Medsurg Comprehensive Final
Questions And Answers With Rationales
A bclient badmitted bfor bacute bpyelonephritis bis babout bto bstart bantibiotic btherapy.
bWhich bsymptom bwould bbe bexpected bin bthis bclient?
1) bHypertension
2) bFlank bpain bon bthe baffected bside
3) bPain bthat bradiates btoward bthe bunaffected bside
4) bNo btenderness bwith bdeep bpalpation bover bthe
CVA b- bcorrect banswers✔✔RATIONAL: b2) bThe bclient bmay bcomplain bof bpain bon bthe
baffected bside bbecause bthe bkidney bis benlarged band bmight bhave bformed ban
babscess.
Hypertension bis bassociated bwith bchronic bpyelonephritis. bPain bmay bradiate bdown
bthe bureters bor bto bthe bepigastrium. bThe bclient bwould bhave btenderness bwith bdeep
bpalpation bover bthe bCVA.
Discharge binstructions bfor ba bclient btreated bfor bacute bpyelonephritis bshould binclude
bwhich bstatement?
- b1. bAvoid btaking bany bdairy bproducts.
- b2. bReturn bfor bfollow-up burine bcultures.
- b3. bStop btaking bthe bprescribed bantibiotics bwhen bthe bsymptoms bsubside.
- b4. bRecurrence bis bunlikely bbecause byou've bbeen btreated bwith bantibiotics. b-
bcorrect banswers✔✔RATIONALE: b2) bThe bclient bneeds bto breturn bfor bfollow-up burine
bcultures bbecause bbacteriuria bmay bbe bpresent bbut basymptomatic. bIntake bof bdairy
bproducts bwon't bcontribute bto bpyelonephritis. bAntibiotics bneed bto bbe btaken bfor bthe
bfull bcourse bof btherapy bregardless bof bthe bsymptoms. bPyelonephritis btypically brecurs
bas ba brelapse bor bnew binfection band bfrequently brecurs bwithin b2 bweeks bof
bcompleting btherapy.
A bclient bis bcomplaining bof bsevere bflank band babdominal bpain. bA bflat bplate bof bthe
babdomen bshows burolithiasis. bWhich bintervention bis bimportant?
- b1. bStrain ball burine
- b2. bLimit bfluid bintake
- b3. bEnforce bstrict bbed brest.
- b4. bEncourage ba bhigh-calcium bdiet b- bcorrect banswers✔✔RATIONALE: b1) bUrine
bshould bbe bstrained bfor bcalculi band bsent bto bthe blaboratory bfor banalysis. bFluid
,bintake bof b3 bto b4 bqt. b3 bto b4 bL/day bis bencouraged bto bflush bthe burinary btract band
bprevent bfurther bcalculi bformation. bAmbulation bis bencouraged bto bhelp bpass bthe
bcalculi bthrough bgravity. bA blow-calcium bformation bof bcalcium bcalculi.
During ba bhealth bhistory, bwhich bstatement bby ba bclient bindicates ba brisk bof brenal
bcalculi?
- b1. b"I've bbeen bdrinking ba blot bof bcola bsoft bdrinks blately."
- b2. b"I've bbeen bjogging bmore bthan busual."
- b3. b"I've bhad bmore bstress bsince bwe badopted ba bchild blast byear."
- b4. b"I'm ba bvegetarian band beat bcheese btwo bor bthree btimes beach
bday." b- bcorrect banswers✔✔RATIONALE: b4) bRenal bcalculi bare bcommonly
bcomposed bof bcalcium. bDiets bhigh bin bcalcium bmay bpredispose ba bperson bto brenal
bcalculi. bMilk band bmilk bproducts bare bhigh bin bcalcium. bCola bsoft bdrinks bdon't
bcontain bingredients bthat bwould bincrease bthe brisk bof brenal bcalculi. bJogging band
bincreased bstress baren't bconsidered brisk bfactors bfor brenal bcalculi bformation.
A bnurse bis binstructing ba bclient bwith boxalate brenal bcalculi. bWhat bfoods bshould bthe
bnurse burge bthe bclient bto beliminate bfrom bhis bdiet?
1) bCitrus bfruits, bmolasses, band bdried bapricots
2) bMilk, bcheese, band bice bcream
3) bSardines, bliver band bkidney
4) bSpinach brhubarb band basparagus b- bcorrect banswers✔✔RATIONALE: b4) bTo
breduce bthe bformation bof boxalate bcalculi, burge bthe bclient bto bavoid bfoods bhigh bin
boxalate, bsuch bas bspinach, brhubarb, band basparagus. bOther boxalate- brich bfoods bto
bavoid binclude btomatoes, bbeets, bchocolate, bcocoa, bcelery, band bparsley.
Citrus bfruits, bmolasses, bdried bapricots, bmilk, bcheese, bice bcream, bsardines band
borgan bmeats bdo bNOT bproduce boxalate band bdo bNOT bneed bto bbe bomitted bfrom
bthe bclient's bdiet.
A bnurse bis bassessing ba bclient bdiagnosed bwith bacute bpyelonephritis. bWhich bof bthe
bfollowing bsymptoms bdoes bthe bnurse bexpect bto bsee?
1) bJaundice band bflank bpain
2) bCostovertebral bangle btenderness band bchills
3) bBurning bsensation bon burination
4) bPolyuria band bnocturia b- bcorrect banswers✔✔RATIONALE: b2) bCostovertebral
bangle btenderness band bchills bare bsymptoms bof bacute bpyelonephritis b(inflammation
bof bthe bkidney band brenal bpelvis). b
Jaundice bindicates bgallbladder bor bliver bobstruction.
A bburning bsensation bon burination bis ba bsign bof blower burinary btract binfection b(UTI).
Nocturia bis bassociated bwith ba blower bUTI bor bbenign bprostatic bhyperplasia.
Polyuria bis bseen bwith bdiabetes bmellitus, bdiabetes binsipidus, bor bthe buse bof
bdiuretics.
A bnurse bis bassessing ba bclient bwho bmight bhave ba bUTI. bWhat bstatement bby bthe
bclient bsuggests bthat ba bUTI bis blikely?
1) bI burinate blarge bamounts.
, 2) bIt bburns bwhen bI burinate.
3) bI bgo bfor bhours bwithout bthe burge bto burinate.
4) bMy burine bhas ba bsweet bsmell. b- bcorrect banswers✔✔RATIONALE: b2) bDysuria
b(painful burination) bis ba bcommon bsymptom bof ba bUTI.
Voiding blarge bamounts bof burine bisn't bassociated bwith bUTI's; bclients bwith bUTI's
bcommonly breport bfrequent bvoiding bof bsmall bamounts bof burine.
A bclient bwith ba bUTI bis bunlikely bto bbe bable bto bgo bfor bhours bwithout burinating
bbecause bUTI's bincrease bfeelings bof burgency bto bvoid.
Urine bwith ba bsweet bacetone bodor bis bassociated bwith bdiabetic bketoacidosis.
Foul-smelling burine bmay bbe ba bsign bof binfection.
While bundergoing bhemodialysis, ba bclient bcomplains bof bmuscle bcramps. bWhat
bintervention bis beffective bin brelieving bmuscle bcramps?
1) bEncourage bactive bROM bexercises.
2) bAdminister ba b5% bdextrose bsolution.
3) bInfuse bnormal bsaline bsolution.
4) bIncrease bthe brate bof bdialysis. b- bcorrect banswers✔✔RATIONALE: b3) bBecause
bmuscle bcramps bcan boccur bwhen bsodium band bwater bare bremoved btoo bquickly
bduring bdialysis, btreatment bincludes badministering bnormal bsaline bor bhypertonic
bnormal bsaline bsolution.
ROM bexercises band ban binfusion bof b5% bdextrose bsolution bwouldn't breduce bmuscle
bcramps.
Reducing, bnot bincreasing, bthe brate bof bdialysis bmay balso balleviate bmuscle bcramps.
Which bclient bis bat bgreatest brisk bfor bdeveloping ba bUTI?
1) bA b35 byear bold bwoman bwith ban barm bfracture.
2) bAn b18 byear bold bwoman basthma.
3) bA b50 byear bold bpostmenopausal bwoman.
4) bA b28 byear bold bwoman bwith bangina. b- bcorrect banswers✔✔RATIONALE: b3)
bWomen bare bmore bprone bto bUTI's bafter bmenopause. bUrinary bstasis bmay bdevelop
bdue bto ba bloss bof bpelvic bmuscle btone band bprolapse bof bthe bbladder bor buterus.
bReduced bestrogen blevels blead bto breduced blevels bof bvaginal bLactobacilli bbacteria,
bwhich bprotect bagainst binfection.
While bchronic bdiseases, bincluding bdiabetes bmellitus band bimpaired bimmunity,
bincrease bthe brisk bof bUTI, bangina, basthma, band bfractures bdon't bincrease bthe brisk
bof bUTI.
A bnurse bis binstructing ba bclient bwith brenal bcalculi babout brecommended bdaily bfluid
bconsumption. bThe bnurse bwould bbe bmost bhelpful bby btelling bthe bclient bto bdrink
bapproximately:
1) b4 bcups bper bday
2) b8 bcups bper bday
3) b12 bcups bper bday
4) b16 bcups bper bday b- bcorrect banswers✔✔RATIONALE: b3) bA bclient bwith brenal
bcalculi bshould bdrink b3L b(12 bcups) bof bfluid bper bday.
Questions And Answers With Rationales
A bclient badmitted bfor bacute bpyelonephritis bis babout bto bstart bantibiotic btherapy.
bWhich bsymptom bwould bbe bexpected bin bthis bclient?
1) bHypertension
2) bFlank bpain bon bthe baffected bside
3) bPain bthat bradiates btoward bthe bunaffected bside
4) bNo btenderness bwith bdeep bpalpation bover bthe
CVA b- bcorrect banswers✔✔RATIONAL: b2) bThe bclient bmay bcomplain bof bpain bon bthe
baffected bside bbecause bthe bkidney bis benlarged band bmight bhave bformed ban
babscess.
Hypertension bis bassociated bwith bchronic bpyelonephritis. bPain bmay bradiate bdown
bthe bureters bor bto bthe bepigastrium. bThe bclient bwould bhave btenderness bwith bdeep
bpalpation bover bthe bCVA.
Discharge binstructions bfor ba bclient btreated bfor bacute bpyelonephritis bshould binclude
bwhich bstatement?
- b1. bAvoid btaking bany bdairy bproducts.
- b2. bReturn bfor bfollow-up burine bcultures.
- b3. bStop btaking bthe bprescribed bantibiotics bwhen bthe bsymptoms bsubside.
- b4. bRecurrence bis bunlikely bbecause byou've bbeen btreated bwith bantibiotics. b-
bcorrect banswers✔✔RATIONALE: b2) bThe bclient bneeds bto breturn bfor bfollow-up burine
bcultures bbecause bbacteriuria bmay bbe bpresent bbut basymptomatic. bIntake bof bdairy
bproducts bwon't bcontribute bto bpyelonephritis. bAntibiotics bneed bto bbe btaken bfor bthe
bfull bcourse bof btherapy bregardless bof bthe bsymptoms. bPyelonephritis btypically brecurs
bas ba brelapse bor bnew binfection band bfrequently brecurs bwithin b2 bweeks bof
bcompleting btherapy.
A bclient bis bcomplaining bof bsevere bflank band babdominal bpain. bA bflat bplate bof bthe
babdomen bshows burolithiasis. bWhich bintervention bis bimportant?
- b1. bStrain ball burine
- b2. bLimit bfluid bintake
- b3. bEnforce bstrict bbed brest.
- b4. bEncourage ba bhigh-calcium bdiet b- bcorrect banswers✔✔RATIONALE: b1) bUrine
bshould bbe bstrained bfor bcalculi band bsent bto bthe blaboratory bfor banalysis. bFluid
,bintake bof b3 bto b4 bqt. b3 bto b4 bL/day bis bencouraged bto bflush bthe burinary btract band
bprevent bfurther bcalculi bformation. bAmbulation bis bencouraged bto bhelp bpass bthe
bcalculi bthrough bgravity. bA blow-calcium bformation bof bcalcium bcalculi.
During ba bhealth bhistory, bwhich bstatement bby ba bclient bindicates ba brisk bof brenal
bcalculi?
- b1. b"I've bbeen bdrinking ba blot bof bcola bsoft bdrinks blately."
- b2. b"I've bbeen bjogging bmore bthan busual."
- b3. b"I've bhad bmore bstress bsince bwe badopted ba bchild blast byear."
- b4. b"I'm ba bvegetarian band beat bcheese btwo bor bthree btimes beach
bday." b- bcorrect banswers✔✔RATIONALE: b4) bRenal bcalculi bare bcommonly
bcomposed bof bcalcium. bDiets bhigh bin bcalcium bmay bpredispose ba bperson bto brenal
bcalculi. bMilk band bmilk bproducts bare bhigh bin bcalcium. bCola bsoft bdrinks bdon't
bcontain bingredients bthat bwould bincrease bthe brisk bof brenal bcalculi. bJogging band
bincreased bstress baren't bconsidered brisk bfactors bfor brenal bcalculi bformation.
A bnurse bis binstructing ba bclient bwith boxalate brenal bcalculi. bWhat bfoods bshould bthe
bnurse burge bthe bclient bto beliminate bfrom bhis bdiet?
1) bCitrus bfruits, bmolasses, band bdried bapricots
2) bMilk, bcheese, band bice bcream
3) bSardines, bliver band bkidney
4) bSpinach brhubarb band basparagus b- bcorrect banswers✔✔RATIONALE: b4) bTo
breduce bthe bformation bof boxalate bcalculi, burge bthe bclient bto bavoid bfoods bhigh bin
boxalate, bsuch bas bspinach, brhubarb, band basparagus. bOther boxalate- brich bfoods bto
bavoid binclude btomatoes, bbeets, bchocolate, bcocoa, bcelery, band bparsley.
Citrus bfruits, bmolasses, bdried bapricots, bmilk, bcheese, bice bcream, bsardines band
borgan bmeats bdo bNOT bproduce boxalate band bdo bNOT bneed bto bbe bomitted bfrom
bthe bclient's bdiet.
A bnurse bis bassessing ba bclient bdiagnosed bwith bacute bpyelonephritis. bWhich bof bthe
bfollowing bsymptoms bdoes bthe bnurse bexpect bto bsee?
1) bJaundice band bflank bpain
2) bCostovertebral bangle btenderness band bchills
3) bBurning bsensation bon burination
4) bPolyuria band bnocturia b- bcorrect banswers✔✔RATIONALE: b2) bCostovertebral
bangle btenderness band bchills bare bsymptoms bof bacute bpyelonephritis b(inflammation
bof bthe bkidney band brenal bpelvis). b
Jaundice bindicates bgallbladder bor bliver bobstruction.
A bburning bsensation bon burination bis ba bsign bof blower burinary btract binfection b(UTI).
Nocturia bis bassociated bwith ba blower bUTI bor bbenign bprostatic bhyperplasia.
Polyuria bis bseen bwith bdiabetes bmellitus, bdiabetes binsipidus, bor bthe buse bof
bdiuretics.
A bnurse bis bassessing ba bclient bwho bmight bhave ba bUTI. bWhat bstatement bby bthe
bclient bsuggests bthat ba bUTI bis blikely?
1) bI burinate blarge bamounts.
, 2) bIt bburns bwhen bI burinate.
3) bI bgo bfor bhours bwithout bthe burge bto burinate.
4) bMy burine bhas ba bsweet bsmell. b- bcorrect banswers✔✔RATIONALE: b2) bDysuria
b(painful burination) bis ba bcommon bsymptom bof ba bUTI.
Voiding blarge bamounts bof burine bisn't bassociated bwith bUTI's; bclients bwith bUTI's
bcommonly breport bfrequent bvoiding bof bsmall bamounts bof burine.
A bclient bwith ba bUTI bis bunlikely bto bbe bable bto bgo bfor bhours bwithout burinating
bbecause bUTI's bincrease bfeelings bof burgency bto bvoid.
Urine bwith ba bsweet bacetone bodor bis bassociated bwith bdiabetic bketoacidosis.
Foul-smelling burine bmay bbe ba bsign bof binfection.
While bundergoing bhemodialysis, ba bclient bcomplains bof bmuscle bcramps. bWhat
bintervention bis beffective bin brelieving bmuscle bcramps?
1) bEncourage bactive bROM bexercises.
2) bAdminister ba b5% bdextrose bsolution.
3) bInfuse bnormal bsaline bsolution.
4) bIncrease bthe brate bof bdialysis. b- bcorrect banswers✔✔RATIONALE: b3) bBecause
bmuscle bcramps bcan boccur bwhen bsodium band bwater bare bremoved btoo bquickly
bduring bdialysis, btreatment bincludes badministering bnormal bsaline bor bhypertonic
bnormal bsaline bsolution.
ROM bexercises band ban binfusion bof b5% bdextrose bsolution bwouldn't breduce bmuscle
bcramps.
Reducing, bnot bincreasing, bthe brate bof bdialysis bmay balso balleviate bmuscle bcramps.
Which bclient bis bat bgreatest brisk bfor bdeveloping ba bUTI?
1) bA b35 byear bold bwoman bwith ban barm bfracture.
2) bAn b18 byear bold bwoman basthma.
3) bA b50 byear bold bpostmenopausal bwoman.
4) bA b28 byear bold bwoman bwith bangina. b- bcorrect banswers✔✔RATIONALE: b3)
bWomen bare bmore bprone bto bUTI's bafter bmenopause. bUrinary bstasis bmay bdevelop
bdue bto ba bloss bof bpelvic bmuscle btone band bprolapse bof bthe bbladder bor buterus.
bReduced bestrogen blevels blead bto breduced blevels bof bvaginal bLactobacilli bbacteria,
bwhich bprotect bagainst binfection.
While bchronic bdiseases, bincluding bdiabetes bmellitus band bimpaired bimmunity,
bincrease bthe brisk bof bUTI, bangina, basthma, band bfractures bdon't bincrease bthe brisk
bof bUTI.
A bnurse bis binstructing ba bclient bwith brenal bcalculi babout brecommended bdaily bfluid
bconsumption. bThe bnurse bwould bbe bmost bhelpful bby btelling bthe bclient bto bdrink
bapproximately:
1) b4 bcups bper bday
2) b8 bcups bper bday
3) b12 bcups bper bday
4) b16 bcups bper bday b- bcorrect banswers✔✔RATIONALE: b3) bA bclient bwith brenal
bcalculi bshould bdrink b3L b(12 bcups) bof bfluid bper bday.
