NURS 341 MED SURG PRACTICE FINAL
REVIEW QUESTIONS AND VERIFFIED
ANSWERS WITH RATIONALES 2024/2025
GUARANTEED SUCCESS
After the insertion of an arteriovenous graft (AVG) in the right forearm,
a patient complains
of pain and coldness of the right fingers. Which action should the nurse
take?
a. Teach the patient about normal AVG function.
b. Remind the patient to take a daily low-dose aspirin tablet.
c. Report the patient's symptoms to the health care provider.
d. Elevate the patient's arm on pillows to above the heart level. -
ANSWER- ANS: C
The patient's complaints suggest the development of distal ischemia
(steal syndrome) and
,may require revision of the AVG. Elevation of the arm above the
heart will further decrease
perfusion. Pain and coolness are not normal after AVG insertion.
Aspirin therapy is not used
to maintain grafts.
DIF: Cognitive Level: Apply (application) REF: 1088
TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity
When a patient with acute kidney injury (AKI) has an arterial blood pH
of 7.30, the nurse will
expect an assessment finding of
a. persistent skin tenting
b. rapid, deep respirations.
c. hot, flushed face and neck.
d. bounding peripheral pulses. - ANSWER- ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul
respirations as the lungs
try to regulate carbon dioxide. Bounding pulses and vasodilation are
not associated with
metabolic acidosis. Because the patient is likely to have fluid
retention, poor skin turgor
would not be a finding in AKI.
DIF: Cognitive Level: Apply (application) REF: 1072
,TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
The nurse is planning care for a patient with severe heart failure who has
developed elevated
blood urea nitrogen (BUN) and creatinine levels. The primary treatment
goal in the plan will
be
a. augmenting fluid volume. .
b. maintaining cardiac output.
c. diluting nephrotoxic substances
d. preventing systemic hypertension. - ANSWER- ANS: B
The primary goal of treatment for acute kidney injury (AKI) is to
eliminate the cause and
provide supportive care while the kidneys recover. Because this
patient's heart failure is
causing AKI, the care will be directed toward treatment of the heart
failure. For renal failure
caused by hypertension, hypovolemia, or nephrotoxins, the other
responses would be correct.
DIF: Cognitive Level: Apply (application) REF: 1073
TOP: Nursing Process: Planning MSC: NCLEX: Physiological
Integrity
A patient who has acute glomerulonephritis is hospitalized with
hyperkalemia. Which
, information will the nurse monitor to evaluate the effectiveness of the
prescribed calcium
gluconate IV?
a. Urine volume
b. Calcium level
c. Cardiac rhythm
d. Neurologic status - ANSWER- ANS: C
The calcium gluconate helps prevent dysrhythmias that might be
caused by the hyperkalemia.
The nurse will monitor the other data as well, but these will not be
helpful in determining the
effectiveness of the calcium gluconate.
DIF: Cognitive Level: Apply (application) REF: 1073
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological
Integrity
Which statement by a patient with stage 5 chronic kidney disease (CKD)
indicates that the
nurse's teaching about management of CKD has been effective?
a. "I need to get most of my protein from low-fat dairy products."
b. "I will increase my intake of fruits and vegetables to 5 per day."
c. "I will measure my urinary output each day to help calculate the
amount I can
drink."
REVIEW QUESTIONS AND VERIFFIED
ANSWERS WITH RATIONALES 2024/2025
GUARANTEED SUCCESS
After the insertion of an arteriovenous graft (AVG) in the right forearm,
a patient complains
of pain and coldness of the right fingers. Which action should the nurse
take?
a. Teach the patient about normal AVG function.
b. Remind the patient to take a daily low-dose aspirin tablet.
c. Report the patient's symptoms to the health care provider.
d. Elevate the patient's arm on pillows to above the heart level. -
ANSWER- ANS: C
The patient's complaints suggest the development of distal ischemia
(steal syndrome) and
,may require revision of the AVG. Elevation of the arm above the
heart will further decrease
perfusion. Pain and coolness are not normal after AVG insertion.
Aspirin therapy is not used
to maintain grafts.
DIF: Cognitive Level: Apply (application) REF: 1088
TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity
When a patient with acute kidney injury (AKI) has an arterial blood pH
of 7.30, the nurse will
expect an assessment finding of
a. persistent skin tenting
b. rapid, deep respirations.
c. hot, flushed face and neck.
d. bounding peripheral pulses. - ANSWER- ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul
respirations as the lungs
try to regulate carbon dioxide. Bounding pulses and vasodilation are
not associated with
metabolic acidosis. Because the patient is likely to have fluid
retention, poor skin turgor
would not be a finding in AKI.
DIF: Cognitive Level: Apply (application) REF: 1072
,TOP: Nursing Process: Assessment MSC: NCLEX: Physiological
Integrity
The nurse is planning care for a patient with severe heart failure who has
developed elevated
blood urea nitrogen (BUN) and creatinine levels. The primary treatment
goal in the plan will
be
a. augmenting fluid volume. .
b. maintaining cardiac output.
c. diluting nephrotoxic substances
d. preventing systemic hypertension. - ANSWER- ANS: B
The primary goal of treatment for acute kidney injury (AKI) is to
eliminate the cause and
provide supportive care while the kidneys recover. Because this
patient's heart failure is
causing AKI, the care will be directed toward treatment of the heart
failure. For renal failure
caused by hypertension, hypovolemia, or nephrotoxins, the other
responses would be correct.
DIF: Cognitive Level: Apply (application) REF: 1073
TOP: Nursing Process: Planning MSC: NCLEX: Physiological
Integrity
A patient who has acute glomerulonephritis is hospitalized with
hyperkalemia. Which
, information will the nurse monitor to evaluate the effectiveness of the
prescribed calcium
gluconate IV?
a. Urine volume
b. Calcium level
c. Cardiac rhythm
d. Neurologic status - ANSWER- ANS: C
The calcium gluconate helps prevent dysrhythmias that might be
caused by the hyperkalemia.
The nurse will monitor the other data as well, but these will not be
helpful in determining the
effectiveness of the calcium gluconate.
DIF: Cognitive Level: Apply (application) REF: 1073
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological
Integrity
Which statement by a patient with stage 5 chronic kidney disease (CKD)
indicates that the
nurse's teaching about management of CKD has been effective?
a. "I need to get most of my protein from low-fat dairy products."
b. "I will increase my intake of fruits and vegetables to 5 per day."
c. "I will measure my urinary output each day to help calculate the
amount I can
drink."
