MedSurg Exam 4 with answers
Which |information |about |an |80-year-old |man |at |the |senior |center |is |of |most |concern |to |the |nurse?
|- |correct |answer |-Unintended |weight |loss
A |62-year-old |man |reports |chronic |constipation. |To |promote |bowel |evacuation, |the |nurse |will |
suggest |that |the |patient |attempt |defecation. |- |correct |answer |-After |eating |breakfast
When |caring |for |a |patient |with |a |history |of |a |total |gastrectomy, |the |nurse |will |monitor |for |- |correct
|answer |-Cobalamin |(vitamin |B12) |deficiency
The |nurse |will |plan |to |monitor |a |patient |with |an |obstructed |common |bile |duct |for |- |correct |answer
|-Steatorrhea
The |nurse |receives |the |following |information |about |a |51-year-old |woman |who |is |scheduled |for |a |
colonoscopy. |Which |information |should |be |communicated |to |the |health |care |provider |before |
sending |the |patient |for |the |procedure? |- |correct |answer |-The |patient |refused |to |drink |the |ordered |
polyethylene |glycol |(GoLYTELY)
Which |statement |to |the |nurse |from |a |patient |with |jaundice |indicates |a |need |for |teaching? |- |correct
|answer |-I |use |acetaminophen |(Tylenol) |q4 |hr |for |back |pain
To |palpate |the |liver |during |a |head-to-toe |physical |assessment, |the |nurse |- |correct |answer |-Places |
one |hand |on |the |patient's |back |and |presses |upward |and |inward |with |the |other |hand |below |the |
patient's |right |costal |margin
Which |finding |by |the |nurse |during |abdominal |auscultation |indicates |a |need |for |a |focused |
abdominal |assessment? |- |correct |answer |-Absent |bowel |sounds
After |assisting |with |a |needle |biopsy |of |the |liver |at |a |patient's |bedside, |the |nurse |should |- |correct |
answer |-Place |the |patient |on |the |right |side |with |the |bed |flat
,A |42-year-old |woman |is |admitted |to |the |outpatient |testing |area |for |an |ultrasound |of |the |
gallbladder. |Which |information |obtained |by |the |nurse |indicates |that |the |ultrasound |may |need |to |
be |rescheduled? |- |correct |answer |-The |patient |ate |a |low-fat |bagel |4 |hours |ago |for |breakfast
The |nurse |is |assessing |an |alert |and |independent |78-year-old |woman |for |malnutrition |risk. |The |most
|appropriate |initial |questions |is |which |of |the |following? |- |correct |answer |-Can |you |tell |me |the |food |
you |ate |yesterday?
A |54-year-old |man |has |just |arrived |in |the |recovery |area |after |an |upper |endoscopy. |Which |
information |collected |by |the |nurse |is |most |important |to |communicate |to |the |health |care |provider?
|- |correct |answer |-The |oral |temperature |is |101.6˚F
A |30-year-old |man |is |being |admitted |to |the |hospital |for |elective |knee |surgery. |Which |assessment |
finding |is |most |important |to |report |to |the |health |care |provider? |- |correct |answer |-Liver |edge |3cm |
below |the |costal |margin
A |58-year-old |woman |has |just |returned |to |the |nursing |unit |after |an |EGD. |Which |action |by |
unlicensed |assistive |personnel |(UAP) |requires |that |the |RN |intervene? |- |correct |answer |-Offering |the
|patient |a |drink |of |water
A |patient |is |being |scheduled |for |ERCP |as |soon |as |possible. |Which |actions |from |the |agency |policy |
for |ERCP |should |the |nurse |take |first? |- |correct |answer |-Place |the |patient |on |NPO |status
While |interviewing |a |30-year-old |man, |the |nurse |learns |that |the |patient |has |a |family |history |of |
familial |adenomatous |polyposis |(FAP). |The |nurse |will |plan |to |assess |the |patient's |knowledge |about
|- |correct |answer |-Risk |for |developing |colorectal |cancer
Which |finding |for |a |19-year-old |female |who |is |a |vegan |may |indicate |the |need |for |cobalamin |
supplementation? |- |correct |answer |-Paresthesias
A |76-year-old |woman |with |a |BMI |of |17 |and |a |low |serum |albumin |level |is |being |admitted |by |the |
nurse. |Which |assessment |finding |will |the |nurse |expect |to |find? |- |correct |answer |-Pitting |edema
,Which |menu |choice |indicates |that |the |patient |is |implementing |plans |to |choose |high-calorie, |high-
protein |foods? |- |correct |answer |-Fried |chicken |with |potatoes |and |gravy
A |48-year-old |woman |has |a |BMI |of |31, |a |normal |C-reactive |protein |level, |and |how |serum |
transferrin |and |albumin |levels. |The |nurse |will |plan |patient |teaching |to |increase |the |patient's |intake |
of |foods |that |are |high |in |- |correct |answer |-Protein
A |48-year-old |man |who |has |just |been |started |on |tube |feedings |of |full-strength |formula |at |100 |
mL/hr |has |6 |diarrhea |stools |the |first |day. |Which |action |should |the |nurse |plan |to |take? |- |correct |
answer |-Slow |the |infusion |rate |of |the |tube |feeding
A |20-year-old |man |with |extensive |facial |injuries |from |a |motor |vehicle |crash |is |receiving |tube |
feedings |through |a |percutaneous |endoscopic |gastrostomy |(PEG). |Which |action |will |the |nurse |
include |in |the |plan |of |care? |- |correct |answer |-Check |the |gastric |residual |volume |q4-6hr
A |malnourished |patient |is |receiving |a |parenteral |nutrition |infusion |containing |amino |acids |and |
dextrose |from |a |bag |that |was |hung |24 |hr |ago. |The |nurse |observes |that |about |50mL |remain |in |the |
PN |container. |Which |action |is |best |for |the |nurse |to |take? |- |correct |answer |-Add |a |new |container |of
|PN |using |the |current |tubing |and |filter
A |patient's |capillary |blood |glucose |level |is |120 |mg/dL |6hr |after |the |nurse |initiated |a |parenteral |
nutrition |infusion. |The |most |appropriate |action |by |the |nurse |is |to |- |correct |answer |-Recheck |the |
capillary |blood |glucose |in |4-6hr
After |abdominal |surgery, |a |patient |with |protein |calorie |malnutrition |is |receiving |parenteral |
nutrition. |Which |is |the |best |indicator |that |the |patient |is |receiving |adequate |nutrition? |- |correct |
answer |-Surgical |incision |is |healing |normally
A |60-year-old |man |who |is |hospitalized |with |an |abdominal |wound |infection |has |only |been |eating |
about |50% |of |meals |and |states, |"Nothing |on |the |menu |sounds |good." |Which |action |by |the |nurse |
will |be |most |effective |in |improving |the |patient's |oral |intake? |- |correct |answer |-Have |family |
members |bring |in |favorite |foods
When |caring |for |a |63-year-old |woman |with |a |soft, |silicone |nasogastric |tube |in |place |for |enteral |
feedings, |the |nurse |will |- |correct |answer |-Flush |the |tubing |after |checking |for |residual |volumes
, A |patient |is |receiving |continuous |enteral |nutrition |through |a |small-bore |silicone |feeding |tube. |What
|should |the |nurse |plan |for |when |this |patient |has |a |CT |scan |ordered? |- |correct |answer |-Shut |the |
feeding |off |30-60 |minutes |before |the |scan
A |healthy |28-year-old |woman |patient |who |weighs |145 |lb |asks |the |nurse |about |the |minimum |daily |
requirement |for |protein. |How |many |grams |of |protein |will |the |nurse |recommend? |- |correct |answer |-
53 |g
A |20-year-old |female |is |being |admitted |for |electrolyte |disorders |of |unknown |etiology. |Which |
assessment |finding |is |most |important |to |report |to |the |health |care |provider? |- |correct |answer |-The |
patient's |serum |potassium |level |is |2.9 |mEq/L
Which |action |for |a |patient |receiving |tube |feedings |through |PEG |may |be |delegated |to |a |licensed |
practical/vocational |nurse? |- |correct |answer |-Providing |skin |care |to |the |area |around |the |tube |site
Which |action |should |the |nurse |take |first |when |preparing |to |teach |a |frail |79-year-old |Hispanic |man |
who |lives |with |an |adult |daughter |about |ways |to |improve |nutrition? |- |correct |answer |-Determine |
who |shops |for |groceries |and |prepares |meals
After |a |change-of-shift |report, |which |patient |will |the |nurse |assess |first? |- |correct |answer |-A |40-
year-old |man |with |continuous |enteral |feedings |who |has |developed |pulmonary |crackles
A |patient |hospitalized |with |chronic |heart |failure |eats |only |about |50% |of |each |meal |and |reports |
feeling |too |tired |to |eat. |Which |action |should |the |nurse |take |first? |- |correct |answer |-Serve |multiple |
feedings |of |high-calorie, |high-protein |foods
A |patient's |peripheral |parenteral |nutrition |bag |is |nearly |empty |and |a |new |PN |bag |has |not |arrived |
yet |from |the |pharmacy. |Which |intervention |is |the |priority? |- |correct |answer |-Infuse |5% |dextrose |in |
water |until |the |new |PN |bag |is |delivered |from |the |pharmacy
A |19-year-old |female |admitted |with |anorexia |nervosa |is |5ft |6in |tall |and |weighs |88lb. |laboratory |
tests |reveal |hypokalemia |and |iron-deficiency |anemia. |Which |nursing |diagnosis |has |the |highest |
priority? |- |correct |answer |-Risk |for |electrolyte |imbalance |r/t |eating |patterns
Which |information |about |an |80-year-old |man |at |the |senior |center |is |of |most |concern |to |the |nurse?
|- |correct |answer |-Unintended |weight |loss
A |62-year-old |man |reports |chronic |constipation. |To |promote |bowel |evacuation, |the |nurse |will |
suggest |that |the |patient |attempt |defecation. |- |correct |answer |-After |eating |breakfast
When |caring |for |a |patient |with |a |history |of |a |total |gastrectomy, |the |nurse |will |monitor |for |- |correct
|answer |-Cobalamin |(vitamin |B12) |deficiency
The |nurse |will |plan |to |monitor |a |patient |with |an |obstructed |common |bile |duct |for |- |correct |answer
|-Steatorrhea
The |nurse |receives |the |following |information |about |a |51-year-old |woman |who |is |scheduled |for |a |
colonoscopy. |Which |information |should |be |communicated |to |the |health |care |provider |before |
sending |the |patient |for |the |procedure? |- |correct |answer |-The |patient |refused |to |drink |the |ordered |
polyethylene |glycol |(GoLYTELY)
Which |statement |to |the |nurse |from |a |patient |with |jaundice |indicates |a |need |for |teaching? |- |correct
|answer |-I |use |acetaminophen |(Tylenol) |q4 |hr |for |back |pain
To |palpate |the |liver |during |a |head-to-toe |physical |assessment, |the |nurse |- |correct |answer |-Places |
one |hand |on |the |patient's |back |and |presses |upward |and |inward |with |the |other |hand |below |the |
patient's |right |costal |margin
Which |finding |by |the |nurse |during |abdominal |auscultation |indicates |a |need |for |a |focused |
abdominal |assessment? |- |correct |answer |-Absent |bowel |sounds
After |assisting |with |a |needle |biopsy |of |the |liver |at |a |patient's |bedside, |the |nurse |should |- |correct |
answer |-Place |the |patient |on |the |right |side |with |the |bed |flat
,A |42-year-old |woman |is |admitted |to |the |outpatient |testing |area |for |an |ultrasound |of |the |
gallbladder. |Which |information |obtained |by |the |nurse |indicates |that |the |ultrasound |may |need |to |
be |rescheduled? |- |correct |answer |-The |patient |ate |a |low-fat |bagel |4 |hours |ago |for |breakfast
The |nurse |is |assessing |an |alert |and |independent |78-year-old |woman |for |malnutrition |risk. |The |most
|appropriate |initial |questions |is |which |of |the |following? |- |correct |answer |-Can |you |tell |me |the |food |
you |ate |yesterday?
A |54-year-old |man |has |just |arrived |in |the |recovery |area |after |an |upper |endoscopy. |Which |
information |collected |by |the |nurse |is |most |important |to |communicate |to |the |health |care |provider?
|- |correct |answer |-The |oral |temperature |is |101.6˚F
A |30-year-old |man |is |being |admitted |to |the |hospital |for |elective |knee |surgery. |Which |assessment |
finding |is |most |important |to |report |to |the |health |care |provider? |- |correct |answer |-Liver |edge |3cm |
below |the |costal |margin
A |58-year-old |woman |has |just |returned |to |the |nursing |unit |after |an |EGD. |Which |action |by |
unlicensed |assistive |personnel |(UAP) |requires |that |the |RN |intervene? |- |correct |answer |-Offering |the
|patient |a |drink |of |water
A |patient |is |being |scheduled |for |ERCP |as |soon |as |possible. |Which |actions |from |the |agency |policy |
for |ERCP |should |the |nurse |take |first? |- |correct |answer |-Place |the |patient |on |NPO |status
While |interviewing |a |30-year-old |man, |the |nurse |learns |that |the |patient |has |a |family |history |of |
familial |adenomatous |polyposis |(FAP). |The |nurse |will |plan |to |assess |the |patient's |knowledge |about
|- |correct |answer |-Risk |for |developing |colorectal |cancer
Which |finding |for |a |19-year-old |female |who |is |a |vegan |may |indicate |the |need |for |cobalamin |
supplementation? |- |correct |answer |-Paresthesias
A |76-year-old |woman |with |a |BMI |of |17 |and |a |low |serum |albumin |level |is |being |admitted |by |the |
nurse. |Which |assessment |finding |will |the |nurse |expect |to |find? |- |correct |answer |-Pitting |edema
,Which |menu |choice |indicates |that |the |patient |is |implementing |plans |to |choose |high-calorie, |high-
protein |foods? |- |correct |answer |-Fried |chicken |with |potatoes |and |gravy
A |48-year-old |woman |has |a |BMI |of |31, |a |normal |C-reactive |protein |level, |and |how |serum |
transferrin |and |albumin |levels. |The |nurse |will |plan |patient |teaching |to |increase |the |patient's |intake |
of |foods |that |are |high |in |- |correct |answer |-Protein
A |48-year-old |man |who |has |just |been |started |on |tube |feedings |of |full-strength |formula |at |100 |
mL/hr |has |6 |diarrhea |stools |the |first |day. |Which |action |should |the |nurse |plan |to |take? |- |correct |
answer |-Slow |the |infusion |rate |of |the |tube |feeding
A |20-year-old |man |with |extensive |facial |injuries |from |a |motor |vehicle |crash |is |receiving |tube |
feedings |through |a |percutaneous |endoscopic |gastrostomy |(PEG). |Which |action |will |the |nurse |
include |in |the |plan |of |care? |- |correct |answer |-Check |the |gastric |residual |volume |q4-6hr
A |malnourished |patient |is |receiving |a |parenteral |nutrition |infusion |containing |amino |acids |and |
dextrose |from |a |bag |that |was |hung |24 |hr |ago. |The |nurse |observes |that |about |50mL |remain |in |the |
PN |container. |Which |action |is |best |for |the |nurse |to |take? |- |correct |answer |-Add |a |new |container |of
|PN |using |the |current |tubing |and |filter
A |patient's |capillary |blood |glucose |level |is |120 |mg/dL |6hr |after |the |nurse |initiated |a |parenteral |
nutrition |infusion. |The |most |appropriate |action |by |the |nurse |is |to |- |correct |answer |-Recheck |the |
capillary |blood |glucose |in |4-6hr
After |abdominal |surgery, |a |patient |with |protein |calorie |malnutrition |is |receiving |parenteral |
nutrition. |Which |is |the |best |indicator |that |the |patient |is |receiving |adequate |nutrition? |- |correct |
answer |-Surgical |incision |is |healing |normally
A |60-year-old |man |who |is |hospitalized |with |an |abdominal |wound |infection |has |only |been |eating |
about |50% |of |meals |and |states, |"Nothing |on |the |menu |sounds |good." |Which |action |by |the |nurse |
will |be |most |effective |in |improving |the |patient's |oral |intake? |- |correct |answer |-Have |family |
members |bring |in |favorite |foods
When |caring |for |a |63-year-old |woman |with |a |soft, |silicone |nasogastric |tube |in |place |for |enteral |
feedings, |the |nurse |will |- |correct |answer |-Flush |the |tubing |after |checking |for |residual |volumes
, A |patient |is |receiving |continuous |enteral |nutrition |through |a |small-bore |silicone |feeding |tube. |What
|should |the |nurse |plan |for |when |this |patient |has |a |CT |scan |ordered? |- |correct |answer |-Shut |the |
feeding |off |30-60 |minutes |before |the |scan
A |healthy |28-year-old |woman |patient |who |weighs |145 |lb |asks |the |nurse |about |the |minimum |daily |
requirement |for |protein. |How |many |grams |of |protein |will |the |nurse |recommend? |- |correct |answer |-
53 |g
A |20-year-old |female |is |being |admitted |for |electrolyte |disorders |of |unknown |etiology. |Which |
assessment |finding |is |most |important |to |report |to |the |health |care |provider? |- |correct |answer |-The |
patient's |serum |potassium |level |is |2.9 |mEq/L
Which |action |for |a |patient |receiving |tube |feedings |through |PEG |may |be |delegated |to |a |licensed |
practical/vocational |nurse? |- |correct |answer |-Providing |skin |care |to |the |area |around |the |tube |site
Which |action |should |the |nurse |take |first |when |preparing |to |teach |a |frail |79-year-old |Hispanic |man |
who |lives |with |an |adult |daughter |about |ways |to |improve |nutrition? |- |correct |answer |-Determine |
who |shops |for |groceries |and |prepares |meals
After |a |change-of-shift |report, |which |patient |will |the |nurse |assess |first? |- |correct |answer |-A |40-
year-old |man |with |continuous |enteral |feedings |who |has |developed |pulmonary |crackles
A |patient |hospitalized |with |chronic |heart |failure |eats |only |about |50% |of |each |meal |and |reports |
feeling |too |tired |to |eat. |Which |action |should |the |nurse |take |first? |- |correct |answer |-Serve |multiple |
feedings |of |high-calorie, |high-protein |foods
A |patient's |peripheral |parenteral |nutrition |bag |is |nearly |empty |and |a |new |PN |bag |has |not |arrived |
yet |from |the |pharmacy. |Which |intervention |is |the |priority? |- |correct |answer |-Infuse |5% |dextrose |in |
water |until |the |new |PN |bag |is |delivered |from |the |pharmacy
A |19-year-old |female |admitted |with |anorexia |nervosa |is |5ft |6in |tall |and |weighs |88lb. |laboratory |
tests |reveal |hypokalemia |and |iron-deficiency |anemia. |Which |nursing |diagnosis |has |the |highest |
priority? |- |correct |answer |-Risk |for |electrolyte |imbalance |r/t |eating |patterns
