Med-Surg 1 Final Exam with answers
Where |is |the |best |place |to |begin |to |select |a |vein |for |an |initial |intravenous |(IV) |site |in |a |left-handed
|patient?
Right |forearm |
Antecubital |vein |of |the |left |arm |
Left |forearm |
Antecubital |vein |of |the |right |arm |- |correct |answer |-Right |Forearm
RATIONALE: |Unless |other |reasons |are |identified, |IV |sites |should |be |started |in |the |most |distal |
portion |of |the |nondominant |arm |or |hand.
A |nurse |assesses |an |area |where |an |intravenous |(IV) |line |had |been |recently |removed. |The |area |has |
redness, |swelling, |and |warmth. |What |should |the |nurse |suspect |as |the |cause? |
Blood |loss |and |hemorrhage |
Embolus |from |the |former |catheter |
Inflammation |and |possible |phlebitis
Infiltration |and |air |embolus |- |correct |answer |-Inflammation |and |possible |phlebitis
RATIONALE: |IV |sites |may |show |signs |of |inflammation |or |infection |or |both |after |an |IV |line |has |been |
removed.
The |K+ |laboratory |report |shows |a |level |of |5.2 |mEq/L. |What |is |the |most |important |assessment |for |
the |nurse |to |make? |
Excessive |thirst |
Frightening |hallucinations |
Irregular |heartbeat |
,Swelling |of |ankles |- |correct |answer |-Irregular |heartbeat
RATIONALE: |Arrhythmias |can |be |triggered |by |hyperkalemia.
A |small |child |is |hospitalized |with |severe |metabolic |acidosis |after |ingesting |a |whole |bottle |of |baby |
aspirin |approximately |8 |hours |earlier. |In |addition |to |providing |reassurance |to |the |patient, |which |
nursing |action |is |the |most |appropriate? |
Inducing |vomiting |
Frequently |assessing |the |mental |and |neurologic |status |
Taking |daily |weights |and |vital |signs |- |correct |answer |-Frequently |assessing |the |mental |and |
neurologic |status
RATIONALE: |The |baby |aspirin |was |ingested |too |long |ago |to |have |vomiting |or |stomach |aspiration |be
|of |any |use. |The |child |requires |frequent |assessment |of |neurologic |function |because |the |child |may |
need |mechanical |ventilation.
When |the |water |absorption |in |the |renal |tubules |becomes |greater |than |normal, |what |assessment |
finding |should |a |nurse |anticipate? |
Less |concentrated |urine |
More |concentrated |urine |
Less |alkaline |urine
More |alkaline |urine |- |correct |answer |-More |concentrated |urine
RATIONALE: |When |more |water |is |kept |back |in |the |body, |the |water |left |to |form |urine |is |less; |
therefore, |the |urine |is |more |concentrated.
A |patient |has |renal |damage |because |of |diabetes. |What |is |the |highest |risk |for |this |patient? |
Hypokalemia |
,Hypercalcemia |
Hyperkalemia |
Hypocalcemia |- |correct |answer |-Hyperkalemia
RATIONALE: |When |the |renal |system |cannot |rid |the |body |of |enough |K+, |this |electrolyte |builds |up |
and |a |condition |called |hyperkalemia |develops.
A |nurse |understands |that |fluid |balance |is |mainly |monitored |in |the |body |by |which |two |systems? |
Respiratory |and |circulatory |
Renal |and |gastrointestinal |
Circulatory |and |renal |
Hepatic |and |lymphatic |- |correct |answer |-Circulatory |and |renal
RATIONALE: |The |monitoring |of |basic |fluid |balance |in |the |body |is |performed |by |the |renal |and |
circulatory |systems.
What |is |usually |associated |with |hyperchloremia?
Respiratory |acidosis |
Respiratory |alkalosis |
Metabolic |acidosis |
Metabolic |alkalosis |- |correct |answer |-Metabolic |acidosis
RATIONALE: |Chlorides |bind |with |positively |charged |ions |such |as |K+ |in |the |patient |with |metabolic |
acidosis.
Each |compartment |of |the |body |has |a |water-fluid |distribution |movement |of |its |own. |What |is |the |
process |allowing |these |fluids |to |move |and |distribute |themselves |among |compartments? |
, Active |transport |
Osmosis |
Filtration |
Diffusion |- |correct |answer |-Osmosis
RATIONALE: |The |intracellular |and |extracellular |compartments |contain |water |and |dissolved |
substances. |The |water |filters |back |and |forth |as |needed |to |maintain |homeostasis |via |osmolarity.
Which |order |should |be |clarified |by |a |nurse |when |transcribing |orders?
|
Potassium |chloride, |80 |mEq |in |1000 |mL |D5W |in |24 |hours |
Potassium |chloride, |40 |mEq |IV |in |10 |mL |D5W |IV |push |
Potassium |chloride, |80 |mEq |in |1000 |mL |D5W |in |12 |hours |
Potassium |chloride, |50 |mEq |in |500 |mL |D5W |in |4 |hours |- |correct |answer |-Potassium |chloride, |40 |
mEq |IV |in |10 |mL |D5W |IV |push
RATIONALE: |Potassium |chloride |is |never |given |by |intravenous |push |in |such |a |small |amount |of |
diluent. |Potassium |chloride |is |always |dissolved |in |D5W |and |should |be |infused |at |no |more |than |10 |
mEq/hr.
What |is |the |source |of |calories |in |IV |solutions? |
Dextrose |
Water |
Vitamins |
Electrolytes |- |correct |answer |-Dextrose
RATIONALE: |Dextrose |is |sugar |and |the |source |of |calories.
An |older |adult |patient |is |quite |ill |and |confused |and |begins |to |cry |pitifully |when |a |nurse |approaches
|the |bed |to |start |an |intravenous |(IV) |line. |What |is |the |best |action |for |the |nurse |at |this |time? |
Where |is |the |best |place |to |begin |to |select |a |vein |for |an |initial |intravenous |(IV) |site |in |a |left-handed
|patient?
Right |forearm |
Antecubital |vein |of |the |left |arm |
Left |forearm |
Antecubital |vein |of |the |right |arm |- |correct |answer |-Right |Forearm
RATIONALE: |Unless |other |reasons |are |identified, |IV |sites |should |be |started |in |the |most |distal |
portion |of |the |nondominant |arm |or |hand.
A |nurse |assesses |an |area |where |an |intravenous |(IV) |line |had |been |recently |removed. |The |area |has |
redness, |swelling, |and |warmth. |What |should |the |nurse |suspect |as |the |cause? |
Blood |loss |and |hemorrhage |
Embolus |from |the |former |catheter |
Inflammation |and |possible |phlebitis
Infiltration |and |air |embolus |- |correct |answer |-Inflammation |and |possible |phlebitis
RATIONALE: |IV |sites |may |show |signs |of |inflammation |or |infection |or |both |after |an |IV |line |has |been |
removed.
The |K+ |laboratory |report |shows |a |level |of |5.2 |mEq/L. |What |is |the |most |important |assessment |for |
the |nurse |to |make? |
Excessive |thirst |
Frightening |hallucinations |
Irregular |heartbeat |
,Swelling |of |ankles |- |correct |answer |-Irregular |heartbeat
RATIONALE: |Arrhythmias |can |be |triggered |by |hyperkalemia.
A |small |child |is |hospitalized |with |severe |metabolic |acidosis |after |ingesting |a |whole |bottle |of |baby |
aspirin |approximately |8 |hours |earlier. |In |addition |to |providing |reassurance |to |the |patient, |which |
nursing |action |is |the |most |appropriate? |
Inducing |vomiting |
Frequently |assessing |the |mental |and |neurologic |status |
Taking |daily |weights |and |vital |signs |- |correct |answer |-Frequently |assessing |the |mental |and |
neurologic |status
RATIONALE: |The |baby |aspirin |was |ingested |too |long |ago |to |have |vomiting |or |stomach |aspiration |be
|of |any |use. |The |child |requires |frequent |assessment |of |neurologic |function |because |the |child |may |
need |mechanical |ventilation.
When |the |water |absorption |in |the |renal |tubules |becomes |greater |than |normal, |what |assessment |
finding |should |a |nurse |anticipate? |
Less |concentrated |urine |
More |concentrated |urine |
Less |alkaline |urine
More |alkaline |urine |- |correct |answer |-More |concentrated |urine
RATIONALE: |When |more |water |is |kept |back |in |the |body, |the |water |left |to |form |urine |is |less; |
therefore, |the |urine |is |more |concentrated.
A |patient |has |renal |damage |because |of |diabetes. |What |is |the |highest |risk |for |this |patient? |
Hypokalemia |
,Hypercalcemia |
Hyperkalemia |
Hypocalcemia |- |correct |answer |-Hyperkalemia
RATIONALE: |When |the |renal |system |cannot |rid |the |body |of |enough |K+, |this |electrolyte |builds |up |
and |a |condition |called |hyperkalemia |develops.
A |nurse |understands |that |fluid |balance |is |mainly |monitored |in |the |body |by |which |two |systems? |
Respiratory |and |circulatory |
Renal |and |gastrointestinal |
Circulatory |and |renal |
Hepatic |and |lymphatic |- |correct |answer |-Circulatory |and |renal
RATIONALE: |The |monitoring |of |basic |fluid |balance |in |the |body |is |performed |by |the |renal |and |
circulatory |systems.
What |is |usually |associated |with |hyperchloremia?
Respiratory |acidosis |
Respiratory |alkalosis |
Metabolic |acidosis |
Metabolic |alkalosis |- |correct |answer |-Metabolic |acidosis
RATIONALE: |Chlorides |bind |with |positively |charged |ions |such |as |K+ |in |the |patient |with |metabolic |
acidosis.
Each |compartment |of |the |body |has |a |water-fluid |distribution |movement |of |its |own. |What |is |the |
process |allowing |these |fluids |to |move |and |distribute |themselves |among |compartments? |
, Active |transport |
Osmosis |
Filtration |
Diffusion |- |correct |answer |-Osmosis
RATIONALE: |The |intracellular |and |extracellular |compartments |contain |water |and |dissolved |
substances. |The |water |filters |back |and |forth |as |needed |to |maintain |homeostasis |via |osmolarity.
Which |order |should |be |clarified |by |a |nurse |when |transcribing |orders?
|
Potassium |chloride, |80 |mEq |in |1000 |mL |D5W |in |24 |hours |
Potassium |chloride, |40 |mEq |IV |in |10 |mL |D5W |IV |push |
Potassium |chloride, |80 |mEq |in |1000 |mL |D5W |in |12 |hours |
Potassium |chloride, |50 |mEq |in |500 |mL |D5W |in |4 |hours |- |correct |answer |-Potassium |chloride, |40 |
mEq |IV |in |10 |mL |D5W |IV |push
RATIONALE: |Potassium |chloride |is |never |given |by |intravenous |push |in |such |a |small |amount |of |
diluent. |Potassium |chloride |is |always |dissolved |in |D5W |and |should |be |infused |at |no |more |than |10 |
mEq/hr.
What |is |the |source |of |calories |in |IV |solutions? |
Dextrose |
Water |
Vitamins |
Electrolytes |- |correct |answer |-Dextrose
RATIONALE: |Dextrose |is |sugar |and |the |source |of |calories.
An |older |adult |patient |is |quite |ill |and |confused |and |begins |to |cry |pitifully |when |a |nurse |approaches
|the |bed |to |start |an |intravenous |(IV) |line. |What |is |the |best |action |for |the |nurse |at |this |time? |
