Certified Medical Surgical Practice Exam
PULMONARY - Answer-
The nurse recognizes the patient most likely to experience hypercarbic respiratory failure is the one with
a diagnosis of
a. acute respiratory distress syndrome
b. pulmonary embolus
c. bronchitis
d. pulmonary edema - Answer-Correct answer: C.
Hypercarbic respiratory failure occurs when conditions cause a reduction in minute volume or an
increase in physiologic dead space (for example, COPD [including bronchitis], asthma, exacerbation of
underlying neuromuscular disease). Hypoxic respiratory failure results from an insult to the pulmonary
tissues (such as pneumonia, ARDS, pulmonary contusion)
A patient with Stage II adenocarcinoma of the lung is being treated with the anti-tumor antibiotic
doxorubicin (Adriamycin). The nurse knows that alteration in dose scheduling of doxorubicin is needed
to decrease the risk of toxicity to which of the following organs:
a. liver
b. heart
c. pancreas
d. kidney - Answer-Correct Answer: B.
,Cardiotoxicity can develop from a cumulative drug effect. Altering the dose scheduling of doxorubicin to
include frequent lower doses has resulted in reduction of cardiotoxicity without compromise of anti
tumor effects.
A 57 Year old patient is admitted to the medical unit for progressive symptoms of dyspnea on exertion
and decreased appetite, and is scheduled for pulmonary function testing. when the patient asks what
the test will measure, the nurse's response is based on the knowledge that the tests are used to identify
which three general patterns of pulmonary abnormality?
a. obstructive, restrictive, and mixed
b. obstructive, constrictive, and mixed
c. restrictive, functional, and mixed
d. constrictive, functional and mixed - Answer-Correct Answer: A.
Pulmonary function tests are used to identify and quantify abnormalities in respiratory function,
including three general patterns of abnormality: obstructive, restrictive, and mixed.
The preferred Mantoux test for screening and diagnosis of tuberculosis should be read by the trained
nurse in:
a. 18 to 24 hours
b. 24 to 36 hours
c. 48 to 72 hours.
d. 72 to 96 hours - Answer-Correct Answer: C.
the skin test should be read 48 to 72 hours after it has been administered.
Arterial blood gas results, including a pH less than 7.35 and a pCO2 greater than 45, would reflect:
a. metabolic acidosis
b. respiratory acidosis
, c. metabolic alkalosis
d. respiratory alkalosis - Answer-Correct Answer: B.
Assess pH; less than 7.35 = acidosis.
Assess pCO2; greater than 45 = respiratory acidosis
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a. decannulation
b. infection
c. bleeding
d. tracheomalacia - Answer-Correct Answer: C.
Common acute risks of tracheostomy include bleeding structures, and failure of the chosen technique to
achieve successful airway placement.
A 32 year old patient on the medical unit experiences an acute asthma episode. All of the following are
ordered to treat the patient. What will the nurse administer FIRST?
a. intravenous corticosteroids
b. oxygen by nasal cannula
c. bronchodilator by meter dose inhaler
d. intravenous fluids - Answer-Correct Answer: B.
Oxygen therapy should be started immediately, with administration monitored by pulse oximetry to
keep SpO2 greater than 90%. Aerosolized medications will be given by nebulizer or metered-dose
inhaler every 20 minutes for 1 hour. Systemic corticosteroids will be indicated if the initial response to
the bronchodilator is insufficient
PULMONARY - Answer-
The nurse recognizes the patient most likely to experience hypercarbic respiratory failure is the one with
a diagnosis of
a. acute respiratory distress syndrome
b. pulmonary embolus
c. bronchitis
d. pulmonary edema - Answer-Correct answer: C.
Hypercarbic respiratory failure occurs when conditions cause a reduction in minute volume or an
increase in physiologic dead space (for example, COPD [including bronchitis], asthma, exacerbation of
underlying neuromuscular disease). Hypoxic respiratory failure results from an insult to the pulmonary
tissues (such as pneumonia, ARDS, pulmonary contusion)
A patient with Stage II adenocarcinoma of the lung is being treated with the anti-tumor antibiotic
doxorubicin (Adriamycin). The nurse knows that alteration in dose scheduling of doxorubicin is needed
to decrease the risk of toxicity to which of the following organs:
a. liver
b. heart
c. pancreas
d. kidney - Answer-Correct Answer: B.
,Cardiotoxicity can develop from a cumulative drug effect. Altering the dose scheduling of doxorubicin to
include frequent lower doses has resulted in reduction of cardiotoxicity without compromise of anti
tumor effects.
A 57 Year old patient is admitted to the medical unit for progressive symptoms of dyspnea on exertion
and decreased appetite, and is scheduled for pulmonary function testing. when the patient asks what
the test will measure, the nurse's response is based on the knowledge that the tests are used to identify
which three general patterns of pulmonary abnormality?
a. obstructive, restrictive, and mixed
b. obstructive, constrictive, and mixed
c. restrictive, functional, and mixed
d. constrictive, functional and mixed - Answer-Correct Answer: A.
Pulmonary function tests are used to identify and quantify abnormalities in respiratory function,
including three general patterns of abnormality: obstructive, restrictive, and mixed.
The preferred Mantoux test for screening and diagnosis of tuberculosis should be read by the trained
nurse in:
a. 18 to 24 hours
b. 24 to 36 hours
c. 48 to 72 hours.
d. 72 to 96 hours - Answer-Correct Answer: C.
the skin test should be read 48 to 72 hours after it has been administered.
Arterial blood gas results, including a pH less than 7.35 and a pCO2 greater than 45, would reflect:
a. metabolic acidosis
b. respiratory acidosis
, c. metabolic alkalosis
d. respiratory alkalosis - Answer-Correct Answer: B.
Assess pH; less than 7.35 = acidosis.
Assess pCO2; greater than 45 = respiratory acidosis
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a. decannulation
b. infection
c. bleeding
d. tracheomalacia - Answer-Correct Answer: C.
Common acute risks of tracheostomy include bleeding structures, and failure of the chosen technique to
achieve successful airway placement.
A 32 year old patient on the medical unit experiences an acute asthma episode. All of the following are
ordered to treat the patient. What will the nurse administer FIRST?
a. intravenous corticosteroids
b. oxygen by nasal cannula
c. bronchodilator by meter dose inhaler
d. intravenous fluids - Answer-Correct Answer: B.
Oxygen therapy should be started immediately, with administration monitored by pulse oximetry to
keep SpO2 greater than 90%. Aerosolized medications will be given by nebulizer or metered-dose
inhaler every 20 minutes for 1 hour. Systemic corticosteroids will be indicated if the initial response to
the bronchodilator is insufficient
