Med Surg 1 Questions and Answers with verified solutions

Med Surg 1 Questions and Answers with verified solutions 1. A patient is being admitted to the hospital on the day before a scheduled surgery. What is the most appropriate initial question for the nurse to ask this preoperative patient? a) "What did your surgeon say to you about the type of surgery you are having?" b) "What questions do you have about your surgery?" c) "What type of surgery are you having and why are you having it done?" d) "What do you know about what will be done to you?" - ANS -c) "What type of surgery are you having and why are you having it done?" 10. The patient has been in the postanesthesia care unit (PACU) for one hour. The patient is now groggy but able to respond to voice commands. While assessing the patient, for what reason would the nurse check the bedclothes underneath the patient? a) Determine drainage from tubes or drains b) Assess for fluid balance c) Detect for possible hemorrhage d) Monitor perspiration - ANS -c) Detect for possible hemorrhage 11. A 65-year-old was diagnosed and treated for right lower lobe pneumonia 4 days ago. Today, the patient came to the ED reporting abrupt onset of chest pain that is worse with inspiration. The nurse knows that the symptoms are consistent with: a) Pleurisy b) Stable angina c) Bacteremia d) Meningitis - ANS -a) Pleurisy 12. The ED nurse is caring for Ginny, a 45-year-old female with a recent history of sexual assault. Ginny came to the ED crying and shaking and stated that she had dyspnea, feeling like she was choking and couldn't breathe, chest pain, and sweating. Ginny reports that the symptoms started about 15 minutes before she came to the ED. Ginny's symptoms are consistent with: a) Myocardial Infarction b) Pneumonia c) Panic Attack d) Influenza - ANS -c) Panic Attack 13. A 86-year-old female has recent changes in her mental status, reports having no appetite, and is running a low grade fever. The nurse suspects: a) Delirium b) Dementia c) Urinary tract infection d) Hypokalemia - ANS -c) Urinary tract infection 14. Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip. He is being admitted to your unit and will have surgery in the morning. Ted has a past medical history of urinary calculi, benign prostatic hypertrophy, and hypertension. When he arrived to the medical-surgical unit, he has a strong body odor and visible dirt on his body. An indwelling urinary catheter was placed in the ED. Ted is at greatest risk for a UTI is related to: a) History of benign prostatic hypertrophy (BPH) b) Poor hygiene c) Indwelling urinary catheter d) History of urinary calculi e) His age - ANS -c) Indwelling urinary catheter 15. A nurse knows that the patient teaching on the pneumococcal vaccine to a 65-year-old patient has been effective when the patient states: a) "The injection will protect me from the flu this year" b) "I am now protected from getting pneumonia during my lifetime" c) "I will need re-vaccination in five years" d) "Now I won't need antibiotics when I get pneumonia" - ANS -c) "I will need re-vaccination in five years" 16. A patient is 14 hours postop from a surgical decompression for compartment syndrome at the site of an ORIF on the left femur. On assessment, the urine output is 100mL in 8 hours, and has a dark, reddish brown color. Based on this assessment finding, the nurse will: a) Check to see if the myoglobin levels decreased b) Administer an ordered prn fluid bolus to reverse fluid volume deficit c) Nothing; this is an expected finding following surgery d) Assess the patient for signs of acute kidney injury - ANS -d) Assess the patient for signs of acute kidney injury 17. A nurse has completed cast care teaching following the application of a plaster cast. The nurse knows that patient teaching has been effective when the patient states: a) "I can shower and then pat the cast dry." b) "If I wrap my cast in plastic, it will last longer." c) "I will call my physician if I have an increase in pain or swelling." d) "I will apply ice on the cast over the fracture site for the next 48 hours." - ANS -c) "I will call my physician if I have an increase in pain or swelling." 18. A 75-year-old male with a history of heart failure (HF) and diabetes mellitus type 2 presents to the ED with abdominal pain. A CT scan with contrast reveals a bowel obstruction that requires surgical resection. On post-operative day 1, the patient develops a severe headache and mental status changes. The resident orders a CT scan with contrast of the head. Before sending the patient to the CT scan, what action is a priority for the nurse? a) Perform a complete neurological assessment before sending the patient to the CT scan b) Evaluate the morning creatinine and BUN lab results c) Contact the on-call cardiologist for immediate evaluation of the patient's cardiac output d) Hold IV fluids for 4 hours prior to the CT scan - ANS -b) Evaluate the morning creatinine and BUN lab results 19. A 75-year-old male with a history of heart failure (HF) and diabetes mellitus type 2 presents to the ED with abdominal pain. A CT scan with contrast reveals a bowel obstruction that requires surgical resection. On post-operative day 1, the patient develops a severe headache and mental status changes. The resident orders a CT scan with contrast of the head. Identify ways to prevent contrast-induced nephropathy. Select all that apply. a) Use of low-osmolar contrast b) Insert a urinary catheter to accurately measure urine output c) Avoid multiple procedures over a 24-48 hour time period d) Hydrate the patient before and after the procedure e) Administer high-dose NSAIDS prior to the procedure - ANS -a) Use of low-osmolar contrast c) Avoid multiple procedures over a 24-48 hour time period d) Hydrate the patient before and after the procedure 2. A benzodiazepine has been administered to a patient preoperatively. After the drug has been administered, the nurse plans to monitor the patient for which side effects? Select all that apply. a) Anxiety b) Hypotension c) Hypocalcemia d) Level of Consciousness e) Sedation - ANS -a) Anxiety d) Level of Consciousness e) Sedation 20. A 80-year-old patient slipped on the ice and fell. The patient is brought to the ED for evaluation for a possible hip fracture. Identify what should be included in the initial assessment for a hip fracture. Select all that apply. a) Co-morbid health conditions b) External rotation of the affected leg c) Shortening of the affected leg d) Muscle spasms of affected leg e) Pain at the fracture site f) Condition of skin of the affected leg - ANS -b) External rotation of the affected leg c) Shortening of the affected leg d) Muscle spasms of affected leg e) Pain at the fracture site 21. The nurse is preparing to administer an intravenous (IV) insulin drip to a patient with hyperglycemia. The nurse knows that only one insulin can be used intravenously. Which insulin can only be given IV? a) NPH b) Regular c) Lispro d) Lantus - ANS -b) Regular 22. A 33-year-old patient hospitalized for a colon resection has just had TPN therapy initiated via a central venous catheter. What nursing actions promote an optimal patient outcome to TPN therapy? Select all that apply. a) Take vital signs every four hours b) Perform a finger stick glucose twice a day c) Record accurate I & O d) Monitor liver function tests e) Record daily weights f) Infuse TPN using aseptic technique over 8 hours g) Monitor serum electrolyte levels - ANS -a) Take vital signs every four hours b) Perform a finger stick glucose twice a day c) Record accurate I & O e) Record daily weights g) Monitor serum electrolyte levels 23. When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? a) Hypoglycemia b) Hyponatremia c) Ketonuria d) Polyphagia - ANS -a) Hypoglycemia 24. The nurse is caring for a patient has been having abnormally low blood glucose concentration. What glucose level would the nurse expect when assessing the laboratory results? a) Lower than 50-60 mg/dL b) Between 60 and 80 mg/dL c) Between 75 and 90 mg/dL d) 95 mg/dL - ANS -a) Lower than 50-60 mg/dL 25. An 84-year-old female patient is brought to the ED by her sister. The sister reports that the patient is unable to properly care for herself and has recently lost weight. Which laboratory test result would best help the nurse assess the patient's nutritional status? a) Pre-albumin level b) Prothrombin time c) Urinalysis d) WBC count - ANS -a) Pre-albumin level