NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
91. The nurse is assessing a client who has a history of Parkinson's disease for the past 5 years. What symptoms
would this client most likely exhibit?
a. Loss of short-term memory, facial tics and grimaces, and constant writhing movements.
b. Shuffling gait, masklike facial expression, and tremors of the head.
c. Extreme muscular weakness, easy fatigability, and ptosis.
d. Numbness of the extremities, loss of balance, and visual disturbances. - Correct Answer :B
Rationale
Parkinson's Disease is one of the most common neurologic progressive disorder of the older client. Shuffling
gait, masklike facial expression, and tremors of the head and hands are common clinical features of
Parkinsonism.
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92. A client is admitted to the medical intensive care unit with a diagnosis of myocardial infarction. The client's
history indicates the infarction occurred ten hours ago. Which laboratory test result would the nurse expect this
client to exhibit?
a. Elevated LDH.
b. Elevated serum amylase.
c. Elevated CK-MB.
d. Elevated hematocrit. - Correct Answer :C
Rationale
The cardiac isoenzyme CK-MB (C) is the one of the cardiac markers to indicate myocardial damage in the
presence of MI symptoms and after a positive troponin. The troponin levels will elevate within 2-3 hours
indicating myocardial ischemia, followed by the CK-MB cardiac markers within 6-9 hours, peaking within 12 to 20
hours after myocardial infarction (MI).
93. In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which substance?
a. Sodium.
b. Antidiuretic hormone.
c. Potassium.
d. Glucose. - Correct Answer :C
Rationale
Clients with primary hyperaldosteronism exhibit a profound decline in the serum levels of potassium
(hypokalemia). Hypertension, along with the hypokalemia are the most prominent and universal signs for this
condition. If both of these findings are present, there is 50% likelihood the client to be diagnosed with
hyperaldosteronism.
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94. Which intervention should the nurse implement for a female client diagnosed with pelvic relaxation disorder?
a. Describe proper administration of vaginal suppositories and cream.
b. Encourage the client to perform Kegel exercises 10 times daily.
c. Explain the importance of using condoms when having sexual intercourse.
d. Discuss the importance of keeping a diary of daily temperature and menstrual cycle events. - Correct Answer
:B
Rationale
Pelvic relaxation disorders are structural disorders resulting from weakening support tissues of the pelvis. Kegel
exercises helps strengthen the surrounding muscles.
95. A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan,
the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most
important to teach the client?
a. Facial flushing.
b. Fever.
c. Pounding headache.
d. Feelings of dizziness. - Correct Answer :D
Rationale
Feelings of dizziness may occur as the result of a decreased heart rate, leading to a decreased cardiac output
which may be an indication of pacemaker failure.
96. The nurse is interviewing a male client with hypertension. Which additional medical diagnosis in the client's
history presents the greatest risk for developing a cerebral vascular accident (CVA)?
a. Diabetes mellitus.
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b. Hypothyroidism.
c. Parkinson's disease.
d. Recurring pneumonia. - Correct Answer :A
Rationale
According to the National Stroke Association (2013), history of diabetes mellitus poses the greatest risk for
developing a CVA, 2-4Xs more than those who do not have diabetes mellitus. The reason for this occurrence is
related to the excess glucose circulating throughout the body not being utilizing by the cells of the body, leading
to the increased fatty deposits or clots inside the blood vessels in the brain or neck, eventually causing a stroke.
97. A 77-year-old female client is admitted to the hospital. She is confused, has no appetite, is nauseated and
vomiting, and is complaining of a headache. Her pulse rate is 43 beats per minute. Which question is a priority for
the nurse to ask this client or her family on admission? "Does the client
a. have her own teeth or dentures?"
b. take aspirin and if so, how much?"
c. take nitroglycerin?"
d. take digitalis?" - Correct Answer :D
Rationale
Although it is important to obtain a complete medication history, the symptoms described are classic for digitalis
toxicity, and assessment of this problem should be made promptly. Elderly persons are particularly susceptible
to digitalis intoxication which manifests itself in such symptoms as anorexia, nausea, vomiting, diarrhea,
headache, and fatigue.
98. A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes is
contributing to the difficulty that he and his wife are having in getting pregnant and wants to know if other
factors could be contributing to their difficulty. What information is best for the nurse to provide? (Select all that
apply.)
a. Marijuana cigarettes do not affect sperm count.
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