Med Surge Final Exam m m m
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatit
m m m m m m m m m m m m m m
is. The nurse should expect to find an elevation of which of following values?
m m m m m m m m m m m m m
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can b
m m m m m m m m m m m m m
e used by the body. It is produced by the pancreas and salivary glands and relea
m m m m m m m m m m m m m m m
sed into the mouth, stomach, and intestines to aid in digestion. The amylase leve
m m m m m m m m m m m m m
l of a client who has acute pancreatitis usually increases within 12 to 24 hr and c
m m m m m m m m m m m m m m m m
an remain elevated for 2 to 3 days.
m m m m m m m
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of en
m m m m m m m m m m m m m m m m
dometriosis. Which of the following findings in the client's history should the nur
m m m m m m m m m m m m
se recognize as consistent with a diagnosis of endometriosis?
m m m m m m m m
Dysmenorrhea that is unresponsive to NSAIDs. m m m m m
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus imp
m m m m m m m m m m m m m m
lants in locations outside the uterus. This typically causes pelvic pain around the
m m m m m m m m m m m m m
time of the menstrual period but can cause pain at other times in the cycle. The
m m m m m m m m m m m m m m m
mdiscomfort is often unrelieved by the use of NSAIDs.
m m m m m m m m
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
m m m m m m m m m m m m m m m m
that resulted in paraplegia. After a week on the unit, the nurse notes that the cli
m m m m m m m m m m m m m m m
ent is withdrawn and increasingly resistant to rehabilitative efforts by the staff. W
m m m m m m m m m m m m
hich of the following actions should the nurse take?
m m m m m m m m
Establish a plan of care with the client that sets attainable goals.
m m m m m m m m m m m
Rational
The nurse should develop a plan of care for this client with mutually set goals. T
m m m m m m m m m m m m m m m
his action invests the client in the rehabilitation process, which encourages feelin
m m m m m m m m m m m
gs of ownership for it, and sees the goals as more attainable
m m m m m m m m m m m
,4….A nurse in a burn treatment center is caring for a client who is admitted wi
m m m m m m m m m m m m m m m
th severe burns to both lower extremities and is scheduled for an escharotomy.
m m m m m m m m m m m m
mThe client's spouse asks the nurse what the procedure entails. Which of the fol
m m m m m m m m m m m m m
lowing nursing statements is appropriate?
m m m m
Large incisions will be made in the eschar to improve circulation.
m m m m m m m m m m
Rational
An escharotomy is a surgical incision made to release pressure and improve circ
m m m m m m m m m m m m
ulation in a part of the body that has a deep burn and is experiencing excessive s
m m m m m m m m m m m m m m m m
welling. Burn injuries that encircle a body part, such as an arm or the chest, can
m m m m m m m m m m m m m m m m
cause swelling and tightness in the affected area, resulting in reduced circulatio
m m m m m m m m m m m
n. Making surgical incisions into the burned tissue allows the skin to expand, red
m m m m m m m m m m m m m
uces tightness and pressure, and improves circulation.
m m m m m m
5….A nurse is caring for a client who has suspected cholecystitis. The nurse shoul
m m m m m m m m m m m m m
d expect the client's urine to appear which of the following colors?
m m m m m m m m m m m
Dark and foamy m m
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
m m m m m m m m m m m m m
mthe kidneys are filtering excess bilirubin from the blood.
m m m m m m m m
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
m m m m m m m m m m m m m m
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tes
m m m m m m m m m m m m m m
ts should the nurse monitor to evaluate the effectiveness of this medication?
m m m m m m m m m m m
Erythrocyte sedimentation rate (ESR) m m m
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecti
m m m m m m m m m m m
ng and monitoring tissue inflammation in clients with RA. As the disease impr
m m m m m m m m m m m m
oves the ESR decreases.
m m m
7….A nurse is providing dietary teaching to a client who has a history of recurrin
m m m m m m m m m m m m m m
g calcium oxalate kidney stones. Which of the following instructions should the
m m m m m m m m m m m m
nurse include in the teaching?
m m m m
Drink 3 L of fluid every day.
m m m m m m
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to
m m m m m m m m m m m m m m m m m m
mdilute the urine and reduce the risk for stone formation.
m m m m m m m m m
8….A nurse is assessing a client who has disseminated intravascular coagulation (
m m m m m m m m m m m
DIC). Which of the following findings should the nurse expect?
m m m m m m m m m
Excessive thrombosis and bleeding
m m m
Rational
The nurse should expect excessive thrombosis and bleeding of mucous membra
m m m m m m m m m m
nes because both DIC impairs both coagulation and anticoagulation pathways.
m m m m m m m m m
9….A nurse is caring for a middle adult client who has just received the diagnos
m m m m m m m m m m m m m m
is of endometrial cancer. In taking a nursing history, which of the following ma
m m m m m m m m m m m m m
nifestations is likely to be reported by this client?
m m m m m m m m
Postmenopausal bleeding m
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of the
m m m m m m m m m m m
uterus). The most common manifestation of endometrial cancer is abnormal ute
m m m m m m m m m m
rine bleeding, including postmenopausal bleeding and bleeding between normal
m m m m m m m m m
periods in premenopausal women.
m m m
10…A nurse is giving a presentation to a community group about preventing ath
m m m m m m m m m m m m
erosclerosis. Which of the following should the nurse include as a modifiable risk
m m m m m m m m m m m m
mfactor for this disorder? (Select all that apply.)
m m m m m m m
Hypercholesterolemia Hype m
rtension
Obesity m
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a m
m m m m m m m m m m m m m m m
edical-
surgical unit. Which of the following room assignments should the nurse make
m m m m m m m m m m m m
for the client?
m m
A room with air exhaust directly to the outdoor environment
m m m m m m m m m
, Rational
A room with air exhaust directly to the outside environment eliminates conta
m m m m m m m m m m m
mination of other client- m m m
care areas. This type of ventilation system is referred to as an airborne infectio
m m m m m m m m m m m m m
n isolation room.
m m
12…A nurse is caring for a client who has Cushing's syndrome. Which of the foll
m m m m m m m m m m m m m m
owing interventions should the nurse expect to perform? (Select all that apply.) A
m m m m m m m m m m m m
ssess blood glucose level
m m m
Assess for neck vein distention
m m m m
Incorrect. Monitor for an irregular heart rate Inc
m m m m m m m
orrect. Monitor for postural hypotension Weigh
m m m m m m
the client daily
m m
13…A nurse is teaching a client about risk factors for osteoporosis. Which of the
m m m m m m m m m m m m m
m following factors should the nurse include in the teaching? (Select all that apply.
m m m m m m m m m m m m
)
Sedentary lifestyle m
mIncorrect. Obesit m
y Aging
m
Caffeine intake Sec m m
ondhand smoke m
Sedentary lifestyle is correct. Immobility depletes bone.
m m m m m m
Obesity is incorrect. Women who are obese have a greater capacity for storing e
m m m m m m m m m m m m m
strogen to help maintain acceptable levels of calcium.
m m m m m m m
Aging is correct. Women lose bone due to estrogen depletion after menopause.
m m m m m m m m m m m m
Caffeine intake is correct. Excessive caffeine intake causes calcium loss in the ur
m m m m m m m m m m m m
ine.
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, both ac
m m m m m m m m m m m m
tive and passive (secondhand) smoking.
m m m m
14…A nurse is caring for a client who has a history of exposure to TB and sympt
m m m m m m m m m m m m m m m m
oms of night sweats and hemoptysis. Which of the following tests should the n
m m m m m m m m m m m m m
urse realize is the most reliable to confirm the diagnosis of active pulmonary TB
m m m m m m m m m m m m m
?
Sputum culture for acid-m m m
fast bacillus Rational
m m
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatit
m m m m m m m m m m m m m m
is. The nurse should expect to find an elevation of which of following values?
m m m m m m m m m m m m m
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can b
m m m m m m m m m m m m m
e used by the body. It is produced by the pancreas and salivary glands and relea
m m m m m m m m m m m m m m m
sed into the mouth, stomach, and intestines to aid in digestion. The amylase leve
m m m m m m m m m m m m m
l of a client who has acute pancreatitis usually increases within 12 to 24 hr and c
m m m m m m m m m m m m m m m m
an remain elevated for 2 to 3 days.
m m m m m m m
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of en
m m m m m m m m m m m m m m m m
dometriosis. Which of the following findings in the client's history should the nur
m m m m m m m m m m m m
se recognize as consistent with a diagnosis of endometriosis?
m m m m m m m m
Dysmenorrhea that is unresponsive to NSAIDs. m m m m m
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus imp
m m m m m m m m m m m m m m
lants in locations outside the uterus. This typically causes pelvic pain around the
m m m m m m m m m m m m m
time of the menstrual period but can cause pain at other times in the cycle. The
m m m m m m m m m m m m m m m
mdiscomfort is often unrelieved by the use of NSAIDs.
m m m m m m m m
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
m m m m m m m m m m m m m m m m
that resulted in paraplegia. After a week on the unit, the nurse notes that the cli
m m m m m m m m m m m m m m m
ent is withdrawn and increasingly resistant to rehabilitative efforts by the staff. W
m m m m m m m m m m m m
hich of the following actions should the nurse take?
m m m m m m m m
Establish a plan of care with the client that sets attainable goals.
m m m m m m m m m m m
Rational
The nurse should develop a plan of care for this client with mutually set goals. T
m m m m m m m m m m m m m m m
his action invests the client in the rehabilitation process, which encourages feelin
m m m m m m m m m m m
gs of ownership for it, and sees the goals as more attainable
m m m m m m m m m m m
,4….A nurse in a burn treatment center is caring for a client who is admitted wi
m m m m m m m m m m m m m m m
th severe burns to both lower extremities and is scheduled for an escharotomy.
m m m m m m m m m m m m
mThe client's spouse asks the nurse what the procedure entails. Which of the fol
m m m m m m m m m m m m m
lowing nursing statements is appropriate?
m m m m
Large incisions will be made in the eschar to improve circulation.
m m m m m m m m m m
Rational
An escharotomy is a surgical incision made to release pressure and improve circ
m m m m m m m m m m m m
ulation in a part of the body that has a deep burn and is experiencing excessive s
m m m m m m m m m m m m m m m m
welling. Burn injuries that encircle a body part, such as an arm or the chest, can
m m m m m m m m m m m m m m m m
cause swelling and tightness in the affected area, resulting in reduced circulatio
m m m m m m m m m m m
n. Making surgical incisions into the burned tissue allows the skin to expand, red
m m m m m m m m m m m m m
uces tightness and pressure, and improves circulation.
m m m m m m
5….A nurse is caring for a client who has suspected cholecystitis. The nurse shoul
m m m m m m m m m m m m m
d expect the client's urine to appear which of the following colors?
m m m m m m m m m m m
Dark and foamy m m
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
m m m m m m m m m m m m m
mthe kidneys are filtering excess bilirubin from the blood.
m m m m m m m m
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
m m m m m m m m m m m m m m
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tes
m m m m m m m m m m m m m m
ts should the nurse monitor to evaluate the effectiveness of this medication?
m m m m m m m m m m m
Erythrocyte sedimentation rate (ESR) m m m
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecti
m m m m m m m m m m m
ng and monitoring tissue inflammation in clients with RA. As the disease impr
m m m m m m m m m m m m
oves the ESR decreases.
m m m
7….A nurse is providing dietary teaching to a client who has a history of recurrin
m m m m m m m m m m m m m m
g calcium oxalate kidney stones. Which of the following instructions should the
m m m m m m m m m m m m
nurse include in the teaching?
m m m m
Drink 3 L of fluid every day.
m m m m m m
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to
m m m m m m m m m m m m m m m m m m
mdilute the urine and reduce the risk for stone formation.
m m m m m m m m m
8….A nurse is assessing a client who has disseminated intravascular coagulation (
m m m m m m m m m m m
DIC). Which of the following findings should the nurse expect?
m m m m m m m m m
Excessive thrombosis and bleeding
m m m
Rational
The nurse should expect excessive thrombosis and bleeding of mucous membra
m m m m m m m m m m
nes because both DIC impairs both coagulation and anticoagulation pathways.
m m m m m m m m m
9….A nurse is caring for a middle adult client who has just received the diagnos
m m m m m m m m m m m m m m
is of endometrial cancer. In taking a nursing history, which of the following ma
m m m m m m m m m m m m m
nifestations is likely to be reported by this client?
m m m m m m m m
Postmenopausal bleeding m
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of the
m m m m m m m m m m m
uterus). The most common manifestation of endometrial cancer is abnormal ute
m m m m m m m m m m
rine bleeding, including postmenopausal bleeding and bleeding between normal
m m m m m m m m m
periods in premenopausal women.
m m m
10…A nurse is giving a presentation to a community group about preventing ath
m m m m m m m m m m m m
erosclerosis. Which of the following should the nurse include as a modifiable risk
m m m m m m m m m m m m
mfactor for this disorder? (Select all that apply.)
m m m m m m m
Hypercholesterolemia Hype m
rtension
Obesity m
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a m
m m m m m m m m m m m m m m m
edical-
surgical unit. Which of the following room assignments should the nurse make
m m m m m m m m m m m m
for the client?
m m
A room with air exhaust directly to the outdoor environment
m m m m m m m m m
, Rational
A room with air exhaust directly to the outside environment eliminates conta
m m m m m m m m m m m
mination of other client- m m m
care areas. This type of ventilation system is referred to as an airborne infectio
m m m m m m m m m m m m m
n isolation room.
m m
12…A nurse is caring for a client who has Cushing's syndrome. Which of the foll
m m m m m m m m m m m m m m
owing interventions should the nurse expect to perform? (Select all that apply.) A
m m m m m m m m m m m m
ssess blood glucose level
m m m
Assess for neck vein distention
m m m m
Incorrect. Monitor for an irregular heart rate Inc
m m m m m m m
orrect. Monitor for postural hypotension Weigh
m m m m m m
the client daily
m m
13…A nurse is teaching a client about risk factors for osteoporosis. Which of the
m m m m m m m m m m m m m
m following factors should the nurse include in the teaching? (Select all that apply.
m m m m m m m m m m m m
)
Sedentary lifestyle m
mIncorrect. Obesit m
y Aging
m
Caffeine intake Sec m m
ondhand smoke m
Sedentary lifestyle is correct. Immobility depletes bone.
m m m m m m
Obesity is incorrect. Women who are obese have a greater capacity for storing e
m m m m m m m m m m m m m
strogen to help maintain acceptable levels of calcium.
m m m m m m m
Aging is correct. Women lose bone due to estrogen depletion after menopause.
m m m m m m m m m m m m
Caffeine intake is correct. Excessive caffeine intake causes calcium loss in the ur
m m m m m m m m m m m m
ine.
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, both ac
m m m m m m m m m m m m
tive and passive (secondhand) smoking.
m m m m
14…A nurse is caring for a client who has a history of exposure to TB and sympt
m m m m m m m m m m m m m m m m
oms of night sweats and hemoptysis. Which of the following tests should the n
m m m m m m m m m m m m m
urse realize is the most reliable to confirm the diagnosis of active pulmonary TB
m m m m m m m m m m m m m
?
Sputum culture for acid-m m m
fast bacillus Rational
m m
