DEWIT MEDICAL-SURGICAL NURSING
2025 complete exam set questions and
answers
C. Informal teaching is individualized one on one teaching which represents the majority of
patient education done by nurses that occurs when an intervention is explained or a question is
answered. Group needs are often the focus of formal patient education courses or classes.
Informal teaching does not necessarily follow a specific formalized plan. It may be planned with
specific content, but it is individualized responses to patient needs. Formal teaching involves the
use of a curriculum/course plan with standardized content. - CORRECT ANSWER- When
describing patient education approaches, the nurse educator would explain that informal
teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs
C. Cognitive theorists believe that attention, relevance, confidence, and satisfaction (ARCS) are
the conditions that, when integrated, motivate someone to learn. Field theorists place
significance on how achievement, power, the need for affiliation, and avoidance motives
influence individual behavior. Sociologic theories are not involved in motivation. - CORRECT
ANSWER- A patient expresses a strong interest in returning to their work, family, and hobbies
after having a stroke. Which theory type would the nurse use to develop a plan of care for the
best results of this patient's motivation style?
a. field
b. biological
c. cognitive
d. sociologic
C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses are at greater risk for
hypothermia. Clients who smoke, consume alcohol, or have impaired peripheral circulation have
a higher incidence of frostbite. - CORRECT ANSWER- The nurse is assessing a group of
clients. Which clients are at greater risk for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic
D
There is no evidence to support the idea that older adult clients perceive pain any differently
than younger clients. The other statements are accurate regarding older clients and pain. -
,d. older clients have a different pain mechanism and do not feel it as much
C
The spectator shows signs of heat stroke, which is a medical emergency. The spectator should
be transported to the ED ASAP. The nurs should take actions to lower his body temp in teh
meantime by removing his shirt and sponging his body with cool water. Lowering body temp by
drinking cool fluids or taking acetaminophen is not as effective in an emergency situation. The
client needs to be cooled quickly and is a priority for treatment - CORRECT ANSWER- The
nurse is working at a first aid booth for a spring training game on a hot day. A spectator comes
in, reporting that he is not feeling well. Vital signs are temp 104.1 F, pulse 132 BPM, respirs 26
breaths/min, and blood pressure 106/66 mm Hg. He trips over his feet as the nurse leads him to
a cot. What is the priory action of the nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink
D
Potassium is a severe tissue irritant. The safest action is to discontinue the solution that
contains the potassium and discontinue the IV altogether, in which case the client would need
another site started. Assessing for a blood return may or may not be successful. The solution
could be diluted (less potassium) and the rate could be slowed once it is determined that the
needle is in the vein. - CORRECT ANSWER- The client is receiving an IV of 60 mEq of
potassium chloride ina 1000 mL solution of dextrose 5% in 0.45% saline. The client states that
the area around the IV site burns. What intervention does the nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion
D
Older adults on fixed incomes are unable to adjust their income to meet rising costs associated
with meeting basic needs - CORRECT ANSWER- A nurse is caring for an older adult client who
lives alone. Which economic situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income
A
Pain triggers a number of physiologic stress responses in the human body. Unrelieved pain can
prolong the stress response and produce a cascade of harmful effects in all body systems. The
stress response causes the endocrine system to release excessive amounts of hormones, such
as cortisol, catecholamines, and glucagon. Insulin and testosterone levels decrease. Increased
endocrine activity in turn initiates a number of metabolic processes, in particular, accelerated
carbohydrate, protein, and fat destruction, whcih can result in weight loss, tachycardia,
,a. prolonged stress response and a cascade of harmful effects system wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
d. decreased carbohydrate, protein, and fat destruction
A
Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia, causing
confusion. Applying oxygen can reduce confusion, even if perfusion is still less than optimum.
Increasing the IV flow rate would increase perfusion. However, depending on the degree of
dehydration, rehydrating the person too rapidly with IV fluids can lead to cerebral edema. -
CORRECT ANSWER- Which intervention in a client with dehydration induced confusion is most
likely to relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours
C
Older adults, because they have less total body water than younger adults, are at greater risk
for development of dehydration. Anyone who is cognitively impaired and cannot obtain fluids
independently or cannot make his or her need for fluids known is at high risk for dehydration -
CORRECT ANSWER- Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid
B
Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to the
development of hyperkalemia. The client should be taught to read labels and to choose a salt
substitute that does not contain potassium. NSAIDs promote the retention of sodium but not
potassium. - CORRECT ANSWER- A nurse is caring for several clients. Which client does the
nurse assess most carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
A
Decreased renal blood flow and reduced glomerular filtration can result in slower medication
excretion time, potentially leading to toxic drug accumulation. Aging results in decreased total
body water and gastrointestinal motility and an increase in the ratio of adipose tissue to lean
body mass, but is not related to dig toxicity. - CORRECT ANSWER- An older adult client
presents with signs and symptoms related to dig toxicity. Which age related change may have
contributed to this problem?
a. decreased renal blood flow
, Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess fluid
loss or fluid retention. Weight loss greater than 0.5 lb daily is indicative of excessive fluid loss.
The other statements are not indicative of practices that will prevent dehydration. - CORRECT
ANSWER- A client is being treated for dehydration. Which statement made by the client
indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
A
In a client with hypokkalemia, progressive skeletal muscle weakness is associated with
increasing severity of hypokalemia. The most life-threatening complication of hypokalemia is
respiratory insufficiency. It is imperative for the nurse to perform a respiratory assessment first to
make sure that the client is not in immediate jeopardy. Next, the nurse would call the health care
provider to obtain orders for potassium replacement. - CORRECT ANSWER- The nurse notes
that the handgrip of the client with hypokalemia has diminished since the previous assessment
one hour ago. Which intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
C
60/40 (desired/have) - CORRECT ANSWER- The physician orders Lasix (furosemide) 60 mg po
every day for your patient. On hand you have Lasix 40 mg. How many tablets will you give the
patient?
a. 3
b. 1
c. 1 1/2
d. 2 1/5
C
Clients on restricted sodium diets generally should avoid processed, smoked, and pickled foods
and those with sauces and other condiments. Foods lowest in sodium include fish, poultry, and
fresh produce. The chinese food likely would have soy sauce, the tomato soup is processed,
and the crackers are a snack food - a category of foods often high in sodium. - CORRECT
ANSWER- A client has been taught to restrict dietary sodium. Which food selection by the client
indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers
A
2025 complete exam set questions and
answers
C. Informal teaching is individualized one on one teaching which represents the majority of
patient education done by nurses that occurs when an intervention is explained or a question is
answered. Group needs are often the focus of formal patient education courses or classes.
Informal teaching does not necessarily follow a specific formalized plan. It may be planned with
specific content, but it is individualized responses to patient needs. Formal teaching involves the
use of a curriculum/course plan with standardized content. - CORRECT ANSWER- When
describing patient education approaches, the nurse educator would explain that informal
teaching is an approach that
a. follows formalized plans
b. has standardized content
c. often occurs one-to-one
d. addresses group needs
C. Cognitive theorists believe that attention, relevance, confidence, and satisfaction (ARCS) are
the conditions that, when integrated, motivate someone to learn. Field theorists place
significance on how achievement, power, the need for affiliation, and avoidance motives
influence individual behavior. Sociologic theories are not involved in motivation. - CORRECT
ANSWER- A patient expresses a strong interest in returning to their work, family, and hobbies
after having a stroke. Which theory type would the nurse use to develop a plan of care for the
best results of this patient's motivation style?
a. field
b. biological
c. cognitive
d. sociologic
C, D, E, F
clients with poor nutrition, fatigue, and multiple chronic illnesses are at greater risk for
hypothermia. Clients who smoke, consume alcohol, or have impaired peripheral circulation have
a higher incidence of frostbite. - CORRECT ANSWER- The nurse is assessing a group of
clients. Which clients are at greater risk for hypothermia or frostbite? (select all that apply)
a. an older woman with hypertension
b. a young man with a body mass index of 42
c. a young many who has just consumed six martinis
d. an older man who smokes a pack of cigarettes a day
e. a young woman who is anorexic
f. a young woman who is diabetic
D
There is no evidence to support the idea that older adult clients perceive pain any differently
than younger clients. The other statements are accurate regarding older clients and pain. -
,d. older clients have a different pain mechanism and do not feel it as much
C
The spectator shows signs of heat stroke, which is a medical emergency. The spectator should
be transported to the ED ASAP. The nurs should take actions to lower his body temp in teh
meantime by removing his shirt and sponging his body with cool water. Lowering body temp by
drinking cool fluids or taking acetaminophen is not as effective in an emergency situation. The
client needs to be cooled quickly and is a priority for treatment - CORRECT ANSWER- The
nurse is working at a first aid booth for a spring training game on a hot day. A spectator comes
in, reporting that he is not feeling well. Vital signs are temp 104.1 F, pulse 132 BPM, respirs 26
breaths/min, and blood pressure 106/66 mm Hg. He trips over his feet as the nurse leads him to
a cot. What is the priory action of the nurse?
a. admin tylenol 650 mg orally
b. encourage rest, and reassess in 15 minutes
c. sponge the victim with cool water and remove his shirt
d. encourage drinking of cool water or sports drink
D
Potassium is a severe tissue irritant. The safest action is to discontinue the solution that
contains the potassium and discontinue the IV altogether, in which case the client would need
another site started. Assessing for a blood return may or may not be successful. The solution
could be diluted (less potassium) and the rate could be slowed once it is determined that the
needle is in the vein. - CORRECT ANSWER- The client is receiving an IV of 60 mEq of
potassium chloride ina 1000 mL solution of dextrose 5% in 0.45% saline. The client states that
the area around the IV site burns. What intervention does the nurse perform first?
a. assess for a blood return
b. notify the physician
c. document the finding
d. stop the IV infusion
D
Older adults on fixed incomes are unable to adjust their income to meet rising costs associated
with meeting basic needs - CORRECT ANSWER- A nurse is caring for an older adult client who
lives alone. Which economic situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income
A
Pain triggers a number of physiologic stress responses in the human body. Unrelieved pain can
prolong the stress response and produce a cascade of harmful effects in all body systems. The
stress response causes the endocrine system to release excessive amounts of hormones, such
as cortisol, catecholamines, and glucagon. Insulin and testosterone levels decrease. Increased
endocrine activity in turn initiates a number of metabolic processes, in particular, accelerated
carbohydrate, protein, and fat destruction, whcih can result in weight loss, tachycardia,
,a. prolonged stress response and a cascade of harmful effects system wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
d. decreased carbohydrate, protein, and fat destruction
A
Dehydration most frequently leads to poor cerebra perfusion and cerebral hypoxia, causing
confusion. Applying oxygen can reduce confusion, even if perfusion is still less than optimum.
Increasing the IV flow rate would increase perfusion. However, depending on the degree of
dehydration, rehydrating the person too rapidly with IV fluids can lead to cerebral edema. -
CORRECT ANSWER- Which intervention in a client with dehydration induced confusion is most
likely to relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours
C
Older adults, because they have less total body water than younger adults, are at greater risk
for development of dehydration. Anyone who is cognitively impaired and cannot obtain fluids
independently or cannot make his or her need for fluids known is at high risk for dehydration -
CORRECT ANSWER- Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid
B
Many salt substitutes are composed of potassium chloride. Heavy use cna contribute to the
development of hyperkalemia. The client should be taught to read labels and to choose a salt
substitute that does not contain potassium. NSAIDs promote the retention of sodium but not
potassium. - CORRECT ANSWER- A nurse is caring for several clients. Which client does the
nurse assess most carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
A
Decreased renal blood flow and reduced glomerular filtration can result in slower medication
excretion time, potentially leading to toxic drug accumulation. Aging results in decreased total
body water and gastrointestinal motility and an increase in the ratio of adipose tissue to lean
body mass, but is not related to dig toxicity. - CORRECT ANSWER- An older adult client
presents with signs and symptoms related to dig toxicity. Which age related change may have
contributed to this problem?
a. decreased renal blood flow
, Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess fluid
loss or fluid retention. Weight loss greater than 0.5 lb daily is indicative of excessive fluid loss.
The other statements are not indicative of practices that will prevent dehydration. - CORRECT
ANSWER- A client is being treated for dehydration. Which statement made by the client
indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
A
In a client with hypokkalemia, progressive skeletal muscle weakness is associated with
increasing severity of hypokalemia. The most life-threatening complication of hypokalemia is
respiratory insufficiency. It is imperative for the nurse to perform a respiratory assessment first to
make sure that the client is not in immediate jeopardy. Next, the nurse would call the health care
provider to obtain orders for potassium replacement. - CORRECT ANSWER- The nurse notes
that the handgrip of the client with hypokalemia has diminished since the previous assessment
one hour ago. Which intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
C
60/40 (desired/have) - CORRECT ANSWER- The physician orders Lasix (furosemide) 60 mg po
every day for your patient. On hand you have Lasix 40 mg. How many tablets will you give the
patient?
a. 3
b. 1
c. 1 1/2
d. 2 1/5
C
Clients on restricted sodium diets generally should avoid processed, smoked, and pickled foods
and those with sauces and other condiments. Foods lowest in sodium include fish, poultry, and
fresh produce. The chinese food likely would have soy sauce, the tomato soup is processed,
and the crackers are a snack food - a category of foods often high in sodium. - CORRECT
ANSWER- A client has been taught to restrict dietary sodium. Which food selection by the client
indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers
A
