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MED-SURG
MED-SURG CERTIFICATION PRACTICE EXAM
QUESTIONS WITH CORRECT VERIFIED
SOLUTIONS 100% GUARANTEED PASS
(LATEST UPDATE)
A 63 year old female patient contacts the clinic to report that she is has been extremely
fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the
following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. - ANS ✓C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. - ANS ✓C
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia - ANS ✓C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING.
Infection comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85%
over 4 hours, the nurse will first:
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MED-SURG
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe - ANS ✓4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail
polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an asthma
attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. - ANS ✓D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a calm
environment. Helping the patient breathe with pursed lips will facilitate the expiration of
trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
cancer. She states that she doesn't want anyone to see her in this condition, even her husband.
This nurse's best response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?" - ANS ✓D
The nurse should allow the patient to share her concerns and express her feelings in a
nonjudgmental environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery - ANS ✓C
Tricuspid valve is located between right atrium and right ventricle
MED-SURG
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MED-SURG
MITRAL VALVE- left atrium and left ventricle
If the Purkinje system is damaged, conduction of the electrical impulse is impaired through
the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His - ANS ✓C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently eject
blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje fibers
The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization - ANS ✓B. Atrial depolarization
Ventricular repolarization is represented by the QRS There is no distinctly visible wave
representing atrial repolarization in the ECG because it occurs during ventricular
depolarization, ventricular repolarization is shown as the interval between the start of the
QRS complex and the end of the T wave
A patient admitted with an abscess in her left thigh undergoes incision and drainage. 3 days
later, she develops fever (temperature of 103°F), chills, lethargy, and shortness of breath.
Infectious endocarditis is suspected. In addition to blood cultures, the nurse would expect
which of these tests?
A. Transesophageal echocardiogram
B. Computed tomography of the chest
C. Cardiac stress test
D. Cardiac enzymes - ANS ✓A.
Echocardiogram to visualize cardiac structures.
Which of the following is a sign of poor perfusion?
A. Mean arterial pressure <80 mmHg
B. Urine output <0.5 ml/kg/hr for 2 consecutive hours
C. Lactate levels > 1mmol/L
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D. Systolic BP of 150 mmHg - ANS ✓B
UO should be greater or equal to .5ml per kg per hour.
MAPs should be between 65-85
Lactate levels should be less than 2.3
SBP of 150 is high but does not indicate poor perfusion
When performing discharge teaching with a patient who is taking warfarin sodium
(Coumadin), the nurse learns that patient used complementary therapies at home. Which of
the following substances is most concerning?
A. Echinacea
B. Vitamin B12
C. Vitamin D
D. Garlic - ANS ✓D. Garlic
When taking warfarin, caution with - garlic, ginseng, ginkgo, ibuprofen, pain drugs, vitamin
E
Garlic may increase bleeding, so supplemental garlic may cause a synergic effect when
combined with coumadin
For the same patient - who is being discharged and is taking warfarin (Coumadin), the nurse
should also emphasize that:
A. Regular follow-up with healthcare provider is essential
B. Aspirin would be recommended for headache therapy
C. The medication can be taken any time of the day
D. Diet should be high in iron content - ANS ✓A
Discuss INR. High INR is a risk for bleeding (GI, hemorrhagic stroke, etc)
Aspirin also being a blood thinner can be too much blood thinning action
Timing of dose needs to be consistent
Iron, mag, and zinc bind with coumadin and decrease absorption, it is not an absolute
contraindication, but it recommended that these supplements be taken two hours apart from
coumadin
Which of the following patient teaching points should the nurse include when providing
discharge instructions to a patient with a new permanent pacemaker and the caregiver (select
all that apply)?
A. Avoid or limit air travel
B. Take and record a daily pulse rate
C. Obtain and wear a Medic Alert ID or bracelet at all times
D. Avoid lifting arm on the side of the pacemaker above shoulder
E. Avoid microwave ovens because they interfere with pacemaker function - ANS ✓B, C, D
MED-SURG
MED-SURG
MED-SURG CERTIFICATION PRACTICE EXAM
QUESTIONS WITH CORRECT VERIFIED
SOLUTIONS 100% GUARANTEED PASS
(LATEST UPDATE)
A 63 year old female patient contacts the clinic to report that she is has been extremely
fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the
following responses by the nurse is most appropriate?
A. You will have more energy if you walk 30 min every day.
B. You don't need to worry. Sleeping a lot is good for you.
C. Come in and see your health care provider today.
D. You should eat more green leafy vegetables. - ANS ✓C
Need more info
The RN performs blood pressure screening at the local community center. Which of the
following individuals is most likely to suffer from a cerebrovascular accident?
A. A 30 year old man who is an account executive
B. A 40 year old man who jogs four times a week.
C. A 60 year old man whose father had a stroke.
D. A 75 year old man who takes multi-vitamins. - ANS ✓C
For the patient with a new tracheostomy, the nurse must be alert to which early complication?
a) Decannulation
b) Infection
c) Bleeding
d) Tracheomalacia - ANS ✓C
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
structures, and failure of the chosen technique to achieve successful airway
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING.
Infection comes 2-3 days later.
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85%
over 4 hours, the nurse will first:
MED-SURG
, 2
MED-SURG
1. Request an order for stat ABGs
2. Start the patient on oxygen by NC at 2L/minute
3. Notify the physician of the change
4. Check the position of the probe on patient's finger or earlobe - ANS ✓4
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail
polish, or dark skin pigmentation.
To decrease a patient's shortness of breath and a sense of impending doom during an asthma
attack, the nurse will:
A. Place the patient on a cardiac monitor and observe from the nurses' station.
B. Let the patient rest alone in a quiet, calm environment.
C. Reassure the patient that the doctor will arrive soon
D. Stay with the patient and encourage pursed-lip breathing. - ANS ✓D
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
important for the nurse to stay with the patient for ongoing assessment and to provide a calm
environment. Helping the patient breathe with pursed lips will facilitate the expiration of
trapped air and help the patient regain control of his or her breathing.
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
cancer. She states that she doesn't want anyone to see her in this condition, even her husband.
This nurse's best response is:
A."Patients' rights protect your privacy. I won't allow anyone in."
B."I've seen gastric cancer patients who look much worse. Don't worry."
C."Would you like to talk to a social worker?"
D."What about your condition worries you?" - ANS ✓D
The nurse should allow the patient to share her concerns and express her feelings in a
nonjudgmental environment.
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
A patient with a tricuspid valve disorder will have impaired blood flow between the:
A. Vena cava and right atrium
B. Left atrium and left ventricle
C. Right atrium and right ventricle
D. Right ventricle and pulmonary artery - ANS ✓C
Tricuspid valve is located between right atrium and right ventricle
MED-SURG
, 3
MED-SURG
MITRAL VALVE- left atrium and left ventricle
If the Purkinje system is damaged, conduction of the electrical impulse is impaired through
the:
A. Atria
B. AV node
C. Ventricles
D. Bundle of His - ANS ✓C
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently eject
blood
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje fibers
The P-wave on an EKG is representative of:
A. Ventricular depolarization
B. Atrial depolarization
C. Atrial repolarization
D. Ventricular repolarization - ANS ✓B. Atrial depolarization
Ventricular repolarization is represented by the QRS There is no distinctly visible wave
representing atrial repolarization in the ECG because it occurs during ventricular
depolarization, ventricular repolarization is shown as the interval between the start of the
QRS complex and the end of the T wave
A patient admitted with an abscess in her left thigh undergoes incision and drainage. 3 days
later, she develops fever (temperature of 103°F), chills, lethargy, and shortness of breath.
Infectious endocarditis is suspected. In addition to blood cultures, the nurse would expect
which of these tests?
A. Transesophageal echocardiogram
B. Computed tomography of the chest
C. Cardiac stress test
D. Cardiac enzymes - ANS ✓A.
Echocardiogram to visualize cardiac structures.
Which of the following is a sign of poor perfusion?
A. Mean arterial pressure <80 mmHg
B. Urine output <0.5 ml/kg/hr for 2 consecutive hours
C. Lactate levels > 1mmol/L
MED-SURG
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MED-SURG
D. Systolic BP of 150 mmHg - ANS ✓B
UO should be greater or equal to .5ml per kg per hour.
MAPs should be between 65-85
Lactate levels should be less than 2.3
SBP of 150 is high but does not indicate poor perfusion
When performing discharge teaching with a patient who is taking warfarin sodium
(Coumadin), the nurse learns that patient used complementary therapies at home. Which of
the following substances is most concerning?
A. Echinacea
B. Vitamin B12
C. Vitamin D
D. Garlic - ANS ✓D. Garlic
When taking warfarin, caution with - garlic, ginseng, ginkgo, ibuprofen, pain drugs, vitamin
E
Garlic may increase bleeding, so supplemental garlic may cause a synergic effect when
combined with coumadin
For the same patient - who is being discharged and is taking warfarin (Coumadin), the nurse
should also emphasize that:
A. Regular follow-up with healthcare provider is essential
B. Aspirin would be recommended for headache therapy
C. The medication can be taken any time of the day
D. Diet should be high in iron content - ANS ✓A
Discuss INR. High INR is a risk for bleeding (GI, hemorrhagic stroke, etc)
Aspirin also being a blood thinner can be too much blood thinning action
Timing of dose needs to be consistent
Iron, mag, and zinc bind with coumadin and decrease absorption, it is not an absolute
contraindication, but it recommended that these supplements be taken two hours apart from
coumadin
Which of the following patient teaching points should the nurse include when providing
discharge instructions to a patient with a new permanent pacemaker and the caregiver (select
all that apply)?
A. Avoid or limit air travel
B. Take and record a daily pulse rate
C. Obtain and wear a Medic Alert ID or bracelet at all times
D. Avoid lifting arm on the side of the pacemaker above shoulder
E. Avoid microwave ovens because they interfere with pacemaker function - ANS ✓B, C, D
MED-SURG
