NURS 341 MED SURG EXAM WITH QUESTIONS
AND VERIFIED ANSWERS|| GUARANTEED
PASS|| ALREADY GRADED A+|| LATEST
VERSION 2025
A patient admitted to the hospital with pneumonia has a history of functional
urinary incontinence. Which nursing action will be included in the plan of care?
a. Demonstrate the use of the Credé maneuver.
b. Teach exercises to strengthen the pelvic floor.
c. Place a bedside commode close to the patient's bed.
d. Use an ultrasound scanner to check postvoiding residuals. - ANSWER-ANS:
C
Modifications in the environment make it easier to avoid functional
incontinence. Checking for residual urine and performing the Credé maneuver
are interventions for overflow incontinence. Kegel exercises are useful for stress
incontinence.
DIF: Cognitive Level: Apply (application) REF: 1059
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
The home health nurse teaches a patient with a neurogenic bladder how to use
intermittent catheterization for bladder emptying. Which patient statement
indicates that the teaching has been effective?
a. "I will buy seven new catheters weekly and use a new one every day."
b. "I will use a sterile catheter and gloves for each time I self-catheterize."
c. "I will clean the catheter carefully before and after each catheterization."
d. "I will take prophylactic antibiotics to prevent any urinary tract infections." -
ANSWER-ANS: C
,Patients who are at home can use a clean technique for intermittent self-
catheterization and change the catheter every 7 days. There is no need to use a
new catheter every day, to use sterile catheters, or to take prophylactic
antibiotics.
DIF: Cognitive Level: Apply (application) REF: 1063
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
A 62-yr-old female patient has been hospitalized for 4 days with acute kidney
injury (AKI) caused by dehydration. Which information will be most important
for the nurse to report to the health care provider?
a. The creatinine level is 3.0 mg/dL.
b. Urine output over an 8-hour period is 2500 mL.
c. The blood urea nitrogen (BUN) level is 67 mg/dL.
d. The glomerular filtration rate is less than 30 mL/min/1.73 m2 - ANSWER-
ANS: B
The high urine output indicates a need to increase fluid intake to prevent
hypovolemia. The other information is typical of AKI and will not require a
change in therapy.
DIF: Cognitive Level: Analyze (analysis) REF: 1072
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A patient with acute kidney injury (AKI) has longer QRS intervals on the
electrocardiogram (ECG) than were noted on the previous shift. Which action
should the nurse take first?
a. Notify the patient's health care provider.
b. Document the QRS interval measurement.
c. Review the chart for the patient's current creatinine level.
d. Check the medical record for the most recent potassium level. - ANSWER-
ANS: D
,The increasing QRS interval is suggestive of hyperkalemia, so the nurse should
check the most recent potassium and then notify the patient's health care
provider. The BUN and creatinine will be elevated in a patient with AKI, but
they would not directly affect the electrocardiogram (ECG). Documentation of
the QRS interval is also appropriate, but interventions to decrease the potassium
level are needed to prevent life-threatening dysrhythmias.
DIF: Cognitive Level: Analyze (analysis) REF: 1072
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A 42-yr-old patient admitted with acute kidney injury due to dehydration has
oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse
take first?
a. Insert a urinary retention catheter.
b. Place the patient on a cardiac monitor.
c. Administer epoetin alfa (Epogen, Procrit).
d. Give sodium polystyrene sulfonate (Kayexalate). - ANSWER-ANS: B
Because hyperkalemia can cause fatal cardiac dysrhythmias, the initial action
should be to monitor the cardiac rhythm. Kayexalate and Epogen will take time
to correct the hyperkalemia and anemia. The catheter allows monitoring of the
urine output but does not correct the cause of the renal failure.
DIF: Cognitive Level: Analyze (analysis) REF: 1073
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A patient has arrived for a scheduled hemodialysis session. Which nursing
action is most appropriate for the registered nurse (RN) to delegate to a dialysis
technician?
a. Teach the patient about fluid restrictions.
b. Check blood pressure before starting dialysis.
, c. Assess for causes of an increase in predialysis weight.
d. Determine the ultrafiltration rate for the hemodialysis. - ANSWER-ANS: B
Dialysis technicians are educated in monitoring for blood pressure. Assessment,
adjustment of the appropriate ultrafiltration rate, and patient teaching require the
education and scope of practice of an RN.
DIF: Cognitive Level: Apply (application) REF: 1089
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with
stage 2 chronic kidney disease. Which observation by the RN requires an
intervention?
a. The LPN/LVN administers the erythropoietin subcutaneously.
b. The LPN/LVN assists the patient to ambulate out in the hallway.
c. The LPN/LVN administers the iron supplement and phosphate binder with
lunch.
d. The LPN/LVN carries a tray containing low-protein foods into the patient's
room. - ANSWER-ANS: C
Oral phosphate binders should not be given at the same time as iron because
they prevent the iron from being absorbed. The phosphate binder should be
given with a meal and the iron given at a different time. The other actions by the
LPN/LVN are appropriate for a patient with renal insufficiency.
DIF: Cognitive Level: Apply (application) REF: 1082
OBJ: Special Questions: Delegation TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
After ureterolithotomy, a patient has a left ureteral catheter and a urethral
catheter in place. Which action will the nurse include in the plan of care?
a. Provide teaching about home care for both catheters.
b. Apply continuous steady tension to the ureteral catheter.
AND VERIFIED ANSWERS|| GUARANTEED
PASS|| ALREADY GRADED A+|| LATEST
VERSION 2025
A patient admitted to the hospital with pneumonia has a history of functional
urinary incontinence. Which nursing action will be included in the plan of care?
a. Demonstrate the use of the Credé maneuver.
b. Teach exercises to strengthen the pelvic floor.
c. Place a bedside commode close to the patient's bed.
d. Use an ultrasound scanner to check postvoiding residuals. - ANSWER-ANS:
C
Modifications in the environment make it easier to avoid functional
incontinence. Checking for residual urine and performing the Credé maneuver
are interventions for overflow incontinence. Kegel exercises are useful for stress
incontinence.
DIF: Cognitive Level: Apply (application) REF: 1059
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
The home health nurse teaches a patient with a neurogenic bladder how to use
intermittent catheterization for bladder emptying. Which patient statement
indicates that the teaching has been effective?
a. "I will buy seven new catheters weekly and use a new one every day."
b. "I will use a sterile catheter and gloves for each time I self-catheterize."
c. "I will clean the catheter carefully before and after each catheterization."
d. "I will take prophylactic antibiotics to prevent any urinary tract infections." -
ANSWER-ANS: C
,Patients who are at home can use a clean technique for intermittent self-
catheterization and change the catheter every 7 days. There is no need to use a
new catheter every day, to use sterile catheters, or to take prophylactic
antibiotics.
DIF: Cognitive Level: Apply (application) REF: 1063
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
A 62-yr-old female patient has been hospitalized for 4 days with acute kidney
injury (AKI) caused by dehydration. Which information will be most important
for the nurse to report to the health care provider?
a. The creatinine level is 3.0 mg/dL.
b. Urine output over an 8-hour period is 2500 mL.
c. The blood urea nitrogen (BUN) level is 67 mg/dL.
d. The glomerular filtration rate is less than 30 mL/min/1.73 m2 - ANSWER-
ANS: B
The high urine output indicates a need to increase fluid intake to prevent
hypovolemia. The other information is typical of AKI and will not require a
change in therapy.
DIF: Cognitive Level: Analyze (analysis) REF: 1072
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A patient with acute kidney injury (AKI) has longer QRS intervals on the
electrocardiogram (ECG) than were noted on the previous shift. Which action
should the nurse take first?
a. Notify the patient's health care provider.
b. Document the QRS interval measurement.
c. Review the chart for the patient's current creatinine level.
d. Check the medical record for the most recent potassium level. - ANSWER-
ANS: D
,The increasing QRS interval is suggestive of hyperkalemia, so the nurse should
check the most recent potassium and then notify the patient's health care
provider. The BUN and creatinine will be elevated in a patient with AKI, but
they would not directly affect the electrocardiogram (ECG). Documentation of
the QRS interval is also appropriate, but interventions to decrease the potassium
level are needed to prevent life-threatening dysrhythmias.
DIF: Cognitive Level: Analyze (analysis) REF: 1072
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A 42-yr-old patient admitted with acute kidney injury due to dehydration has
oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse
take first?
a. Insert a urinary retention catheter.
b. Place the patient on a cardiac monitor.
c. Administer epoetin alfa (Epogen, Procrit).
d. Give sodium polystyrene sulfonate (Kayexalate). - ANSWER-ANS: B
Because hyperkalemia can cause fatal cardiac dysrhythmias, the initial action
should be to monitor the cardiac rhythm. Kayexalate and Epogen will take time
to correct the hyperkalemia and anemia. The catheter allows monitoring of the
urine output but does not correct the cause of the renal failure.
DIF: Cognitive Level: Analyze (analysis) REF: 1073
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A patient has arrived for a scheduled hemodialysis session. Which nursing
action is most appropriate for the registered nurse (RN) to delegate to a dialysis
technician?
a. Teach the patient about fluid restrictions.
b. Check blood pressure before starting dialysis.
, c. Assess for causes of an increase in predialysis weight.
d. Determine the ultrafiltration rate for the hemodialysis. - ANSWER-ANS: B
Dialysis technicians are educated in monitoring for blood pressure. Assessment,
adjustment of the appropriate ultrafiltration rate, and patient teaching require the
education and scope of practice of an RN.
DIF: Cognitive Level: Apply (application) REF: 1089
OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
MSC: NCLEX: Safe and Effective Care Environment
A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with
stage 2 chronic kidney disease. Which observation by the RN requires an
intervention?
a. The LPN/LVN administers the erythropoietin subcutaneously.
b. The LPN/LVN assists the patient to ambulate out in the hallway.
c. The LPN/LVN administers the iron supplement and phosphate binder with
lunch.
d. The LPN/LVN carries a tray containing low-protein foods into the patient's
room. - ANSWER-ANS: C
Oral phosphate binders should not be given at the same time as iron because
they prevent the iron from being absorbed. The phosphate binder should be
given with a meal and the iron given at a different time. The other actions by the
LPN/LVN are appropriate for a patient with renal insufficiency.
DIF: Cognitive Level: Apply (application) REF: 1082
OBJ: Special Questions: Delegation TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
After ureterolithotomy, a patient has a left ureteral catheter and a urethral
catheter in place. Which action will the nurse include in the plan of care?
a. Provide teaching about home care for both catheters.
b. Apply continuous steady tension to the ureteral catheter.
