Chapter 36 med surg
Ignatavicius: Medical-Surgical Nursing, 8th Edition
1. ANS: D
The student should not compress both carotid arteries at the same time to
avoid brain ischemia. Blood pressure should be taken and compared in both
arms. Prolonged capillary refill is considered to be greater than 5 seconds in
an older adult, so classifying refill of 4 seconds as normal would not require
intervention. Bruits should be auscultated.: 1. A student nurse is assessing
the peripheral vascular system of an older adult. What action by the
student would cause the faculty member to intervene?
a. Assessing blood pressure in both upper extremities
b.Auscultating the carotid arteries for any bruits
c. Classifying capillary refill of 4 seconds as normal
d. Palpating both carotid arteries at the same time
2. ANS: D
Triglycerides in men should be below 160 mg/dL. The other values are
appro- priate for adult males.: 2. The nurse is reviewing the lipid panel of
a male client who has atherosclerosis. Which finding is most
concerning?
a. Cholesterol: 126 mg/dL
b.High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d.Triglycerides: 198 mg/dL
3. ANS: B
The diet recommended for this client would be low in saturated fats and red
meat, high in vegetables and whole grains (fiber), low in salt, and low in
trans fat. The best choice is the chicken with broccoli and tomatoes. The
, Chapter 36 med surg
Ignatavicius: Medical-Surgical Nursing, 8th Edition
French fries have too much fat and the iceberg lettuce has little fiber. The
catfish is fried. The spaghetti dinner has too much red meat and no
vegetables.: 3. The nurse is evaluating a 3-day diet history with a client
who has an elevated lipid panel. What meal selection indicates the
client is managing this condition well with diet?
a. A 4-ounce steak, French fries, iceberg lettuce
b.Baked chicken breast, broccoli, tomatoes
c. Fried catfish, cornbread, peas
d. Spaghetti with meat sauce, garlic bread
4. ANS: A
There is a drug-food interaction between statins and grapefruit that can lead
to acute kidney failure. This client has elevated renal laboratory results,
indicat- ing some degree of kidney involvement. The nurse should assess if
the client eats grapefruit or drinks grapefruit juice. Dehydration can cause
the BUN to be elevated, but the elevation in creatinine is more specific for a
kidney injury. The client does not necessarily need to be admitted. A
urinalysis may or may not
, Chapter 36 med surg
Ignatavicius: Medical-Surgical Nursing, 8th Edition
be ordered.: 4. A nurse is working with a client who takes atorvastatin
(Lipitor). The clients recent laboratory results include a blood urea
nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by
the nurse is best?
a. Ask if the client eats grapefruit.
b.Assess the client for dehydration.
c. Facilitate admission to the hospital.
d. Obtain a random urinalysis.
5. ANS: B
Most people with hypertension are asymptomatic, although a small percent-
age do have symptoms such as headache. The nurse should explain this
to the client. Asking about paying for medications is not related because
the client has already admitted nonadherence. Threatening the client with
possible complications will not increase compliance.: 5. A client has
been diagnosed with hypertension but does not take the
antihypertensive medications because of a lack of symptoms. What
response by the nurse is best?
a. Do you have trouble affording your medications?
b.Most people with hypertension do not have symptoms.
c.You are lucky; most people get severe morning headaches.
d.You need to take your medicine or you will get kidney failure.
6. ANS: C
Essential hypertension is the most common type of hypertension and has
no specific cause such as an underlying disease process. Hypertension that
is due to another disease process is called secondary hypertension. A
Ignatavicius: Medical-Surgical Nursing, 8th Edition
1. ANS: D
The student should not compress both carotid arteries at the same time to
avoid brain ischemia. Blood pressure should be taken and compared in both
arms. Prolonged capillary refill is considered to be greater than 5 seconds in
an older adult, so classifying refill of 4 seconds as normal would not require
intervention. Bruits should be auscultated.: 1. A student nurse is assessing
the peripheral vascular system of an older adult. What action by the
student would cause the faculty member to intervene?
a. Assessing blood pressure in both upper extremities
b.Auscultating the carotid arteries for any bruits
c. Classifying capillary refill of 4 seconds as normal
d. Palpating both carotid arteries at the same time
2. ANS: D
Triglycerides in men should be below 160 mg/dL. The other values are
appro- priate for adult males.: 2. The nurse is reviewing the lipid panel of
a male client who has atherosclerosis. Which finding is most
concerning?
a. Cholesterol: 126 mg/dL
b.High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d.Triglycerides: 198 mg/dL
3. ANS: B
The diet recommended for this client would be low in saturated fats and red
meat, high in vegetables and whole grains (fiber), low in salt, and low in
trans fat. The best choice is the chicken with broccoli and tomatoes. The
, Chapter 36 med surg
Ignatavicius: Medical-Surgical Nursing, 8th Edition
French fries have too much fat and the iceberg lettuce has little fiber. The
catfish is fried. The spaghetti dinner has too much red meat and no
vegetables.: 3. The nurse is evaluating a 3-day diet history with a client
who has an elevated lipid panel. What meal selection indicates the
client is managing this condition well with diet?
a. A 4-ounce steak, French fries, iceberg lettuce
b.Baked chicken breast, broccoli, tomatoes
c. Fried catfish, cornbread, peas
d. Spaghetti with meat sauce, garlic bread
4. ANS: A
There is a drug-food interaction between statins and grapefruit that can lead
to acute kidney failure. This client has elevated renal laboratory results,
indicat- ing some degree of kidney involvement. The nurse should assess if
the client eats grapefruit or drinks grapefruit juice. Dehydration can cause
the BUN to be elevated, but the elevation in creatinine is more specific for a
kidney injury. The client does not necessarily need to be admitted. A
urinalysis may or may not
, Chapter 36 med surg
Ignatavicius: Medical-Surgical Nursing, 8th Edition
be ordered.: 4. A nurse is working with a client who takes atorvastatin
(Lipitor). The clients recent laboratory results include a blood urea
nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by
the nurse is best?
a. Ask if the client eats grapefruit.
b.Assess the client for dehydration.
c. Facilitate admission to the hospital.
d. Obtain a random urinalysis.
5. ANS: B
Most people with hypertension are asymptomatic, although a small percent-
age do have symptoms such as headache. The nurse should explain this
to the client. Asking about paying for medications is not related because
the client has already admitted nonadherence. Threatening the client with
possible complications will not increase compliance.: 5. A client has
been diagnosed with hypertension but does not take the
antihypertensive medications because of a lack of symptoms. What
response by the nurse is best?
a. Do you have trouble affording your medications?
b.Most people with hypertension do not have symptoms.
c.You are lucky; most people get severe morning headaches.
d.You need to take your medicine or you will get kidney failure.
6. ANS: C
Essential hypertension is the most common type of hypertension and has
no specific cause such as an underlying disease process. Hypertension that
is due to another disease process is called secondary hypertension. A
