DAVIS ADVANTAGE FOR MEDICAL
SURGICAL NURSING EXAM WITH
VERIFIED SOLUTIONS AND
RATIONALES
The nurse is caring for a client with Crohn's disease and colonic strictures. Which assessment
finding requires the nurse to consult the health care provider immediately?
A) Traces of blood in the stool
B) Distended abdomen
C) Temperature of 100.0° F (37.8° C)
D) Crampy lower abdominal pain ✔️✔️B
The presence of strictures predisposes the client to intestinal obstruction. Abdominal distention
may indicate that the client has developed an obstruction of the large bowel, and the client's
provider should be notified right away. Low-grade fever, bloody diarrhea, and crampy
abdominal pain are common symptoms of Crohn's disease.
What is my favorite football team?
A) I hate football!!
B) the Fightin' Irish
C) GO BUCKS!!!!
,D) that team up north ✔️✔️C
Seriously, if you don't know the instructor's favorite football by this time, you need to listen to
your recordings from the first lecture. Just sayin'
The nurse is caring for a client who is receiving heparin therapy for a venous thromboembolism
(VTE). The client's activated partial thromboplastin time (aPTT) before heparin therapy was 30
seconds. Which aPTT result indicates that anticoagulation is adequate at this time?
A) 30 seconds
B) 150 seconds
C) 60 seconds
D) 15 seconds ✔️✔️C
Therapeutic aPTT values for clients receiving heparin should range from 1.5 to 2.5 times the
control value.
The nurse is caring for a patient who is being discharged home after a splenectomy. What
information on immune function needs to be included in this patient's discharge planning?
A) Limiting contact with the general population
B) The importance of wearing a face mask in public
C) The mechanisms of the inflammatory response
,D) Basic infection control techniques ✔️✔️D
The spleen is one of the major organs of the immune system. Without the spleen, the patient is at
higher risk for infection; so, the nurse must be sure that the patient understands basic principles
of infection control. The patient with a splenectomy does not need to understand the mechanisms
of inflammatory response. The patient with a splenectomy does not need to wear a face mask in
public as long as the patient understands and maintains the basic principles of infection control.
The patient who has had a splenectomy does not need to limit contact with the general
population as long as the patient understands and maintains the basic principles of infection
control.
A client is admitted with infection and a high fever. Which assessments by the nurse take
priority? (Select all that apply.)
A) Skin turgor
B) Pulse quality
C) Blood pressure
D) Bowel sounds
E) Respiratory effort
F) Mental status ✔️✔️A, B, C, F
Dehydration can accompany fever, especially if the client is sweating profusely. Blood pressure,
pulse quality, and skin turgor are assessments of fluid status. Mental status changes can
accompany fluid losses, especially in older clients.
, The health care provider has prescribed a client sodium warfarin (Coumadin) while he is still
receiving intravenous heparin. Which is the nurse's best action?
A) Turn off the heparin before administering the warfarin.
B) Clarify the warfarin order with the nursing supervisor.
C) Administer both heparin and warfarin as prescribed.
D) Hold the warfarin dose until the heparin is discontinued. ✔️✔️C
Although both heparin and warfarin are anticoagulants, they have different mechanisms of action
and onsets of action. Because warfarin has such a slow onset, it must be started while the client is
still receiving heparin. Once the warfarin is therapeutic, as evidenced by the international
normalized ratio (INR), the client's heparin can be safely discontinued. Effects of heparin will be
cleared from the client's bloodstream within a few hours.
Individuals of low socioeconomic status are at an increased risk for infection because of which
of the following? (Select all that apply.)
A) High cost of medications
B) Inadequate nutrition
C) Easy access to health screenings
D) Uninsured or underinsured status ✔️✔️A, B, D
SURGICAL NURSING EXAM WITH
VERIFIED SOLUTIONS AND
RATIONALES
The nurse is caring for a client with Crohn's disease and colonic strictures. Which assessment
finding requires the nurse to consult the health care provider immediately?
A) Traces of blood in the stool
B) Distended abdomen
C) Temperature of 100.0° F (37.8° C)
D) Crampy lower abdominal pain ✔️✔️B
The presence of strictures predisposes the client to intestinal obstruction. Abdominal distention
may indicate that the client has developed an obstruction of the large bowel, and the client's
provider should be notified right away. Low-grade fever, bloody diarrhea, and crampy
abdominal pain are common symptoms of Crohn's disease.
What is my favorite football team?
A) I hate football!!
B) the Fightin' Irish
C) GO BUCKS!!!!
,D) that team up north ✔️✔️C
Seriously, if you don't know the instructor's favorite football by this time, you need to listen to
your recordings from the first lecture. Just sayin'
The nurse is caring for a client who is receiving heparin therapy for a venous thromboembolism
(VTE). The client's activated partial thromboplastin time (aPTT) before heparin therapy was 30
seconds. Which aPTT result indicates that anticoagulation is adequate at this time?
A) 30 seconds
B) 150 seconds
C) 60 seconds
D) 15 seconds ✔️✔️C
Therapeutic aPTT values for clients receiving heparin should range from 1.5 to 2.5 times the
control value.
The nurse is caring for a patient who is being discharged home after a splenectomy. What
information on immune function needs to be included in this patient's discharge planning?
A) Limiting contact with the general population
B) The importance of wearing a face mask in public
C) The mechanisms of the inflammatory response
,D) Basic infection control techniques ✔️✔️D
The spleen is one of the major organs of the immune system. Without the spleen, the patient is at
higher risk for infection; so, the nurse must be sure that the patient understands basic principles
of infection control. The patient with a splenectomy does not need to understand the mechanisms
of inflammatory response. The patient with a splenectomy does not need to wear a face mask in
public as long as the patient understands and maintains the basic principles of infection control.
The patient who has had a splenectomy does not need to limit contact with the general
population as long as the patient understands and maintains the basic principles of infection
control.
A client is admitted with infection and a high fever. Which assessments by the nurse take
priority? (Select all that apply.)
A) Skin turgor
B) Pulse quality
C) Blood pressure
D) Bowel sounds
E) Respiratory effort
F) Mental status ✔️✔️A, B, C, F
Dehydration can accompany fever, especially if the client is sweating profusely. Blood pressure,
pulse quality, and skin turgor are assessments of fluid status. Mental status changes can
accompany fluid losses, especially in older clients.
, The health care provider has prescribed a client sodium warfarin (Coumadin) while he is still
receiving intravenous heparin. Which is the nurse's best action?
A) Turn off the heparin before administering the warfarin.
B) Clarify the warfarin order with the nursing supervisor.
C) Administer both heparin and warfarin as prescribed.
D) Hold the warfarin dose until the heparin is discontinued. ✔️✔️C
Although both heparin and warfarin are anticoagulants, they have different mechanisms of action
and onsets of action. Because warfarin has such a slow onset, it must be started while the client is
still receiving heparin. Once the warfarin is therapeutic, as evidenced by the international
normalized ratio (INR), the client's heparin can be safely discontinued. Effects of heparin will be
cleared from the client's bloodstream within a few hours.
Individuals of low socioeconomic status are at an increased risk for infection because of which
of the following? (Select all that apply.)
A) High cost of medications
B) Inadequate nutrition
C) Easy access to health screenings
D) Uninsured or underinsured status ✔️✔️A, B, D
