2/9/24, 3:07 PM Medical Surgical EXAM 4 Questions AND Correct Answers 2023
MEDICAL SURGICAL EXAM 4 QUES
QUESTIONS
TIONS AND
CORRECT ANSWERS 2023
1) After receiving change-of-shift report on the following four patients, which patient should the nurse see
first?
a. A 60-yr-old patient with right-sided weakness who has an infusion of tPA
prescribed
b. A 50-yr-old patient who has atrial fibrillation and a new order for warfarin
(Coumadin)
c. A 30-yr-old patient with a subarachnoid hemorrhage 2 days ago who has
nimodipine scheduled
d. A 40-yr-old patient who had a transient ischemic attack yesterday and has a dose of
aspirin due
2) The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a
mechanical ventilator with 10cm H2O of peak end-expiratory pressure (PEEP). What new finding indicates
that the nurse needs to notify the health care provider immediately?
a. O2 saturation of 93%
b. Respirations of 20 breaths/min
c. Green nasogastric tube drainage
d. Increased jugular venous distention
3) The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is receiving
mechanical ventilation. Which intervention will most directly treat this finding?
a. Reposition the patient every 1 to 2 hours.
b. Increase suctioning frequency to every hour.
c. Add additional water to the patient’s enteral feedings.
d. Instill 5 mL of sterile saline into the ET before suctioning.
4) An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer
to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset
confusion. What should the nurse plan to do?
a. Give PRN lorazepam (Ativan) and cancel the transfer.
b. Inform the receiving nurse and then transfer the patient.
c. Notify the health care provider and postpone the transfer.
d. Obtain an order for restraints as needed and transfer the patient.
-A patient who is orally intubated and receiving mechanical ventilation is anxious and is “fighting” the
ventilator. Which action should the nurse take next?
a. Verbally coach the patient to breathe with the ventilator.
b. Sedate the patient with the ordered PRN lorazepam (Ativan).
c. Manually ventilate the patient with a bag-valve-mask device.
d. Increase the rate for the ordered propofol (Diprivan) infusion.
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, 2/9/24, 3:07 PM Medical Surgical EXAM 4 Questions AND Correct Answers 2023
5) After endotracheal suctioning, the nurse notes that the intracranial pressure (ICP) for a patient with a
traumatic head injury has increased from 14 to 17 mm Hg. Which action should the nurse take first?
a. Document the increase in intracranial pressure.
b. Ensure that the patient’s neck is in neutral position.
c. Notify the health care provider about the change in pressure.
d. Increase the rate of the prescribed propofol (Diprivan) infusion.
6) A patient with suspected neurogenic shock after a diving accident has arrived in the emergency
department. A cervical collar is in place. Which actions should the nurse take? (Select all that apply.)
a. Prepare to administer atropine IV.
b. Obtain baseline body temperature.
c. Infuse large volumes of lactated Ringer’s solution.
d. Provide high-flow O2 (100%) by nonrebreather mask.
e. Prepare for emergent intubation and mechanical ventilation.
7) After reviewing the information shown in the accompanying figure for a patient with pneumonia and
sepsis, which information is most important to report to the health care provider?
a. Temperature and IV site appearance
b. Oxygen saturation and breath sounds
c. Platelet count and presence of petechiae
d. Blood pressure, pulse rate, respiratory rate
8) Which finding about a patient who is receiving vasopressin to treat septic shock indicates an
immediate need for the nurse to
contact the health care provider?
a. The patient’s urine output is 18 mL/hr.
b. The patient’s heart rate is 110 beats/min.
c. The patient’s peripheral pulses are weak.
d. The patient reports diffuse chest pressure.
9) Which assessment information is most important for the nurse to obtain when evaluating whether
treatment of a patient with anaphylactic shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation
about:blank 2/8
MEDICAL SURGICAL EXAM 4 QUES
QUESTIONS
TIONS AND
CORRECT ANSWERS 2023
1) After receiving change-of-shift report on the following four patients, which patient should the nurse see
first?
a. A 60-yr-old patient with right-sided weakness who has an infusion of tPA
prescribed
b. A 50-yr-old patient who has atrial fibrillation and a new order for warfarin
(Coumadin)
c. A 30-yr-old patient with a subarachnoid hemorrhage 2 days ago who has
nimodipine scheduled
d. A 40-yr-old patient who had a transient ischemic attack yesterday and has a dose of
aspirin due
2) The nurse is caring for a patient with a subarachnoid hemorrhage who is intubated and placed on a
mechanical ventilator with 10cm H2O of peak end-expiratory pressure (PEEP). What new finding indicates
that the nurse needs to notify the health care provider immediately?
a. O2 saturation of 93%
b. Respirations of 20 breaths/min
c. Green nasogastric tube drainage
d. Increased jugular venous distention
3) The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is receiving
mechanical ventilation. Which intervention will most directly treat this finding?
a. Reposition the patient every 1 to 2 hours.
b. Increase suctioning frequency to every hour.
c. Add additional water to the patient’s enteral feedings.
d. Instill 5 mL of sterile saline into the ET before suctioning.
4) An 81-yr-old patient who has been in the intensive care unit (ICU) for a week is now stable and transfer
to the progressive care unit is planned. On rounds, the nurse notices that the patient has new onset
confusion. What should the nurse plan to do?
a. Give PRN lorazepam (Ativan) and cancel the transfer.
b. Inform the receiving nurse and then transfer the patient.
c. Notify the health care provider and postpone the transfer.
d. Obtain an order for restraints as needed and transfer the patient.
-A patient who is orally intubated and receiving mechanical ventilation is anxious and is “fighting” the
ventilator. Which action should the nurse take next?
a. Verbally coach the patient to breathe with the ventilator.
b. Sedate the patient with the ordered PRN lorazepam (Ativan).
c. Manually ventilate the patient with a bag-valve-mask device.
d. Increase the rate for the ordered propofol (Diprivan) infusion.
about:blank 1/8
, 2/9/24, 3:07 PM Medical Surgical EXAM 4 Questions AND Correct Answers 2023
5) After endotracheal suctioning, the nurse notes that the intracranial pressure (ICP) for a patient with a
traumatic head injury has increased from 14 to 17 mm Hg. Which action should the nurse take first?
a. Document the increase in intracranial pressure.
b. Ensure that the patient’s neck is in neutral position.
c. Notify the health care provider about the change in pressure.
d. Increase the rate of the prescribed propofol (Diprivan) infusion.
6) A patient with suspected neurogenic shock after a diving accident has arrived in the emergency
department. A cervical collar is in place. Which actions should the nurse take? (Select all that apply.)
a. Prepare to administer atropine IV.
b. Obtain baseline body temperature.
c. Infuse large volumes of lactated Ringer’s solution.
d. Provide high-flow O2 (100%) by nonrebreather mask.
e. Prepare for emergent intubation and mechanical ventilation.
7) After reviewing the information shown in the accompanying figure for a patient with pneumonia and
sepsis, which information is most important to report to the health care provider?
a. Temperature and IV site appearance
b. Oxygen saturation and breath sounds
c. Platelet count and presence of petechiae
d. Blood pressure, pulse rate, respiratory rate
8) Which finding about a patient who is receiving vasopressin to treat septic shock indicates an
immediate need for the nurse to
contact the health care provider?
a. The patient’s urine output is 18 mL/hr.
b. The patient’s heart rate is 110 beats/min.
c. The patient’s peripheral pulses are weak.
d. The patient reports diffuse chest pressure.
9) Which assessment information is most important for the nurse to obtain when evaluating whether
treatment of a patient with anaphylactic shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation
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