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Exam (elaborations)

MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s)

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MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s) Exam 1 1. A patient has received atropine before surgery and complains of dry mouth. Which action by the nurse is best? Answer: Tell the patient dry mouth is an expected side effect. 2. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse? Answer: The patient is planning to drive home after surgery. 3. As the nurse prepares a patient the morning of surgery, the patient refuses to remove a wedding ring, saying, "I have never taken it off since the day I was married." Which response by the nurse is best? Answer: Suggest that the patient give the ring to a family member to keep. 4. The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a patient who is scheduled for surgery in a few days. The results are white blood cell (WBC) count 10.2 × 103/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 × 103/µL. Which action should the nurse take? Answer: Continue to prepare the patient for the surgical procedure. 5. A 36-year-old female is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery? Answer: The patient's statement that her last menstrual period was 8 weeks ago 6. Which information in the preoperative patient's medication history is most important to communicate to the health care provider? Answer: The patient takes garlic capsules daily. 7. A patient who takes a diuretic and a β-blocker to control blood pressure is scheduled for breast reconstruction surgery. Which patient information is most important to communicate to the health care provider before surgery? Answer: Serum potassium 3.2 mEq/L 8. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated shoulder. What does the nurse anticipate? Answer: Starting an IV in the patient’s unaffected arm. 9. While in the holding area, a patient reveals to the nurse that his father had a high fever after surgery. What action by the nurse is a priority? Answer: Alert the anesthesia care provider of the family member’s reaction to surgery 10. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a student, would require the nurse to intervene? Answer: The student wears street clothed in the semi-restricted area. 11. The operating room nurse is providing orientation to a student nurse. Which action would the nurse list as a major responsibility of a scrub nurse? Answer: Keep both hands above the operating table level 12. A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anesthesia. While in the PACU, what assessment finding is most important for the nurse to report? Answer: Weak chest movement 13. Which action in the perioperative patient plan of care can the charge nurse delegate to a surgical technologist? Answer: Pass sterile instruments and supplies to the surgeon and scrub technician 14. When caring for a patient who has received general anesthetic, the circulating nurse notes red, raised wheals on the patient’s arms. Which action should the nurse take? Answer: Notify the ACP 15. The NG tube is removed 2nd day postop, pt is placed on a clear, liquid diet. 4 hrs later the pt complains of sharp, cramping gas pains. What action by the RN is most appropriate? Answer: assist the patient to ambulate 16. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate? Answer: Continue to take vital signs every 15 minutes. 17. A postop patient has not voided for 8 hrs after surgery…. what action should the nurse take first? Answer: Bladder scan 18. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit. Which action by the nurse on the clinical unit should be performed first? Answer: Take the patient's vital signs. 19. A postop pt has a nursing dx of ineffective airway clearance. The nurse determines that interventions for this nursing diagnosis have been successful if which is observed? Answer: Patients breath sounds are clear to auscultation 20. In the postanesthesia care unit (PACU), a patient's vital signs are blood pressure 116/72, pulse 74, respirations 12, and SpO2 91%. The patient is sleepy but awakens easily. Which action should the nurse take first? Answer: Encourage the patient to take deep breaths. 21. Which action could the PACU nurse delegate to an UAP? Answer: Help with transfer onto a stretcher 22. An older pt is being dc from the ambulatory surgical unit following L eye surgery. The pt tells the nurse, “I don’t know if I can take care of myself once I’m home”. Which action by the nurse is most appropriate? Answer: discuss specific concerns regarding self-care 23. A patient is admitted with possible botulism poisoning after eating home-canned green beans. Which intervention ordered would the nurse question? Answer: Encourage oral fluids to 3L/day 24. A 22-year-old patient who sustained a T2 spinal cord injury 10 days ago tells the nurse "i want to be transferred to a hospital where the nurses know what they are doing"… Answer: Request patient to take part in their care

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