ADVANCED MED SURG UPDATED TEST PAPER QUESTIONS
AND SOLUTIONS GUARANTEE A+
✔✔A nurse explains to another nurse that chronic lymphocytic leukemia (CLL) is: -
✔✔Often asymptomatic and diagnosed incidentally during routine physical examination
✔✔An alert patient at the scene of an explosion has a respiratory rate of 24 breaths per
minute, a faint stridor, and soot on the face. The patient's heart rate is 120 beats per
minute. Which collaborative action would be most appropriate to implement first? -
✔✔Prophylactically intubating the patient
✔✔During fluid resuscitation for hypovolemic shock, the following laboratory values are
obtained: pH 7.31PaO2 88 mm HgPCO2 30 mmHgHCO3 24 mEqHemoglobin 12.8 g
(normal 13.5-17 g/dL)Hematocrit 32% (normal 40-54%) Nursing management of this
patient needs to include - ✔✔Administration of crystalloid 200 mL/hr
✔✔The nurse is preparing an infusion of Norepinephrine for a patient in severe septic
shock. Why is this medication being used for the patient? - ✔✔It reverses hypotension
when fluid resuscitation was unsuccessful
✔✔Early goal-directed therapy for management of severe sepsis or septic shock
involves maximizing cardiac preload, afterload, and contractility to balance oxygen
delivery to tissues with demand. During the first 6 hours of resuscitation for sepsis-
induced hypoperfusion, which of the following pairs of parameters represents desired
target values? - ✔✔CVP: 12 mmHg; MAP: 67 mmHg
✔✔Which finding indicates that re-hydration is complete and hypovolemic shock has
been successfully treated in a non-intubated patient? - ✔✔CVP = 8 mmHg
✔✔A patient in hypovolemic shock would be expected to have a high SVR because: -
✔✔They have released catecholamines, which stimulate the alpha receptors in blood
vessels, thereby "shrinking" the vessels to fit around the existing blood volume
✔✔The nurse is caring for a patient who was brought into the emergency department
after being struck by lightning. This patient's injuries will most likely be to which body
areas? - ✔✔Heart and bones
✔✔A nurse caring for a patient with a spinal cord injury experiencing hypotension and
bradycardia, will plan to administer all of the following collaborative interventions
EXCEPT: - ✔✔Apresoline
✔✔A patient rescued from a small house fire is brought to the emergency department.
There is no burn injury to the skin, however laboratory results show an elevated carbon
, monoxide (CO) level. Which intervention would the nurse expect to implement? -
✔✔Give 100% oxygen by mask
✔✔A patient is experiencing acute respiratory distress after eating an item of a known
food allergy. The nurse will implement all of the following interventions when providing
emergency care to this patient EXCEPT: - ✔✔Prepare to administer antithrombolytic
agents as prescribed
✔✔A patient with cardiomyopathy is demonstrating signs of cardiogenic shock. The
nurse realizes that this type of shock is due to: - ✔✔Reduced cardiac output
✔✔The nurse delegates care for a patient with leukemia to a licensed practical nurse
(LPN). Which instruction is the most important for the RN to provide to the LPN? -
✔✔Wash hands frequently
✔✔The nurse is evaluating a patient for the presence of systemic inflammatory
response syndrome (SIRS). Which assessment data indicates the presence of SIRS? -
✔✔Temperature 38.4 C, respiratory rate 23, pulse rate 98, and PaCO2 30
✔✔What intervention will the nurse implement to prevent injury in the patient with bone
cancer? - ✔✔Using a lift sheet when repositioning the patient
✔✔The nurse is preparing medications for a patient being treated for cardiogenic shock.
The nurse might administer all of the following medications EXCEPT: - ✔✔Epinephrine
✔✔A patient in ICU with a burn circling the left upper leg suddenly experiences
excruciating pain, pallor in the left lower extremity, and loss of left pedal pulse. The
nurse would immediately notify the physician because this patient might be developing:
- ✔✔Compartment syndrome
✔✔Steroids may be provided to a patient in septic shock. What would the nurse expect
when providing this medication? - ✔✔There is a risk of superinfection when steroids are
given
✔✔A patient is diagnosed with cardiac tamponade. When planning care, the nurse will
include interventions to address which type of shock? - ✔✔obstructive
✔✔An electrical worker comes in with significant 2nd and 3rd degree burns to his right
hand and wrist. He is unresponsive, so is unable to tell you what happened. Which is
the nurse's priority assessment? - ✔✔Assess his cardiac status
✔✔A patient, experiencing vasodilation, is diagnosed with distributive shock. The nurse
will assess the patient for all etiologies EXCEPT: - ✔✔hemorrhage
AND SOLUTIONS GUARANTEE A+
✔✔A nurse explains to another nurse that chronic lymphocytic leukemia (CLL) is: -
✔✔Often asymptomatic and diagnosed incidentally during routine physical examination
✔✔An alert patient at the scene of an explosion has a respiratory rate of 24 breaths per
minute, a faint stridor, and soot on the face. The patient's heart rate is 120 beats per
minute. Which collaborative action would be most appropriate to implement first? -
✔✔Prophylactically intubating the patient
✔✔During fluid resuscitation for hypovolemic shock, the following laboratory values are
obtained: pH 7.31PaO2 88 mm HgPCO2 30 mmHgHCO3 24 mEqHemoglobin 12.8 g
(normal 13.5-17 g/dL)Hematocrit 32% (normal 40-54%) Nursing management of this
patient needs to include - ✔✔Administration of crystalloid 200 mL/hr
✔✔The nurse is preparing an infusion of Norepinephrine for a patient in severe septic
shock. Why is this medication being used for the patient? - ✔✔It reverses hypotension
when fluid resuscitation was unsuccessful
✔✔Early goal-directed therapy for management of severe sepsis or septic shock
involves maximizing cardiac preload, afterload, and contractility to balance oxygen
delivery to tissues with demand. During the first 6 hours of resuscitation for sepsis-
induced hypoperfusion, which of the following pairs of parameters represents desired
target values? - ✔✔CVP: 12 mmHg; MAP: 67 mmHg
✔✔Which finding indicates that re-hydration is complete and hypovolemic shock has
been successfully treated in a non-intubated patient? - ✔✔CVP = 8 mmHg
✔✔A patient in hypovolemic shock would be expected to have a high SVR because: -
✔✔They have released catecholamines, which stimulate the alpha receptors in blood
vessels, thereby "shrinking" the vessels to fit around the existing blood volume
✔✔The nurse is caring for a patient who was brought into the emergency department
after being struck by lightning. This patient's injuries will most likely be to which body
areas? - ✔✔Heart and bones
✔✔A nurse caring for a patient with a spinal cord injury experiencing hypotension and
bradycardia, will plan to administer all of the following collaborative interventions
EXCEPT: - ✔✔Apresoline
✔✔A patient rescued from a small house fire is brought to the emergency department.
There is no burn injury to the skin, however laboratory results show an elevated carbon
, monoxide (CO) level. Which intervention would the nurse expect to implement? -
✔✔Give 100% oxygen by mask
✔✔A patient is experiencing acute respiratory distress after eating an item of a known
food allergy. The nurse will implement all of the following interventions when providing
emergency care to this patient EXCEPT: - ✔✔Prepare to administer antithrombolytic
agents as prescribed
✔✔A patient with cardiomyopathy is demonstrating signs of cardiogenic shock. The
nurse realizes that this type of shock is due to: - ✔✔Reduced cardiac output
✔✔The nurse delegates care for a patient with leukemia to a licensed practical nurse
(LPN). Which instruction is the most important for the RN to provide to the LPN? -
✔✔Wash hands frequently
✔✔The nurse is evaluating a patient for the presence of systemic inflammatory
response syndrome (SIRS). Which assessment data indicates the presence of SIRS? -
✔✔Temperature 38.4 C, respiratory rate 23, pulse rate 98, and PaCO2 30
✔✔What intervention will the nurse implement to prevent injury in the patient with bone
cancer? - ✔✔Using a lift sheet when repositioning the patient
✔✔The nurse is preparing medications for a patient being treated for cardiogenic shock.
The nurse might administer all of the following medications EXCEPT: - ✔✔Epinephrine
✔✔A patient in ICU with a burn circling the left upper leg suddenly experiences
excruciating pain, pallor in the left lower extremity, and loss of left pedal pulse. The
nurse would immediately notify the physician because this patient might be developing:
- ✔✔Compartment syndrome
✔✔Steroids may be provided to a patient in septic shock. What would the nurse expect
when providing this medication? - ✔✔There is a risk of superinfection when steroids are
given
✔✔A patient is diagnosed with cardiac tamponade. When planning care, the nurse will
include interventions to address which type of shock? - ✔✔obstructive
✔✔An electrical worker comes in with significant 2nd and 3rd degree burns to his right
hand and wrist. He is unresponsive, so is unable to tell you what happened. Which is
the nurse's priority assessment? - ✔✔Assess his cardiac status
✔✔A patient, experiencing vasodilation, is diagnosed with distributive shock. The nurse
will assess the patient for all etiologies EXCEPT: - ✔✔hemorrhage
