,
, Medical-Surgical Nursing Test Bank and Practice
Questions Brunner and Suddarth 16th Edition
Question 1
Question:
A nurse is caring for a patient who has been vomiting for 3 days. Which acid-base
imbalance should the nurse anticipate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Metabolic alkalosis
Rationale:
Prolonged vomiting causes the loss of hydrochloric acid (HCl) from the stomach. This
loss of acid leads to an increase in bicarbonate (base) in the body, resulting in
metabolic alkalosis. Metabolic acidosis would occur with loss of bicarbonate (e.g.,
diarrhea). Respiratory acidosis occurs with hypoventilation, and respiratory alkalosis
occurs with hyperventilation.
Question 2
Question:
A nurse is caring for a patient with heart failure who is taking digoxin and
furosemide. Which assessment finding requires immediate intervention?
A. Heart rate of 58 beats/min
B. Serum potassium level of 3.2 mEq/L
C. Digoxin level of 1.0 ng/mL
D. Weight loss of 1 kg
Correct Answer: B. Serum potassium level of 3.2 mEq/L
Rationale:
Furosemide is a loop diuretic that causes potassium loss. Hypokalemia (potassium <
3.5 mEq/L) increases the risk of digoxin toxicity. The nurse should report this finding
immediately and anticipate potassium replacement. A heart rate of 58 is slightly low
but not immediately life-threatening. A digoxin level of 1.0 ng/mL is within the
therapeutic range (0.5-2.0 ng/mL). Weight loss of 1 kg is an expected effect of
diuresis.
Question 3
, Question:
A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD)
who is experiencing an exacerbation. Which intervention should the nurse implement
first?
A. Administer a bronchodilator
B. Place the patient in a high Fowler's position
C. Obtain an arterial blood gas
D. Start an intravenous line
Correct Answer: B. Place the patient in a high Fowler's position
Rationale:
Positioning the patient in high Fowler's position facilitates lung expansion and
improves ventilation-perfusion matching, making it the priority immediate
intervention to improve oxygenation. Administering bronchodilators and obtaining
ABGs are important but follow positioning. Starting an IV is not the priority for
immediate respiratory distress.
Question 4
Question:
A patient with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA).
Which order should the nurse implement first?
A. Administer regular insulin IV bolus
B. Infuse 0.9% sodium chloride IV bolus
C. Administer potassium IV
D. Administer sodium bicarbonate
Correct Answer: B. Infuse 0.9% sodium chloride IV bolus
Rationale:
Patients with DKA are severely dehydrated due to osmotic diuresis. Fluid
resuscitation with 0.9% sodium chloride is the priority to restore intravascular volume
and perfusion. Insulin is administered after fluids are initiated. Potassium is added
after insulin therapy begins and potassium levels drop. Bicarbonate is only used in
severe acidosis.
Question 5
Question:
A nurse is assessing a patient with cirrhosis who has ascites. Which finding requires
immediate follow-up?
A. Confusion and disorientation
B. Spider angiomas on the chest
, Medical-Surgical Nursing Test Bank and Practice
Questions Brunner and Suddarth 16th Edition
Question 1
Question:
A nurse is caring for a patient who has been vomiting for 3 days. Which acid-base
imbalance should the nurse anticipate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Metabolic alkalosis
Rationale:
Prolonged vomiting causes the loss of hydrochloric acid (HCl) from the stomach. This
loss of acid leads to an increase in bicarbonate (base) in the body, resulting in
metabolic alkalosis. Metabolic acidosis would occur with loss of bicarbonate (e.g.,
diarrhea). Respiratory acidosis occurs with hypoventilation, and respiratory alkalosis
occurs with hyperventilation.
Question 2
Question:
A nurse is caring for a patient with heart failure who is taking digoxin and
furosemide. Which assessment finding requires immediate intervention?
A. Heart rate of 58 beats/min
B. Serum potassium level of 3.2 mEq/L
C. Digoxin level of 1.0 ng/mL
D. Weight loss of 1 kg
Correct Answer: B. Serum potassium level of 3.2 mEq/L
Rationale:
Furosemide is a loop diuretic that causes potassium loss. Hypokalemia (potassium <
3.5 mEq/L) increases the risk of digoxin toxicity. The nurse should report this finding
immediately and anticipate potassium replacement. A heart rate of 58 is slightly low
but not immediately life-threatening. A digoxin level of 1.0 ng/mL is within the
therapeutic range (0.5-2.0 ng/mL). Weight loss of 1 kg is an expected effect of
diuresis.
Question 3
, Question:
A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD)
who is experiencing an exacerbation. Which intervention should the nurse implement
first?
A. Administer a bronchodilator
B. Place the patient in a high Fowler's position
C. Obtain an arterial blood gas
D. Start an intravenous line
Correct Answer: B. Place the patient in a high Fowler's position
Rationale:
Positioning the patient in high Fowler's position facilitates lung expansion and
improves ventilation-perfusion matching, making it the priority immediate
intervention to improve oxygenation. Administering bronchodilators and obtaining
ABGs are important but follow positioning. Starting an IV is not the priority for
immediate respiratory distress.
Question 4
Question:
A patient with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA).
Which order should the nurse implement first?
A. Administer regular insulin IV bolus
B. Infuse 0.9% sodium chloride IV bolus
C. Administer potassium IV
D. Administer sodium bicarbonate
Correct Answer: B. Infuse 0.9% sodium chloride IV bolus
Rationale:
Patients with DKA are severely dehydrated due to osmotic diuresis. Fluid
resuscitation with 0.9% sodium chloride is the priority to restore intravascular volume
and perfusion. Insulin is administered after fluids are initiated. Potassium is added
after insulin therapy begins and potassium levels drop. Bicarbonate is only used in
severe acidosis.
Question 5
Question:
A nurse is assessing a patient with cirrhosis who has ascites. Which finding requires
immediate follow-up?
A. Confusion and disorientation
B. Spider angiomas on the chest
