SAUNDERS HESI MED SURG |Questions with
100% Correct Answers
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid,
thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an
acid-base imbalance (hyperventilation). If this occurs, the medication will probably be
discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects.
Elevated blood pressure may be expected from the pain that occurs with a burn injury.
Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates which laboratory test will be prescribed?
1. Potassium level
2. Triglyceride level
3. Hemoglobin A1C
4. Total cholesterol level - ✔️✔️2
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
There is no indication that isotretinoin affects potassium, hemoglobin A1C, or total cholesterol
levels
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the
client is
also, taking which medication?
1. Digoxin
2. Phenytoin
3. Vitamin A
,4. Furosemide - ✔️✔️3
Isotretinoin is a metabolite of vitamin A and can
produce a generalized intensification of isotretinoin toxicity. Because of the potential for
increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy.
There are no contraindications associated with digoxin, phenytoin, or furosemide.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse should apply
the medication to which body area? (SELECT ALL THAT APPLY.)
1. Back
2. Axilla
3. Eyelids
4. Soles of the feet
5. Palms of the hands - ✔️✔️1, 4, 5
Topical corticosteroids can be absorbed into the
systemic circulation. Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions where
permeability is poor (back, palms, soles). The nurse should avoid areas of higher absorption to
prevent systemic absorption.
The clinic nurse is performing an admission assessment on a client and notes that the client is
taking azelaic acid. The nurse determines that which client complaint may be associated with
use of this
medication?
1. Itching
2. Euphoria
3. Drowsiness
,4. Frequent urination - ✔️✔️1
Azelaic acid is a topical medication used to treat
mild to moderate acne. Adverse effects include burning, itching, stinging, redness of the skin,
and hypopigmentation of the skin in clients with a dark complexion. The effects noted in the
other options are not specifically associated with this medication.
Silver sulfadiazine is prescribed for a client with a
partial-thickness burn and the nurse provides teaching about the medication. Which statement
made by the client indicates a need for further teaching about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication is likely to cause stinging every time it is applied."
4. "The medication should be applied directly to the wound." - ✔️✔️3
Silver sulfadiazine is an antibacterial that has a
broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It
is applied directly to the wound to assist in healing. It does not cause stinging when applied.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied at
which times?
1. Immediately before swimming
2. 5 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - ✔️✔️4
, Sunscreens are most effective when applied at least
30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied after swimming or sweating.
The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma.
Which would the nurse expect to note specifically in this disorder?
1. Increased calcium level
2. Increased white blood cells
3. Decreased blood urea nitrogen level
4. Decreased number of plasma cells in the bone marrow - ✔️✔️1
Findings indicative of multiple myeloma are an increased number of plasma cells in the bone
marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone
tissue, and an elevated blood urea nitrogen level. An increased white blood cell count may or
may not be present and is not related specifically to multiple myeloma.
The nurse is creating a plan of care for the client with multiple myeloma and includes which
priority intervention in the plan?
1. Encouraging fluids
2. Providing frequent oral care
3. Coughing and deep breathing
4. Monitoring the red blood cell count - ✔️✔️1
Hypercalcemia caused by bone destruction is a priority concern in the client with multiple
myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output
of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to
dilute the calcium overload but also to prevent protein from precipitating in the renal tubules.
Options 2, 3, and 4 may be components of the plan of care but are not the priority in this client.
100% Correct Answers
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid,
thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an
acid-base imbalance (hyperventilation). If this occurs, the medication will probably be
discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects.
Elevated blood pressure may be expected from the pain that occurs with a burn injury.
Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates which laboratory test will be prescribed?
1. Potassium level
2. Triglyceride level
3. Hemoglobin A1C
4. Total cholesterol level - ✔️✔️2
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
There is no indication that isotretinoin affects potassium, hemoglobin A1C, or total cholesterol
levels
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the
client is
also, taking which medication?
1. Digoxin
2. Phenytoin
3. Vitamin A
,4. Furosemide - ✔️✔️3
Isotretinoin is a metabolite of vitamin A and can
produce a generalized intensification of isotretinoin toxicity. Because of the potential for
increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy.
There are no contraindications associated with digoxin, phenytoin, or furosemide.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse should apply
the medication to which body area? (SELECT ALL THAT APPLY.)
1. Back
2. Axilla
3. Eyelids
4. Soles of the feet
5. Palms of the hands - ✔️✔️1, 4, 5
Topical corticosteroids can be absorbed into the
systemic circulation. Absorption is higher from regions where the skin is especially permeable
(scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions where
permeability is poor (back, palms, soles). The nurse should avoid areas of higher absorption to
prevent systemic absorption.
The clinic nurse is performing an admission assessment on a client and notes that the client is
taking azelaic acid. The nurse determines that which client complaint may be associated with
use of this
medication?
1. Itching
2. Euphoria
3. Drowsiness
,4. Frequent urination - ✔️✔️1
Azelaic acid is a topical medication used to treat
mild to moderate acne. Adverse effects include burning, itching, stinging, redness of the skin,
and hypopigmentation of the skin in clients with a dark complexion. The effects noted in the
other options are not specifically associated with this medication.
Silver sulfadiazine is prescribed for a client with a
partial-thickness burn and the nurse provides teaching about the medication. Which statement
made by the client indicates a need for further teaching about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication is likely to cause stinging every time it is applied."
4. "The medication should be applied directly to the wound." - ✔️✔️3
Silver sulfadiazine is an antibacterial that has a
broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It
is applied directly to the wound to assist in healing. It does not cause stinging when applied.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied at
which times?
1. Immediately before swimming
2. 5 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - ✔️✔️4
, Sunscreens are most effective when applied at least
30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens
should be reapplied after swimming or sweating.
The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma.
Which would the nurse expect to note specifically in this disorder?
1. Increased calcium level
2. Increased white blood cells
3. Decreased blood urea nitrogen level
4. Decreased number of plasma cells in the bone marrow - ✔️✔️1
Findings indicative of multiple myeloma are an increased number of plasma cells in the bone
marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone
tissue, and an elevated blood urea nitrogen level. An increased white blood cell count may or
may not be present and is not related specifically to multiple myeloma.
The nurse is creating a plan of care for the client with multiple myeloma and includes which
priority intervention in the plan?
1. Encouraging fluids
2. Providing frequent oral care
3. Coughing and deep breathing
4. Monitoring the red blood cell count - ✔️✔️1
Hypercalcemia caused by bone destruction is a priority concern in the client with multiple
myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output
of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to
dilute the calcium overload but also to prevent protein from precipitating in the renal tubules.
Options 2, 3, and 4 may be components of the plan of care but are not the priority in this client.
