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Advanced med surg exam notes 2025
Advanced medsurg (Galen College of Nursing)
1. The nurse has provided discharge instruc4ons to a client who is newly diagnosed with nephro4c
syndrome. Which of the following client statements indicates a correct understanding of the teaching
A. I should take all prescribed an4bio4cs un4l their gone
B. I should avoid using any type of salt subs4tute on my food
C. I must decrease my intake of foods high in potassium
D. I must protect myself from developing an infec7on Pg 1362
2. The nurse is reviewing the laboratory results of an assigned client; it is a priority for the nurse to follow
up with the PCP if the client
A. Is receiving prescribed digoxin and has a BUN level that has increased from 15 to 19mg/dl
over the past 3 days
B. Had a mitral mechanical valve replacement and taking prescribed warfarin that has an INR
that is 3.2
C. Is receiving prescribed enoxaparin post op cardiac surgery and the platelets have decreased
from 200,000 to 175,000 over the past 2 days
D. Had a AAA repair 2 days ago and has a crea7nine that has increased from 0.9 to 2.5mg/dl
3. The nurse is caring for a client who has been hospitalized for 8 days with AKI caused by dehydra4on
which of the following should the nurse report immediately to the PCP
A. A BUN level of 67mg/dl
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B. A rhythm strip reading that has tall, peaked T waves
C. A decreased GFR
D. A crea4nine level of 3mg/dl
4. The nurse is caring for a client who is receiving gentamicin IV for infec4on and has developed oliguria
and increased blood pressure. Which of the following ac4ons should the nurse take Xrst
A. Collect a urine sample to check specixc gravity
B. Obtain a prescrip7on for gentamicin peak and trough levels
C. Insert a prescribed urinary catheter
D. Raise the head of the bed to a 45-degree angle
5. The nurse is caring for a client with CKD, the client is repor4ng muscle weakness diarrhea, and 4ngling
in the hands. Which ac4on should the nurse take Xrst
A. No4fy the PCP
B. Check the client’s most recent serum electrolyte levels
C. Evaluate the client’s urine output for the past 4 hrs
D. Determine if the client is scheduled to receive hemodialysis
E. Obtain a blood specimen for ABG’s
6. The nurse is talking with a client who has CKD and has been receiving hemodialysis 3x week. Which of
the following client statements is a priority follow-up by the nurse
A. I try and limit my intake of dietary sodium to 5g a day
B. I have no4ced that my skin looks like it has a layer of frost on it
C. I have no4ced that my breath has developed a very unpleasant odor
D. I will make sure that I consume at least 50g of protein every day
7. The nurse is teaching a client who is in the late stage of CKD. Which of the following client statements
indicates a correct understanding of the teaching
A. I should obtain much of my protein from dairy products and eggs
B. I can expect to have an increase in my energy level a\er dialysis treatment
C. Hemodialysis will be performed 2x week in an outpt ceneter
D. If I develop and fa4gue or weakness I should report it to my doctor
8. The nurse is caring for a client who has returned from receiving hemodialysis treatment. It requires
immediate follow up by the nurse if the client has
Downloaded by NELSON KIIRU ()
Lomoarcpsd|26582732
Advanced med surg exam notes 2025
Advanced medsurg (Galen College of Nursing)
1. The nurse has provided discharge instruc4ons to a client who is newly diagnosed with nephro4c
syndrome. Which of the following client statements indicates a correct understanding of the teaching
A. I should take all prescribed an4bio4cs un4l their gone
B. I should avoid using any type of salt subs4tute on my food
C. I must decrease my intake of foods high in potassium
D. I must protect myself from developing an infec7on Pg 1362
2. The nurse is reviewing the laboratory results of an assigned client; it is a priority for the nurse to follow
up with the PCP if the client
A. Is receiving prescribed digoxin and has a BUN level that has increased from 15 to 19mg/dl
over the past 3 days
B. Had a mitral mechanical valve replacement and taking prescribed warfarin that has an INR
that is 3.2
C. Is receiving prescribed enoxaparin post op cardiac surgery and the platelets have decreased
from 200,000 to 175,000 over the past 2 days
D. Had a AAA repair 2 days ago and has a crea7nine that has increased from 0.9 to 2.5mg/dl
3. The nurse is caring for a client who has been hospitalized for 8 days with AKI caused by dehydra4on
which of the following should the nurse report immediately to the PCP
A. A BUN level of 67mg/dl
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
B. A rhythm strip reading that has tall, peaked T waves
C. A decreased GFR
D. A crea4nine level of 3mg/dl
4. The nurse is caring for a client who is receiving gentamicin IV for infec4on and has developed oliguria
and increased blood pressure. Which of the following ac4ons should the nurse take Xrst
A. Collect a urine sample to check specixc gravity
B. Obtain a prescrip7on for gentamicin peak and trough levels
C. Insert a prescribed urinary catheter
D. Raise the head of the bed to a 45-degree angle
5. The nurse is caring for a client with CKD, the client is repor4ng muscle weakness diarrhea, and 4ngling
in the hands. Which ac4on should the nurse take Xrst
A. No4fy the PCP
B. Check the client’s most recent serum electrolyte levels
C. Evaluate the client’s urine output for the past 4 hrs
D. Determine if the client is scheduled to receive hemodialysis
E. Obtain a blood specimen for ABG’s
6. The nurse is talking with a client who has CKD and has been receiving hemodialysis 3x week. Which of
the following client statements is a priority follow-up by the nurse
A. I try and limit my intake of dietary sodium to 5g a day
B. I have no4ced that my skin looks like it has a layer of frost on it
C. I have no4ced that my breath has developed a very unpleasant odor
D. I will make sure that I consume at least 50g of protein every day
7. The nurse is teaching a client who is in the late stage of CKD. Which of the following client statements
indicates a correct understanding of the teaching
A. I should obtain much of my protein from dairy products and eggs
B. I can expect to have an increase in my energy level a\er dialysis treatment
C. Hemodialysis will be performed 2x week in an outpt ceneter
D. If I develop and fa4gue or weakness I should report it to my doctor
8. The nurse is caring for a client who has returned from receiving hemodialysis treatment. It requires
immediate follow up by the nurse if the client has
Downloaded by NELSON KIIRU ()
