MED SURG 2 FINAL EXAM/MEDICAL
SURGICAL NURSING II FINAL TEST BANK
WITH ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED RATIONALE ANSWERS|
CURRENTLY TESTING VERSION | ALREADY
GRADED A+|NEWEST |2026-2027
A nurse is monitoring a client who has a chest tube in place connected to wall suction
due to a right-sided pneumothorax. The client complains of chest burning. Which of the
following actions should the nurse take?
Strip the client's chest tube.
Reposition the client.
Clamp the client's chest tube.
Increase the client's wall suction.
Reposition the client.
The nurse repositioning the client is an appropriate action to relieve chest burning
from the chest tube.
A client with a massive hemothorax and pneumothorax has absent breath sounds in the
right lung. To promote improved V/Q matching, how should the nurse position the
client?
In a reclining chair bed
On the right side
1|Page
,On the left side
Supine with the head of the bed elevated
On the left side
When there is impaired function of 1 lung, the client should be positioned with the
unaffected lung in the dependent position to promote perfusion to the functioning
tissue. If the diseased lung is positioned dependently, more V/Q mismatch occurs.
The head of the bed may be elevated or a reclining chair may be used, with the
client positioned on the unaffected side, to maximize thoracic expansion if the
client has increased work of breathing.
The best client response to treatment of ARDS occurs when initial management
includes what?
Treatment of the underlying condition
Endotracheal intubation and mechanical ventilation
Administration of prophylactic antibiotics
Treatment with diuretics and mild fluid restriction
Treatment of the underlying condition
Because ARDS is precipitated by a physiologic insult, a critical factor in its
prevention and early management is treatment of the underlying condition.
Prophylactic antibiotics, treatment with diuretics and fluid restriction, and
mechanical ventilation are used as ARDS progresses.
A nurse in the emergency department is caring for a client who has pulmonary edema,
reports dyspnea, and appears anxious. The client's blood pressure is 108/79 and his
apical pulse is 112. Which of the following interventions is the nurse's priority?
2|Page
,Reassure the client.
Give the client sublingual nitroglycerin.
Place the client in high-Fowler's position with legs dependent.
Administer high-flow oxygen at 5 L/min by facemask to the client.
Administer high-flow oxygen at 5 L/min by facemask to the client.
A client who has pulmonary edema is critically ill and is hypoxic. The first action
the nurse should take when using the airway, breathing, circulation approach to
client care is to administer high-flow oxygen at 5 L/min by facemask to the client.
When should the nurse check for leaks in the chest tube and pleural drainage system?
Fluid in the water-seal chamber fluctuates with the patient's breathing.
There is constant bubbling of water in the suction control chamber.
There is continuous bubbling in the water-seal chamber.
The water levels in the water-seal and suction control chambers are decreased.
There is continuous bubbling in the water-seal chamber.
The water-seal chamber should bubble intermittently as air leaves the lung with
exhalation in a spontaneously breathing patient. Continuous bubbling indicates a
leak. The water in the suction control chamber will bubble continuously and the
fluid in the water-seal chamber fluctuates (tidaling) with the patient's breathing.
Water in the suction control chamber, and perhaps in the water-seal chamber,
evaporates and may have to be replaced periodically.
3|Page
, What is an advantage of a tracheostomy over an endotracheal (ET) tube for long-term
management of an upper airway obstruction?
A tracheostomy is safer to perform in an emergency.
A tracheostomy tube allows for more comfort and mobility.
An ET tube is more likely to lead to lower respiratory tract infection.
An ET tube has a higher risk of tracheal pressure necrosis.
A tracheostomy tube allows for more comfort and mobility.
With a tracheostomy (versus an endotracheal [ET] tube), patient comfort is
increased because there is no tube in the mouth. Because the tube is more secure,
mobility is improved. The ET tube is more easily inserted in an emergency situation.
It is preferable to perform a tracheostomy in the operating room because it requires
careful dissection, but it can be performed with local anesthetic in the intensive
care unit (ICU) or in an emergency. With a cuff, tracheal pressure necrosis is as
much a risk with a tracheostomy tube as with an ET tube, and infection is also as
likely to occur because the defenses of the upper airway are bypassed.
A nurse is developing a plan of care for a client who is postoperative. Which of the
following interventions should the nurse include in the plan to prevent pulmonary
complications?
Perform range-of-motion exercises
Encourage the use of an incentive spirometer
Administer an expectorant
Place suction equipment at the bedside
4|Page
SURGICAL NURSING II FINAL TEST BANK
WITH ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED RATIONALE ANSWERS|
CURRENTLY TESTING VERSION | ALREADY
GRADED A+|NEWEST |2026-2027
A nurse is monitoring a client who has a chest tube in place connected to wall suction
due to a right-sided pneumothorax. The client complains of chest burning. Which of the
following actions should the nurse take?
Strip the client's chest tube.
Reposition the client.
Clamp the client's chest tube.
Increase the client's wall suction.
Reposition the client.
The nurse repositioning the client is an appropriate action to relieve chest burning
from the chest tube.
A client with a massive hemothorax and pneumothorax has absent breath sounds in the
right lung. To promote improved V/Q matching, how should the nurse position the
client?
In a reclining chair bed
On the right side
1|Page
,On the left side
Supine with the head of the bed elevated
On the left side
When there is impaired function of 1 lung, the client should be positioned with the
unaffected lung in the dependent position to promote perfusion to the functioning
tissue. If the diseased lung is positioned dependently, more V/Q mismatch occurs.
The head of the bed may be elevated or a reclining chair may be used, with the
client positioned on the unaffected side, to maximize thoracic expansion if the
client has increased work of breathing.
The best client response to treatment of ARDS occurs when initial management
includes what?
Treatment of the underlying condition
Endotracheal intubation and mechanical ventilation
Administration of prophylactic antibiotics
Treatment with diuretics and mild fluid restriction
Treatment of the underlying condition
Because ARDS is precipitated by a physiologic insult, a critical factor in its
prevention and early management is treatment of the underlying condition.
Prophylactic antibiotics, treatment with diuretics and fluid restriction, and
mechanical ventilation are used as ARDS progresses.
A nurse in the emergency department is caring for a client who has pulmonary edema,
reports dyspnea, and appears anxious. The client's blood pressure is 108/79 and his
apical pulse is 112. Which of the following interventions is the nurse's priority?
2|Page
,Reassure the client.
Give the client sublingual nitroglycerin.
Place the client in high-Fowler's position with legs dependent.
Administer high-flow oxygen at 5 L/min by facemask to the client.
Administer high-flow oxygen at 5 L/min by facemask to the client.
A client who has pulmonary edema is critically ill and is hypoxic. The first action
the nurse should take when using the airway, breathing, circulation approach to
client care is to administer high-flow oxygen at 5 L/min by facemask to the client.
When should the nurse check for leaks in the chest tube and pleural drainage system?
Fluid in the water-seal chamber fluctuates with the patient's breathing.
There is constant bubbling of water in the suction control chamber.
There is continuous bubbling in the water-seal chamber.
The water levels in the water-seal and suction control chambers are decreased.
There is continuous bubbling in the water-seal chamber.
The water-seal chamber should bubble intermittently as air leaves the lung with
exhalation in a spontaneously breathing patient. Continuous bubbling indicates a
leak. The water in the suction control chamber will bubble continuously and the
fluid in the water-seal chamber fluctuates (tidaling) with the patient's breathing.
Water in the suction control chamber, and perhaps in the water-seal chamber,
evaporates and may have to be replaced periodically.
3|Page
, What is an advantage of a tracheostomy over an endotracheal (ET) tube for long-term
management of an upper airway obstruction?
A tracheostomy is safer to perform in an emergency.
A tracheostomy tube allows for more comfort and mobility.
An ET tube is more likely to lead to lower respiratory tract infection.
An ET tube has a higher risk of tracheal pressure necrosis.
A tracheostomy tube allows for more comfort and mobility.
With a tracheostomy (versus an endotracheal [ET] tube), patient comfort is
increased because there is no tube in the mouth. Because the tube is more secure,
mobility is improved. The ET tube is more easily inserted in an emergency situation.
It is preferable to perform a tracheostomy in the operating room because it requires
careful dissection, but it can be performed with local anesthetic in the intensive
care unit (ICU) or in an emergency. With a cuff, tracheal pressure necrosis is as
much a risk with a tracheostomy tube as with an ET tube, and infection is also as
likely to occur because the defenses of the upper airway are bypassed.
A nurse is developing a plan of care for a client who is postoperative. Which of the
following interventions should the nurse include in the plan to prevent pulmonary
complications?
Perform range-of-motion exercises
Encourage the use of an incentive spirometer
Administer an expectorant
Place suction equipment at the bedside
4|Page
