RN Adult Medical Surgical Exam
Test Bank RN Adult Medical Surgical Exam
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% Verified Solutions | Updated
Per Latest Guidelines | Graded A+
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A.Hypokalemia
B.Microalbuminuria
C.Elevated serum lipid levels
D.Ketonuria –
Correct Answer :Correct Answer: B
A+ TEST BANK 1
, RN Adult Medical Surgical Exam
Rationale:
Microalbuminuria is the earliest sign of diabetic nephropathy and indicates the need for
follow-up evaluation. Hyperkalemia, not option A, is associated with end-stage renal disease
caused by diabetic nephropathy. Option C may be elevated in end-stage renal disease. Option
D may signal the onset of diabetic ketoacidosis (DKA).
The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very
restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock
is in place. Which action should the nurse take first?
A.Measure the urine specific gravity.
B.Obtain IV fluids for infusion per protocol.
C.Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds. –
Correct Answer :Correct Answer: B
Rationale:
The client is at risk for hypovolemic shock because of the postoperative status and is
exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore
tissue perfusion. Options A, C, and D are all important interventions but are of lower priority
than option B.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube
draining bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit
levels are decreased. Which additional change in laboratory data should the nurse expect?
A+ TEST BANK 2
, RN Adult Medical Surgical Exam
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results –
Correct Answer :Correct Answer: C
Rationale:
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria
from the digestion of proteins increase ammonia levels in clients with advanced liver disease,
so removal of blood, a protein source, from the intestine results in a reduced level of
ammonia. Options A, B, and D will not be significantly affected by the removal of blood.
The nurse is preparing a teaching plan for a group of healthy adults. Which individual is most
likely to maintain optimum health?
A.A teacher whose blood glucose levels average 126 mg/dL daily with oral antidiabetic drugs
B.An accountant whose blood pressure averages 140/96 mm Hg and who says he does not
have time to exercise
C.A stock broker whose total serum cholesterol level dropped to 290 mg/dL with diet
modifications
D.A recovering IV heroin user who contracted hepatitis more than 10 years ago –
Correct Answer :Correct Answer: A
Rationale:
The diabetic teacher has assumed responsibility for self-care, so among those listed, he or she
is the most likely to maintain optimum health. Option B has expressed a lack of interest in
A+ TEST BANK 3
, RN Adult Medical Surgical Exam
health promotion. Option C continues to demonstrate a high-risk cholesterol level despite a
reported attempt at dietary modifications. Previous IV drug use and a history of hepatitis
make this individual a health risk despite the fact that the individual is in recovery.
Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder?
A.Stress incontinence
B.Infection
C.Painless gross hematuria
D.Peritonitis –
Correct Answer :Correct Answer: B
Rationale:
Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result
of a sudden increase in intra-abdominal pressure. Option C is the most common symptom of
bladder cancer. Option D is the most common and serious complication of peritoneal dialysis.
During assessment of a client in the intensive care unit, the nurse notes that the client's
breath sounds are clear on auscultation, but jugular vein distention and muffled heart sounds
are present. Which action should the nurse take first?
A.Prepare the client for a pericardial tap.
B.Administer intravenous furosemide.
A+ TEST BANK 4
Test Bank RN Adult Medical Surgical Exam
QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% Verified Solutions | Updated
Per Latest Guidelines | Graded A+
Which abnormal laboratory finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy?
A.Hypokalemia
B.Microalbuminuria
C.Elevated serum lipid levels
D.Ketonuria –
Correct Answer :Correct Answer: B
A+ TEST BANK 1
, RN Adult Medical Surgical Exam
Rationale:
Microalbuminuria is the earliest sign of diabetic nephropathy and indicates the need for
follow-up evaluation. Hyperkalemia, not option A, is associated with end-stage renal disease
caused by diabetic nephropathy. Option C may be elevated in end-stage renal disease. Option
D may signal the onset of diabetic ketoacidosis (DKA).
The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very
restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock
is in place. Which action should the nurse take first?
A.Measure the urine specific gravity.
B.Obtain IV fluids for infusion per protocol.
C.Prepare for insertion of a central venous catheter.
D.Auscultate the client's breath sounds. –
Correct Answer :Correct Answer: B
Rationale:
The client is at risk for hypovolemic shock because of the postoperative status and is
exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore
tissue perfusion. Options A, C, and D are all important interventions but are of lower priority
than option B.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube
draining bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit
levels are decreased. Which additional change in laboratory data should the nurse expect?
A+ TEST BANK 2
, RN Adult Medical Surgical Exam
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results –
Correct Answer :Correct Answer: C
Rationale:
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria
from the digestion of proteins increase ammonia levels in clients with advanced liver disease,
so removal of blood, a protein source, from the intestine results in a reduced level of
ammonia. Options A, B, and D will not be significantly affected by the removal of blood.
The nurse is preparing a teaching plan for a group of healthy adults. Which individual is most
likely to maintain optimum health?
A.A teacher whose blood glucose levels average 126 mg/dL daily with oral antidiabetic drugs
B.An accountant whose blood pressure averages 140/96 mm Hg and who says he does not
have time to exercise
C.A stock broker whose total serum cholesterol level dropped to 290 mg/dL with diet
modifications
D.A recovering IV heroin user who contracted hepatitis more than 10 years ago –
Correct Answer :Correct Answer: A
Rationale:
The diabetic teacher has assumed responsibility for self-care, so among those listed, he or she
is the most likely to maintain optimum health. Option B has expressed a lack of interest in
A+ TEST BANK 3
, RN Adult Medical Surgical Exam
health promotion. Option C continues to demonstrate a high-risk cholesterol level despite a
reported attempt at dietary modifications. Previous IV drug use and a history of hepatitis
make this individual a health risk despite the fact that the individual is in recovery.
Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder?
A.Stress incontinence
B.Infection
C.Painless gross hematuria
D.Peritonitis –
Correct Answer :Correct Answer: B
Rationale:
Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result
of a sudden increase in intra-abdominal pressure. Option C is the most common symptom of
bladder cancer. Option D is the most common and serious complication of peritoneal dialysis.
During assessment of a client in the intensive care unit, the nurse notes that the client's
breath sounds are clear on auscultation, but jugular vein distention and muffled heart sounds
are present. Which action should the nurse take first?
A.Prepare the client for a pericardial tap.
B.Administer intravenous furosemide.
A+ TEST BANK 4
