Medical-Surgical Nursing Certification EXAM LATEST
WITH QUESTIONS AND CORRECT
ANSWERS|GRADED A+
Which of the following teaching points is the priority when the nurse is teaching the client about
caring for a plaster cast?
1. The cast gives off heat as it dries.
2. The client can bear weight on the cast in 1 hour.
3. A stockinette and soft padding are put over the leg area before casting.
4. Immediately report any increase in drainage or interruption in cast integrity. - ANSWER-4.
Immediately report any increase in drainage or interruption in cast integrity.
Increases in drainage or interruption in cast integrity will affect healing and could lead to
osteomyelitis. To apply a cast, the skin is washed and dried well. A stockinette is placed smoothly and
evenly over the area to be casted, followed by a roll of padding. The plaster is then rolled onto the
padding, and the edges are trimmed or smoothed if needed. A plaster cast gives off heat as it dries. A
plaster cast can tolerate the weight-bearing once it is dry, which varies from 24 to 72 hours,
depending on the nature and thickness of the cast.
Test-Taking Strategy: Note the word "priority." Recalling the drainage is a sign of infection will direct
you to "immediately report any increase in drainage or interruption in cast integrity." Review the
principles of cast care and the client teaching points if you had difficulty with this question.
The nurse is providing instructions to a client and family regarding home care following cataract
removal from the left eye. The nurse would plan to teach the client which of the following pieces of
information about positioning in the postoperative period?
1. Lower the head between the knees 3 times a day.
2. Bend below the waist as often as possible.
3. Avoid sleeping on the left side.
4. Sleep only on the left side. - ANSWER-3. Avoid sleeping on the left side.
,Following cataract surgery, the client should not sleep on the left side of he body that was operated
on. Clients should also avoid bending below the level of the waist so as not to increase intraocular
pressure.
Test-Taking Strategy: Remember that options that are comparable or alike are not likely to be correct.
With this in mind, eliminate "lower the head between the knees 3 times a day" and "bend below the
waist as often as possible" first. Choose correctly between the two remaining options, using
knowledge of positioning following eye surgery and principles related to gravity and edema
formation. Review the care to the client following cataract surgery if you had difficulty with this
question.
The client with hypertension has been prescribed a low-sodium diet. The nurse teaching this client
about foods that are allowed should plan to include which of the following in a list provided to the
client?
1. Tomato soup
2. Boiled shrimp
3. Instant oatmeal
4. Summer squash - ANSWER-4. Summer squash
Foods that are lower in sodium are fruits and vegetables (summer squash) because they do not
contain physiological saline. Highly processed or refined foods ( tomato soup and instant oatmeal) are
higher in sodium unless they are specifically noted as "low sodium." Saltwater fish and shellfish are
higher in sodium.
Test-Taking Strategy: Begin to answer this question by eliminating "boiled shrimp" as being highest in
sodium. Eliminate the other correct options they are processed foods. Review the foods that are high
and low in sodium if you had difficulty with this question.
The client has been diagnosed with gout. In developing a teaching plan for this client, the nurse should
include a list that identifies which of the following foods to be avoided?
1. Chicken liver
2. Carrots
,3. Tapioca
4. Chocolate - ANSWER-1. Chicken liver
Liver and other organ meats should be omitted from the diet of a client who has gout because of high
purine content. Purines are a form of protein. The food items identified in the other options contain
negligible amounts of purines and may be consumed freely by the client with gout.
Test-Taking Strategy: Focus on the pathophysiology of the client's diagnosis and subject, foods high in
purine. Remember that organ meats are high in purines.
The client is resuming a diet after hemigastrectomy. To minimize complications, the nurse would tell
the client to avoid doing which of the following?
1. Lying down after eating
2. Drinking liquids with meals
3. Eating six meals a day
4. Excluding concentrated sweets in the diet - ANSWER-2. Drinking liquids with meals
The client who had a hemigastrectomy is at risk for dumping syndrome. This client should be placed
on a diet that is high in protein, moderate in fat, and high in calories. The client should avoid drinking
liquids with meals. Frequent small meals are encouraged, and the client should avoid concentrated
sweets.
The nurse is providing dietary teaching to a client receiving potassium-sparing diuretic about foods
that are low in potassium. The nurse should include which of the following on a list of foods that have
low potassium content?
1. Apple
2. Carrots
3. Spinach
4. Avocado - ANSWER-1. Apple
, On medium apple with skin provides approximately 159 mg of potassium per serving, so it has the
lowest potassium content of these choices. Raw spinach (oz) provides 470 mg of potassium. One large
carrot has 341 mg of potassium. One medium avocado provides the highest potassium content, 1097
mg.
Test-Taking Strategy: Focus on the subject, the low potassium food. Use knowledge about the
nutritional content of foods to assist in directing you to "apple."
The nurse understands that increasing the flow of oxygen to more than 2L/min in the client with
chronic obstructive pulmonary disease (COPD) could be harmful because it:
1. Is drying the nasal mucosal passages
2. Decreases diaphragmatic excursion and depth
3. Increases the risk of pneumonia and atelectasis
4. Decreases the client's oxygen-based respiratory drive - ANSWER-4. Decreases the client's oxygen-
based respiratory drive
Normally, respiratory rate varies with the amount of carbon dioxide present in the blood. In clients
with COPD, this natural process becomes ineffective after exposure to high levels of carbon dioxide
for prolonged periods of time. Instead, the level of oxygen provides the respiratory stimulus. The
client with COPD cannot increase oxygen levels independently because this could decrease the
respiratory drive, leading to respiratory failure.
Test-Taking Strategy: Use knowledge of basic respiratory physiology to answer this question.
Remember that the client with COPD should not increase the flow of oxygen to more than 2L/min,
because this could severely decrease the respiratory drive.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which
of the following arterial blood gases (ABG) findings?
1. pH, 7.40; PaO2 90 mmHg; CO2 39 Meq/L; HCO3, 23 mEq/L
2. pH, 7.32; PaO2,85 mmHg; CO2 57 Meq/L; HCO3, 26 mEq/L
3. pH, 7.47; PaO2 82 mmHg; CO2 30 Meq/L; HCO3, 31 mEq/L
WITH QUESTIONS AND CORRECT
ANSWERS|GRADED A+
Which of the following teaching points is the priority when the nurse is teaching the client about
caring for a plaster cast?
1. The cast gives off heat as it dries.
2. The client can bear weight on the cast in 1 hour.
3. A stockinette and soft padding are put over the leg area before casting.
4. Immediately report any increase in drainage or interruption in cast integrity. - ANSWER-4.
Immediately report any increase in drainage or interruption in cast integrity.
Increases in drainage or interruption in cast integrity will affect healing and could lead to
osteomyelitis. To apply a cast, the skin is washed and dried well. A stockinette is placed smoothly and
evenly over the area to be casted, followed by a roll of padding. The plaster is then rolled onto the
padding, and the edges are trimmed or smoothed if needed. A plaster cast gives off heat as it dries. A
plaster cast can tolerate the weight-bearing once it is dry, which varies from 24 to 72 hours,
depending on the nature and thickness of the cast.
Test-Taking Strategy: Note the word "priority." Recalling the drainage is a sign of infection will direct
you to "immediately report any increase in drainage or interruption in cast integrity." Review the
principles of cast care and the client teaching points if you had difficulty with this question.
The nurse is providing instructions to a client and family regarding home care following cataract
removal from the left eye. The nurse would plan to teach the client which of the following pieces of
information about positioning in the postoperative period?
1. Lower the head between the knees 3 times a day.
2. Bend below the waist as often as possible.
3. Avoid sleeping on the left side.
4. Sleep only on the left side. - ANSWER-3. Avoid sleeping on the left side.
,Following cataract surgery, the client should not sleep on the left side of he body that was operated
on. Clients should also avoid bending below the level of the waist so as not to increase intraocular
pressure.
Test-Taking Strategy: Remember that options that are comparable or alike are not likely to be correct.
With this in mind, eliminate "lower the head between the knees 3 times a day" and "bend below the
waist as often as possible" first. Choose correctly between the two remaining options, using
knowledge of positioning following eye surgery and principles related to gravity and edema
formation. Review the care to the client following cataract surgery if you had difficulty with this
question.
The client with hypertension has been prescribed a low-sodium diet. The nurse teaching this client
about foods that are allowed should plan to include which of the following in a list provided to the
client?
1. Tomato soup
2. Boiled shrimp
3. Instant oatmeal
4. Summer squash - ANSWER-4. Summer squash
Foods that are lower in sodium are fruits and vegetables (summer squash) because they do not
contain physiological saline. Highly processed or refined foods ( tomato soup and instant oatmeal) are
higher in sodium unless they are specifically noted as "low sodium." Saltwater fish and shellfish are
higher in sodium.
Test-Taking Strategy: Begin to answer this question by eliminating "boiled shrimp" as being highest in
sodium. Eliminate the other correct options they are processed foods. Review the foods that are high
and low in sodium if you had difficulty with this question.
The client has been diagnosed with gout. In developing a teaching plan for this client, the nurse should
include a list that identifies which of the following foods to be avoided?
1. Chicken liver
2. Carrots
,3. Tapioca
4. Chocolate - ANSWER-1. Chicken liver
Liver and other organ meats should be omitted from the diet of a client who has gout because of high
purine content. Purines are a form of protein. The food items identified in the other options contain
negligible amounts of purines and may be consumed freely by the client with gout.
Test-Taking Strategy: Focus on the pathophysiology of the client's diagnosis and subject, foods high in
purine. Remember that organ meats are high in purines.
The client is resuming a diet after hemigastrectomy. To minimize complications, the nurse would tell
the client to avoid doing which of the following?
1. Lying down after eating
2. Drinking liquids with meals
3. Eating six meals a day
4. Excluding concentrated sweets in the diet - ANSWER-2. Drinking liquids with meals
The client who had a hemigastrectomy is at risk for dumping syndrome. This client should be placed
on a diet that is high in protein, moderate in fat, and high in calories. The client should avoid drinking
liquids with meals. Frequent small meals are encouraged, and the client should avoid concentrated
sweets.
The nurse is providing dietary teaching to a client receiving potassium-sparing diuretic about foods
that are low in potassium. The nurse should include which of the following on a list of foods that have
low potassium content?
1. Apple
2. Carrots
3. Spinach
4. Avocado - ANSWER-1. Apple
, On medium apple with skin provides approximately 159 mg of potassium per serving, so it has the
lowest potassium content of these choices. Raw spinach (oz) provides 470 mg of potassium. One large
carrot has 341 mg of potassium. One medium avocado provides the highest potassium content, 1097
mg.
Test-Taking Strategy: Focus on the subject, the low potassium food. Use knowledge about the
nutritional content of foods to assist in directing you to "apple."
The nurse understands that increasing the flow of oxygen to more than 2L/min in the client with
chronic obstructive pulmonary disease (COPD) could be harmful because it:
1. Is drying the nasal mucosal passages
2. Decreases diaphragmatic excursion and depth
3. Increases the risk of pneumonia and atelectasis
4. Decreases the client's oxygen-based respiratory drive - ANSWER-4. Decreases the client's oxygen-
based respiratory drive
Normally, respiratory rate varies with the amount of carbon dioxide present in the blood. In clients
with COPD, this natural process becomes ineffective after exposure to high levels of carbon dioxide
for prolonged periods of time. Instead, the level of oxygen provides the respiratory stimulus. The
client with COPD cannot increase oxygen levels independently because this could decrease the
respiratory drive, leading to respiratory failure.
Test-Taking Strategy: Use knowledge of basic respiratory physiology to answer this question.
Remember that the client with COPD should not increase the flow of oxygen to more than 2L/min,
because this could severely decrease the respiratory drive.
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) anticipates which
of the following arterial blood gases (ABG) findings?
1. pH, 7.40; PaO2 90 mmHg; CO2 39 Meq/L; HCO3, 23 mEq/L
2. pH, 7.32; PaO2,85 mmHg; CO2 57 Meq/L; HCO3, 26 mEq/L
3. pH, 7.47; PaO2 82 mmHg; CO2 30 Meq/L; HCO3, 31 mEq/L
