MED SURGE II EXAM . QUESTIONS WITH CORRECT AND VERIFIED ANSWERS. A+ GRADE GUARANTEED.

MED SURGE II EXAM . QUESTIONS WITH CORRECT AND VERIFIED ANSWERS. A+ GRADE GUARANTEED. Question 1 2 out of 2 points Correct A nurse is caring for a 6-year-old client with cystic fibrosis. To enhance the child's nutritional status, which priority intervention should be included in the plan of care? Answers: A. Provision of five to six small meals per day rather than three larger meals CorrectB. Pancreatic enzyme supplementation with meals C. Magnesium, thiamine, and iron supplementation D. Total parenteral nutrition (TPN) Response Feedback: Rationale: Nearly 90% of clients with CF have pancreatic exocrine insufficiency and require oral pancreatic enzyme supplementation with meals. Frequent, small meals or TPN are not normally indicated. Vitamin supplements are required, but specific replacement of magnesium, thiamine, and iron is not typical. Question 2 2 out of 2 points Correct A client was fitted with an arm cast after fracturing the humerus. Twelve hours after the application of the cast, the client tells the nurse that the injured arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action? A. Petal the edges of the client's cast. B. Obtain a prescription for a different analgesic. C. Encourage the client to wiggle and move the fingers. CorrectD. Prepare the client for opening or bivalving of the cast. Response Feedback: Rationale: Acute compartment syndrome involves a sudden and severe decrease in blood flow to the tissues distal to an area of injury that results in ischemic necrosis if prompt, decisive intervention does not occur. Removing or bivalving the cast is necessary to relieve pressure. Prescribing different analgesics does not address the underlying problem. Encouraging the client to move the fingers or perform range-of-motion exercises will not treat or prevent compartment syndrome. Petaling the edges of a cast with tape prevents abrasions and skin breakdown, not compartment syndrome. Question 3 2 out of 2 points Correct Which of the following clients should the nurse recognize as being at the highest risk for the development of osteomyelitis? CorrectA. An older adult client with an infected pressure ulcer in the sacral area B. An infant diagnosed with jaundice C. A middle-aged adult who takes ibuprofen daily for rheumatoid arthritis D. A 17-year-old football player who had orthopedic surgery 6 weeks prior Response Feedback: Rationale: Clients who are at high risk of osteomyelitis include those who are poorly nourished, older adults, and clients who are obese. The older adult client with an infected sacral pressure ulcer is at the greatest risk for the development of osteomyelitis, as this client has two risk factors: age and the presence of a soft-tissue infection that has the potential to extend into the bone. The client with rheumatoid arthritis has one risk factor and the infant with jaundice has no identifiable risk factors. The client 6 weeks’ postsurgery is beyond the usual window of time for the development of a postoperative surgical wound infection. Question 4 0 out of 2 points Incorrect A client with a right tibial fracture is being discharged home after having a cast applied. What instruction should the nurse provide in relationship to the client's cast care? A. "Use a clean object to scratch itches inside the cast." CorrectB. "Keep your right leg elevated above heart level." C. "A foul smell from the cast is normal after the first few days." D. "Cover the cast with a blanket until the cast dries." Response Feedback: Rationale: The leg should be elevated to promote venous return and prevent edema. The cast shouldn't be covered while drying because this will cause heat buildup and prevent air circulation. No foreign object should be inserted inside the cast because of the risk of cutting the skin and causing an infection. A foul smell from a cast is never normal and may indicate an infection. Question 5 0 out of 2 points Incorrect A patient/client weighs 200 lb. Available is 25,000 units of heparin in 1000 mL of D5W. The physician orders to start the drip at 14 units/kg/hour. A. What is the concentration of the solution? units/mL B. What is the correct dose based on the patient’s weight? units/hour B. What is the correct IV rate in mL/hr? mL/hr Selected Answer: a) 25 units/ml b) 76440 units/hr c) 3058 ml/hr Correct Answer: Correct A. 25000 units/1000 mL = 25 units/mL B. 200 lb/2.2 = 90.9 kg 90.9 kg x 14 units/kg/hour = 1 272.6 units/hour C. 1272.6 units/hour divided by 25000 units x 1000 mL = 50.9 or 51 mL/hr Response Feedback: [None Given] Question 6 2 out of 2 points Correct When assessing for substances that are known to harm workers' lungs, the occupational health nurse should assess their potential exposure to which of the following? A. Gypsum B. Organic acids C. Solvents CorrectD. Asbestos