MEDICAL SURGICAL NURSING (Surgery)
CERTIFICATION PRACTICE EXAM
QUESTIONS CORRECTLY ANSWERED RATED
A.
The patient with Cushing syndrome is unable to react physiologically to
stressors, so discharge teaching should include ways to reduce or manage
stress; for example, the patient should avoid exposure to extreme
temperatures, infections, and emotional disturbance.
Answer (B) is indicated for the patient with Hypoparathyroidism.
Answer (C, D) are instructions for patients with Hyperthyroidism.
The nurse is performing discharge teaching for a client diagnosed with
Cushing's disease. Which statement made by the client demonstrates an
understanding of the instructions?
A. "I will be sure to notify my health-care provider if I start to run a
fever."
B. "Before I stop taking the prednisone, I will be taught how to taper it
off."
C. "If I get weak and shaky, I need to eat some hard candy or drink some
juice."
D. "It is fine if I continue to participate in weekend games of tackle
football."
Verified Answer -A. "I will be sure to notify my health-care provider if I
start to run a fever."
,Cushing's syndrome predisposes the client to develop infections as a
result of the immunosuppressive nature of the disease.
(B) The client has too much cortisol; this client would not be receiving
prednisone, a steroid medication. This is indicated for Addison's disease.
(C) These are symptoms of hypoglycemia, which would not be expected
in this client because this client has high glucose levels (Hyperglycemic).
(D) The client is predisposed to osteoporosis and fractures. Contact
sports should be avoided.
Test-Taking Hint:
If the test taker is not aware of the disease problem, And if all else fails,
you can still answer this question correctly by referring to common
standard discharge instructions - namely, notify the health-care provider
of a fever.
A patient is hospitalized with adrenocortical insufficiency (Addison's
disease). Which nursing activity should you delegate to the nursing
assistant?
A. Remind patient to change positions slowly.
B. Check the patient for muscle weakness.
C. Teach the patient how to collect 24-hour urine.
D. Plan nursing interventions to promote fluid balance.
Verified Answer -A. Remind patient to change positions slowly.
Patients with hypofunction of the adrenal glands often have hypotension
and should be instructed to change positions slowly. Once a patient has
been instructed, it is appropriate for the nursing assistant to remind the
patient of those instructions.
,Answers (B, C, D) all involve assessing, teaching, and planning nursing
care require more education and should be done by a licensed RN.
The nurse is caring for a patient who has received long-term
corticosteroid treatment for Addison's disease. The nurse is aware of the
patient's risk for injury related to development of what potential
complication related to this treatment.
A. Osteogenesis imperfecta
B. Osteosarcoma
C. Osteoporosis
D. Osteomalacia
Verified Answer -C. Osteoporosis
Long-term corticosteroid use (greater than 3 months) can contribute to
the development of osteroporosis and the risk for fragility fractures.
Answers (A, B, D) are all diseases that result in weak or brittle bones, but
they are not caused by steroid use.
Osteogenesis imperfecta = is a genetic disorder characterized by bones
that break easily
Osteosarcoma = is the most common type of bone cancer.
Osteomalacia = softening of the bones caused by a deficiency of Vit D or
Calcium
The patient with adrenal insufficiency is to be discharged on prednisone
10 mg orally each day. What will you be sure to teach the patient?
, A. Report excessive weight gain or swelling to the physician.
B. Rapid changes of position may cause hypotension.
C. A diet with foods high in potassium may be beneficial.
D. Signs of hypoglycemia may occur while taking this drug.
Verified Answer -A. Report excessive weight gain or swelling to the
physician.
Rapid weight gain and edema are signs of excessive drug therapy, and
the dose of the drug needs to be adjusted.
Answers (B, C, D) - Hypertension, hyperkalemia, and hyperglycemia are
common in patients with Addison's disease Adrenal Hypofunction, -
Prednisone does not cause Hypotension, Hypokalemia or Hypoglycemia,
and these symptoms are to be expected in someone with Addison's
disease.
The patient in Addisonian Crisis is unable to respond to stress. Before
discharge, the nurse should instruct the patient and his family that during
stress it'll be necessary to:
A. Administer cortisone I.M.
B. Drink 8 oz. (237 mL) of fluids
C. Perform capillary blood glucose monitoring four times daily
D. Continue to take his usual dose of hydrocortisone
Verified Answer -A. Administer cortisone I.M.
A - Patients with Addison's disease and their family members should
know how to administer I.M. hydrocortisone during periods of stress.
CERTIFICATION PRACTICE EXAM
QUESTIONS CORRECTLY ANSWERED RATED
A.
The patient with Cushing syndrome is unable to react physiologically to
stressors, so discharge teaching should include ways to reduce or manage
stress; for example, the patient should avoid exposure to extreme
temperatures, infections, and emotional disturbance.
Answer (B) is indicated for the patient with Hypoparathyroidism.
Answer (C, D) are instructions for patients with Hyperthyroidism.
The nurse is performing discharge teaching for a client diagnosed with
Cushing's disease. Which statement made by the client demonstrates an
understanding of the instructions?
A. "I will be sure to notify my health-care provider if I start to run a
fever."
B. "Before I stop taking the prednisone, I will be taught how to taper it
off."
C. "If I get weak and shaky, I need to eat some hard candy or drink some
juice."
D. "It is fine if I continue to participate in weekend games of tackle
football."
Verified Answer -A. "I will be sure to notify my health-care provider if I
start to run a fever."
,Cushing's syndrome predisposes the client to develop infections as a
result of the immunosuppressive nature of the disease.
(B) The client has too much cortisol; this client would not be receiving
prednisone, a steroid medication. This is indicated for Addison's disease.
(C) These are symptoms of hypoglycemia, which would not be expected
in this client because this client has high glucose levels (Hyperglycemic).
(D) The client is predisposed to osteoporosis and fractures. Contact
sports should be avoided.
Test-Taking Hint:
If the test taker is not aware of the disease problem, And if all else fails,
you can still answer this question correctly by referring to common
standard discharge instructions - namely, notify the health-care provider
of a fever.
A patient is hospitalized with adrenocortical insufficiency (Addison's
disease). Which nursing activity should you delegate to the nursing
assistant?
A. Remind patient to change positions slowly.
B. Check the patient for muscle weakness.
C. Teach the patient how to collect 24-hour urine.
D. Plan nursing interventions to promote fluid balance.
Verified Answer -A. Remind patient to change positions slowly.
Patients with hypofunction of the adrenal glands often have hypotension
and should be instructed to change positions slowly. Once a patient has
been instructed, it is appropriate for the nursing assistant to remind the
patient of those instructions.
,Answers (B, C, D) all involve assessing, teaching, and planning nursing
care require more education and should be done by a licensed RN.
The nurse is caring for a patient who has received long-term
corticosteroid treatment for Addison's disease. The nurse is aware of the
patient's risk for injury related to development of what potential
complication related to this treatment.
A. Osteogenesis imperfecta
B. Osteosarcoma
C. Osteoporosis
D. Osteomalacia
Verified Answer -C. Osteoporosis
Long-term corticosteroid use (greater than 3 months) can contribute to
the development of osteroporosis and the risk for fragility fractures.
Answers (A, B, D) are all diseases that result in weak or brittle bones, but
they are not caused by steroid use.
Osteogenesis imperfecta = is a genetic disorder characterized by bones
that break easily
Osteosarcoma = is the most common type of bone cancer.
Osteomalacia = softening of the bones caused by a deficiency of Vit D or
Calcium
The patient with adrenal insufficiency is to be discharged on prednisone
10 mg orally each day. What will you be sure to teach the patient?
, A. Report excessive weight gain or swelling to the physician.
B. Rapid changes of position may cause hypotension.
C. A diet with foods high in potassium may be beneficial.
D. Signs of hypoglycemia may occur while taking this drug.
Verified Answer -A. Report excessive weight gain or swelling to the
physician.
Rapid weight gain and edema are signs of excessive drug therapy, and
the dose of the drug needs to be adjusted.
Answers (B, C, D) - Hypertension, hyperkalemia, and hyperglycemia are
common in patients with Addison's disease Adrenal Hypofunction, -
Prednisone does not cause Hypotension, Hypokalemia or Hypoglycemia,
and these symptoms are to be expected in someone with Addison's
disease.
The patient in Addisonian Crisis is unable to respond to stress. Before
discharge, the nurse should instruct the patient and his family that during
stress it'll be necessary to:
A. Administer cortisone I.M.
B. Drink 8 oz. (237 mL) of fluids
C. Perform capillary blood glucose monitoring four times daily
D. Continue to take his usual dose of hydrocortisone
Verified Answer -A. Administer cortisone I.M.
A - Patients with Addison's disease and their family members should
know how to administer I.M. hydrocortisone during periods of stress.
