NURSING 120 Advanced Med Surg Final Exam - Questions and Answers 2023 GradedA+

NURSING 120 Advanced Med Surg Final Exam - Questions and Answers 2023 GradedA+. A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the following findings should the nurse expect? a. Decreased brian natriuretic peptide (BNP) b. Elevated central venous pressure (CVP) c. Decreased pulmonary pressure d. Increases urinary output 10. A client comes into the ED reporting nausea and vomiting that worsens when lying down and without relief from antacids. The provider suspects’ acute pancreatitis. Which of the following lab test results should the nurse expect to see if the client has acute pancreatitis? a. Decreased WBC b. Increased serum amylase c. Decreased serum lipase d. Increased serum calcium 11. A nurse in the ICU is caring for a client who has acute respiratory distress syndrome (ARDS) and is receiving mechanical via an endotracheal tube. The provider plans to exubate her within the next 24 hour. Which of the following is an important criterion for exubating the client? a. Ability to cough effectively b. Adequate tidal volume without manually assisted breaths c. No indication of infection d. No need for supplemental oxygen 12. A nurse is caring for a client following a CT scan with dye who suffered from an anaphylactic reaction. Which of the following conditions requires a priority nursing response? a. urticaria b. stridor c. tachypnea d. angioedema 13. A nurse is caring for a female client who came in to the ED reporting SOB and pain in the lung area. Her heart rate is 110/min, resp. rate 40/min, and blood pressure 140/80 mmHg. Her arterial blood gases are: pH 7.5, PaCO2 29 mmHg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. Which of the following is the priority intervention? a. Prepare for mechanical ventilation b. Administer oxygen via facemask c. Prepare to administer a sedative d. Monitor for pulmonary embolism 14. A nurse is monitoring a client who has just had a thoracentesis to remove pleural fluid. Which of the following clinical manifestations indicate a complication that requires notifying the immediately? a. Serosanguineous drainage from the puncture site b. Discomfort at the puncture site c. Increased heart rate d. Decreased temperature 15. A group of college students was attending a weekend football rally when one of the students stumbled and fell into the bonfire. Although several friends quickly intervened, the client sustained partial-thickness burns to lower legs, chest, and both forearms. Which of the following is priority nursing action when the client is brought to the ED? a. cover the burned area with sterile gauze b. inspect mouth for signs of inhalation c. administer intravenous pain medication d. draw blood for a CBC 16. A triage nurse in an emergency dept is caring for a client who has gunshot wound to the right side of chest. The nurse notices thick dressing on the chest and sucking noise coming from the wound. The client has a pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take initially? a. Raise the foot of the bed to a 90 degree angle b. Remove the dressing to inspect the wound c. Prepare to insert a central line d. Administer oxygen via nasal cannula 17. A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client’s heart rate increases from 86/min to 110/min and becomes irregular. The nurse should know that the requires which of the following? a. A cardiology consult b. Less frequent suctioning c. An antidysrhythmic medication d. Pre-oxygenation prior to suctioning 18. The nurse is caring for a client who is receiving a blood transfusion. The transfusion started minutes ago at a rate of 100 mL/hr. The client begins to complain of low back pain and headache increasingly restless. What is the first nursing action? a. Stop the transfusion, disconnect the blood tubing, and begin a primary infusion of normal saline solution b. Slow the infusion and evaluate the vital signs and the client’s history of transfusion reactions c. Slow the infusion of blood and begin infusion of normal saline solution from the Y connector. d. Recheck the unit of blood for correct identification numbers and crossmatch information 19. A client with a diagnosis of disseminated intravascular coagulation (DIC) has the assessment findings: blood pressure of 76/56, temperature 102.6 degrees, resp. 24 breath/min., with complaints of severe neck and back pain. Which nursing action should the nurse implement first? a. Administer acetaminophen (Tylenol) PO. b. Administer ibuprofen (Motrin) PO. c. Draw coagulation study blood work in the AM d. Give morphine sulfate IV 20. The nurse administering albuterol (Proventil) via a metered-dose inhaler (MDI) to a client who has a history of coronary artery disease is now in congestive heart failure. What side effects will be particularly important to observe for when the client takes the medication? a. Tremors and central nervous system stimulation b. Tachycardia and chest discomfort c. Development of oral candidiasis d. An increase in blood pressure 21. The nurse is assessing a client who is on a ventilator and has an endotracheal tube in place. What data confirms that the tube has migrated too far into the trachea? a. Decreased breath sounds are heard over the left side of the chest b. Increased rhonchi are present at the lung bases bilaterally c. Ventilator pressure alarm continues to sound d. Client is able to speak and coughs excessively 22. What is the desired action of dopamine (Intropin) when administered in the treatment of shock? a. It increases myocardial contractility b. It is associated with fewer severe allergic reactions c. It causes rapid vasodilation of the vascular bed d. It supports renal perfusion by dilation of the renal arteries 23. The nurse is monitoring an IV infusion of sodium nitroprusside (Nirpride). Fifteen minutes after the infusion is started, the client’s BP goes from 190/120 mm Hg to 120/90 mm Hg. What is the priority nursing action? a. Recheck the BP and call the doctor b. Decrease the infusion rate and recheck the blood pressure in 5 minutes c. Stop the medication and keep the IV open with D5W. d. Assess the client’s tolerance of the current level of BP 24. Norepinephrine (Levophed) has been ordered for a client in hypovolemic shock. Before administering the drug, the nurse should make sure that the client has: a. A heart rate of less than 120 beats/min b. Urine output of at least 30 mL/hr. c. Received adequate anticoagulation d. Been receiving adequate IV fluid replacement