Med Surge (Lewis)
Exam 1 - Evolve
Questions with
Answers
User [Date] [Course title]
,The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment
data will be of most concern to the nurse?
a. 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: Answer A
A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should notify the health care provider about which assessment finding?
a. Reported weight gain
b. Serum hematocrit of 42%
c. Serum sodium level of 120 mg/dL
d. Total urinary output of 280 mL during past 8 hours - Correct Answer: Answer C
A patient is admitted for hypovolemia associated with multiple draining wounds. Which assessment
would be the most accurate way for the nurse to evaluate fluid balance?
a. Skin turgor
b. Daily weight
c. Presence of edema
d. Hourly urine output - Correct Answer: Answer B
The home health nurse cares for an alert and oriented older adult patient with a history of dehydration.
Which instructions should the nurse give to this patient related to fluid intake?
a. "Increase fluids if your mouth feels dry.
b. "More fluids are needed if you feel thirsty."
c. "Drink more fluids in the late evening hours."
d. "If you feel lethargic or confused, you need more to drink." - Correct Answer: Answer A
A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of
generalized weakness. It is most appropriate for the nurse to take which action?
,a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Suggest that the patient avoid orange juice with meals.
d. Ask the health care provider to order a basic metabolic panel. - Correct Answer: Answer D
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by
the patient indicates that the teaching about this medication has been effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast." - Correct Answer: Answer D
A newly admitted patient is diagnosed with hyponatremia. When making room assignments, the charge
nurse should take which action?
a. Assign the patient to a room near the nurse's station.
b. Place the patient in a room nearest to the water fountain.
c. Place the patient on telemetry to monitor for peaked T waves.
d. Assign the patient to a semi-private room and place an order for a low-salt diet. - Correct Answer:
Answer A
IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia.
Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion. - Correct Answer: Answer B
A postoperative patient who had surgery for a perforated gastric ulcer has been receiving nasogastric
suction for 3 days. The patient now has a serum sodium level of 127 mEq/L (127 mmol/L). Which
prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
, b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium decreases to less than 128 mEq/L. - Correct Answer: Answer A
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?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - Correct Answer: Answer D
The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep respirations.
Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery. - Correct Answer: Answer C
An older adult patient who is malnourished presents to the emergency department with a serum
protein level of 5.2 g/dL. The nurse would expect which clinical manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness - Correct Answer: Answer B
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is most
important for the nurse to monitor for while the patient is receiving this infusion?
a. Lung sounds
b. Urinary output
Exam 1 - Evolve
Questions with
Answers
User [Date] [Course title]
,The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment
data will be of most concern to the nurse?
a. 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: Answer A
A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should notify the health care provider about which assessment finding?
a. Reported weight gain
b. Serum hematocrit of 42%
c. Serum sodium level of 120 mg/dL
d. Total urinary output of 280 mL during past 8 hours - Correct Answer: Answer C
A patient is admitted for hypovolemia associated with multiple draining wounds. Which assessment
would be the most accurate way for the nurse to evaluate fluid balance?
a. Skin turgor
b. Daily weight
c. Presence of edema
d. Hourly urine output - Correct Answer: Answer B
The home health nurse cares for an alert and oriented older adult patient with a history of dehydration.
Which instructions should the nurse give to this patient related to fluid intake?
a. "Increase fluids if your mouth feels dry.
b. "More fluids are needed if you feel thirsty."
c. "Drink more fluids in the late evening hours."
d. "If you feel lethargic or confused, you need more to drink." - Correct Answer: Answer A
A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of
generalized weakness. It is most appropriate for the nurse to take which action?
,a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Suggest that the patient avoid orange juice with meals.
d. Ask the health care provider to order a basic metabolic panel. - Correct Answer: Answer D
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by
the patient indicates that the teaching about this medication has been effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast." - Correct Answer: Answer D
A newly admitted patient is diagnosed with hyponatremia. When making room assignments, the charge
nurse should take which action?
a. Assign the patient to a room near the nurse's station.
b. Place the patient in a room nearest to the water fountain.
c. Place the patient on telemetry to monitor for peaked T waves.
d. Assign the patient to a semi-private room and place an order for a low-salt diet. - Correct Answer:
Answer A
IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia.
Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion. - Correct Answer: Answer B
A postoperative patient who had surgery for a perforated gastric ulcer has been receiving nasogastric
suction for 3 days. The patient now has a serum sodium level of 127 mEq/L (127 mmol/L). Which
prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
, b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium decreases to less than 128 mEq/L. - Correct Answer: Answer A
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?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - Correct Answer: Answer D
The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep respirations.
Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery. - Correct Answer: Answer C
An older adult patient who is malnourished presents to the emergency department with a serum
protein level of 5.2 g/dL. The nurse would expect which clinical manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness - Correct Answer: Answer B
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is most
important for the nurse to monitor for while the patient is receiving this infusion?
a. Lung sounds
b. Urinary output
