Med Surg Final Exam with answers
Which |are |probable |findings |in |a |person |with |an |acute |left |DVT: |(select |all |that |apply) |- |correct |
answer |-mild |to |moderate |calf |pain |and |tenderness |
pain |in |calf |on |dorsiflexion |of |foot |
unilateral |edema
A |patient |with |a |history |of |a |6cm |abdominal |aortic |aneurysm |is |admitted |to |the |emergency |
department |with |severe |back |pain |and |bilateral |flank |ecchymosis. |The |vital |signs |are |BP |86/58, |
pulse |138, |RR |34. |The |nurse |plans |interventions |for |the |patient |based |on |the |expectation |that |
treatment |will |include: |- |correct |answer |-immediate |surgery
A |69 |year |old |patient |is |admitted |to |the |hospital |for |elective |repair |of |an |abdominal |aortic |
aneurysm. |The |history |includes |hypertension |for |25 |years, |hyperlipidemia |for |15 |years |and |smoking
|for |50 |years. |The |patient |asks |the |nurse |what |caused |the |aneurysm. |The |nurse's |best |response |
includes |the |information |that: |- |correct |answer |-weakness |of |arterial |walls |eventually |results |in |an |
aneurysm
The |nurse |identifies |a |nursing |diagnosis |of |risk |for |altered |peripheral |tissue |perfusion |related |to |
bypass |graft |thrombosis(occlusion) |for |a |patient |following |an |abdominal |aneurysm |repair. |An |
appropriate |intervention |to |prevent |this |problem |in |the |immediate |post |operative |period |is |to: |- |
correct |answer |-Administer |IV |fluids |at |a |rate |to |keep |the |MAP |> |60 |and |arterial |BP |within |a |
normal |range
After |repair |of |an |abdominal |aortic |aneurysm, |the |nurse |notes |that |the |patient |does |not |have |
popliteal, |posterior |tibial, |or |dorsalis |pedis |pulses. |The |legs |are |cool |and |painful. |Which |action |is |
appropriate |for |the |nurse |to |take |first? |- |correct |answer |-notify |the |surgeon |and |anesthesiologist
When |the |nurse |is |caring |for |a |patient |on |the |first |post |operative |day |after |an |abdominal |aortic |
aneurysm |repair, |the |information |that |is |most |significant |when |the |nurse |is |assessing |for |the |return
|of |peristalsis |is: |- |correct |answer |-passing |of |flatus |and |hypoactive |bowel |sounds
A |72 |year |old |patient |is |hospitalized |for |an |aortic |dissection |of |the |abdominal |aorta |that |stabilizes |
with |treatment. |The |nurse |develops |a |teaching |plan |for |the |patient's |discharge |that |includes |
,information |about: |- |correct |answer |-the |use |of |antihypertensive |medications |to |lower |the |risk |of |
further |dissection |or |bleeding |from |the |high |blood |pressure
A |patient |recovering |on |a |general |surgical |unit |from |an |aortic |valve |replacement |one |week |ago |
developed |sudden |severe |pain |pulselessness, |pallor |and |coolness |in |the |left |leg. |The |nurse |should |
notify |the |healthcare |provider |and: |- |correct |answer |-Keep |the |patient |in |bed |with |leg |straight |and |
notify |the |physician.
During |an |assessment |of |a |63-year-old |patient |at |the |clinic, |the |patient |says |I |have |always |taken |an
|evening |walk |but |lately |my |leg |cramps |and |hurts |just |after |a |few |minutes |of |walking |the |pain |goes
|away |after |I |stop |walking |though. |The |nurse |should: |- |correct |answer |-Attempt |to |palpate |the |
dorsalis |pedis |and |posterior |tibial |pulses |indicating |intermittent |claudication.
The |nurse |perform |an |assessment |with |a |patient |who |has |chronic |peripheral |arterial |disease |of |the
|lights |would |expect |to |find: |- |correct |answer |-Prolonged |capillary |refill, |shiny, |taut |hairless |skin
A |patient |who |has |had |a |femoral |popliteal |bypass |graft |to |the |right |leg |is |being |cared |for |on |the |
surgical |unit. |Which |action |by |an |LPN/LVN |caring |for |the |patient |requires |the |RN |to |intervene? |- |
correct |answer |-The |LPN/LVN |has |the |patient |sit |in |the |bedside |chair |for |seven |hours.
The |healthcare |provider |orders |for |continuous |IV |heparin |infusion |for |a |patient |with |swelling |and |
pain |in |the |upper |leg |caused |by |a |DVT |while |the |patient |is |receiving |the |heparin |infusion |the |nurse
|should |- |correct |answer |-Monitor |daily |heparin |levels |or |PTT |once |patient |reaches |therapeutic |
levels
Patient |with |a |DVT |is |started |on |IV |heparin |and |oral |warfarin. |The |patient |asked |the |nurse |why |
two |medications |are |necessary. |The |nurses |best |response |to |the |patient |is: |- |correct |answer |-The |
heparin |will |work |immediately |but |the |warfarin |takes |several |days |to |have |an |effect |on |coagulation
A |42-year-old |service |counter |worker |undergoes |sclerotherapy |for |treatment |of |superficial |varicose |
vein's |in |the |outpatient |center. |Before |discharging |the |patient, |the |nurse |teaches |the |patient |that: |-
|correct |answer |-Compression |stockings |should |be |applied |before |getting |out |of |bed.
, A |patient |with |PAD |has |a |new |prescription |for |Plavix. |Which |information |should |the |nurse |include |
when |teaching |a |patient |about |this |medication? |- |correct |answer |-Call |if |you |notice |that |your |stools
|are |black |or |have |blood |in |them.
When |evaluating |the |discharge |teaching |for |a |patient |with |chronic |peripheral |artery |disease |the |
nurse |determines |the |need |for |further |instruction |when |the |patient |says |I |will... |- |correct |answer |-
Use |a |heating |pad |on |my |feet |at |night |to |increase |the |circulation |and |warmth |in |my |feet.
Which |assessment |finding |for |a |patient |who |has |been |omitted |with |the |right |calf |DVT |requires |
immediate |action |by |the |nurse: |- |correct |answer |-New |onset |shortness |of |breath
Which |action |for |the |nurse |delegate |to |unlicensed |assistive |personnel |who |are |providing |care |for |a |
patient |who |is |at |risk |for |DVT? |- |correct |answer |-Apply |sequential |compression |device |to |
unaffected |leg |whenever |the |patient |is |in |bed.
A |client |with |an |infusion |pump |has |an |order |for |3000 |mL |of |D5 |W |over |24 |hours. |What |rate |would |
you |set |the |infusion |pump |at |in |milliliters |per |hour |- |correct |answer |-125 |ml/hr
Following |orders |are |received |for |a |patient |who |has |just |been |admitted |with |probable |bacterial |
pneumonia |and |sepsis. |Which |one |will |the |nurse |accomplish |first |- |correct |answer |-Obtain |blood |
cultures
The |nurse |will |explain |to |a |client |that |the |most |helpful |test |and |the |evaluation |of |possible |
pulmonary |embolus |is: |- |correct |answer |-Spiral |CT
The |nurse |would |coach |the |asthmatic |client |in |pursed |lip |breathing |because |this |technique: |- |
correct |answer |-Increases |pressure |in |the |airway |allowing |for |longer |exhalation
Mr. |Allen |is |a |65-year-old |man |diagnosed |with |tuberculosis. |He |is |receiving |INH |to |treat |the |TB. |The
|nurse |would |also |expect |an |order |for: |- |correct |answer |-Pyridoxine |(B6)
Nurse |caring |for |a |client |who |recently |converted |from |negative |to |a |positive |tuberculin |skin |test, |
would |anticipate |as |part |of |a |prevention |program |a |prescription |for: |- |correct |answer |-INH
Which |are |probable |findings |in |a |person |with |an |acute |left |DVT: |(select |all |that |apply) |- |correct |
answer |-mild |to |moderate |calf |pain |and |tenderness |
pain |in |calf |on |dorsiflexion |of |foot |
unilateral |edema
A |patient |with |a |history |of |a |6cm |abdominal |aortic |aneurysm |is |admitted |to |the |emergency |
department |with |severe |back |pain |and |bilateral |flank |ecchymosis. |The |vital |signs |are |BP |86/58, |
pulse |138, |RR |34. |The |nurse |plans |interventions |for |the |patient |based |on |the |expectation |that |
treatment |will |include: |- |correct |answer |-immediate |surgery
A |69 |year |old |patient |is |admitted |to |the |hospital |for |elective |repair |of |an |abdominal |aortic |
aneurysm. |The |history |includes |hypertension |for |25 |years, |hyperlipidemia |for |15 |years |and |smoking
|for |50 |years. |The |patient |asks |the |nurse |what |caused |the |aneurysm. |The |nurse's |best |response |
includes |the |information |that: |- |correct |answer |-weakness |of |arterial |walls |eventually |results |in |an |
aneurysm
The |nurse |identifies |a |nursing |diagnosis |of |risk |for |altered |peripheral |tissue |perfusion |related |to |
bypass |graft |thrombosis(occlusion) |for |a |patient |following |an |abdominal |aneurysm |repair. |An |
appropriate |intervention |to |prevent |this |problem |in |the |immediate |post |operative |period |is |to: |- |
correct |answer |-Administer |IV |fluids |at |a |rate |to |keep |the |MAP |> |60 |and |arterial |BP |within |a |
normal |range
After |repair |of |an |abdominal |aortic |aneurysm, |the |nurse |notes |that |the |patient |does |not |have |
popliteal, |posterior |tibial, |or |dorsalis |pedis |pulses. |The |legs |are |cool |and |painful. |Which |action |is |
appropriate |for |the |nurse |to |take |first? |- |correct |answer |-notify |the |surgeon |and |anesthesiologist
When |the |nurse |is |caring |for |a |patient |on |the |first |post |operative |day |after |an |abdominal |aortic |
aneurysm |repair, |the |information |that |is |most |significant |when |the |nurse |is |assessing |for |the |return
|of |peristalsis |is: |- |correct |answer |-passing |of |flatus |and |hypoactive |bowel |sounds
A |72 |year |old |patient |is |hospitalized |for |an |aortic |dissection |of |the |abdominal |aorta |that |stabilizes |
with |treatment. |The |nurse |develops |a |teaching |plan |for |the |patient's |discharge |that |includes |
,information |about: |- |correct |answer |-the |use |of |antihypertensive |medications |to |lower |the |risk |of |
further |dissection |or |bleeding |from |the |high |blood |pressure
A |patient |recovering |on |a |general |surgical |unit |from |an |aortic |valve |replacement |one |week |ago |
developed |sudden |severe |pain |pulselessness, |pallor |and |coolness |in |the |left |leg. |The |nurse |should |
notify |the |healthcare |provider |and: |- |correct |answer |-Keep |the |patient |in |bed |with |leg |straight |and |
notify |the |physician.
During |an |assessment |of |a |63-year-old |patient |at |the |clinic, |the |patient |says |I |have |always |taken |an
|evening |walk |but |lately |my |leg |cramps |and |hurts |just |after |a |few |minutes |of |walking |the |pain |goes
|away |after |I |stop |walking |though. |The |nurse |should: |- |correct |answer |-Attempt |to |palpate |the |
dorsalis |pedis |and |posterior |tibial |pulses |indicating |intermittent |claudication.
The |nurse |perform |an |assessment |with |a |patient |who |has |chronic |peripheral |arterial |disease |of |the
|lights |would |expect |to |find: |- |correct |answer |-Prolonged |capillary |refill, |shiny, |taut |hairless |skin
A |patient |who |has |had |a |femoral |popliteal |bypass |graft |to |the |right |leg |is |being |cared |for |on |the |
surgical |unit. |Which |action |by |an |LPN/LVN |caring |for |the |patient |requires |the |RN |to |intervene? |- |
correct |answer |-The |LPN/LVN |has |the |patient |sit |in |the |bedside |chair |for |seven |hours.
The |healthcare |provider |orders |for |continuous |IV |heparin |infusion |for |a |patient |with |swelling |and |
pain |in |the |upper |leg |caused |by |a |DVT |while |the |patient |is |receiving |the |heparin |infusion |the |nurse
|should |- |correct |answer |-Monitor |daily |heparin |levels |or |PTT |once |patient |reaches |therapeutic |
levels
Patient |with |a |DVT |is |started |on |IV |heparin |and |oral |warfarin. |The |patient |asked |the |nurse |why |
two |medications |are |necessary. |The |nurses |best |response |to |the |patient |is: |- |correct |answer |-The |
heparin |will |work |immediately |but |the |warfarin |takes |several |days |to |have |an |effect |on |coagulation
A |42-year-old |service |counter |worker |undergoes |sclerotherapy |for |treatment |of |superficial |varicose |
vein's |in |the |outpatient |center. |Before |discharging |the |patient, |the |nurse |teaches |the |patient |that: |-
|correct |answer |-Compression |stockings |should |be |applied |before |getting |out |of |bed.
, A |patient |with |PAD |has |a |new |prescription |for |Plavix. |Which |information |should |the |nurse |include |
when |teaching |a |patient |about |this |medication? |- |correct |answer |-Call |if |you |notice |that |your |stools
|are |black |or |have |blood |in |them.
When |evaluating |the |discharge |teaching |for |a |patient |with |chronic |peripheral |artery |disease |the |
nurse |determines |the |need |for |further |instruction |when |the |patient |says |I |will... |- |correct |answer |-
Use |a |heating |pad |on |my |feet |at |night |to |increase |the |circulation |and |warmth |in |my |feet.
Which |assessment |finding |for |a |patient |who |has |been |omitted |with |the |right |calf |DVT |requires |
immediate |action |by |the |nurse: |- |correct |answer |-New |onset |shortness |of |breath
Which |action |for |the |nurse |delegate |to |unlicensed |assistive |personnel |who |are |providing |care |for |a |
patient |who |is |at |risk |for |DVT? |- |correct |answer |-Apply |sequential |compression |device |to |
unaffected |leg |whenever |the |patient |is |in |bed.
A |client |with |an |infusion |pump |has |an |order |for |3000 |mL |of |D5 |W |over |24 |hours. |What |rate |would |
you |set |the |infusion |pump |at |in |milliliters |per |hour |- |correct |answer |-125 |ml/hr
Following |orders |are |received |for |a |patient |who |has |just |been |admitted |with |probable |bacterial |
pneumonia |and |sepsis. |Which |one |will |the |nurse |accomplish |first |- |correct |answer |-Obtain |blood |
cultures
The |nurse |will |explain |to |a |client |that |the |most |helpful |test |and |the |evaluation |of |possible |
pulmonary |embolus |is: |- |correct |answer |-Spiral |CT
The |nurse |would |coach |the |asthmatic |client |in |pursed |lip |breathing |because |this |technique: |- |
correct |answer |-Increases |pressure |in |the |airway |allowing |for |longer |exhalation
Mr. |Allen |is |a |65-year-old |man |diagnosed |with |tuberculosis. |He |is |receiving |INH |to |treat |the |TB. |The
|nurse |would |also |expect |an |order |for: |- |correct |answer |-Pyridoxine |(B6)
Nurse |caring |for |a |client |who |recently |converted |from |negative |to |a |positive |tuberculin |skin |test, |
would |anticipate |as |part |of |a |prevention |program |a |prescription |for: |- |correct |answer |-INH
