MED SURG 3 MIDTERM QUESTIONS WITH VERIFIED
ANSWERS
A nurse is working in the emergency department when a 17-year-old patient presents in
acute sickle cell crisis. He tells the nurse he is just getting over the flu and has been
vomiting for three days. What is the nurse's highest priority for this patient? - Answers -
Start an IV and give fluids to hydrate the patient
A critically ill patient has been diagnosed with disseminated intravascular coagulation
(DIC). What pattern of abnormal laboratory results does the nurse expect? Select all
that apply. - Answers - b) High prothrombin time (PT) and partial thromboplastin time
(PTT)
c) Increased fibrin degradation products and presence of D-dimers
d) Decreased fibrinogen and thrombocytes
A critical care patient has been receiving a continuous heparin drip for treatment of
possible deep vein thrombosis for 4 days. The patient now has developed symptoms
consistent with heparin-induced thrombocytopenia (HIT). What change in therapy does
the nurse anticipate? - Answers - Discontinuation of all heparin and heparin-coated
devices
A 22-year-old male is in the ICU with sepsis. The physicians are trying to rule out acute
DIC. The nurse performs a primary assessment of the patient at the beginning of shift.
Which of the following items would be part of the initial assessment for this patient?
Select all that apply. - Answers - A) Check for signs of bleeding in the gums and/or
mouth.
C) Check IV sites or any areas where the patient may have had labs drawn for bleeding
D) Check for altered level of consciousness
The patient is being evaluated for oxygen deficit. What laboratory study will be most
helpful to the nurse in this evaluation? - Answers - Red blood cell count
The nurse is interpreting a patients complete blood count. What does the CBC give an
overall indication of? - Answers - Bone marrow health
The patient is seriously ill and has developed a fever, a cough productive of thick,
yellow sputum, and respiratory insufficiency. What changes in the white blood cell
differential count does the nurse expect to find? - Answers - Increased neutrophils and
bands
A patient presents to the unit with pallor, dyspnea, and dizziness. The patient has a
history of fatigue. Lab test results show low counts in the TIBC and iron levels. Based
, on this information, which of the following is the likely disorder for this patient? -
Answers - iron-deficient anemia
An immunocomprised patient presents with the following: chills, tachycardia, tachypnea,
and hypotension. The critical care nurse suspects which of the following? - Answers -
early septic shock
When obtaining a history for a patient who is being admitted for hematological or
immune disorders, the nurse first inquires about the chief complaint and history of
present illness. The nurse next inquires about which of the following? - Answers -
medical history
When performing a physical examination of a hematological or immunocompromised
patient, the critical care nurse focuses on which of the following major areas? - Answers
- skin, liver, spleen, lymph nodes
Which of the following are included in the management of a patient with hypocalcemia?
SATA - Answers - Iv fluids for hydration
medication to enhance renal excretion of calcium
dialysis
continue monitoring?
a patient admitted to the icu with the following symptoms: weak pulse, distant heart etc.
- Answers - cardiac tamponade
Selecting the ideal candidate for transplantation is an intricate process. To evaluate a
patients suitability for transplantation, a comprehensive analysis on the patient is
performed that includes which of the following types of assessments? Select all that
apply. - Answers - A) Multisystem (ABO)
B) Physiological (complete physical)
C) Psychosocial (lab results)
The critical care nurse knows that determination of compatibility in transplantation
involves the evaluation of two major antigen systems. A mismatch in compatibility may
cause an immediate reaction leading to organ loss. The primary determinant for solid
organ transplantation is which of the following? - Answers - ABO grouping
a critically ill cancer patient has severe hyperglycemia what treatment should the nurse
initiate first? - Answers - give high-volume intravenous saline
a patient with cancer has developed probable cardiac tamponade. The patient most
likely presents with which of the following symptoms? - Answers - Muffled or distant
heart sounds
ANSWERS
A nurse is working in the emergency department when a 17-year-old patient presents in
acute sickle cell crisis. He tells the nurse he is just getting over the flu and has been
vomiting for three days. What is the nurse's highest priority for this patient? - Answers -
Start an IV and give fluids to hydrate the patient
A critically ill patient has been diagnosed with disseminated intravascular coagulation
(DIC). What pattern of abnormal laboratory results does the nurse expect? Select all
that apply. - Answers - b) High prothrombin time (PT) and partial thromboplastin time
(PTT)
c) Increased fibrin degradation products and presence of D-dimers
d) Decreased fibrinogen and thrombocytes
A critical care patient has been receiving a continuous heparin drip for treatment of
possible deep vein thrombosis for 4 days. The patient now has developed symptoms
consistent with heparin-induced thrombocytopenia (HIT). What change in therapy does
the nurse anticipate? - Answers - Discontinuation of all heparin and heparin-coated
devices
A 22-year-old male is in the ICU with sepsis. The physicians are trying to rule out acute
DIC. The nurse performs a primary assessment of the patient at the beginning of shift.
Which of the following items would be part of the initial assessment for this patient?
Select all that apply. - Answers - A) Check for signs of bleeding in the gums and/or
mouth.
C) Check IV sites or any areas where the patient may have had labs drawn for bleeding
D) Check for altered level of consciousness
The patient is being evaluated for oxygen deficit. What laboratory study will be most
helpful to the nurse in this evaluation? - Answers - Red blood cell count
The nurse is interpreting a patients complete blood count. What does the CBC give an
overall indication of? - Answers - Bone marrow health
The patient is seriously ill and has developed a fever, a cough productive of thick,
yellow sputum, and respiratory insufficiency. What changes in the white blood cell
differential count does the nurse expect to find? - Answers - Increased neutrophils and
bands
A patient presents to the unit with pallor, dyspnea, and dizziness. The patient has a
history of fatigue. Lab test results show low counts in the TIBC and iron levels. Based
, on this information, which of the following is the likely disorder for this patient? -
Answers - iron-deficient anemia
An immunocomprised patient presents with the following: chills, tachycardia, tachypnea,
and hypotension. The critical care nurse suspects which of the following? - Answers -
early septic shock
When obtaining a history for a patient who is being admitted for hematological or
immune disorders, the nurse first inquires about the chief complaint and history of
present illness. The nurse next inquires about which of the following? - Answers -
medical history
When performing a physical examination of a hematological or immunocompromised
patient, the critical care nurse focuses on which of the following major areas? - Answers
- skin, liver, spleen, lymph nodes
Which of the following are included in the management of a patient with hypocalcemia?
SATA - Answers - Iv fluids for hydration
medication to enhance renal excretion of calcium
dialysis
continue monitoring?
a patient admitted to the icu with the following symptoms: weak pulse, distant heart etc.
- Answers - cardiac tamponade
Selecting the ideal candidate for transplantation is an intricate process. To evaluate a
patients suitability for transplantation, a comprehensive analysis on the patient is
performed that includes which of the following types of assessments? Select all that
apply. - Answers - A) Multisystem (ABO)
B) Physiological (complete physical)
C) Psychosocial (lab results)
The critical care nurse knows that determination of compatibility in transplantation
involves the evaluation of two major antigen systems. A mismatch in compatibility may
cause an immediate reaction leading to organ loss. The primary determinant for solid
organ transplantation is which of the following? - Answers - ABO grouping
a critically ill cancer patient has severe hyperglycemia what treatment should the nurse
initiate first? - Answers - give high-volume intravenous saline
a patient with cancer has developed probable cardiac tamponade. The patient most
likely presents with which of the following symptoms? - Answers - Muffled or distant
heart sounds
