Med-Surg Practice Questions with
Solutions
The nurse is caring for four clients on a medical-surgical unit. Which client
should the
nurse see initially?
1. A client admitted with hepatitis A who has had severe diarrhea for the last
24 hours
2. A client admitted with pneumonia who is has small amounts of yellow
productive sputum
3. A client admitted with fever of unknown origin (FUO) who has been
without fever for the last 48 hours
4. A client admitted with a wound infection whose WBC is 8,500 mm3 - -
Answer: 1
Rationale: The nurse must decide which client should be seen on the initial
rounds of the
day. The nurse must remember that the first client to be seen should be the
client
who needs the attention of the nurse initially. A client with hepatitis A does
experience diarrhea, but diarrhea for the last 24 hours could cause the client
to
have a problem with dehydration and experience a state of fluid volume
deficit.
- The nurse is preparing to administer influenza vaccines to a mass drive-
through clinic.
Which statement by a client would indicate further questioning prior to
giving the client
the influenza vaccine?
1. "I am allergic to horse hair."
2. "I try to get my vaccine every year."
3. "I am not allergic to anything except eggs."
4. "My husband had a severe allergic reaction after he received his influenza
vaccine." - -Answer: 3
Rationale: Influenza vaccines are recommended for person at high risk for
serious
sequelae of influenza. The nurse should be aware that client with a
sensitivity to
eggs should not receive the vaccine. Vaccines prepared from chicken or duck
embryos are contraindicated in clients who are allergic to eggs.
, - Each client's response to pain may be influenced by multiple factors.
Select all that
apply:
a. Age
b. Past experience with pain
c. Cultural influences
d. Knowledge - -Correct Answers: a; b; c; d
Rationale: All factors listed can influence a client's response to pain.
- The nurse is caring for four clients on a medical-surgical unit. The secretary
gives the
nurse the morning labs. Which of the following labs would require that the
nurse call the
physician and inform the healthcare provider about the client's
abnormalities?
1. WBC 14,600 mm3
2. Serum protein 6.9 g/dL
3. I & D (incision and drainage) showing no growth for the last 24 hours
4. Albumin 4.2 g/dL - -Answer: 1
Rationale: When the nurse is caring for several clients, all of the labs should
be checked
frequently throughout the shift to assess for any abnormalities. The WBC in
option 1 is
abnormal. (Normal WBC 4,000-10,000 mm3
.) All of the other lab results are within
acceptable range; therefore, the results should not be called in to the
physician.
- The nurse is orienting a new graduate. The nurse is reinforcing the
importance of
standard precautions. Which of the following observations by the nurse
would require
further education regarding standard precautions?
1. The graduate nurse understands to wash hands when entering and exiting
the client's room.
2. The graduate nurse wears gloves when serving breakfast trays to various
clients.
3. The graduate nurse wears a gown, gloves, and goggles when suctioning a
client.
4. The graduate nurse leaves all supplies in the room of a client who is in
,contact isolation. - -Answer: 2
Rationale: The nurse must have an understanding of standard precautions.
Prevention is
the most important measure to prevent nosocomial infections. Standard
precautions were published in 1996 that provide guidelines for the handling
of
blood and other body fluids. These guidelines are used with all clients,
regardless
of whether they have a known infectious disease. Standard precautions are
used by all healthcare workers who have direct contact with clients or with
their body
fluids. It is not necessary for the nurse to wear gloves while delivering food
trays
to the client, because there is not contact with the client.
- A 45-year-old woman presents to the ambulatory clinic for a gynecological
examination. The health history reveals no significant personal or family
medical history.
What information concerning health-promotion behaviors should be
presented to the
client?
a. It is time to begin having mammograms every other year.
b. If the client is in a monogamous relationship, Pap smears will not be
needed.
c. Bone density examinations are indicated every year.
d. Recommended calcium intake is at least 1,200 mg per day. - -Answer: d
Rationale: The recommended calcium intake is at least 1,200 mg per day.
This will be
beneficial in the prevention of osteoporosis. Women should begin having
annual
mammograms by age 40. Pap smears are continued for women in
monogamous
relationships. For women with no significant risk for the development of
osteoporosis,
bone density examinations should be done every other year.
- The admitting department alerts the nurse on a medical-surgical unit that
a client with
active tuberculosis (TB) is being admitted to the unit. Which type of isolation
is
appropriate based on the client's diagnosis?
1. Standard precautions
, 2. Airborne precautions
3. Droplet precautions
4. Contact precautions - -Answer: 2
In addition to handwashing and standard precautions, the nature and spread
of some
infectious diseases require that special techniques be used to protect
uninfected clients
and workers. The client with pulmonary tuberculosis will be placed in
airborne
precautions. The client should be placed in a private room with special
ventilation that
does not allow air to circulate to general hospital ventilation; a mask or
special filter
respirators will be used for everyone entering the room.
- A 75-year-old client seeks care at an ambulatory clinic. The client reports
having
experienced extreme drowsiness after recently taking dosages of an over-
the-counter cold
medication. When collecting data, the nurse notes the client reports taking
only the
prescribed amount of the preparation. What inferences can be made by the
nurse
concerning the events?
a. The client likely has taken more of the preparation than stated.
b. The client likely has experienced a reaction between the cold medication
and other
routine medications.
c. The client's age has influenced his response to the medication.
d. The client is allergic to the cold medication. - -Answer: c
Rationale: Older clients often experience altered responses to medications.
These changes
are in response to age-related developments in the kidneys and liver. There
is no evidence
the client has taken too much medication. There is no information provided
to indicate
the client is taking other medications. Allergic reactions typically manifest
with
integumentary- or respiratory-related symptoms.
- The nurse is colleting data from a client regarding past alcohol use history.
What
question will provide the greatest amount of information?
Solutions
The nurse is caring for four clients on a medical-surgical unit. Which client
should the
nurse see initially?
1. A client admitted with hepatitis A who has had severe diarrhea for the last
24 hours
2. A client admitted with pneumonia who is has small amounts of yellow
productive sputum
3. A client admitted with fever of unknown origin (FUO) who has been
without fever for the last 48 hours
4. A client admitted with a wound infection whose WBC is 8,500 mm3 - -
Answer: 1
Rationale: The nurse must decide which client should be seen on the initial
rounds of the
day. The nurse must remember that the first client to be seen should be the
client
who needs the attention of the nurse initially. A client with hepatitis A does
experience diarrhea, but diarrhea for the last 24 hours could cause the client
to
have a problem with dehydration and experience a state of fluid volume
deficit.
- The nurse is preparing to administer influenza vaccines to a mass drive-
through clinic.
Which statement by a client would indicate further questioning prior to
giving the client
the influenza vaccine?
1. "I am allergic to horse hair."
2. "I try to get my vaccine every year."
3. "I am not allergic to anything except eggs."
4. "My husband had a severe allergic reaction after he received his influenza
vaccine." - -Answer: 3
Rationale: Influenza vaccines are recommended for person at high risk for
serious
sequelae of influenza. The nurse should be aware that client with a
sensitivity to
eggs should not receive the vaccine. Vaccines prepared from chicken or duck
embryos are contraindicated in clients who are allergic to eggs.
, - Each client's response to pain may be influenced by multiple factors.
Select all that
apply:
a. Age
b. Past experience with pain
c. Cultural influences
d. Knowledge - -Correct Answers: a; b; c; d
Rationale: All factors listed can influence a client's response to pain.
- The nurse is caring for four clients on a medical-surgical unit. The secretary
gives the
nurse the morning labs. Which of the following labs would require that the
nurse call the
physician and inform the healthcare provider about the client's
abnormalities?
1. WBC 14,600 mm3
2. Serum protein 6.9 g/dL
3. I & D (incision and drainage) showing no growth for the last 24 hours
4. Albumin 4.2 g/dL - -Answer: 1
Rationale: When the nurse is caring for several clients, all of the labs should
be checked
frequently throughout the shift to assess for any abnormalities. The WBC in
option 1 is
abnormal. (Normal WBC 4,000-10,000 mm3
.) All of the other lab results are within
acceptable range; therefore, the results should not be called in to the
physician.
- The nurse is orienting a new graduate. The nurse is reinforcing the
importance of
standard precautions. Which of the following observations by the nurse
would require
further education regarding standard precautions?
1. The graduate nurse understands to wash hands when entering and exiting
the client's room.
2. The graduate nurse wears gloves when serving breakfast trays to various
clients.
3. The graduate nurse wears a gown, gloves, and goggles when suctioning a
client.
4. The graduate nurse leaves all supplies in the room of a client who is in
,contact isolation. - -Answer: 2
Rationale: The nurse must have an understanding of standard precautions.
Prevention is
the most important measure to prevent nosocomial infections. Standard
precautions were published in 1996 that provide guidelines for the handling
of
blood and other body fluids. These guidelines are used with all clients,
regardless
of whether they have a known infectious disease. Standard precautions are
used by all healthcare workers who have direct contact with clients or with
their body
fluids. It is not necessary for the nurse to wear gloves while delivering food
trays
to the client, because there is not contact with the client.
- A 45-year-old woman presents to the ambulatory clinic for a gynecological
examination. The health history reveals no significant personal or family
medical history.
What information concerning health-promotion behaviors should be
presented to the
client?
a. It is time to begin having mammograms every other year.
b. If the client is in a monogamous relationship, Pap smears will not be
needed.
c. Bone density examinations are indicated every year.
d. Recommended calcium intake is at least 1,200 mg per day. - -Answer: d
Rationale: The recommended calcium intake is at least 1,200 mg per day.
This will be
beneficial in the prevention of osteoporosis. Women should begin having
annual
mammograms by age 40. Pap smears are continued for women in
monogamous
relationships. For women with no significant risk for the development of
osteoporosis,
bone density examinations should be done every other year.
- The admitting department alerts the nurse on a medical-surgical unit that
a client with
active tuberculosis (TB) is being admitted to the unit. Which type of isolation
is
appropriate based on the client's diagnosis?
1. Standard precautions
, 2. Airborne precautions
3. Droplet precautions
4. Contact precautions - -Answer: 2
In addition to handwashing and standard precautions, the nature and spread
of some
infectious diseases require that special techniques be used to protect
uninfected clients
and workers. The client with pulmonary tuberculosis will be placed in
airborne
precautions. The client should be placed in a private room with special
ventilation that
does not allow air to circulate to general hospital ventilation; a mask or
special filter
respirators will be used for everyone entering the room.
- A 75-year-old client seeks care at an ambulatory clinic. The client reports
having
experienced extreme drowsiness after recently taking dosages of an over-
the-counter cold
medication. When collecting data, the nurse notes the client reports taking
only the
prescribed amount of the preparation. What inferences can be made by the
nurse
concerning the events?
a. The client likely has taken more of the preparation than stated.
b. The client likely has experienced a reaction between the cold medication
and other
routine medications.
c. The client's age has influenced his response to the medication.
d. The client is allergic to the cold medication. - -Answer: c
Rationale: Older clients often experience altered responses to medications.
These changes
are in response to age-related developments in the kidneys and liver. There
is no evidence
the client has taken too much medication. There is no information provided
to indicate
the client is taking other medications. Allergic reactions typically manifest
with
integumentary- or respiratory-related symptoms.
- The nurse is colleting data from a client regarding past alcohol use history.
What
question will provide the greatest amount of information?
