

auscultate breath sounds

take a chest x-ray
use of incentive spirometer
ABG analysis

The nurse teaches a client who has deep vein thrombosis (DVT) about elastic stockings. Which of the
following statements, if made by the client, indicates to the nurse that teaching was SUCCESSFUL? *

“I should wear the stockings even when I am asleep.”

“Every 4 hours I should remove the stockings for a half hour.”
“I will wear the stockings until the physician tells me to remove them.”
“I should put on the stockings before getting out of bed in the morning.”

Which of the following is an uncontrollable risk factor that has been linked to the development of
coronary artery disease (CAD)? *

stress
obesity
exercise
 Heredity

While obtaining patient histories, which patient does the nurse identify as having the highest risk for
CAD? *

A white man, age 54, who is a smoker and has a stressful lifestyle
A white woman, age 68, with a BP of 172/100 mm Hg and who is physically inactive
An Asian woman, age 45, with a cholesterol level of 240 mg/dL and a BP of 130/74 mm Hg
An obese African American man, age 65, with a cholesterol level of 195 mg/dL and a BP of 128/76 mm
Hg

Nurses hold a variety of roles when providing care to a perioperative patient. Which of the following role
would be the responsibility of the scrub nurse? *

Assess the readiness of the client prior to surgery

Ensure that the airway is adequate
Account for the number of sponges, needles, supplies, Used during the surgical procedure
Evaluate the type of anesthesia appropriate for the surgical client

A nurse is reviewing the physician’s order sheet for the preoperative client, which states that the client
must be on nothing per mouth (NPO) status after midnight. The nurse would clarify whether which of the
following medications should be given to the client and not withheld? *

Conjugated estrogen (Premarin)

Atenolol (Tenormin)
Cyclobenzaprine (Flexeril)
Ferrous sulfate

Which manifestation is an indication that a patient is having a hypertensive emergency? *

Symptoms of a stroke with an elevated BP

A systolic BP >200 mm Hg and a diastolic BP >120 mm Hg
A sudden rise in BP accompanied by neurologic impairment
A severe elevation of BP that occurs over several days or weeks

Which of the following statements best describes pleural effusion? *

collapse of alveoli
collapse of a bronchiole
fluid in the alveolar space
fluid accumulation between the linings of the pleural space

Which of the following rationale best explains maintaining NPO (nothing per orem) status on a client
preoperatively? *
 To avoid reaction to the anesthetic drugs
To prevent risk for aspiration
To monitor intake and output accurately
To prevent inappropriate bowel during surgery

A 67-year-old client is in distress after being admitted with an exacerbation of COPD. In which position
should the nurse put the client to promote optimal lung expansion? *

prone
reverse trendelenburg
supine
high fowler's

Which of the following statements about myocardial infarction pain is incorrect? *

It is relieved by rest and inactivity.

It is substernal in location.
It is sudden in onset and prolonged in duration.
It is viselike and radiates to the shoulders and arms.

The nurse is caring for a patient whose recent unexplained weight loss and history of smoking have
prompted diagnostic testing for cancer. What symptom is most closely associated with the early stages
of laryngeal cancer? *

Hoarseness
Dyspnea
Dysphagia
Frequent nosebleeds

While team effort is needed in the OR for efficient and quality patient care delivery, we should limit the
number of people in the room for infection control. Who comprise this team? *

Surgeon, anesthesiologist, scrub nurse, radiologist, orderly

Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

In planning care for the patient with bronchiectasis, which nursing intervention should the nurse
include? *

Relieve or reduce pain

Prevent paroxysmal coughing
Prevent spread of the disease to others
Promote drainage and removal of mucus
Medical Surgical In Nursing-1 P2 Exam (Part-1)

Which of the following tests is most commonly used to diagnose cholecystitis? *

A. Endoscopy
B. Barium swallow
C. Abdominal ultrasound
D. Abdominal computed tomography scan

The client is diagnosed with acute pancreatitis. What health-care provider's admitting order should the
nurse question? *

A. Bedrest with bathroom privileges

B. Initiate IV therapy of D5W at 125 mL/hr.
C. Weight client daily
D. Low fat, low carb diet

During a school party a child with a known food allergy has an itchy throat, is wheezing, and reports not
feeling "quite right." The nurse should do the following in what order from first to last? All options must
be used. *

A. Assess vital signs.

B. Position to facilitate breathing.
C. Send someone to activate the Emergency Management Systems (EMS).
D. Administer the child's epinephrine.
E. Notify the parents.

If a client had irritable bowel syndrome, which of the following diagnostic tests would determine if the
diagnosis is Crohn's disease or ulcerative colitis? *

A. Abdominal computed tomography (CT) scan

B. Abdominal x-ray
C. Barium swallow
D. Colonoscopy with biopsy

A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these
assessment findings, the nurse should further assess the client for which of the following
complications? *

A. Deficient fluid volume.

B. Intestinal obstruction.
 C. Bowel ischemia.
D. Peritonitis.

Which of the following laboratory results would be expected in a client with peritonitis? *

A. Partial thromboplastin time above 100 seconds

B. Hemoglobin level below 10 mg/dl
C. Potassium level above 5.5 mEq/L
D. White blood cell count above 15,000/ul

The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To
determine whether the client currently is experiencing difficulty, the nurse asks the client about the
presence of which of the following early symptoms? *

A. Urge incontinence
B. Nocturia
C. Decreased force in the stream of urine
D. Urinary retention

Systemic lupus erythematosus (SLE) primarily attacks which of the following tissues? *

A. Lung
B. Heart
C. Nerve
D. Connective

A nurse is caring for a client with systemic lupus erythematosus (SLE) who is taking hydroxychloroquine
(Plaquenil). The nurse understands that the primary concern with this drug is: *

A. Pulmonary fibrosis.
B. Cushingoid effects.
C. Retinal toxicity.
D. Renal toxicity.

On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse
should conduct a focused assessment for: *

A. Limited motion of joints.

B. Deformed joints of the hands.
C. Early morning stiffness.
D. Rheumatoid nodules.

Which of the following instructions should the nurse give a client with pancreatitis during discharge
teaching? *
 A. Consume high-fat meals
B. Consume low-calorie meals
C. Limit daily intake of alcohol
D. Avoid beverages that contain caffeine

Gout is caused by the buildup of what substance in the body? *

A. White blood cells

B Synovial fluid (found in joints)
C Uric acid
D Blood plasma

The nurse recognizes that urinary elimination changes may occur even in healthy elders because: *

A. the bladder distends, and its capacity increases.

B. elders ignore the need to void.
C. the amount of urine retained after voiding increases.
D. urine becomes more concentrated.

To prevent the spread of hepatitis A virus (HAV) infection the nurse is especially careful when: *

A. Disposing of food trays

B. Emptying bed pans
C. Taking an oral temperature
D. Changing IV

Copious amounts of frothy, greenish vaginal discharge would be a symptom with which of the following
infections? *

A. Gonorrhea
B. Candidiasis
C. Herpes simplex
D. Trichomoniasis

Which of the following complications is thought to be the most common cause of appendicitis? *

A. A fecalith
B. Bowel kinking
C. Internal bowel occlusion
D. Abdominal wall swelling

Which of the following symptoms is a classic sign of systemic lupus erythematosus (SLE)? *

A. Vomiting
 B. Weight loss
C. Difficulty urinating
D. Superficial lesions over the cheeks and nose

Which of the following factors is most commonly associated with the development of pancreatitis? *

A. Alcohol abuse
B. Hypercalcemia
C. Hyperlipidemia
D. Pancreatic duct obstruction

A 23 year old patient is admitted with suspected appendicitis. The patient states he is having pain
around the umbilicus that extends into the lower part of his abdomen. In addition, he says that the pain is
worst on the right lower quadrant. The patient points to his abdomen at a location which is about a
one-third distance between the anterior superior iliac spine and umbilicus. What other signs and
symptoms are associated with appendicitis. Select all that apply. *

A. Increased red blood Cells

B. Patient has the desire to be positioned in the prone position to relieve pain
C. Umbilical pain that extends in the right lower quadrant
D. Abdominal rebound tenderness
E. Abdominal Flaccidity

In which of the following groups is most important for the client to understand the importance of an
annual Papanicolaou test? *

A. Clients with a pregnancy before age 20

B. Clients with a history of recurrent candidiasis
C. Clients with a long history of oral contraceptive use
D. clients infected with the human papillomavirus (HPV)

A patient with hepatitis B is being discharged in 2 days. In the discharge teaching plan the nurse should
include instructions to: *

A. Avoid alcohol for the first 3 weeks

B. Use a condom during sexual intercourse
C. Have family members get an injection of immunoglobin
D. Follow a low-protein, moderate-carbohydrate, moderate-fat diet

Which of the following should the nurse assess when completing the history and physical examination of
a client diagnosed with osteoarthritis? *

A. Anemia.
B. Osteoporosis.
C. Weight loss.
 D. Local joint pain.

The “rapid” HIV antibody testing is performed on a patient at high risk for HIV infection. What should the
nurse explain about this test? *

A. The test measures the activity of the HIV and reports viral loads as real numbers.
B. This test is highly reliable, and in 5 minutes the patient will know if HIV infection is present.
C. If the results are positive, another blood test and a return appointment for results will be necessary.
D. This test detects drug-resistant viral mutations that are present in viral genes to evaluate
resistance to antiretroviral drugs

Which of the following goals for medications prescribed to treat rheumatoid arthritis is accurate? *

A. To cure the disease

B. To prevent osteoporosis
C. To control inflammation
D. To encourage bone regeneration

The nurse is preparing health promotion teaching for a client with gallbladder disease. Which topic
should the nurse include in the teaching session? (Select all that apply.) *

A. Role of a high-cholesterol diet on gallstone formation

B. Role of hypolipidemia on gallstone formation
C. Importance of a low-cholesterol diet
D. Dangers of rapid weight loss
E. Importance of a high-fiber diet

A nurse is caring for a client with the following laboratory values: white blood cell count (WBC)
4,500/mm3, neutrophils 15%, and bands 1%. Based on the client's absolute neutrophil count (ANC), the
nurse knows that the clients risk for infection is: *

A. No increased risk
B. Significant risk
C. low risk
D. intermediate risk

During a home health visit you are helping a patient with gout identify foods in their pantry they should
avoid eating. Select all the foods below the patient should avoid: *

A. Sardines
B. Whole wheat bread
C. Sweetbreads
D. Crackers
E. Craft beer
F. Bananas
Surgical management of ulcerative colitis may be performed to treat which of the following
complications? *

A. Gastritis
B. Bowel herniation
C. Bowel outpoutching
D. Bowel perforation

When evaluating a male client for complications of acute pancreatitis, the nurse would observe for: *

A. increased intracranial pressure.

B. decreased urine output.
C. bradycardia.
D. hypertension.

Which of the following associated disorders may the client with Crohn's disease exhibit? *

A. Ankylosing spondylitis
B. Colon cancer
C. Malabsorption
D. Lactase deficiency

Which of the following interventions should be included in the medical management of Crohn's
disease? *

A. Increasing oral intake of fiber

B. Administering laxatives
C. Using long-term steroid therapy
D. Increasing physical activity

When counseling a client in the ways to prevent cholecystitis, which of the following guidelines is most
important? *

A. Eat a low-protein diet

B. Eat a high-cholesterol diet
C. Limit exercise to 10 minutes a day
D. Keep weight proportional to height

Which of the following factors should the focus of nursing management in a client with acute
pancreatitis? *

A. Pain control
B. Dietary management
C. Fluid and electrolyte balance
 D. Management of hypoglycemia

Which of the following medications is most effective for treating the pain associated with irritable bowel
disease? *

A. Acetaminophen
B. Opiates
C. Steroids
D. Stool softeners

Which of the following conditions is most likely to cause hepatitis? *

A. Metastasis
B. Viral infection
C. Bacterial infection
D. Biliary dysfunction

Which of the following symptoms is associated with ulcerative colitis? *

A. Fistulas
B. Soft stools
C. Rectal bleeding
D. Dumping syndrome

In cystitis to minimize experiencing nocturia, the nurse would teach the patient to: *

A. Perform perineal hygiene after urinating.

B. Set up a toileting schedule.
C. Double void.
D. Limit fluids before bedtime.

A client with viral hepatitis may exhibit which of the following symptoms? *

A. Arthralgia
B. Excitability
C. Headache
D. Polyphagia

The nurse is providing care for a newly married woman with systemic lupus erythematosus (SLE). Which
client statement indicates plan of care understanding? *

A. "I will take birth control pills while I am taking cytotoxic medications."
B. "I do not need to contact the doctor if I develop a fever or rash."
C. "I plan to go to the movies this weekend so that I get out of the house."
 D. "I can take ibuprofen as indicated for pain."

Which of the following body substances most easily transmits human immunodeficiency virus (HIV)? *

A. Feces and saliva

B. Blood and semen
C. Breastmilk and tears
D. vaginal secretions and urine

A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches the client about
disease transmission and advises the client to inform his sexual partners of the infection. The client
refuses, stating, "This is my business and I'm not telling anyone. Besides, chlamydia doesn't cause any
harm like the other STDs." How should the nurse proceed? *

A. Do nothing because the client's sexual habits place him at risk for contracting other STDs.
B. Educate the client about why it's important to inform sexual contacts so they can receive treatment.
C. Inform the health department that this client contracted an STD.
D. Inform the client's sexual contacts of their possible exposure to chlamydia.

Which of the following conditions is most likely to directly cause peritonitis? *

A. Cholelithiasis
B. Gastritis
C. Perforated ulcer
D. Hiatal hernia

Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)? Select all that apply. *

A. Adults between the ages of 20 and 50 years.

B. Adults who have had an infectious disease with the Epstein-Barr virus.
C. Adults that are of the male gender.
D. Adults who possess the genetic link, specifically HLA-DR4.
E. Adults who also have osteoarthritis.

A patient is recovering after having an appendectomy. The patient is 48 hours post-opt from surgery and
is tolerating full liquids. The physician orders for the patient to try solid foods. What types of foods
should the patient incorporate in their diet? *

A. Foods high in fiber

B. Foods low in fiber
C. Foods high in carbohydrates
D. Foods low in protein

A client who has been diagnosed with renal calculi reports that the pain is intermittent and less colicky.
Which of the following nursing actions is most important at this time? *
 A. Report hematuria to the physician.
B. Strain the urine carefully.
C. Administer meperidine (Demerol) every 3 hours.
D. Apply warm compresses to the flank area.

Which of the following statements shows that a client does not understand the cause of an exacerbation
of systemic lupus erythematosus (SLE) *

A. "I need to stay away from sunlight."

B. "I don't have to worry if I get a strep throat."
C. "I need to work on managing stress in my life."
D. "I don't have to worry about changing my diet."

The client is admitted to the medical department with a diagnosis of R/O acute pancreatitis. What
laboratory values should the nurse monitor to confirm this diagnosis? *

A. Creatinine and BUN

B. Troponin and CK-MB
C. Serum amylase and lipase
D. Serum bilirubin and calcium

A client asks what causes gallstones to form. Which factor should the nurse explain as being present
when these stones are formed? (Select all that apply.) *

A. Rapid weight gain

B. Abnormal bile composition
C. Excess cholesterol
D. Inflammation of the gallbladder
E. Biliary stasis

Which of the following symptoms may be exhibited by a client with Crohn's disease? *

A. bloody diarrhea
B. narrow stools
C. nausea and vomiting
D. Steatorrhea

A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote
optimal immunologic function. Which snacks have the greatest probability of stimulating
autoimmunity? *

A. Applesauce and dried apricots

B. Potato chips and chocolate milk shakes
C. Raisins and carrot sticks
 D. Fruit salad and mineral water

Medical Surgical In Nursing-1 Lecture P2 Exam (Part-2)

Pulmonary tuberculosis (PTB) is a communicable disease transmitted by which of the following

methods? *

1 point

sexual contact
using dirty needles
using an infected person’s eating utensils
inhaling droplets exhaled from an infected person

In patients with fluid volume excess and circulating overload, the potential outcome is: *

1 point

cell swelling
cerebral cell dehydration
water intoxication
congestive heart failure (CHF)

The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On assessment,
the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep
tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note
in a client with hyponatremia? *

1 point

Muscle twitches
Decreased Urinary output
Hyperactive bowel sounds
Increased specific gravity of the urine

The nurse recognizes that the goals of teaching regarding the transmission of pulmonary tuberculosis
(TB) have been met when the patient with TB *

1 point

demonstrates correct use of a nebulizer.

washes dishes and personal items after use.
covers the mouth and nose when coughing.
reports daily to the public health department.
Which of the following organisms most commonly causes community-acquired pneumonia in adults? *

1 point

Heamophilus influenzae
Klebsiella pneumoniae
Streptococcus pneumoniae
Staphylococcus pneumoniae

If your patient is hypercalcemic, you would expect to: *

1 point

administer I.V. sodium bicarbonate.

administer vitamin D.
hydrate the patient.
administer digoxin.

A patient with respiratory alkalosis is sedated. The nurse knows this intervention is effective when the: *

1 point

PO2 is 80%
HCO3 is 50 mEq/L
pH is 7.36
PaCO2 is 33 DILI SURE :>

The health care provider writes an order for bacteriologic testing for a patient who has a positive
tuberculosis skin test. Which action will the nurse take? *

1 point

Repeat the tuberculin skin testing.

Teach about the reason for the blood tests.
Obtain consecutive sputum specimens from the patient for 3 days.
Instruct the patient to expectorate three specimens as soon as possible.

Patient Mimi was diagnosed with an imbalance in calcium and has a serum level of 7.5 mg/dL. Upon
assessment, there was flexion of the wrist and adduction of metacarpal and phalanges after BP taking.
This assessment refers to: *

1 point

Trousseau’s sign
Chvostek’s sign
 Homan's sign
Kernig's sign

A client is diagnosed with thromboangiitis obliterans (Buerger’s disease). The nurse places highest
priority on teaching the client about modifications of which risk factor related to this disease? *

1 point

exposure to heat
cigarette smoking
excessive water intake
diet low in vitamin C

A patient with tented skin turgor, dry mucous membranes, and decreased urinary output is under nurse
Mark’s care. Which nursing intervention should be included the care plan of Mark for his patient? *

1 point

Administering I.V. and oral fluids

Clustering necessary activities throughout the day
Assessing color, odor, and amount of sputum
Monitoring serum albumin and total protein levels

Which of the following conditions most commonly results in coronary artery disease? *

1 point

atherosclerosis
diabetes mellitus
myocardial infarction
renal failure

An elderly client with pneumonia may appear with which of the following symptoms first? *

1 point

Altered mental status and dehydration

Fever and chills
Hemoptysis and dyspnea
Pleuritic chest pain and cough

When teaching your patient with hypomagnesemia about a proper diet, you should recommend that he
consume plenty of: *

seafood.
fruits.
 corn products.
dairy products.
Maria, an 85-year-old patient with a feeding tube, has been experiencing severe watery stool. The patient
is lethargic and has poor skin turgor, a pulse of 120, and hyperactive reflexes. Nursing interventions
would include: *

1 point

measuring and recording intake and output and daily weights

administering salt tablets and monitoring hypertonic parenteral solutions
administering sedatives
applying wrist restraints to avoid displacement of the feeding tube

How can the spread of filoviruses be restricted? *

1 point

New antivirals
New humanized monoclonal antibodies
Hygiene and social distancing
New vaccine

A patient is admitted with 1.000 mL of diarrhea per day for the last 3 days. An IV of 0.45% NaCl with 5%
dextrose is infused. Which of the following nursing interventions is the most appropriate? *

1 point

Assess the patient for signs of hyperkalemia.

Get an infusion controller from central supply.
Mix all antibiotics in 0.45% NaCl with 5% dextrose.
Check the patient’s potassium level and contact the doctor for IV additive orders.

During assessment of the chest in a patient with pneumococcal pneumonia, the nurse would expect to
find *

1 point

vesicular breath sounds.

increased tactile fremitus.
dry, nonproductive cough.
hyperresonance to percussion.

A client seeks treatment in an ambulatory care center for symptoms of Raynaud’s disease. The nurse
instructs the client to: *

1 point
 Decrease cigarette smoking by one-half.
Alternate exposures to both heat and cold.
Continue activity during vasospasm for quicker relief of symptoms.
Wear protective items, such as gloves and warm socks, as necessary.

The home care nurse screens a group of residents in a dependent living facility for risk factors to
pneumonia. The nurse determines that which of the following clients is MOST at risk to develop
pneumonia? *

1 point

An 87-year-old male who smokes and has a history of lung cancer.

A 76-year-old male who has a history of hypertension and type II diabetes.
A 72-year-old female who has left-sided hemiparesis after a cerebrovascular accident.
An 80-year-old female who walks one mile every day and has a history of depression.

When planning care for the patient with hypertrophic CMP, what should the nurse include? *

1 point

Ventricular pacing
Administration of vasodilators
Teach the patient to avoid strenuous activity and dehydration DILI SURE :>
Surgery for cardiac transplantation will need to be done soon

The nurse has been assigned to a client with Raynaud’s disease. The nurse realizes that the underlying
etiology of Raynaud’s disease is unknown but that it is characterized by: *

1 point

episodic vasospastic disorder of the aorta.

episodic vasospastic disorder of the capillaries.
episodic vasospastic disorder of the small veins.
episodic vasospastic disorder of the small arteries.

The nurse assessed the client and noted shortness of breath and recent trip to China. The client is
strongly suspected of having Middle East Respiratory Syndrome (MERS-CoV). Which of these prescribed
actions will the nurse take first? *

1 point

Place the client on airborne and contact precautions

Introduce normal saline at 75 mL/hr
Give methylprednisolone (SOLU-Medrol) 1 g intravenously (IV)
Take blood, urine, sputum cultures
A client with COPD is admitted to the hospital with acute exacerbation. Which of the following blood gas
results would the nurse most likely expect to note? *

1 point

pH 7.48, PaCO2 30
pH 7.19, PaCO2 51
pH 7.22, HCO3 20
pH 7.53, HCO3 29

Patient X is diagnosed with constipation. As a knowledgeable nurse, which nursing intervention is

appropriate for maintaining normal bowel function? *

1 point

Assessing dietary intake

Decreasing fluid intake
Providing limited physical activity
Turning, coughing, and deep breathing

A client with atherosclerosis asks the nurse about dietary modifications to lower the risk of heart disease.
The nurse instructs the client to eat which of the following foods? *

1 point

roast beef
cheese burger
fresh cantaloupe
mashed potato with gravy

A patient who is lethargic and exhibits deep, rapid respirations has the following arterial blood gas (ABG)
results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. How should the nurse interpret
these results? *

1 point

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

Daniel who is a marathon runner is at high risk for fluid volume deficit. Which one of the following is a
related factor? *

1 point

decreased diuresis
 disease-related process
decreased breathing and perspiration
increased breathing and perspiration

Because smoking cessation is a critical strategy for the client diagnosed with Buerger’s disease, the
nurse anticipates that the client will go home with a prescription for which of the following
medications? *

1 point

Nitroglycerin
Nicotine (Nicotrol)
Ibuprofen
Furosemide (Lasix)

Which patient has the greatest risk for pre-renal AKI? *

1 point

The patient is hypovolemic because of hemorrhage.

The patient relates a history of chronic urinary tract obstruction.
The patient has vascular changes related to coagulopathies.
The patient is receiving antibiotics such as gentamicin.

Atherosclerosis impedes coronary blood flow by which of the following mechanisms? *

1 point

Plaques obstruct the vein.

Plaques obstruct the artery.
Blood clots form outside the vessel wall.
Hardened vessels dilate to allow blood to flow through.

A nurse is planning care for a client with hypokalemia. Which interventions should be included in the plan
of care? Select all that apply. *

1 point

Ensure adequate fluid intake.

Implement safety measures to prevent falls
Encourage low fiber foods to prevent diarrhea.
Instruct the client about foods that contain potassium.
Encourage the client to obtain assistance to ambulate.
A patient who is on Lasix therapy asks the nurse about potassium-rich foods, which of the following
foods would the nurse recommend? *

1 point

oranges
apples
pears
Peaches

When caring for a patient during the oliguric phase of acute kidney injury, what would be an appropriate
nursing intervention? *

1 point

Weigh patient three times weekly

Increase dietary sodium and potassium
Provide a low-protein, high-carbohydrate diet
Restrict fluids according to the previous day's fluid loss

When performing discharge teaching for a patient with any type of CMP, what should the nurse instruct
the patient to do (select all that apply)? *

1 point

Eat a low-sodium diet.

Go to the gym every day.
Engage in stress reduction activities.
Abstain from alcohol and caffeine intake.
Avoid strenuous activity and allow for periods of rest.
Suggest that caregivers learn cardiopulmonary resuscitation (CPR).

Which of the following controllable risk factors for coronary artery disease (CAD) appears most closely
linked to the development of the disease? *

1 point

age
gender
smoking
high cholesterol levels
An 85-year-old patient with a feeding tube has been experiencing severe watery stool. The patient is
lethargic and has poor skin turgor, a pulse of 120 bpm, and hyperactive reflexes. Nursing interventions
would include: *

1 point

administering sedatives.
measuring and recording intake and output and daily weights.
applying wrist restraints to avoid displacement of the feeding tube.
administering salt tablets and monitoring hypertonic parenteral solutions.

Which information will the nurse include in the patient teaching plan for a patient who is receiving
rifampin (Rifadin) for treatment of tuberculosis? *

1 point

"Your urine, sweat, and tears will be orange colored."

"Read a newspaper daily to check for changes in vision."
"Take vitamin B6 daily to prevent peripheral nerve damage."
"Call the health care provider if you notice any hearing loss."

A 25-year-old client has active pulmonary tuberculosis (PTB). Which of the following symptoms will he
exhibit? *

1 point

chest and lower back pain

headache and photophobia
chills, fever, night sweats, and hemoptysis
fever, altered mental status, and non-productive sputum

A nurse is developing a teaching plan for the client with Raynaud’s disease. The nurse plans to tell the
client that the symptoms may improve with: *

daily cool baths, which will provide an analgesic effect.

a high-protein diet, which will minimize tissue malnutrition.
vitamin K administration which will prevent tendencies toward bleeding.
keeping the hands and feet warm and dry, which will prevent vasoconstriction.

Which of the following pathophysiological mechanisms that occurs in the lung parenchyma allows
pneumonia to develop? *

Atelectasis
Bronchiectasis
Effusion
Inflammation
A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for
continued mechanical ventilation. How should the nurse interpret the following arterial blood gas results:
pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L? *

1 point

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

Lassa and Ebola are emergent viruses in W. Africa. What is their origin? *

1 point

Humans
Primates
Fruit bats
Pigs

A patient with PAD has a nursing diagnosis of ineffective peripheral tissue perfusion. What should be
included in the teaching plan for this patient (select all that apply)? *

1 point

Keep legs and feet warm.

Apply cold compresses when the legs become swollen.
Walk at least 30 minutes per day to the point of discomfort.
Use nicotine replacement therapy as a substitute for smoking.
Inspect lower extremities for pulses, temperature, and any injury.

A 79-year-old client is admitted with pneumonia. Which nursing diagnosis should take priority? *

Anxiety related to dyspnea and chest pain

Ineffective airway clearance related to retained secretions
Acute pain related to lung expansion secondary to lung infection
Risk for imbalanced fluid volume related to increased insensible fluid losses

A nurse is admitting a client suspected of having pulmonary tuberculosis (PTB) to the hospital. The
nurse understands that the MOST accurate method for confirming the diagnosis is: *

A chest x-ray positive for lung lesions.

A positive purified protein derivative test (PPD).
A sputum culture positive for Mycobacterium tuberculosis.
Obtaining data about the client’s long history of hemoptysis.
Which of the following nursing diagnoses might apply to a patient with fluid volume deficit? *

1 point

altered bowel elimination

urinary incontinence
decreased cardiac output
increased cardiac output

Which of the following arterial blood gas values indicates uncompensated metabolic alkalosis? *

1 point

pH 7.48, PaCO2 42, HCO3 30

pH 7.48, PaCO2 46, HCO3 30
pH 7.48, PaCO2 34, HCO3 20
pH 7.48, PaCO2 34, HCO3 26

A client who has fallen from a ladder and fractured three ribs has arterial blood gas (ABG) results of pH
7.38, PaCO2 38 mmHg, and HCO3 23 mEq/L. The nurse interprets that the client’s ABGs indicate which of
the following? *

1 point

normal results
metabolic acidosis
metabolic alkalosis
respiratory acidosis

Following teaching about medications for PAD, the nurse determines that additional instruction is
necessary when the patient makes which statement? *

1 point

“I should take one aspirin a day to prevent clotting in my legs.”

“The lisinopril I use for my blood pressure may help me walk further without pain.”
“I will need to have frequent blood tests to evaluate the effect of the Coumadin I will be taking.”
“Pletal should help me increase my walking distance and help prevent clots from forming in my legs.”