Strayer University NUR 350 Med Surg II Midterm (pdf) | 2026/2027 |
Med-Surg II Q&A | Medical-Surgical Nursing
1. A nurse is planning care for a client who will undergo peritoneal dialysis.
Which of the following actions should the nurse take? (Select all that apply.)
A) Monitor blood glucose levels
B) Report cloudy dialysate return
C) Warm the dialysate in a microwave oven
D) Assess for shortness of breath
E) Check the access site dressing for wetness
F) Maintain medical asepsis when accessing the catheter insertion site
Correct Answer: Monitor blood glucose levels, Report cloudy dialysate return,
Assess for shortness of breath, Check the access site dressing for wetness
Rationale: Peritoneal dialysis uses dextrose-based dialysate, which can raise
blood glucose, so monitoring is essential. Cloudy return indicates peritonitis
and must be reported. Shortness of breath can indicate fluid overload or
pulmonary complications. The access site should be checked for wetness as
a sign of leakage. Dialysate should never be warmed in a microwave due to
uneven heating; it should be warmed using a heating pad or warmer. Strict
surgical asepsis, not just medical asepsis, is required when accessing the
catheter.
2. Which of the following is an expected finding in a client with end-stage
kidney disease?
A) Increased calcium level
B) Marked azotemia
C) Polyuria
D) Hypercalcemia
,Correct Answer: Marked azotemia
Rationale: End-stage kidney disease (ESKD) results in the accumulation of
waste products such as urea, leading to marked azotemia. Calcium levels are
typically decreased due to impaired vitamin D activation and
hyperphosphatemia. Oliguria or anuria, not polyuria, is expected.
Hypercalcemia is not characteristic; hypocalcemia is more common.
3. A nurse is caring for a client who has a new diagnosis of acute kidney
injury (AKI). Which finding should the nurse expect during the oliguric phase?
A) Increased urine output
B) Hyperkalemia
C) Hypophosphatemia
D) Metabolic alkalosis
Correct Answer: Hyperkalemia
Rationale: During the oliguric phase of AKI, urine output decreases to less
than 400 mL/day. Potassium excretion is impaired, leading to hyperkalemia,
which can cause life-threatening cardiac dysrhythmias. Metabolic acidosis,
not alkalosis, occurs due to the inability to excrete acids.
Hyperphosphatemia and hypocalcemia are also common.
4. The nurse is assessing a client with chronic kidney disease (CKD) who is
receiving erythropoietin therapy. Which laboratory value should the nurse
monitor to evaluate the effectiveness of this therapy?
A) Serum creatinine
B) Blood urea nitrogen (BUN)
C) Hemoglobin and hematocrit
D) Serum potassium
,Correct Answer: Hemoglobin and hematocrit
Rationale: Erythropoietin stimulates red blood cell production in the bone
marrow. Monitoring hemoglobin and hematocrit evaluates the effectiveness
of therapy in treating anemia associated with CKD. Creatinine and BUN
reflect kidney function, and potassium reflects electrolyte balance.
5. A client with end-stage kidney disease is scheduled for a kidney
transplant. The nurse understands that which finding is a contraindication to
transplantation?
A) Hypertension
B) Diabetes mellitus
C) Active infection
D) Hyperlipidemia
Correct Answer: Active infection
Rationale: Active infection is a contraindication to kidney transplantation
because immunosuppressive therapy required post-transplant would worsen
the infection and increase the risk of sepsis. Hypertension, diabetes mellitus,
and hyperlipidemia are managed conditions that do not preclude
transplantation.
6. The nurse is teaching a client with chronic kidney disease about dietary
modifications. Which statement by the client indicates understanding?
A) "I should increase my intake of potassium-rich foods."
B) "I need to limit my intake of foods high in phosphorus."
C) "I can eat as much protein as I want."
D) "I should increase my fluid intake to flush out toxins."
, Correct Answer: "I need to limit my intake of foods high in phosphorus."
Rationale: Clients with CKD should limit phosphorus intake to prevent
hyperphosphatemia and its complications, including bone disease and
vascular calcification. Potassium restriction may also be necessary
depending on the stage of CKD. Protein is typically restricted to reduce urea
production, and fluid intake is often limited to prevent fluid overload.
7. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding is most consistent with this diagnosis?
A) Increased anterior-posterior (AP) chest diameter
B) Decreased respiratory rate
C) Pink, moist mucous membranes
D) Clubbing of the fingers
Correct Answer: Increased anterior-posterior (AP) chest diameter
Rationale: COPD is characterized by air trapping and hyperinflation, leading
to a barrel chest with an increased AP diameter. Respiratory rate is typically
increased, not decreased, as the client works to breathe. Clubbing may occur
in chronic hypoxemia but is more commonly associated with lung cancer or
bronchiectasis. Mucous membranes are often pale or cyanotic due to
hypoxemia.
8. The nurse is caring for a client with COPD who is prescribed oxygen
therapy. Which statement about oxygen administration in COPD is correct?
A) Oxygen should be administered at high flow rates to correct hypoxemia
quickly
B) Oxygen should be administered at low flow rates to avoid suppressing the
respiratory drive
Med-Surg II Q&A | Medical-Surgical Nursing
1. A nurse is planning care for a client who will undergo peritoneal dialysis.
Which of the following actions should the nurse take? (Select all that apply.)
A) Monitor blood glucose levels
B) Report cloudy dialysate return
C) Warm the dialysate in a microwave oven
D) Assess for shortness of breath
E) Check the access site dressing for wetness
F) Maintain medical asepsis when accessing the catheter insertion site
Correct Answer: Monitor blood glucose levels, Report cloudy dialysate return,
Assess for shortness of breath, Check the access site dressing for wetness
Rationale: Peritoneal dialysis uses dextrose-based dialysate, which can raise
blood glucose, so monitoring is essential. Cloudy return indicates peritonitis
and must be reported. Shortness of breath can indicate fluid overload or
pulmonary complications. The access site should be checked for wetness as
a sign of leakage. Dialysate should never be warmed in a microwave due to
uneven heating; it should be warmed using a heating pad or warmer. Strict
surgical asepsis, not just medical asepsis, is required when accessing the
catheter.
2. Which of the following is an expected finding in a client with end-stage
kidney disease?
A) Increased calcium level
B) Marked azotemia
C) Polyuria
D) Hypercalcemia
,Correct Answer: Marked azotemia
Rationale: End-stage kidney disease (ESKD) results in the accumulation of
waste products such as urea, leading to marked azotemia. Calcium levels are
typically decreased due to impaired vitamin D activation and
hyperphosphatemia. Oliguria or anuria, not polyuria, is expected.
Hypercalcemia is not characteristic; hypocalcemia is more common.
3. A nurse is caring for a client who has a new diagnosis of acute kidney
injury (AKI). Which finding should the nurse expect during the oliguric phase?
A) Increased urine output
B) Hyperkalemia
C) Hypophosphatemia
D) Metabolic alkalosis
Correct Answer: Hyperkalemia
Rationale: During the oliguric phase of AKI, urine output decreases to less
than 400 mL/day. Potassium excretion is impaired, leading to hyperkalemia,
which can cause life-threatening cardiac dysrhythmias. Metabolic acidosis,
not alkalosis, occurs due to the inability to excrete acids.
Hyperphosphatemia and hypocalcemia are also common.
4. The nurse is assessing a client with chronic kidney disease (CKD) who is
receiving erythropoietin therapy. Which laboratory value should the nurse
monitor to evaluate the effectiveness of this therapy?
A) Serum creatinine
B) Blood urea nitrogen (BUN)
C) Hemoglobin and hematocrit
D) Serum potassium
,Correct Answer: Hemoglobin and hematocrit
Rationale: Erythropoietin stimulates red blood cell production in the bone
marrow. Monitoring hemoglobin and hematocrit evaluates the effectiveness
of therapy in treating anemia associated with CKD. Creatinine and BUN
reflect kidney function, and potassium reflects electrolyte balance.
5. A client with end-stage kidney disease is scheduled for a kidney
transplant. The nurse understands that which finding is a contraindication to
transplantation?
A) Hypertension
B) Diabetes mellitus
C) Active infection
D) Hyperlipidemia
Correct Answer: Active infection
Rationale: Active infection is a contraindication to kidney transplantation
because immunosuppressive therapy required post-transplant would worsen
the infection and increase the risk of sepsis. Hypertension, diabetes mellitus,
and hyperlipidemia are managed conditions that do not preclude
transplantation.
6. The nurse is teaching a client with chronic kidney disease about dietary
modifications. Which statement by the client indicates understanding?
A) "I should increase my intake of potassium-rich foods."
B) "I need to limit my intake of foods high in phosphorus."
C) "I can eat as much protein as I want."
D) "I should increase my fluid intake to flush out toxins."
, Correct Answer: "I need to limit my intake of foods high in phosphorus."
Rationale: Clients with CKD should limit phosphorus intake to prevent
hyperphosphatemia and its complications, including bone disease and
vascular calcification. Potassium restriction may also be necessary
depending on the stage of CKD. Protein is typically restricted to reduce urea
production, and fluid intake is often limited to prevent fluid overload.
7. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding is most consistent with this diagnosis?
A) Increased anterior-posterior (AP) chest diameter
B) Decreased respiratory rate
C) Pink, moist mucous membranes
D) Clubbing of the fingers
Correct Answer: Increased anterior-posterior (AP) chest diameter
Rationale: COPD is characterized by air trapping and hyperinflation, leading
to a barrel chest with an increased AP diameter. Respiratory rate is typically
increased, not decreased, as the client works to breathe. Clubbing may occur
in chronic hypoxemia but is more commonly associated with lung cancer or
bronchiectasis. Mucous membranes are often pale or cyanotic due to
hypoxemia.
8. The nurse is caring for a client with COPD who is prescribed oxygen
therapy. Which statement about oxygen administration in COPD is correct?
A) Oxygen should be administered at high flow rates to correct hypoxemia
quickly
B) Oxygen should be administered at low flow rates to avoid suppressing the
respiratory drive
