Solutions manual for MED SURG 201 Final
Exam – Questions and correct Answers
solutions with Rationales
## **1. A nurse is caring for a client with COPD. Which oxygen delivery device is safest to
maintain chronic CO₂ retainers?**
**Answer:** Venturi mask
**Rationale:** Provides **precise, controlled FiO₂**, preventing high oxygen
concentrations that can suppress respiratory drive in COPD.
---
## **2. A client with heart failure reports sudden weight gain of 2.5 kg in 24 hours. What is
the priority action?**
**Answer:** Assess for worsening fluid overload and notify provider
**Rationale:** >2 kg/day indicates acute fluid retention—possible HF exacerbation.
---
## **3. Which lab finding indicates DKA rather than HHS?**
**Answer:** Serum ketones positive
**Rationale:** Ketone production is unique to DKA due to fat breakdown and acidosis.
---
## **4. A client is receiving IV potassium. Which action is essential?**
**Answer:** Use an IV pump to control the infusion rate
**Rationale:** Potassium must be infused slowly to avoid fatal dysrhythmias.
,---
## **5. A nurse notes peaked T waves on ECG. Which electrolyte imbalance is
suspected?**
**Answer:** Hyperkalemia
**Rationale:** Tall, peaked T waves are classic for elevated potassium.
---
## **6. What is priority for a client with acute pancreatitis?**
**Answer:** NPO to reduce pancreatic stimulation
**Rationale:** Food stimulates pancreatic enzymes, increasing pain and inflammation.
---
## **7. A post-operative client suddenly develops tachycardia and dyspnea. What does
the nurse suspect?**
**Answer:** Pulmonary embolism
**Rationale:** Acute onset dyspnea + tachycardia after surgery indicates PE.
---
## **8. A client with liver cirrhosis has ascites. Which medication is expected?**
**Answer:** Spironolactone
**Rationale:** Potassium-sparing diuretics are preferred to manage ascites.
---
## **9. A client with anemia reports fatigue. Which laboratory value confirms anemia?**
**Answer:** Low hemoglobin
**Rationale:** Hemoglobin level directly reflects oxygen-carrying capacity.
---
## **10. Which assessment confirms fluid volume deficit?**
**Answer:** Increased urine specific gravity
**Rationale:** Concentrated urine indicates dehydration.
, ---
## **11. A nurse prepares to give digoxin. Which finding warrants withholding the
dose?**
**Answer:** Apical pulse < 60 bpm
**Rationale:** Bradycardia increases risk for digoxin toxicity.
---
## **12. Which condition leads to metabolic acidosis?**
**Answer:** Severe diarrhea
**Rationale:** Loss of bicarbonate-rich intestinal fluids causes acidosis.
---
## **13. A client with pneumonia has crackles. What causes this finding?**
**Answer:** Fluid in alveoli
**Rationale:** Crackles occur when small airways open through fluid.
---
## **14. The priority in sickle cell crisis is:**
**Answer:** Pain management
**Rationale:** Vaso-occlusion causes severe ischemic pain; immediate relief is critical.
---
## **15. What is the best indicator of kidney function?**
**Answer:** Serum creatinine
**Rationale:** Creatinine accurately reflects GFR and renal health.
---
## **16. A client with C. difficile is placed on what precautions?**
**Answer:** Contact (gloves + gown, soap & water)
**Rationale:** Spores require strict contact precautions.
Exam – Questions and correct Answers
solutions with Rationales
## **1. A nurse is caring for a client with COPD. Which oxygen delivery device is safest to
maintain chronic CO₂ retainers?**
**Answer:** Venturi mask
**Rationale:** Provides **precise, controlled FiO₂**, preventing high oxygen
concentrations that can suppress respiratory drive in COPD.
---
## **2. A client with heart failure reports sudden weight gain of 2.5 kg in 24 hours. What is
the priority action?**
**Answer:** Assess for worsening fluid overload and notify provider
**Rationale:** >2 kg/day indicates acute fluid retention—possible HF exacerbation.
---
## **3. Which lab finding indicates DKA rather than HHS?**
**Answer:** Serum ketones positive
**Rationale:** Ketone production is unique to DKA due to fat breakdown and acidosis.
---
## **4. A client is receiving IV potassium. Which action is essential?**
**Answer:** Use an IV pump to control the infusion rate
**Rationale:** Potassium must be infused slowly to avoid fatal dysrhythmias.
,---
## **5. A nurse notes peaked T waves on ECG. Which electrolyte imbalance is
suspected?**
**Answer:** Hyperkalemia
**Rationale:** Tall, peaked T waves are classic for elevated potassium.
---
## **6. What is priority for a client with acute pancreatitis?**
**Answer:** NPO to reduce pancreatic stimulation
**Rationale:** Food stimulates pancreatic enzymes, increasing pain and inflammation.
---
## **7. A post-operative client suddenly develops tachycardia and dyspnea. What does
the nurse suspect?**
**Answer:** Pulmonary embolism
**Rationale:** Acute onset dyspnea + tachycardia after surgery indicates PE.
---
## **8. A client with liver cirrhosis has ascites. Which medication is expected?**
**Answer:** Spironolactone
**Rationale:** Potassium-sparing diuretics are preferred to manage ascites.
---
## **9. A client with anemia reports fatigue. Which laboratory value confirms anemia?**
**Answer:** Low hemoglobin
**Rationale:** Hemoglobin level directly reflects oxygen-carrying capacity.
---
## **10. Which assessment confirms fluid volume deficit?**
**Answer:** Increased urine specific gravity
**Rationale:** Concentrated urine indicates dehydration.
, ---
## **11. A nurse prepares to give digoxin. Which finding warrants withholding the
dose?**
**Answer:** Apical pulse < 60 bpm
**Rationale:** Bradycardia increases risk for digoxin toxicity.
---
## **12. Which condition leads to metabolic acidosis?**
**Answer:** Severe diarrhea
**Rationale:** Loss of bicarbonate-rich intestinal fluids causes acidosis.
---
## **13. A client with pneumonia has crackles. What causes this finding?**
**Answer:** Fluid in alveoli
**Rationale:** Crackles occur when small airways open through fluid.
---
## **14. The priority in sickle cell crisis is:**
**Answer:** Pain management
**Rationale:** Vaso-occlusion causes severe ischemic pain; immediate relief is critical.
---
## **15. What is the best indicator of kidney function?**
**Answer:** Serum creatinine
**Rationale:** Creatinine accurately reflects GFR and renal health.
---
## **16. A client with C. difficile is placed on what precautions?**
**Answer:** Contact (gloves + gown, soap & water)
**Rationale:** Spores require strict contact precautions.
