KAPLAN MEDICAL SURGICAL
INTEGRATED TEST ACTUAL EXAM 300+
QUESTIONS AND ANSWERS GRADED
A+
Which of the following statements indicates client understanding about
the tracheostomy? - ANS-I will perform suctioning 3 times a day (every
8 hrs)
Which assessment finding indicates a spinal cord injury? - ANS-dilated
pupils
What interventions would you apply for a pt diagnosed with Herpes? -
ANS-Contact precautions, wear gown and gloves
Which electrolyte uimbalance uincreases uthe urisk ufor
udigoxin/digitalis/digibind utoxicity? u- uANS-
hypokalemia
A client with peptic ulcer disease has a new NG tube in place with
orders for NG tube monitoring for the nurse. What is an expected
finding? - ANS-scant blood may be seen for the first 12-24 hrs
Suspected stomach perforation due to a peptic ulcer s/s: - ANS--rigid
abdomen
-tachycardia
-rebound tenderness
Complications of enteral feedings: - ANS-Overfeeding: abd distention,
N/V
Diarrhea
,Aspiration Pneumonia
Nursing actions to prevent overfeeding r/t enteral feedings: - ANS--
check residual Q 4-6 hr
-withhold as prescribed then resume
Nursing actions for diarrhea r/t enteral feedings: - ANS--slow the rate &
contact provider
-contact dietitian
-provide skin care & protection
Endoscopy (EGD) positioning - ANS-left side lying
Before an Endoscopy (EGD): - ANS--NPO 6-8 hr
-remove dentures
Gastroenteritis care plan: - ANS--restrict dairy, caffeine, milk
-eat foods high in potassium
-increase fluid intake
-contact precautions
In what order do you open the sterile package? - ANS-flap furthest from
body, side flaps, then closest
A nurse has removed a sterile pack from its outside cover and place it
on a clean work surface in preparation for an invasive procedure.
Which of the following flaps should the nurse unfold first:
A. closest to body
B. right side
C. left side
,D. farthest from body - ANS-D
A nurse is wearing sterile gloves in prep for performing a sterile
procedure. Which of the following objects can the nurse touch without
breaking sterile technique (Select all that apply)
A. bottle containing sterile solution
B. edge of sterile drape at the base of the field
C. inner wrapping of an item on the sterile field
D. irrigation syringe on the sterile field
E. one gloved hand with the other gloved hand - ANS-C, D, E
A nurse has prepared a sterile field for assisting a provider with a chest
tube insertion. Which of the following events should the nurse
recognize as contaminating the field (Select all that apply)
A. provider drops a sterile instrument onto the near side of the sterile
field
B. nurse moistens a cotton ball with sterile normal saline and places it
on sterile field
C. procedure is delayed 1hr because the provider receives an
emergency call
D. nurse turns to speak to someone who enters through the door
behind the nurse
E. clients hand brushes against the outer edge of the sterile field - ANS-
B, C, D
TB is suspected, what precautionary actions to do? - ANS--negative
airflow room, airborne precautions
-nurses wear N95 mask, client wears if going out of the room
-admin heat & humidified O2 therapy as prescribed
TB interventions: - ANS--family members should be screened
, -4 meds taken for 6-12 months
-not contagious when they have 3 negative sputum cultures
What to watch for when on Isoniazid: - ANS-numb/tingling in the hands
& feet
What to watch for when on Rifampin: - ANS--orange secretions normal
-watch for jaundice
-interferes with birth control
What to watch for when on Ethambutol: - ANS-vision changes
Client teaching for genital herpes: - ANS--can be transmitted with or
w/out blisters
-sexual partners should be informed & screened
-no cure, just meds to help w/symptoms
-abstain from intercourse until lesions are completely healed
-gently clean areas w/mild soap & water
Caring for a client following a stroke of the right side with left-sided
hemipalegia: - ANS--thicken liquids/foods
-high fowlers
-speech therapist for helping w/eating & speech
-monitor gag reflex/swallowing abilities
-have suction equipment available
-occupational therapy
-support left arm with pillows, slings, etc
High sodium foods clients with HF & Pulmonary edema should avoid: -
ANS--cheese
-soups
-bread
-cold cuts/cured meats
INTEGRATED TEST ACTUAL EXAM 300+
QUESTIONS AND ANSWERS GRADED
A+
Which of the following statements indicates client understanding about
the tracheostomy? - ANS-I will perform suctioning 3 times a day (every
8 hrs)
Which assessment finding indicates a spinal cord injury? - ANS-dilated
pupils
What interventions would you apply for a pt diagnosed with Herpes? -
ANS-Contact precautions, wear gown and gloves
Which electrolyte uimbalance uincreases uthe urisk ufor
udigoxin/digitalis/digibind utoxicity? u- uANS-
hypokalemia
A client with peptic ulcer disease has a new NG tube in place with
orders for NG tube monitoring for the nurse. What is an expected
finding? - ANS-scant blood may be seen for the first 12-24 hrs
Suspected stomach perforation due to a peptic ulcer s/s: - ANS--rigid
abdomen
-tachycardia
-rebound tenderness
Complications of enteral feedings: - ANS-Overfeeding: abd distention,
N/V
Diarrhea
,Aspiration Pneumonia
Nursing actions to prevent overfeeding r/t enteral feedings: - ANS--
check residual Q 4-6 hr
-withhold as prescribed then resume
Nursing actions for diarrhea r/t enteral feedings: - ANS--slow the rate &
contact provider
-contact dietitian
-provide skin care & protection
Endoscopy (EGD) positioning - ANS-left side lying
Before an Endoscopy (EGD): - ANS--NPO 6-8 hr
-remove dentures
Gastroenteritis care plan: - ANS--restrict dairy, caffeine, milk
-eat foods high in potassium
-increase fluid intake
-contact precautions
In what order do you open the sterile package? - ANS-flap furthest from
body, side flaps, then closest
A nurse has removed a sterile pack from its outside cover and place it
on a clean work surface in preparation for an invasive procedure.
Which of the following flaps should the nurse unfold first:
A. closest to body
B. right side
C. left side
,D. farthest from body - ANS-D
A nurse is wearing sterile gloves in prep for performing a sterile
procedure. Which of the following objects can the nurse touch without
breaking sterile technique (Select all that apply)
A. bottle containing sterile solution
B. edge of sterile drape at the base of the field
C. inner wrapping of an item on the sterile field
D. irrigation syringe on the sterile field
E. one gloved hand with the other gloved hand - ANS-C, D, E
A nurse has prepared a sterile field for assisting a provider with a chest
tube insertion. Which of the following events should the nurse
recognize as contaminating the field (Select all that apply)
A. provider drops a sterile instrument onto the near side of the sterile
field
B. nurse moistens a cotton ball with sterile normal saline and places it
on sterile field
C. procedure is delayed 1hr because the provider receives an
emergency call
D. nurse turns to speak to someone who enters through the door
behind the nurse
E. clients hand brushes against the outer edge of the sterile field - ANS-
B, C, D
TB is suspected, what precautionary actions to do? - ANS--negative
airflow room, airborne precautions
-nurses wear N95 mask, client wears if going out of the room
-admin heat & humidified O2 therapy as prescribed
TB interventions: - ANS--family members should be screened
, -4 meds taken for 6-12 months
-not contagious when they have 3 negative sputum cultures
What to watch for when on Isoniazid: - ANS-numb/tingling in the hands
& feet
What to watch for when on Rifampin: - ANS--orange secretions normal
-watch for jaundice
-interferes with birth control
What to watch for when on Ethambutol: - ANS-vision changes
Client teaching for genital herpes: - ANS--can be transmitted with or
w/out blisters
-sexual partners should be informed & screened
-no cure, just meds to help w/symptoms
-abstain from intercourse until lesions are completely healed
-gently clean areas w/mild soap & water
Caring for a client following a stroke of the right side with left-sided
hemipalegia: - ANS--thicken liquids/foods
-high fowlers
-speech therapist for helping w/eating & speech
-monitor gag reflex/swallowing abilities
-have suction equipment available
-occupational therapy
-support left arm with pillows, slings, etc
High sodium foods clients with HF & Pulmonary edema should avoid: -
ANS--cheese
-soups
-bread
-cold cuts/cured meats
