,GALEN|NU155/NU 155 Medical-Surgical
Nursing I Final Exam | Galen | 26/27(PDF)
1. The nurse is preparing a client for a surgical procedure. Which member of the healthcare team is
legally responsible for obtaining the client's informed consent?
A) The registered nurse
B) The licensed practical nurse
C) The surgeon performing the procedure
D) The anesthesiologist
Correct Answer: C) The surgeon performing the procedure
Rationale: Informed consent for a surgical procedure must be obtained by the physician who will
perform the procedure. The surgeon is legally responsible for explaining the risks, benefits, and
alternatives. The nurse's role is to witness the signature and ensure the client understands the
information.
2. A client prescribed warfarin for atrial fibrillation should be instructed to avoid which food due to its
interaction with the medication?
A) Grapefruit juice
B) Leafy green vegetables
C) Dairy products
D) Bananas
Correct Answer: B) Leafy green vegetables
Rationale: Leafy green vegetables are high in vitamin K, which antagonizes the effects of warfarin and
can reduce its anticoagulant effect. Consistent intake is more important than avoidance, but large
fluctuations in vitamin K intake should be avoided. Grapefruit juice interacts with many medications
but not warfarin.
,3. Which assessment finding in a client with a head injury is the earliest indicator of increased
intracranial pressure?
A) Pupillary dilation
B) Decorticate posturing
C) Change in level of consciousness
D) Cushing's triad
Correct Answer: C) Change in level of consciousness
Rationale: A change in level of consciousness is the earliest and most sensitive indicator of increased
intracranial pressure. Pupillary changes, posturing, and Cushing's triad (widening pulse pressure,
bradycardia, irregular respirations) occur later as ICP continues to rise.
4. A client with cirrhosis and ascites is prescribed a diuretic. Which laboratory value should the nurse
monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B) Serum potassium
Rationale: Diuretics, especially loop and thiazide diuretics, can cause potassium loss leading to
hypokalemia. Serum potassium should be monitored closely in clients with cirrhosis receiving diuretic
therapy. While sodium, calcium, and magnesium are important, potassium is the most immediate
concern.
5. A client with hyperthyroidism is prescribed propylthiouracil. The nurse should monitor the client for
which adverse effect?
A) Hypoglycemia
B) Agranulocytosis
C) Hyperkalemia
, D) Bradycardia
Correct Answer: B) Agranulocytosis
Rationale: Propylthiouracil, an antithyroid medication, can cause agranulocytosis, a severe drop in
white blood cells. Clients should be monitored for signs of infection such as fever and sore throat.
Hypoglycemia, hyperkalemia, and bradycardia are not typical adverse effects of this medication.
6. A client with type 1 diabetes mellitus is most likely to exhibit which pathophysiological
characteristic?
A) Insulin resistance at the cellular receptor level
B) Autoimmune destruction of pancreatic beta cells
C) Overproduction of glucagon by alpha cells
D) Decreased sensitivity of liver cells to insulin
Correct Answer: B) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by an autoimmune process that destroys the beta cells in the
islets of Langerhans, leading to an absolute insulin deficiency. Insulin resistance is the hallmark of type
2 diabetes. Overproduction of glucagon and decreased liver sensitivity are secondary factors.
7. A client who uses peripheral vision to look at the nurse is most likely exhibiting a sign of which
condition?
A) Glaucoma
B) Diabetic retinopathy
C) Macular degeneration
D) Cataracts
Correct Answer: C) Macular degeneration
Nursing I Final Exam | Galen | 26/27(PDF)
1. The nurse is preparing a client for a surgical procedure. Which member of the healthcare team is
legally responsible for obtaining the client's informed consent?
A) The registered nurse
B) The licensed practical nurse
C) The surgeon performing the procedure
D) The anesthesiologist
Correct Answer: C) The surgeon performing the procedure
Rationale: Informed consent for a surgical procedure must be obtained by the physician who will
perform the procedure. The surgeon is legally responsible for explaining the risks, benefits, and
alternatives. The nurse's role is to witness the signature and ensure the client understands the
information.
2. A client prescribed warfarin for atrial fibrillation should be instructed to avoid which food due to its
interaction with the medication?
A) Grapefruit juice
B) Leafy green vegetables
C) Dairy products
D) Bananas
Correct Answer: B) Leafy green vegetables
Rationale: Leafy green vegetables are high in vitamin K, which antagonizes the effects of warfarin and
can reduce its anticoagulant effect. Consistent intake is more important than avoidance, but large
fluctuations in vitamin K intake should be avoided. Grapefruit juice interacts with many medications
but not warfarin.
,3. Which assessment finding in a client with a head injury is the earliest indicator of increased
intracranial pressure?
A) Pupillary dilation
B) Decorticate posturing
C) Change in level of consciousness
D) Cushing's triad
Correct Answer: C) Change in level of consciousness
Rationale: A change in level of consciousness is the earliest and most sensitive indicator of increased
intracranial pressure. Pupillary changes, posturing, and Cushing's triad (widening pulse pressure,
bradycardia, irregular respirations) occur later as ICP continues to rise.
4. A client with cirrhosis and ascites is prescribed a diuretic. Which laboratory value should the nurse
monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B) Serum potassium
Rationale: Diuretics, especially loop and thiazide diuretics, can cause potassium loss leading to
hypokalemia. Serum potassium should be monitored closely in clients with cirrhosis receiving diuretic
therapy. While sodium, calcium, and magnesium are important, potassium is the most immediate
concern.
5. A client with hyperthyroidism is prescribed propylthiouracil. The nurse should monitor the client for
which adverse effect?
A) Hypoglycemia
B) Agranulocytosis
C) Hyperkalemia
, D) Bradycardia
Correct Answer: B) Agranulocytosis
Rationale: Propylthiouracil, an antithyroid medication, can cause agranulocytosis, a severe drop in
white blood cells. Clients should be monitored for signs of infection such as fever and sore throat.
Hypoglycemia, hyperkalemia, and bradycardia are not typical adverse effects of this medication.
6. A client with type 1 diabetes mellitus is most likely to exhibit which pathophysiological
characteristic?
A) Insulin resistance at the cellular receptor level
B) Autoimmune destruction of pancreatic beta cells
C) Overproduction of glucagon by alpha cells
D) Decreased sensitivity of liver cells to insulin
Correct Answer: B) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is caused by an autoimmune process that destroys the beta cells in the
islets of Langerhans, leading to an absolute insulin deficiency. Insulin resistance is the hallmark of type
2 diabetes. Overproduction of glucagon and decreased liver sensitivity are secondary factors.
7. A client who uses peripheral vision to look at the nurse is most likely exhibiting a sign of which
condition?
A) Glaucoma
B) Diabetic retinopathy
C) Macular degeneration
D) Cataracts
Correct Answer: C) Macular degeneration
