MEDSURG COMPREHENSIVE FINAL
EXAM QUESTIONS WITH CORRECT
ANSWERS RATIONALES
AOclientOadmittedOforOacuteOpyelonephritisOisOaboutOtoOstartOantibioticOtherapy.OWhichOsymptomOwouldOb
eOexpectedOinOthisOclient?
1)OHypertension
2)OFlankOpainOonOtheOaffectedOside
3)OPainOthatOradiatesOtowardOtheOunaffectedOside
4)ONoOtendernessOwithOdeepOpalpationOoverOthe
CVAO-OcorrectOanswer-
RATIONAL:O2)OTheOclientOmayOcomplainOofOpainOonOtheOaffectedOsideObecauseOtheOkidneyOisOenlargedOand
OmightOhaveOformedOanOabscess.
HypertensionOisOassociatedOwithOchronicOpyelonephritis.OPainOmayOradiateOdownOtheOuretersOorOtoOtheOe
pigastrium.OTheOclientOwouldOhaveOtendernessOwithOdeepOpalpationOoverOtheOCVA.
DischargeOinstructionsOforOaOclientOtreatedOforOacuteOpyelonephritisOshouldOincludeOwhichOstatement?
-O1.OAvoidOtakingOanyOdairyOproducts.
-O2.OReturnOforOfollow-upOurineOcultures.
-O3.OStopOtakingOtheOprescribedOantibioticsOwhenOtheOsymptomsOsubside.
-O4.ORecurrenceOisOunlikelyObecauseOyou'veObeenOtreatedOwithOantibiotics.O-OcorrectOanswer-
RATIONALE:O2)OTheOclientOneedsOtoOreturnOforOfollow-
upOurineOculturesObecauseObacteriuriaOmayObeOpresentObutOasymptomatic.OIntakeOofOdairyOproductsOwon'
tOcontributeOtoOpyelonephritis.OAntibioticsOneedOtoObeOtakenOforOtheOfullOcourseOofOtherapyOregardlessOofO
theOsymptoms.OPyelonephritisOtypicallyOrecursOasOaOrelapseOorOnewOinfectionOandOfrequentlyOrecursOwithi
nO2OweeksOofOcompletingOtherapy.
AOclientOisOcomplainingOofOsevereOflankOandOabdominalOpain.OAOflatOplateOofOtheOabdomenOshowsOurolithi
asis.OWhichOinterventionOisOimportant?
-O1.OStrainOallOurine
-O2.OLimitOfluidOintake
-O3.OEnforceOstrictObedOrest.
,-O4.OEncourageOaOhigh-calciumOdietO-OcorrectOanswer-
RATIONALE:O1)OUrineOshouldObeOstrainedOforOcalculiOandOsentOtoOtheOlaboratoryOforOanalysis.OFluidOintakeO
ofO3OtoO4Oqt.O3OtoO4OL/dayOisOencouragedOtoOflushOtheOurinaryOtractOandOpreventOfurtherOcalculiOformation
.OAmbulationOisOencouragedOtoOhelpOpassOtheOcalculiOthroughOgravity.OAOlow-
calciumOformationOofOcalciumOcalculi.
DuringOaOhealthOhistory,OwhichOstatementObyOaOclientOindicatesOaOriskOofOrenalOcalculi?
-O1.O"I'veObeenOdrinkingOaOlotOofOcolaOsoftOdrinksOlately."
-O2.O"I'veObeenOjoggingOmoreOthanOusual."
-O3.O"I'veOhadOmoreOstressOsinceOweOadoptedOaOchildOlastOyear."
-O4.O"I'mOaOvegetarianOandOeatOcheeseOtwoOorOthreeOtimesOeachOday."O-
OcorrectOanswer-
RATIONALE:O4)ORenalOcalculiOareOcommonlyOcomposedOofOcalcium.ODietsOhighOinOcalciumOmayOpredispose
OaOpersonOtoOrenalOcalculi.OMilkOandOmilkOproductsOareOhighOinOcalcium.OColaOsoftOdrinksOdon'tOcontainOin
gredientsOthatOwouldOincreaseOtheOriskOofOrenalOcalculi.OJoggingOandOincreasedOstressOaren'tOconsideredOr
iskOfactorsOforOrenalOcalculiOformation.
AOnurseOisOinstructingOaOclientOwithOoxalateOrenalOcalculi.OWhatOfoodsOshouldOtheOnurseOurgeOtheOclientOt
oOeliminateOfromOhisOdiet?
1)OCitrusOfruits,Omolasses,OandOdriedOapricots
2)OMilk,Ocheese,OandOiceOcream
3)OSardines,OliverOandOkidney
4)OSpinachOrhubarbOandOasparagusO-OcorrectOanswer-
RATIONALE:O4)OToOreduceOtheOformationOofOoxalateOcalculi,OurgeOtheOclientOtoOavoidOfoodsOhighOinOoxalat
e,OsuchOasOspinach,Orhubarb,OandOasparagus.OOtherOoxalate-
OrichOfoodsOtoOavoidOincludeOtomatoes,Obeets,Ochocolate,Ococoa,Ocelery,OandOparsley.
CitrusOfruits,Omolasses,OdriedOapricots,Omilk,Ocheese,OiceOcream,OsardinesOandOorganOmeatsOdoONOTOprod
uceOoxalateOandOdoONOTOneedOtoObeOomittedOfromOtheOclient'sOdiet.
AOnurseOisOassessingOaOclientOdiagnosedOwithOacuteOpyelonephritis.OWhichOofOtheOfollowingOsymptomsOdo
esOtheOnurseOexpectOtoOsee?
1)OJaundiceOandOflankOpain
2)OCostovertebralOangleOtendernessOandOchills
3)OBurningOsensationOonOurination
, 4)OPolyuriaOandOnocturiaO-OcorrectOanswer-
RATIONALE:O2)OCostovertebralOangleOtendernessOandOchillsOareOsymptomsOofOacuteOpyelonephritisO(infla
mmationOofOtheOkidneyOandOrenalOpelvis).O
JaundiceOindicatesOgallbladderOorOliverOobstruction.
AOburningOsensationOonOurinationOisOaOsignOofOlowerOurinaryOtractOinfectionO(UTI).
NocturiaOisOassociatedOwithOaOlowerOUTIOorObenignOprostaticOhyperplasia.
PolyuriaOisOseenOwithOdiabetesOmellitus,OdiabetesOinsipidus,OorOtheOuseOofOdiuretics.
AOnurseOisOassessingOaOclientOwhoOmightOhaveOaOUTI.OWhatOstatementObyOtheOclientOsuggestsOthatOaOUTIOi
sOlikely?
1)OIOurinateOlargeOamounts.
2)OItOburnsOwhenOIOurinate.
3)OIOgoOforOhoursOwithoutOtheOurgeOtoOurinate.
4)OMyOurineOhasOaOsweetOsmell.O-OcorrectOanswer-
RATIONALE:O2)ODysuriaO(painfulOurination)OisOaOcommonOsymptomOofOaOUTI.
VoidingOlargeOamountsOofOurineOisn'tOassociatedOwithOUTI's;OclientsOwithOUTI'sOcommonlyOreportOfrequen
tOvoidingOofOsmallOamountsOofOurine.
AOclientOwithOaOUTIOisOunlikelyOtoObeOableOtoOgoOforOhoursOwithoutOurinatingObecauseOUTI'sOincreaseOfeeli
ngsOofOurgencyOtoOvoid.
UrineOwithOaOsweetOacetoneOodorOisOassociatedOwithOdiabeticOketoacidosis.
Foul-smellingOurineOmayObeOaOsignOofOinfection.
WhileOundergoingOhemodialysis,OaOclientOcomplainsOofOmuscleOcramps.OWhatOinterventionOisOeffectiveOinO
relievingOmuscleOcramps?
1)OEncourageOactiveOROMOexercises.
2)OAdministerOaO5%OdextroseOsolution.
3)OInfuseOnormalOsalineOsolution.
4)OIncreaseOtheOrateOofOdialysis.O-OcorrectOanswer-
RATIONALE:O3)OBecauseOmuscleOcrampsOcanOoccurOwhenOsodiumOandOwaterOareOremovedOtooOquicklyOdu
ringOdialysis,OtreatmentOincludesOadministeringOnormalOsalineOorOhypertonicOnormalOsalineOsolution.
ROMOexercisesOandOanOinfusionOofO5%OdextroseOsolutionOwouldn'tOreduceOmuscleOcramps.
Reducing,OnotOincreasing,OtheOrateOofOdialysisOmayOalsoOalleviateOmuscleOcramps.
EXAM QUESTIONS WITH CORRECT
ANSWERS RATIONALES
AOclientOadmittedOforOacuteOpyelonephritisOisOaboutOtoOstartOantibioticOtherapy.OWhichOsymptomOwouldOb
eOexpectedOinOthisOclient?
1)OHypertension
2)OFlankOpainOonOtheOaffectedOside
3)OPainOthatOradiatesOtowardOtheOunaffectedOside
4)ONoOtendernessOwithOdeepOpalpationOoverOthe
CVAO-OcorrectOanswer-
RATIONAL:O2)OTheOclientOmayOcomplainOofOpainOonOtheOaffectedOsideObecauseOtheOkidneyOisOenlargedOand
OmightOhaveOformedOanOabscess.
HypertensionOisOassociatedOwithOchronicOpyelonephritis.OPainOmayOradiateOdownOtheOuretersOorOtoOtheOe
pigastrium.OTheOclientOwouldOhaveOtendernessOwithOdeepOpalpationOoverOtheOCVA.
DischargeOinstructionsOforOaOclientOtreatedOforOacuteOpyelonephritisOshouldOincludeOwhichOstatement?
-O1.OAvoidOtakingOanyOdairyOproducts.
-O2.OReturnOforOfollow-upOurineOcultures.
-O3.OStopOtakingOtheOprescribedOantibioticsOwhenOtheOsymptomsOsubside.
-O4.ORecurrenceOisOunlikelyObecauseOyou'veObeenOtreatedOwithOantibiotics.O-OcorrectOanswer-
RATIONALE:O2)OTheOclientOneedsOtoOreturnOforOfollow-
upOurineOculturesObecauseObacteriuriaOmayObeOpresentObutOasymptomatic.OIntakeOofOdairyOproductsOwon'
tOcontributeOtoOpyelonephritis.OAntibioticsOneedOtoObeOtakenOforOtheOfullOcourseOofOtherapyOregardlessOofO
theOsymptoms.OPyelonephritisOtypicallyOrecursOasOaOrelapseOorOnewOinfectionOandOfrequentlyOrecursOwithi
nO2OweeksOofOcompletingOtherapy.
AOclientOisOcomplainingOofOsevereOflankOandOabdominalOpain.OAOflatOplateOofOtheOabdomenOshowsOurolithi
asis.OWhichOinterventionOisOimportant?
-O1.OStrainOallOurine
-O2.OLimitOfluidOintake
-O3.OEnforceOstrictObedOrest.
,-O4.OEncourageOaOhigh-calciumOdietO-OcorrectOanswer-
RATIONALE:O1)OUrineOshouldObeOstrainedOforOcalculiOandOsentOtoOtheOlaboratoryOforOanalysis.OFluidOintakeO
ofO3OtoO4Oqt.O3OtoO4OL/dayOisOencouragedOtoOflushOtheOurinaryOtractOandOpreventOfurtherOcalculiOformation
.OAmbulationOisOencouragedOtoOhelpOpassOtheOcalculiOthroughOgravity.OAOlow-
calciumOformationOofOcalciumOcalculi.
DuringOaOhealthOhistory,OwhichOstatementObyOaOclientOindicatesOaOriskOofOrenalOcalculi?
-O1.O"I'veObeenOdrinkingOaOlotOofOcolaOsoftOdrinksOlately."
-O2.O"I'veObeenOjoggingOmoreOthanOusual."
-O3.O"I'veOhadOmoreOstressOsinceOweOadoptedOaOchildOlastOyear."
-O4.O"I'mOaOvegetarianOandOeatOcheeseOtwoOorOthreeOtimesOeachOday."O-
OcorrectOanswer-
RATIONALE:O4)ORenalOcalculiOareOcommonlyOcomposedOofOcalcium.ODietsOhighOinOcalciumOmayOpredispose
OaOpersonOtoOrenalOcalculi.OMilkOandOmilkOproductsOareOhighOinOcalcium.OColaOsoftOdrinksOdon'tOcontainOin
gredientsOthatOwouldOincreaseOtheOriskOofOrenalOcalculi.OJoggingOandOincreasedOstressOaren'tOconsideredOr
iskOfactorsOforOrenalOcalculiOformation.
AOnurseOisOinstructingOaOclientOwithOoxalateOrenalOcalculi.OWhatOfoodsOshouldOtheOnurseOurgeOtheOclientOt
oOeliminateOfromOhisOdiet?
1)OCitrusOfruits,Omolasses,OandOdriedOapricots
2)OMilk,Ocheese,OandOiceOcream
3)OSardines,OliverOandOkidney
4)OSpinachOrhubarbOandOasparagusO-OcorrectOanswer-
RATIONALE:O4)OToOreduceOtheOformationOofOoxalateOcalculi,OurgeOtheOclientOtoOavoidOfoodsOhighOinOoxalat
e,OsuchOasOspinach,Orhubarb,OandOasparagus.OOtherOoxalate-
OrichOfoodsOtoOavoidOincludeOtomatoes,Obeets,Ochocolate,Ococoa,Ocelery,OandOparsley.
CitrusOfruits,Omolasses,OdriedOapricots,Omilk,Ocheese,OiceOcream,OsardinesOandOorganOmeatsOdoONOTOprod
uceOoxalateOandOdoONOTOneedOtoObeOomittedOfromOtheOclient'sOdiet.
AOnurseOisOassessingOaOclientOdiagnosedOwithOacuteOpyelonephritis.OWhichOofOtheOfollowingOsymptomsOdo
esOtheOnurseOexpectOtoOsee?
1)OJaundiceOandOflankOpain
2)OCostovertebralOangleOtendernessOandOchills
3)OBurningOsensationOonOurination
, 4)OPolyuriaOandOnocturiaO-OcorrectOanswer-
RATIONALE:O2)OCostovertebralOangleOtendernessOandOchillsOareOsymptomsOofOacuteOpyelonephritisO(infla
mmationOofOtheOkidneyOandOrenalOpelvis).O
JaundiceOindicatesOgallbladderOorOliverOobstruction.
AOburningOsensationOonOurinationOisOaOsignOofOlowerOurinaryOtractOinfectionO(UTI).
NocturiaOisOassociatedOwithOaOlowerOUTIOorObenignOprostaticOhyperplasia.
PolyuriaOisOseenOwithOdiabetesOmellitus,OdiabetesOinsipidus,OorOtheOuseOofOdiuretics.
AOnurseOisOassessingOaOclientOwhoOmightOhaveOaOUTI.OWhatOstatementObyOtheOclientOsuggestsOthatOaOUTIOi
sOlikely?
1)OIOurinateOlargeOamounts.
2)OItOburnsOwhenOIOurinate.
3)OIOgoOforOhoursOwithoutOtheOurgeOtoOurinate.
4)OMyOurineOhasOaOsweetOsmell.O-OcorrectOanswer-
RATIONALE:O2)ODysuriaO(painfulOurination)OisOaOcommonOsymptomOofOaOUTI.
VoidingOlargeOamountsOofOurineOisn'tOassociatedOwithOUTI's;OclientsOwithOUTI'sOcommonlyOreportOfrequen
tOvoidingOofOsmallOamountsOofOurine.
AOclientOwithOaOUTIOisOunlikelyOtoObeOableOtoOgoOforOhoursOwithoutOurinatingObecauseOUTI'sOincreaseOfeeli
ngsOofOurgencyOtoOvoid.
UrineOwithOaOsweetOacetoneOodorOisOassociatedOwithOdiabeticOketoacidosis.
Foul-smellingOurineOmayObeOaOsignOofOinfection.
WhileOundergoingOhemodialysis,OaOclientOcomplainsOofOmuscleOcramps.OWhatOinterventionOisOeffectiveOinO
relievingOmuscleOcramps?
1)OEncourageOactiveOROMOexercises.
2)OAdministerOaO5%OdextroseOsolution.
3)OInfuseOnormalOsalineOsolution.
4)OIncreaseOtheOrateOofOdialysis.O-OcorrectOanswer-
RATIONALE:O3)OBecauseOmuscleOcrampsOcanOoccurOwhenOsodiumOandOwaterOareOremovedOtooOquicklyOdu
ringOdialysis,OtreatmentOincludesOadministeringOnormalOsalineOorOhypertonicOnormalOsalineOsolution.
ROMOexercisesOandOanOinfusionOofO5%OdextroseOsolutionOwouldn'tOreduceOmuscleOcramps.
Reducing,OnotOincreasing,OtheOrateOofOdialysisOmayOalsoOalleviateOmuscleOcramps.