NUR 113 Medical-surgical Study Questions and correct answers

NUR 113 Medical-
] ]




surgical Study Questions and correct an
] ] ] ] ]




swers 2026-2027 ] ]




1. ]The ]nurse ]obtains ]all ]of ]the ]following ]assessment ]data ]about ]a ]patient ]with ]deficient ]fluid ]vol
ume ]caused ]by ]a ]massive ]burn ]injury. ]Which ]of ]the ]following ]assessment ]data ]will ]be ]of ]greatest
]concern?




a.



The ]blood ]pressure ]is ]90/40 ]mm ]Hg.



b.



Urine ]output ]is ]30 ]ml ]over ]the ]last ]hour.



c.



Oral ]fluid ]intake ]is ]100 ]ml ]for ]the ]last ]8 ]hours.



d.



There ]is ]prolonged ]skin ]tenting ]over ]the ]sternum. ]- ]correct ]answer: ]The ]blood ]pressure ]is ]90/40 ]
mm ]Hg.

,Rationale: ]The ]blood ]pressure ]indicates ]that ]the ]patient ]may ]be ]developing ]hypovolemic ]shock ]
as ]a ]result ]of ]fluid ]loss. ]This ]will ]require ]immediate ]intervention ]to ]prevent ]the ]complications ]ass
ociated ]with ]systemic ]hypoperfusion. ]The ]poor ]oral ]intake, ]decreased ]urine ]output, ]and ]skin ]ten
ting ]all ]indicate ]the ]need ]for ]increasing ]the ]patients ]fluid ]intake ]but ]not ]as ]urgently ]as ]the ]hypot
ension.



2. ]A ]recently ]admitted ]patient ]has ]a ]small ]cell ]carcinoma ]of ]the ]lung, ]which ]is ]causing ]the ]syndro
me ]of ]inappropriate ]antidiuretic ]hormone ](SIADH). ]The ]nurse ]will ]monitor ]carefully ]for



a.



increased ]total ]urinary ]output.



b.



elevation ]of ]serum ]hematocrit.



c.



decreased ]serum ]sodium ]level.



d.



rapid ]and ]unexpected ]weight ]loss. ]- ]correct ]answer: ]decreased ]serum ]sodium ]level.



Rationale: ]SIADH ]causes ]water ]retention ]and ]a ]decrease ]in ]serum ]sodium ]level. ]Weight ]loss, ]incr
eased ]urine ]output, ]and ]elevated ]serum ]hematocrit ]may ]be ]associated ]with ]excessive ]loss ]of ]wa
ter, ]but ]not ]with ]SIADH ]and ]water ]retention.

,3. ]When ]the ]nurse ]is ]evaluating ]the ]fluid ]balance ]for ]a ]patient ]admitted ]for ]hypovolemia ]associa
ted ]with ]multiple ]draining ]wounds, ]the ]most ]accurate ]assessment ]to ]include ]is



a.



skin ]turgor.



b.



daily ]weight.



c.



presence ]of ]edema.



d.



hourly ]urine ]output. ]- ]correct ]answer: ]daily ]weight.



Rationale: ]Daily ]weight ]is ]the ]most ]easily ]obtained ]and ]accurate ]means ]of ]assessing ]volume ]stat
us. ]Skin ]turgor ]varies ]considerably ]with ]age. ]Considerable ]excess ]fluid ]volume ]may ]be ]present ]b
efore ]fluid ]moves ]into ]the ]interstitial ]space ]and ]causes ]edema. ]Hourly ]urine ]outputs ]do ]not ]take ]
account ]of ]fluid ]intake ]or ]of ]fluid ]loss ]through ]insensible ]loss, ]sweating, ]or ]loss ]from ]the ]gastroin
testinal ]tract ]or ]wounds.



4. ]When ]caring ]for ]an ]alert ]and ]oriented ]elderly ]patient ]with ]a ]history ]of ]dehydration, ]the ]home ]
health ]nurse ]will ]teach ]the ]patient ]to ]increase ]fluid ]intake

, a.



in ]the ]late ]evening ]hours.



b.



if ]the ]oral ]mucosa ]feels ]dry.



c.



when ]the ]patient ]feels ]thirsty.



d.



as ]soon ]as ]changes ]in ]level ]of ]consciousness ]
(LOC) ]occur. ]- ]correct ]answer: ]if ]the ]oral ]mucosa ]feels ]dry.



Rationale: ]An ]alert, ]elderly ]patient ]will ]be ]able ]to ]self-
assess ]for ]signs ]of ]oral ]dryness ]such ]as ]thick ]oral ]secretions ]or ]dry-
appearing ]mucosa. ]The ]thirst ]mechanism ]decreases ]with ]age ]and ]is ]not ]an ]accurate ]indicator ]of ]
volume ]depletion. ]Many ]older ]patients ]prefer ]to ]restrict ]fluids ]slightly ]in ]the ]evening ]to ]improve ]
sleep ]quality. ]The ]patient ]will ]not ]be ]likely ]to ]notice ]and ]act ]appropriately ]when ]changes ]in ]LOC ]
occur.



5. ]A ]patient ]is ]taking ]a ]potassium-
wasting ]diuretic ]for ]treatment ]of ]hypertension. ]The ]nurse ]will ]teach ]the ]patient ]to ]report ]sympt
oms ]of ]adverse ]effects ]such ]as