MED SURG II EXAMS SCRIPT UPDATED EXAM QUESTIONS
AND ANSWERS RATED A+
✔✔A nurse is completing an integumentary assessment of a client w anemia. Which of
the following is an expected finding?
Absent skin turgor
Spoon shaped nails
shiny hairless legs
Yellow mucous membranes - ✔✔a client with anemia will have nail deformities and
pale/cyanotic mucous membranes
✔✔A nurse receives a phone call from a client seeking information about his new
prescription for erythorpoetin (Epogen). Which of the following information should be
reviewed w the client?
The client needs erythrocyte sedimentation rate weekly
the client should check hgb and hct twice a week
blood pressure can decrease
Folic acid production will increase - ✔✔Erythropoetin increases RBC production. The
B/P shold increase and the client should test hgb and hct twice a week.
✔✔Arthroscopy - ✔✔performed to assess the condition of the joint and can be used to
simultaneously repair tears and joint defects; Contraindicated if infection is present in
the joint or client cannot bend joint at least 40 degrees. Client presents joint pain,
swelling, creptius, and joint instability. Reinforce about post procedure exercises
(straight leg raises, quadriceps setting isometrics). Measure peripheral neurovascular
status and limb drsgs Q Hr or per protocol. Ice/Elevate the extremity for 24 hr, take an
analgesic for pain, apply sling or splint if prescribed, and maintain activity restrictions.
Ensure client is able to use crutches if limited weight bearing is prescribed. Monitor the
color, temp, pain, and sensation. Notify the provider of any changes (swelling, increased
joint pain, thrombophlebitis, and infection) Notify immediately of fever, swelling, or
redness.
✔✔Nuclear Scans - ✔✔performed to evaluate entire skeletal system; A radionuclide test
involves radioactive material injected 2-3 hr before scanning and most commonly used
to detect hairline bone fractures. They can detect tumors, fractures, and diseases of the
bone (osteomyelitis, osteoporosis, vertebral compression fractures).
Gallium/Thallium scans are more sensitive to detecting bone problems than a bone
scan; the radioisotope migrate to tissues of the brain, liver, and breast and used to
detect disease of these organs. Radionuclide is injected 4-6 hr before scanning. The
scan itself takes 30-60 mins and can require sedation in order for the client to lie still
during this time. Repeat scanning occur at 24, 48, and 72. Client presentation is bone
pain. Check for allergies to radioisotope or conditions such as RF or pregnancy.
Emphasize the need to lie very still during the length of procedure and must empty
bladder before the procedure. The client doesn't need to take any radioactive
,precautions following the procedure. Encourage client to drink fluids to increase
excretion of radioisotopes in urine and feces.
✔✔Dual X ray Absorptiometry (DXA) - ✔✔done to estimate density of bone mass-
usually in the hip or spine- and presence/extent of osteoporosis. DXA uses two beams
of radiation and findings are analyzed by a computer and interpreted by a radiologist.
NO CONTRAST MATERIAL IS USED. Client receives a score that relates their amt of
bone density to that of other people in their age group and gender. The client will lie on
an x ray table while a scan of the skeletal area is done. Baseline for postmenopausal
state is done at 40 YO. Client may present a decrease in height, bone pain, and
fractures dt calcium loss. The client may stay dressed but must remove all metallic
jewelry/objects. Post procedure, the client follow up w the provider regarding
supplements and meds that can be needed if bone loss is present (Biophosphanates
and Calcitonin)
✔✔Electromyography (EMG) and Nerve Conduction Studies - ✔✔done to determine the
presence and cause of muscle weakness; it is performed at the bedside or EMG lab.
Thin needles are placed in the muscle under study and attached to an electrode, which
is attached to an oscilloscope. Electrical activity is recorded during muscle contraction.
Nerve conduction study- flat electrodes are taped on the skin and low electrical currents
are sent through the electrodes and muscl responses to the stimulus is recorded.
Indications- Neuromuscular disorders, Motor neuron disease (amyotrophic lateral
sclerosis, myasthenia gravis, and Guillain Barre), and peripheral nerve disorders (carpal
tunnel). Muscle relaxants and anticoagulants are contraindicated for this procedure.
When both EMG and nerve conduction studies are ordered, the nerve conduction is
done first. Discomfort may be felt w needle insertion and when electrical current is sent
through the electrodes. The client can be asked to flex his muscle w insertion of needle.
Some bruising can occur at insertion site and the client should report swelling and
tenderness at injection site. Instruct the client to apply ice to prevent hematoma
formation and to reduce swelling and pain.
✔✔A nurse is reviewing preoperative teaching w a client who is to undergo arthroscopy
to repair injury to the shoulder. Which of the following statements by the nurse are
appropriate? SATA
Avoid damage and moisture to cast of arm
Inspect incision daily for signs of infection
Resume normal activity within 12 hr
Position the affected extremity in the dependent position
Perform isometric exercise as directed - ✔✔With an arthroscopy repair, the incision is
monitored daily for s/s of infection and client will perform prescribed exercises post
procedure. A sling is applied to immobilize shoulder and promote healing. Activities are
resumed per provider but usually restricted to prevent damage to affected extremity.
The arm should be positioned across the chest in a non dependent to reduce swelling
and promote venous return.
, ✔✔A nurse is contributing to the POC of a client who is post operative following an
arthroscopy of the knee. Which of the following should the nurse include in the POC?
SATA
Inspect color and temp of affected extremity
Apply warm compresses to incision site
Elevate the extremity
Administer opioid medications
Check pulses and sensation in the foot - ✔✔Following an arthroscopy of the knee, the
nurse should inspect the color, temp, pulse, and sensation of the client extremity to
assess for circulation to the foot. The nurse will admin analgesics such as opioids to
decrease discomfort and elevate the extremity to decrease swelling and pain. Ice will be
applied the first 24 hrs to the incisional site to decrease swelling and pain.
✔✔A nurse is reinforcing teaching w a client who is scheduled for a bone scan. Which
of the following statements by the nurse is appropriate?
The procedure will take about 1 hr
You will need to be placed in a tube-like structure during the procedure
You will need to take precautions w your urine for 24 hrs after the procedure
A radioactive substance is injected before the procedure - ✔✔With a bone scan, the
nurse will inject a radioactive substance before the procedure; The scan itself takes
about 30-60 mins but the entire procedure takes several hrs, Radioactive precautions
after the procedure are not necessary.
✔✔A nurse is reviewing information w a client scheduled for a dual x ray absorpiometry
(DXA) scan. Which of the following should the nurse include? SATA
The test requires use of contrast material
The hip and Spine are the usual areas to be scanned
The scan is used to detect osteoarthritis
Bone pain can indicate the need for a scan
At age 40 years, a baseline scan is recommended - ✔✔DXA is used to determine bone
density and osteoporosis. No contrast material is needed. The hip and spine are the
usual areas to be scanned. Bone pain can indicate a need for a bone scan. And for
postmenopausal state, a baseline may bee done at 40 YO.
✔✔A nurse is assisting with the care of a client who is to have an electromyography
(EMG). Which of the following should the nurse expect to be included in the POC?
SATA
Inspect the client's skin for bruising
Apply ice at insertion sites
Determine whether the client takes muscle relaxants
Instruct the client to flex muscles while the needle is inserted
Expect swelling, redness, and tenderness at insertion site - ✔✔W/ an EMG a needle is
inserted in the muscle to determine presence and cause of muscle weakness. The
client should expect some bruising at insertion site and apply ice at the insertion site to
prevent hematoma formation and decrease swelling and pain. The nurse should
AND ANSWERS RATED A+
✔✔A nurse is completing an integumentary assessment of a client w anemia. Which of
the following is an expected finding?
Absent skin turgor
Spoon shaped nails
shiny hairless legs
Yellow mucous membranes - ✔✔a client with anemia will have nail deformities and
pale/cyanotic mucous membranes
✔✔A nurse receives a phone call from a client seeking information about his new
prescription for erythorpoetin (Epogen). Which of the following information should be
reviewed w the client?
The client needs erythrocyte sedimentation rate weekly
the client should check hgb and hct twice a week
blood pressure can decrease
Folic acid production will increase - ✔✔Erythropoetin increases RBC production. The
B/P shold increase and the client should test hgb and hct twice a week.
✔✔Arthroscopy - ✔✔performed to assess the condition of the joint and can be used to
simultaneously repair tears and joint defects; Contraindicated if infection is present in
the joint or client cannot bend joint at least 40 degrees. Client presents joint pain,
swelling, creptius, and joint instability. Reinforce about post procedure exercises
(straight leg raises, quadriceps setting isometrics). Measure peripheral neurovascular
status and limb drsgs Q Hr or per protocol. Ice/Elevate the extremity for 24 hr, take an
analgesic for pain, apply sling or splint if prescribed, and maintain activity restrictions.
Ensure client is able to use crutches if limited weight bearing is prescribed. Monitor the
color, temp, pain, and sensation. Notify the provider of any changes (swelling, increased
joint pain, thrombophlebitis, and infection) Notify immediately of fever, swelling, or
redness.
✔✔Nuclear Scans - ✔✔performed to evaluate entire skeletal system; A radionuclide test
involves radioactive material injected 2-3 hr before scanning and most commonly used
to detect hairline bone fractures. They can detect tumors, fractures, and diseases of the
bone (osteomyelitis, osteoporosis, vertebral compression fractures).
Gallium/Thallium scans are more sensitive to detecting bone problems than a bone
scan; the radioisotope migrate to tissues of the brain, liver, and breast and used to
detect disease of these organs. Radionuclide is injected 4-6 hr before scanning. The
scan itself takes 30-60 mins and can require sedation in order for the client to lie still
during this time. Repeat scanning occur at 24, 48, and 72. Client presentation is bone
pain. Check for allergies to radioisotope or conditions such as RF or pregnancy.
Emphasize the need to lie very still during the length of procedure and must empty
bladder before the procedure. The client doesn't need to take any radioactive
,precautions following the procedure. Encourage client to drink fluids to increase
excretion of radioisotopes in urine and feces.
✔✔Dual X ray Absorptiometry (DXA) - ✔✔done to estimate density of bone mass-
usually in the hip or spine- and presence/extent of osteoporosis. DXA uses two beams
of radiation and findings are analyzed by a computer and interpreted by a radiologist.
NO CONTRAST MATERIAL IS USED. Client receives a score that relates their amt of
bone density to that of other people in their age group and gender. The client will lie on
an x ray table while a scan of the skeletal area is done. Baseline for postmenopausal
state is done at 40 YO. Client may present a decrease in height, bone pain, and
fractures dt calcium loss. The client may stay dressed but must remove all metallic
jewelry/objects. Post procedure, the client follow up w the provider regarding
supplements and meds that can be needed if bone loss is present (Biophosphanates
and Calcitonin)
✔✔Electromyography (EMG) and Nerve Conduction Studies - ✔✔done to determine the
presence and cause of muscle weakness; it is performed at the bedside or EMG lab.
Thin needles are placed in the muscle under study and attached to an electrode, which
is attached to an oscilloscope. Electrical activity is recorded during muscle contraction.
Nerve conduction study- flat electrodes are taped on the skin and low electrical currents
are sent through the electrodes and muscl responses to the stimulus is recorded.
Indications- Neuromuscular disorders, Motor neuron disease (amyotrophic lateral
sclerosis, myasthenia gravis, and Guillain Barre), and peripheral nerve disorders (carpal
tunnel). Muscle relaxants and anticoagulants are contraindicated for this procedure.
When both EMG and nerve conduction studies are ordered, the nerve conduction is
done first. Discomfort may be felt w needle insertion and when electrical current is sent
through the electrodes. The client can be asked to flex his muscle w insertion of needle.
Some bruising can occur at insertion site and the client should report swelling and
tenderness at injection site. Instruct the client to apply ice to prevent hematoma
formation and to reduce swelling and pain.
✔✔A nurse is reviewing preoperative teaching w a client who is to undergo arthroscopy
to repair injury to the shoulder. Which of the following statements by the nurse are
appropriate? SATA
Avoid damage and moisture to cast of arm
Inspect incision daily for signs of infection
Resume normal activity within 12 hr
Position the affected extremity in the dependent position
Perform isometric exercise as directed - ✔✔With an arthroscopy repair, the incision is
monitored daily for s/s of infection and client will perform prescribed exercises post
procedure. A sling is applied to immobilize shoulder and promote healing. Activities are
resumed per provider but usually restricted to prevent damage to affected extremity.
The arm should be positioned across the chest in a non dependent to reduce swelling
and promote venous return.
, ✔✔A nurse is contributing to the POC of a client who is post operative following an
arthroscopy of the knee. Which of the following should the nurse include in the POC?
SATA
Inspect color and temp of affected extremity
Apply warm compresses to incision site
Elevate the extremity
Administer opioid medications
Check pulses and sensation in the foot - ✔✔Following an arthroscopy of the knee, the
nurse should inspect the color, temp, pulse, and sensation of the client extremity to
assess for circulation to the foot. The nurse will admin analgesics such as opioids to
decrease discomfort and elevate the extremity to decrease swelling and pain. Ice will be
applied the first 24 hrs to the incisional site to decrease swelling and pain.
✔✔A nurse is reinforcing teaching w a client who is scheduled for a bone scan. Which
of the following statements by the nurse is appropriate?
The procedure will take about 1 hr
You will need to be placed in a tube-like structure during the procedure
You will need to take precautions w your urine for 24 hrs after the procedure
A radioactive substance is injected before the procedure - ✔✔With a bone scan, the
nurse will inject a radioactive substance before the procedure; The scan itself takes
about 30-60 mins but the entire procedure takes several hrs, Radioactive precautions
after the procedure are not necessary.
✔✔A nurse is reviewing information w a client scheduled for a dual x ray absorpiometry
(DXA) scan. Which of the following should the nurse include? SATA
The test requires use of contrast material
The hip and Spine are the usual areas to be scanned
The scan is used to detect osteoarthritis
Bone pain can indicate the need for a scan
At age 40 years, a baseline scan is recommended - ✔✔DXA is used to determine bone
density and osteoporosis. No contrast material is needed. The hip and spine are the
usual areas to be scanned. Bone pain can indicate a need for a bone scan. And for
postmenopausal state, a baseline may bee done at 40 YO.
✔✔A nurse is assisting with the care of a client who is to have an electromyography
(EMG). Which of the following should the nurse expect to be included in the POC?
SATA
Inspect the client's skin for bruising
Apply ice at insertion sites
Determine whether the client takes muscle relaxants
Instruct the client to flex muscles while the needle is inserted
Expect swelling, redness, and tenderness at insertion site - ✔✔W/ an EMG a needle is
inserted in the muscle to determine presence and cause of muscle weakness. The
client should expect some bruising at insertion site and apply ice at the insertion site to
prevent hematoma formation and decrease swelling and pain. The nurse should
