MEDSURG MIDTERM
1. Which Laboratory value will the nurse monitor to determine if prednisone has been effective for client with
acute exacerbation of rheumatoid arthritis?
a) Blood glucose,
b) Liver function tests,
c) C-Reactive protein level
d) Serum protein level
2. Which assessment finding for a patient who has had a surgical reduction of an open fracture of the right
radius is most important to report to the health care provider?
a) Serous wound drainage
b) Right arm muscle spasms
c) Right arm pain with movement
d) Temperature 101.4F (38.6 C)
3. Following laminectomy with a spinal fusion to treat a herniated disc, a patient reports numbness and tingling
of the right lower leg. The first action that the nurse should take is
a. report the patients complaint to the surgeon.
b. check the chart for preoperative assessment data.
c. check the vital signs for indications of hemorrhage.
d. turn the patient to the side to relieve pressure on the right leg.
4. A patient arrives at the outpatient surgical center for a scheduled laparoscopy under
a. general anesthesia. Which information requires the nurse's preoperative intervention to
b. maintain patient safety?
i. The patient has never had general anesthesia.
ii. The patient is planning to drive home after surgery.
iii. The patient had a sip of water 4 hours before arriving.
iv. The patient's insurance does not cover outpatient surgery.
5. After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat), which
patient statement indicates that the teaching has been effective?
a. "I can expect some nausea as a side effect of nitroglycerin."
b. "I should only take the nitroglycerin if I start to have chest pain."
c. “I will call an ambulance if i still have pain after taking 3 nitroglycerin 5 minutes apart” OR “I can
take up to 3 tablets in 5 minutes”
d. "Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart."
6. When titrating IV nitroglycerin for a patient with a myocardial infarction (MI) which action will the nurse take
to evaluate the effectiveness of the drug?
a. Monitor heart rate.
b. Ask about chest pain.
c. Check blood pressure.
d. Observe for dysrhythmias.
7. The health care provider writes an order for Digoxin Elixir 250mcg PO Daily. The client’s apical pulse is
70bpm. Pharmacy dispenses you with 0.5mg/2mL. How many mL will you administer per dose?
a. 0.5x1000=500
b. 250/500x2= 1 mL
, 8. The nurse assesses a patient with chronic obstructive pulmonary disease (COPD) who has been admitted
with increasing dyspnea over the last 3 days. Which finding is most important for the nurse to report to the
health care provider?
a. Respirations are 36 breaths/minute.
b. Anterior-posterior chest ratio is 1:1.
c. Lung expansion is decreased bilaterally.
d. Hyperresonance to percussion is present.
9. A client who is involved in a motor vehicle crash has a tracheostomy placed to allow for continued
mechanical ventilation. How should the nurse interpret the following arterial blood gas results? pH 7.48
PaO2 88mm Hg, PaCO2 32mm Hg, and HCO3 23 mEq/L?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
10. A patient who has been receiving diuretic therapy is admitted to the emergency department with a serum
potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the patient is
on which medication?
a. Oral digoxin (Lanoxin) 0.25 mg daily
b. Ibuprofen (Motrin) 400 mg every 6 hours
c. Metoprolol (Lopressor) 12.5 mg orally daily
d. Lantus insulin 24 U subcutaneously every evening
11. A client who is lethargic and exhibits deep, rapid respirations has the following arterial blood gas (ABG)
results: pH 7.32, PaO2 88 mmHg, PaCO2 37 mmHg, and HCO3 16 mEq/L. How would the nurse interpret
these results?
a. Metabolic acidosis
b. Metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis
12. An older client receiving iso-osmolar continuous tube feeding develops restlessness, agitation, and
weakness. Which laboratory result should the nurse report to the HCP immediately?
a. K+3.4mEq/L
b. Ca+2.78mg/dL
c. Ma+154 mEq/L-This might be Na+, not Ma+
d. PO4-3 4.8mg/dL
13. After receiving a change-of-shift report, which patient should the nurse assess first?
a. The patient who has multiple black wounds on the feet and ankles
b. The newly admitted patient with a stage IV pressure ulcer on the coccyx
c. The patient who has been receiving chemotherapy and has a temperature of 102
d. The patient who needs to be medicated with multiple analgesics before a scheduled dressing
change.
14. An older woman was admitted to the medical unit with GI bleeding and fluid volume deficit. Clinical
manifestations of this problem are (select all that apply)
a. weight loss.
b. dry oral mucosa.
c. full bounding pulse.
d. engorged neck veins.
e. decreased central venous pressure.
1. Which Laboratory value will the nurse monitor to determine if prednisone has been effective for client with
acute exacerbation of rheumatoid arthritis?
a) Blood glucose,
b) Liver function tests,
c) C-Reactive protein level
d) Serum protein level
2. Which assessment finding for a patient who has had a surgical reduction of an open fracture of the right
radius is most important to report to the health care provider?
a) Serous wound drainage
b) Right arm muscle spasms
c) Right arm pain with movement
d) Temperature 101.4F (38.6 C)
3. Following laminectomy with a spinal fusion to treat a herniated disc, a patient reports numbness and tingling
of the right lower leg. The first action that the nurse should take is
a. report the patients complaint to the surgeon.
b. check the chart for preoperative assessment data.
c. check the vital signs for indications of hemorrhage.
d. turn the patient to the side to relieve pressure on the right leg.
4. A patient arrives at the outpatient surgical center for a scheduled laparoscopy under
a. general anesthesia. Which information requires the nurse's preoperative intervention to
b. maintain patient safety?
i. The patient has never had general anesthesia.
ii. The patient is planning to drive home after surgery.
iii. The patient had a sip of water 4 hours before arriving.
iv. The patient's insurance does not cover outpatient surgery.
5. After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat), which
patient statement indicates that the teaching has been effective?
a. "I can expect some nausea as a side effect of nitroglycerin."
b. "I should only take the nitroglycerin if I start to have chest pain."
c. “I will call an ambulance if i still have pain after taking 3 nitroglycerin 5 minutes apart” OR “I can
take up to 3 tablets in 5 minutes”
d. "Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart."
6. When titrating IV nitroglycerin for a patient with a myocardial infarction (MI) which action will the nurse take
to evaluate the effectiveness of the drug?
a. Monitor heart rate.
b. Ask about chest pain.
c. Check blood pressure.
d. Observe for dysrhythmias.
7. The health care provider writes an order for Digoxin Elixir 250mcg PO Daily. The client’s apical pulse is
70bpm. Pharmacy dispenses you with 0.5mg/2mL. How many mL will you administer per dose?
a. 0.5x1000=500
b. 250/500x2= 1 mL
, 8. The nurse assesses a patient with chronic obstructive pulmonary disease (COPD) who has been admitted
with increasing dyspnea over the last 3 days. Which finding is most important for the nurse to report to the
health care provider?
a. Respirations are 36 breaths/minute.
b. Anterior-posterior chest ratio is 1:1.
c. Lung expansion is decreased bilaterally.
d. Hyperresonance to percussion is present.
9. A client who is involved in a motor vehicle crash has a tracheostomy placed to allow for continued
mechanical ventilation. How should the nurse interpret the following arterial blood gas results? pH 7.48
PaO2 88mm Hg, PaCO2 32mm Hg, and HCO3 23 mEq/L?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
10. A patient who has been receiving diuretic therapy is admitted to the emergency department with a serum
potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the patient is
on which medication?
a. Oral digoxin (Lanoxin) 0.25 mg daily
b. Ibuprofen (Motrin) 400 mg every 6 hours
c. Metoprolol (Lopressor) 12.5 mg orally daily
d. Lantus insulin 24 U subcutaneously every evening
11. A client who is lethargic and exhibits deep, rapid respirations has the following arterial blood gas (ABG)
results: pH 7.32, PaO2 88 mmHg, PaCO2 37 mmHg, and HCO3 16 mEq/L. How would the nurse interpret
these results?
a. Metabolic acidosis
b. Metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis
12. An older client receiving iso-osmolar continuous tube feeding develops restlessness, agitation, and
weakness. Which laboratory result should the nurse report to the HCP immediately?
a. K+3.4mEq/L
b. Ca+2.78mg/dL
c. Ma+154 mEq/L-This might be Na+, not Ma+
d. PO4-3 4.8mg/dL
13. After receiving a change-of-shift report, which patient should the nurse assess first?
a. The patient who has multiple black wounds on the feet and ankles
b. The newly admitted patient with a stage IV pressure ulcer on the coccyx
c. The patient who has been receiving chemotherapy and has a temperature of 102
d. The patient who needs to be medicated with multiple analgesics before a scheduled dressing
change.
14. An older woman was admitted to the medical unit with GI bleeding and fluid volume deficit. Clinical
manifestations of this problem are (select all that apply)
a. weight loss.
b. dry oral mucosa.
c. full bounding pulse.
d. engorged neck veins.
e. decreased central venous pressure.
