Med Surg III Final Exam 2025 | NSG 233 Med Surg III
Final Exam | Complete Exam Questions and Correct
Answers | Graded A+ | Just Released
A 79 year old patient has been admitted with BPH. What is most appropriate to
include in the nursing plan of care
a. Limit fluid intake to no more than 1000 ml/day
b. Leave a light on in the bathroom during the night
c. Ask the patient to use a urinal so that urine can be measured
d. Pad the patients bed to accommodate overflow incontinence - (ANSWER)B
The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the
light on in the bathroom is appropriate. Fluids should be encouraged because
dehydration is more common in older patients. The information in the question
does not indicate that measurement of the patient's output is necessary or that
the patient has overflow incontinence.
A female patient with a suspected UTI is to provide a clean catch urine specimen
for culture and sensitivity testing. To obtain the specimen, the nurse will:
a. Have the patient empty the bladder completely, then obtain the next urine
specimen that the patient is able to void
b. Teach the patient to clean the urethral area, void a small amount into the
toilet, and then void into a sterile specimen cup
c. Insert a short sterile mini catheter attached to a collecting container into the
urethra and bladder to obtain the specimen
d. Clean the area around the meatus with a povidine-iodine (betadine) swab and
then have the patient void into a sterile container - (ANSWER)B
, 2
This answer describes the technique for obtaining a clean-catch specimen. The
answer beginning, "insert a short, small, 'mini' catheter attached to a collecting
container" describes a technique that would result in a sterile specimen, but a
health care provider's order for a catheterized specimen would be required. Using
Betadine before obtaining the specimen is not necessary, and might result in
suppressing the growth of some bacteria. The technique described in the answer
beginning "have the patient empty the bladder completely" would not result in a
sterile specimen.
Which statement made by a patient who had a cystoscopy the previous day
should be reported immediately to the HCP?
a. My urine looks pink
b. My IV site is bruised
c. My sleep was restless
d. My temperature is 101 - (ANSWER)D
The patient's elevated temperature may indicate a bladder infection, a possible
complication of cystoscopy. The health care provider should be notified so that
antibiotic therapy can be started. Pink-tinged urine is expected after a cystoscopy.
The insomnia and bruising should be discussed further with the patient but do not
indicate a need to notify the health care provider.
To determine possible causes, the nurse will ask a patient admitted with acute
glomerulonephritis about:
a. Recent bladder infection
b. History of kidney stones
c. Recent sore throat and fever
, 3
d. History of high blood pres - (ANSWER)B
Acute glomerulonephritis frequently occurs after a streptococcal infection such as
strep throat. It is not caused by kidney stones, hypertension, or urinary tract
infection (UTI).
The nurse will anticipate teaching a patient with nephrotic syndrome who
develops flank pain about treatment with:
a. Antibiotics
b. Antifungals
c. Anticoagulants
d. Antihypertensive - (ANSWER)C
Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis,
and anticoagulation is needed. Antibiotics are used to treat a patient with flank
pain caused by pyelonephritis. Fungal pyelonephritis is uncommon and is treated
with antifungals. Antihypertensives are used if the patient has high blood
pressure
The nurse will plan to teach a 27 year old woman who smokes two packs a day
about the risk for:
a. Kidney stones
b. Bladder cancer
c. Bladder infection
d. Interstitial cystitis - (ANSWER)B
, 4
Cigarette smoking is a risk factor for bladder cancer. The patient's risk for
developing interstitial cystitis, urinary tract infection (UTI), or kidney stones will
not be reduced by quitting smoking.
Following rectal surgery, a patient voids about 50 mL of urine every 30-60
minutes for the first 4 hours. Which nursing intervention is most appropriate?
a. Monitor the patients intake and output overnight
b. Have the patient drink small amounts of fluid frequently
c. Use an ultrasound scanner to check the postvoid residual volume
d. Reassure the patient that this is normal after anesthesia for rectal surgery -
(ANSWER)C
An ultrasound scanner can be used to check for residual urine after the patient
voids. Because the patient's history and clinical manifestations are consistent with
overflow incontinence, it is not appropriate to have the patient drink small
amounts. Although overflow incontinence is not unusual after surgery, the nurse
should intervene to correct the physiologic problem, not just reassure the patient.
The patient may develop reflux into the renal pelvis and discomfort from a full
bladder if the nurse waits to address the problem for several hours.
The home health nurse teaches a patient with a neurogenic bladder how to use
intermittent catheterization for bladder emptying. Which patient statement
indicates that the teaching has been effective?
a. I will buy seven new catheters weekly and use a new one everyday
b. I will use a sterile catheter and gloves for each time I self-catheterize
c. I will clean the catheter carefully before and after each catheterization