1
NURS 480 Medical-Surgical FINAL EXAM
NURS 480 Medical-Surgical FINALE EXAM
2 WEST COAST UNIVERSITY PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
ACE
n assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory
test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C. Potassium
, 2
NURS 480 Medical-Surgical FINAL EXAM
D. Glucose
Answer- C
Rationale-
Clients with primary aldosteronism exhibit a profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and universal sign. The serum sodium
level is normal or elevated, depending on the amount of water resorbed with the sodium.
Option B is influenced by parathyroid hormone (PTH). Option D is not affected by primary
aldosteronism.
What is the result of end-stage renal disease
Elevated serum lipid levels
What is the result of diabetic ketoacidosis (DKA)
ketonuria
What is associated with end-stage renal disease
Hyperkalemia?
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A. Continuous IV infusion of magnesium
B. One-time infusion of albumin
C. Continuous epidural infusion of morphine
D. Intermittent infusion of IV vancomycin
, 3
NURS 480 Medical-Surgical FINAL EXAM
Answer- C
Rationale-
All four of these clients have the potential to have significant complications. The client with
the morphine epidural infusion is at highest risk for respiratory depression and should be
assessed first. Option A can cause hypotension. The client receiving option B is at lowest risk
for serious complications. Although option D can cause nephrotoxicity and phlebitis, these
problems are not as immediately life threatening as option C.
A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant in
the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s.
B. A close family member contracted tuberculosis last year.
C. The client smokes one to two packs of cigarettes per day.
D. The client has been 40 pounds overweight for 15 years.
Answer- C
Rationale-
Smoking, considered to be a modifiable risk factor, is the most significant risk factor for the
development of COPD. The exact mechanism of genetic and hereditary implications for the
development of COPD is still under investigation, although exposure to similar predisposing
factors (e.g., smoking or inhaling secondhand smoke) may increase the likelihood of COPD
incidence among family members. Options B and D do not exceed the risks associated with
cigarette smoking in the development of COPD.
, 4
NURS 480 Medical-Surgical FINAL EXAM
Which description of symptoms is characteristic of a client diagnosed with trigeminal
neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties
B. Sudden, stabbing, severe pain over the lip and chin
C. Unilateral facial weakness and paralysis
D. Difficulty in chewing, talking, and swallowing
Answer- B
Rationale-
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric shock, in the
area innervated by one or more branches of the trigeminal nerve (cranial V). Option A would
be characteristic of Ménière syndrome (cranial nerve VIII). Option C would be characteristic
of Bell palsy (cranial nerve VII). Option D would be characteristic of disorders of the
hypoglossal (cranial nerve XII).
A client with chronic asthma is admitted to the PACU complaining of pain at a level of 8 on a
1 to 10 scale, with a blood pressure of 124/78 mm Hg, pulse of 88 beats/min, and respirations
of 20 breaths/min. The PACU recovery prescription is "Morphine, 2 to 4 mg IV push, while in
recovery for pain level over 5." Which intervention should the nurse implement?
A. Give the medication as prescribed to decrease the client's pain.
B. Call the anesthesia provider for a different medication for pain.
C. Use nonpharmacologic techniques before giving the medication.
NURS 480 Medical-Surgical FINAL EXAM
NURS 480 Medical-Surgical FINALE EXAM
2 WEST COAST UNIVERSITY PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
ACE
n assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory
test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C. Potassium
, 2
NURS 480 Medical-Surgical FINAL EXAM
D. Glucose
Answer- C
Rationale-
Clients with primary aldosteronism exhibit a profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and universal sign. The serum sodium
level is normal or elevated, depending on the amount of water resorbed with the sodium.
Option B is influenced by parathyroid hormone (PTH). Option D is not affected by primary
aldosteronism.
What is the result of end-stage renal disease
Elevated serum lipid levels
What is the result of diabetic ketoacidosis (DKA)
ketonuria
What is associated with end-stage renal disease
Hyperkalemia?
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A. Continuous IV infusion of magnesium
B. One-time infusion of albumin
C. Continuous epidural infusion of morphine
D. Intermittent infusion of IV vancomycin
, 3
NURS 480 Medical-Surgical FINAL EXAM
Answer- C
Rationale-
All four of these clients have the potential to have significant complications. The client with
the morphine epidural infusion is at highest risk for respiratory depression and should be
assessed first. Option A can cause hypotension. The client receiving option B is at lowest risk
for serious complications. Although option D can cause nephrotoxicity and phlebitis, these
problems are not as immediately life threatening as option C.
A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant in
the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s.
B. A close family member contracted tuberculosis last year.
C. The client smokes one to two packs of cigarettes per day.
D. The client has been 40 pounds overweight for 15 years.
Answer- C
Rationale-
Smoking, considered to be a modifiable risk factor, is the most significant risk factor for the
development of COPD. The exact mechanism of genetic and hereditary implications for the
development of COPD is still under investigation, although exposure to similar predisposing
factors (e.g., smoking or inhaling secondhand smoke) may increase the likelihood of COPD
incidence among family members. Options B and D do not exceed the risks associated with
cigarette smoking in the development of COPD.
, 4
NURS 480 Medical-Surgical FINAL EXAM
Which description of symptoms is characteristic of a client diagnosed with trigeminal
neuralgia (tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties
B. Sudden, stabbing, severe pain over the lip and chin
C. Unilateral facial weakness and paralysis
D. Difficulty in chewing, talking, and swallowing
Answer- B
Rationale-
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric shock, in the
area innervated by one or more branches of the trigeminal nerve (cranial V). Option A would
be characteristic of Ménière syndrome (cranial nerve VIII). Option C would be characteristic
of Bell palsy (cranial nerve VII). Option D would be characteristic of disorders of the
hypoglossal (cranial nerve XII).
A client with chronic asthma is admitted to the PACU complaining of pain at a level of 8 on a
1 to 10 scale, with a blood pressure of 124/78 mm Hg, pulse of 88 beats/min, and respirations
of 20 breaths/min. The PACU recovery prescription is "Morphine, 2 to 4 mg IV push, while in
recovery for pain level over 5." Which intervention should the nurse implement?
A. Give the medication as prescribed to decrease the client's pain.
B. Call the anesthesia provider for a different medication for pain.
C. Use nonpharmacologic techniques before giving the medication.
