2026 MEDSURGE EXAM WITH QUESTIONS AND CORREC ANSWERS
Lewis chapter 17
Lewis chapter 17
The nurse is caring for a patient with a massive burn injury and possible
hypovolemia. Which assessment data will be of most concern to the nurse?
a. Blood pressure is 90/40 mm Hg.
b. Urine output is 30 mL over the last hour.
c. Oral fluid intake is 100 mL for the last 8 hours.
d. There is prolonged skin tenting over the sternum.
A patient who has a small cell carcinoma of the lung develops syndrome of
inappropriate antidiuretic hormone (SIADH). The nurse should notify the health
care provider about which assessment finding?
a. Reported weight gain
b. Serum hematocrit of 42%
c. Serum sodium level of 120 mg/dL
d. Total urinary output of 280 mL during past 8 hours
A patient is admitted for hypovolemia associated with multiple draining wounds.
Which assessment would be the most accurate way for the nurse to evaluate fluid
balance?
a. Skin turgor
b. Daily weight
c. Presence of edema
d. Hourly urine output
The home health nurse cares for an alert and oriented older adult patient with a
history of dehydration. Which instructions should the nurse give to this patient
related to fluid intake?
a. "Increase fluids if your mouth feels dry.
b. "More fluids are needed if you feel thirsty."
c. "Drink more fluids in the late evening hours."
d. "If you feel lethargic or confused, you need more to drink."
A patient who is taking a potassium-wasting diuretic for treatment of hypertension
complains of generalized weakness. It is most appropriate for the nurse to take
which action?
a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Suggest that the patient avoid orange juice with meals.
d. Ask the health care provider to order a basic metabolic panel.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient.
Which statement by the patient indicates that the teaching about this medication
has been effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast."
A newly admitted patient is diagnosed with hyponatremia. When making room
assignments, the charge nurse should take which action?
a. Assign the patient to a room near the nurse's station.
b. Place the patient in a room nearest to the water fountain.
c. Place the patient on telemetry to monitor for peaked T waves.
d. Assign the patient to a semi-private room and place an order for a low-salt diet.
IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with
severe hypokalemia. Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion.
A postoperative patient who had surgery for a perforated gastric ulcer has been
receiving nasogastric suction for 3 days. The patient now has a serum sodium level
, 2026 MEDSURGE EXAM WITH QUESTIONS AND CORREC ANSWERS
Lewis chapter 17
of 127 mEq/L (127 mmol/L). Which prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium decreases to less than 128 mEq/L.
A patient who was involved in a motor vehicle crash has had a tracheostomy
placed to allow for continued mechanical ventilation. How should the nurse
interpret the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2
32 mm Hg, and HCO3 25 mEq/L?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
The nurse notes that a patient who was admitted with diabetic ketoacidosis has
rapid, deep respirations. Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery.
An older adult patient who is malnourished presents to the emergency department
with a serum protein level of 5.2 g/dL. The nurse would expect which clinical
manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness
A patient receives 3% NaCl solution for correction of hyponatremia. Which
assessment is most important for the nurse to monitor for while the patient is
receiving this infusion?
a. Lung sounds
b. Urinary output
c. Peripheral pulses
d. Peripheral edema
The long-term care nurse is evaluating the effectiveness of protein supplements for
an older resident who has a low serum total protein level. Which assessment
finding indicates that the patient's condition has improved?
a. Hematocrit 28%
b. Absence of skin tenting
c. Decreased peripheral edema
d. Blood pressure 110/72 mm Hg
A patient who is lethargic and exhibits deep, rapid respirations has the following
arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and
HCO3 16 mEq/L. How should the nurse interpret these results?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
A patient who has been receiving diuretic therapy is admitted to the emergency
department with a serum potassium level of 3.0 mEq/L. The nurse should alert the
health care provider immediately that the patient is on which medication?
a. Oral digoxin (Lanoxin) 0.25 mg daily
b. Ibuprofen (Motrin) 400 mg every 6 hours
c. Metoprolol (Lopressor) 12.5 mg orally daily
d. Lantus insulin 24 U subcutaneously every evening
The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which
nursing action should the nurse include on the care plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau's and Chvostek's signs.
d. Encourage fluid intake up to 4000 mL every day.
Lewis chapter 17
Lewis chapter 17
The nurse is caring for a patient with a massive burn injury and possible
hypovolemia. Which assessment data will be of most concern to the nurse?
a. Blood pressure is 90/40 mm Hg.
b. Urine output is 30 mL over the last hour.
c. Oral fluid intake is 100 mL for the last 8 hours.
d. There is prolonged skin tenting over the sternum.
A patient who has a small cell carcinoma of the lung develops syndrome of
inappropriate antidiuretic hormone (SIADH). The nurse should notify the health
care provider about which assessment finding?
a. Reported weight gain
b. Serum hematocrit of 42%
c. Serum sodium level of 120 mg/dL
d. Total urinary output of 280 mL during past 8 hours
A patient is admitted for hypovolemia associated with multiple draining wounds.
Which assessment would be the most accurate way for the nurse to evaluate fluid
balance?
a. Skin turgor
b. Daily weight
c. Presence of edema
d. Hourly urine output
The home health nurse cares for an alert and oriented older adult patient with a
history of dehydration. Which instructions should the nurse give to this patient
related to fluid intake?
a. "Increase fluids if your mouth feels dry.
b. "More fluids are needed if you feel thirsty."
c. "Drink more fluids in the late evening hours."
d. "If you feel lethargic or confused, you need more to drink."
A patient who is taking a potassium-wasting diuretic for treatment of hypertension
complains of generalized weakness. It is most appropriate for the nurse to take
which action?
a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Suggest that the patient avoid orange juice with meals.
d. Ask the health care provider to order a basic metabolic panel.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient.
Which statement by the patient indicates that the teaching about this medication
has been effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast."
A newly admitted patient is diagnosed with hyponatremia. When making room
assignments, the charge nurse should take which action?
a. Assign the patient to a room near the nurse's station.
b. Place the patient in a room nearest to the water fountain.
c. Place the patient on telemetry to monitor for peaked T waves.
d. Assign the patient to a semi-private room and place an order for a low-salt diet.
IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with
severe hypokalemia. Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion.
A postoperative patient who had surgery for a perforated gastric ulcer has been
receiving nasogastric suction for 3 days. The patient now has a serum sodium level
, 2026 MEDSURGE EXAM WITH QUESTIONS AND CORREC ANSWERS
Lewis chapter 17
of 127 mEq/L (127 mmol/L). Which prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium decreases to less than 128 mEq/L.
A patient who was involved in a motor vehicle crash has had a tracheostomy
placed to allow for continued mechanical ventilation. How should the nurse
interpret the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2
32 mm Hg, and HCO3 25 mEq/L?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
The nurse notes that a patient who was admitted with diabetic ketoacidosis has
rapid, deep respirations. Which action should the nurse take?
a. Give the prescribed PRN lorazepam (Ativan).
b. Start the prescribed PRN oxygen at 2 to 4 L/min.
c. Administer the prescribed normal saline bolus and insulin.
d. Encourage the patient to take deep, slow breaths with guided imagery.
An older adult patient who is malnourished presents to the emergency department
with a serum protein level of 5.2 g/dL. The nurse would expect which clinical
manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness
A patient receives 3% NaCl solution for correction of hyponatremia. Which
assessment is most important for the nurse to monitor for while the patient is
receiving this infusion?
a. Lung sounds
b. Urinary output
c. Peripheral pulses
d. Peripheral edema
The long-term care nurse is evaluating the effectiveness of protein supplements for
an older resident who has a low serum total protein level. Which assessment
finding indicates that the patient's condition has improved?
a. Hematocrit 28%
b. Absence of skin tenting
c. Decreased peripheral edema
d. Blood pressure 110/72 mm Hg
A patient who is lethargic and exhibits deep, rapid respirations has the following
arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and
HCO3 16 mEq/L. How should the nurse interpret these results?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
A patient who has been receiving diuretic therapy is admitted to the emergency
department with a serum potassium level of 3.0 mEq/L. The nurse should alert the
health care provider immediately that the patient is on which medication?
a. Oral digoxin (Lanoxin) 0.25 mg daily
b. Ibuprofen (Motrin) 400 mg every 6 hours
c. Metoprolol (Lopressor) 12.5 mg orally daily
d. Lantus insulin 24 U subcutaneously every evening
The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which
nursing action should the nurse include on the care plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau's and Chvostek's signs.
d. Encourage fluid intake up to 4000 mL every day.
