Med Surge Final Exam
1…. A nurse is reviewing the laboratory data of a client who has acute
pancreatitis. The nurse should expect to find an elevation of which of following
values?
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can be
used by the body. It is produced by the pancreas and salivary glands and released
into the mouth, stomach, and intestines to aid in digestion. The amylase level of a
client who has acute pancreatitis usually increases within 12 to 24 hr and can
remain elevated for 2 to 3 days.
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of
endometriosis. Which of the following findings in the client's history should the
nurse recognize as consistent with a diagnosis of endometriosis?
Dysmenorrhea that is unresponsive to NSAIDs.
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus
implants in locations outside the uterus. This typically causes pelvic pain around
the time of the menstrual period but can cause pain at other times in the cycle.
The discomfort is often unrelieved by the use of NSAIDs.
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
that resulted in paraplegia. After a week on the unit, the nurse notes that the
client is withdrawn and increasingly resistant to rehabilitative efforts by the staff.
Which of the following actions should the nurse take?
Establish a plan of care with the client that sets attainable goals.
Rational
The nurse should develop a plan of care for this client with mutually set goals.
This action invests the client in the rehabilitation process, which encourages
feelings of ownership for it, and sees the goals as more attainable
,4….A nurse in a burn treatment center is caring for a client who is admitted with
severe burns to both lower extremities and is scheduled for an escharotomy. The
client's spouse asks the nurse what the procedure entails. Which of the following
nursing statements is appropriate?
Large incisions will be made in the eschar to improve circulation.
Rational
An escharotomy is a surgical incision made to release pressure and improve
circulation in a part of the body that has a deep burn and is experiencing
excessive swelling. Burn injuries that encircle a body part, such as an arm or the
chest, can cause swelling and tightness in the affected area, resulting in reduced
circulation. Making surgical incisions into the burned tissue allows the skin to
expand, reduces tightness and pressure, and improves circulation.
5….A nurse is caring for a client who has suspected cholecystitis. The nurse should
expect the client's urine to appear which of the following colors?
Dark and foamy
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
the kidneys are filtering excess bilirubin from the blood.
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests
should the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting
and monitoring tissue inflammation in clients with RA. As the disease improves
the ESR decreases.
7….A nurse is providing dietary teaching to a client who has a history of recurring
calcium oxalate kidney stones. Which of the following instructions should the
nurse include in the teaching?
Drink 3 L of fluid every day.
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to
dilute the urine and reduce the risk for stone formation.
8….A nurse is assessing a client who has disseminated intravascular coagulation
(DIC). Which of the following findings should the nurse expect?
Excessive thrombosis and bleeding
Rational
The nurse should expect excessive thrombosis and bleeding of mucous
membranes because both DIC impairs both coagulation and anticoagulation
pathways.
9….A nurse is caring for a middle adult client who has just received the diagnosis
of endometrial cancer. In taking a nursing history, which of the following
manifestations is likely to be reported by this client?
Postmenopausal bleeding
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of the
uterus). The most common manifestation of endometrial cancer is abnormal
uterine bleeding, including postmenopausal bleeding and bleeding between
normal periods in premenopausal women.
10…A nurse is giving a presentation to a community group about preventing
atherosclerosis. Which of the following should the nurse include as a modifiable
risk factor for this disorder? (Select all that apply.)
Hypercholesterolemia
Hypertension
Obesity
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a
medical-surgical unit. Which of the following room assignments should the nurse
make for the client?
A room with air exhaust directly to the outdoor environment
, Rational
A room with air exhaust directly to the outside environment eliminates
contamination of other client-care areas. This type of ventilation system is
referred to as an airborne infection isolation room.
12…A nurse is caring for a client who has Cushing's syndrome. Which of the
following interventions should the nurse expect to perform? (Select all that
apply.)
Assess blood glucose level
Assess for neck vein distention
Incorrect. Monitor for an irregular heart rate
Incorrect. Monitor for postural hypotension
Weigh the client daily
13…A nurse is teaching a client about risk factors for osteoporosis. Which of the
following factors should the nurse include in the teaching? (Select all that apply.)
Sedentary lifestyle
Incorrect. Obesity
Aging
Caffeine intake
Secondhand smoke
Sedentary lifestyle is correct. Immobility depletes bone.
Obesity is incorrect. Women who are obese have a greater capacity for storing
estrogen to help maintain acceptable levels of calcium.
Aging is correct. Women lose bone due to estrogen depletion after menopause.
Caffeine intake is correct. Excessive caffeine intake causes calcium loss in the
urine.
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, both
active and passive (secondhand) smoking.
14…A nurse is caring for a client who has a history of exposure to TB and
symptoms of night sweats and hemoptysis. Which of the following tests should
the nurse realize is the most reliable to confirm the diagnosis of active pulmonary
TB?
Sputum culture for acid-fast bacillus
1…. A nurse is reviewing the laboratory data of a client who has acute
pancreatitis. The nurse should expect to find an elevation of which of following
values?
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can be
used by the body. It is produced by the pancreas and salivary glands and released
into the mouth, stomach, and intestines to aid in digestion. The amylase level of a
client who has acute pancreatitis usually increases within 12 to 24 hr and can
remain elevated for 2 to 3 days.
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of
endometriosis. Which of the following findings in the client's history should the
nurse recognize as consistent with a diagnosis of endometriosis?
Dysmenorrhea that is unresponsive to NSAIDs.
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus
implants in locations outside the uterus. This typically causes pelvic pain around
the time of the menstrual period but can cause pain at other times in the cycle.
The discomfort is often unrelieved by the use of NSAIDs.
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
that resulted in paraplegia. After a week on the unit, the nurse notes that the
client is withdrawn and increasingly resistant to rehabilitative efforts by the staff.
Which of the following actions should the nurse take?
Establish a plan of care with the client that sets attainable goals.
Rational
The nurse should develop a plan of care for this client with mutually set goals.
This action invests the client in the rehabilitation process, which encourages
feelings of ownership for it, and sees the goals as more attainable
,4….A nurse in a burn treatment center is caring for a client who is admitted with
severe burns to both lower extremities and is scheduled for an escharotomy. The
client's spouse asks the nurse what the procedure entails. Which of the following
nursing statements is appropriate?
Large incisions will be made in the eschar to improve circulation.
Rational
An escharotomy is a surgical incision made to release pressure and improve
circulation in a part of the body that has a deep burn and is experiencing
excessive swelling. Burn injuries that encircle a body part, such as an arm or the
chest, can cause swelling and tightness in the affected area, resulting in reduced
circulation. Making surgical incisions into the burned tissue allows the skin to
expand, reduces tightness and pressure, and improves circulation.
5….A nurse is caring for a client who has suspected cholecystitis. The nurse should
expect the client's urine to appear which of the following colors?
Dark and foamy
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
the kidneys are filtering excess bilirubin from the blood.
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests
should the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting
and monitoring tissue inflammation in clients with RA. As the disease improves
the ESR decreases.
7….A nurse is providing dietary teaching to a client who has a history of recurring
calcium oxalate kidney stones. Which of the following instructions should the
nurse include in the teaching?
Drink 3 L of fluid every day.
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to
dilute the urine and reduce the risk for stone formation.
8….A nurse is assessing a client who has disseminated intravascular coagulation
(DIC). Which of the following findings should the nurse expect?
Excessive thrombosis and bleeding
Rational
The nurse should expect excessive thrombosis and bleeding of mucous
membranes because both DIC impairs both coagulation and anticoagulation
pathways.
9….A nurse is caring for a middle adult client who has just received the diagnosis
of endometrial cancer. In taking a nursing history, which of the following
manifestations is likely to be reported by this client?
Postmenopausal bleeding
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of the
uterus). The most common manifestation of endometrial cancer is abnormal
uterine bleeding, including postmenopausal bleeding and bleeding between
normal periods in premenopausal women.
10…A nurse is giving a presentation to a community group about preventing
atherosclerosis. Which of the following should the nurse include as a modifiable
risk factor for this disorder? (Select all that apply.)
Hypercholesterolemia
Hypertension
Obesity
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a
medical-surgical unit. Which of the following room assignments should the nurse
make for the client?
A room with air exhaust directly to the outdoor environment
, Rational
A room with air exhaust directly to the outside environment eliminates
contamination of other client-care areas. This type of ventilation system is
referred to as an airborne infection isolation room.
12…A nurse is caring for a client who has Cushing's syndrome. Which of the
following interventions should the nurse expect to perform? (Select all that
apply.)
Assess blood glucose level
Assess for neck vein distention
Incorrect. Monitor for an irregular heart rate
Incorrect. Monitor for postural hypotension
Weigh the client daily
13…A nurse is teaching a client about risk factors for osteoporosis. Which of the
following factors should the nurse include in the teaching? (Select all that apply.)
Sedentary lifestyle
Incorrect. Obesity
Aging
Caffeine intake
Secondhand smoke
Sedentary lifestyle is correct. Immobility depletes bone.
Obesity is incorrect. Women who are obese have a greater capacity for storing
estrogen to help maintain acceptable levels of calcium.
Aging is correct. Women lose bone due to estrogen depletion after menopause.
Caffeine intake is correct. Excessive caffeine intake causes calcium loss in the
urine.
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, both
active and passive (secondhand) smoking.
14…A nurse is caring for a client who has a history of exposure to TB and
symptoms of night sweats and hemoptysis. Which of the following tests should
the nurse realize is the most reliable to confirm the diagnosis of active pulmonary
TB?
Sputum culture for acid-fast bacillus
