Brunner & Suddarth's Textbook of
Medical-Surgical Nursing Exam
Expected questions and Answers.
Client has 3 in (7.6 cm) right lower abdominal incision. Proximal 2 in (5 cm) of incision
edges are red and well-approximated. Distal portion of incision has separated and has
yellow drainage on dressing. Bulb drain has serosanguinous drainage and clumps of
yellow pus. Oxygen saturation on room air 97%. Blood pressure, 112/60 mm Hg; heart
rate, 102 beats/min; respiratory rate, 22 breaths/min; temperature, 101.2F (38.4C)
orally. Denies chills. Bowel sounds hypoactive in all 4 quadrants. Client reports passing
flatus, no Abdomen firm and slightly distended bowel movement. Lungs clear to
auscultation bilaterally. Client reports incisional pain level of 3/10 red blood cell count
4.2 million/mcl, thirty (30) minutes following oxycodone 5 mg orally. Reports an
increased, but tolerabl - ANSWER--has separated and has yellow drainage on dressing
-clumps of yellow pus
-102 beats/min; respiratory rate, 22 breaths/min; temperature, 101.2°F
(38.4°C) orally
-White blood count 12.9 x 103 cells/mm3 (12.9 x 109 /l)
-blood glucose level 130 mg/dl (7.21 mmol/l).
The nurse monitors a client for side effects associated with furosemide, which is newly
prescribed for the treatment of heart failure.
Due to the client's high risk for developing _________ as a result of the prescribed
medication, the nurse focuses on monitoring the client for __________. - ANSWER-Due
to the client's high risk for developing hypokalemia as a result of the prescribed
medication, the nurse focuses on monitoring the client for ventricular arrhythmia.
A client has been admitted to the hospital with a large sacral pressure ulcer. The
physician prescribes the wound care protocol to be performed twice a day. What would
be a statement on the plan of care that would address the implementation phase of the
nursing process for this client? - ANSWER-Turn the client every 2 hours.
The basic difference between nursing diagnoses and collaborative problems -
ANSWER-Nurses manage collaborative problems using physician-prescribed
interventions.
Nursing diagnoses can be managed by independent nursing interventions.
A nurse saw a coworker steal drugs from a locked cabinet. The supervisor notices the
missing drugs and has a good idea who is responsible for the theft. The supervisor asks
if the nurse saw anything out of the ordinary. Which professional value reflects a nurse's
duty to tell the truth? - ANSWER-Veracity
,Veracity is the nurse's duty to tell the truth in all professional situations.
A nurse is working in a rural nurse-managed agency that provides immunizations,
health assessments, and screening services. The nurse is most likely working in which
of the following? - ANSWER-Community nursing center
Which is a primary task of nursing research? - ANSWER-Contributing to the scientific
base of nursing practice
A student nurse has been assigned to provide basic care for a 58-year-old man with a
diagnosis of AIDS-related pneumonia. The student tells the instructor that she is
unwilling to care for this client. What key component of critical thinking is most likely
missing from this student's practice? - ANSWER-Withholding judgment
A nurse in a hospice facility cares for clients with terminal illnesses and witnesses a
great deal of pain and emotional distress. Which factor that affects healthcare ethics
determines how the nurse must respond when a client asks for help in ending his or her
suffering? - ANSWER-Legislative and judicial decisions
The nurse is caring for a client who is withdrawing from heavy alcohol use and who is
consequently combative and confused, despite the administration of benzodiazepines.
The client has a fractured hip that he suffered in a traumatic accident and is trying to get
out of bed. What is the most appropriate action for the nurse to take? - ANSWER-
Obtain a physician's order to restrain the client.
Who should be involved in establishing specific and realistic outcomes, so the client
does not become frustrated in trying to achieve them? - ANSWER-The client and family
Which of the following patient age groups is currently one of the fastest growing age
groups in the population? - ANSWER-Adults 65 years of age and over
The nurse monitors a male client for symptoms of urethral strictures following a
transurethral resection of the prostate (TURP) for the treatment of prostate cancer.
Client symptoms indicative of this complication that the nurse monitors for following a
TURP include _________, __________, and _______________. - ANSWER-Client
symptoms indicative of this complication that the nurse monitors for following a TURP
include straining, dysuria, and a weak urinary stream.
The nurse on a telemetry unit is caring for a 54-year-old male client, admitted with chest
pain, who has an arteriovenous (AV) fistula in the left arm for hemodialysis secondary to
chronic kidney disease.
Specify if the intervention is indicated or contraindicated for this client.
-Take blood pressure readings in the left arm.
, -Auscultate for a bruit over AV fistula every 8 hours.
-Assess for redness, swelling, and drainage at AV fistula site.
-Use AV fistula site to draw blood.
-Palpate for a thrill over the AV fistula every 8 hours.
-Wrap the AV fistula site in the left arm with a compression dressing. - ANSWER-
Indicated
-Auscultate for a bruit over AV fistula every 8 hours.
-Assess for redness, swelling, and drainage at AV fistula site.
-Palpate for a thrill over the AV fistula every 8 hours.
Contraindicated
-Take blood pressure readings in the left arm.
-Use AV fistula site to draw blood.
-Wrap the AV fistula site in the left arm with a compression dressing.
The nurse is providing education to a 65-year-old female client with pneumococcal
pneumonia being discharged from the health clinic on oral antibiotics. The client is a
nonsmoker, takes levothyroxine for Hashimoto disease, and is otherwise in good health.
The nurse in the oncology clinic is caring for a 42-year-old female client receiving
chemotherapy with fludarabine for acute myeloid leukemia who has developed
petechiae, epistaxis, and ecchymosis.
client has developed ______________ that the laboratory results will reveal
__________ - ANSWER-client has developed hemorrhage that the laboratory results
will reveal thrombocytopenia.
The nurse provides care for a client, with a history of atherosclerosis, who is
hospitalized for the initiation of pharmacotherapy for the treatment of hypothyroidism.
The client is at highest risk for developing _______________ as evidenced by
_______________. - ANSWER-The client is at highest risk for developing cardiac
dysfunction as evidenced by angina.
The nurse is caring for a 24-year-old female client with a right tibial fracture treated with
a cast 2 hours ago. The client now reports unrelenting pain, rated as 7/10, despite
taking oxycodone, and decreased sensation in the right foot. A nursing assessment
reveals the right foot is cooler and paler than the left foot, with delayed capillary refill
and a weak pulse.
Based on the nursing assessment, the priority action the nurse should take is to
_________________________ and prepare the client for _________________. -
ANSWER-Based on the nursing assessment, the priority action the nurse should take is
to notify the orthopedic health care provider immediately and prepare the client for
bivalving of the cast.
Medical-Surgical Nursing Exam
Expected questions and Answers.
Client has 3 in (7.6 cm) right lower abdominal incision. Proximal 2 in (5 cm) of incision
edges are red and well-approximated. Distal portion of incision has separated and has
yellow drainage on dressing. Bulb drain has serosanguinous drainage and clumps of
yellow pus. Oxygen saturation on room air 97%. Blood pressure, 112/60 mm Hg; heart
rate, 102 beats/min; respiratory rate, 22 breaths/min; temperature, 101.2F (38.4C)
orally. Denies chills. Bowel sounds hypoactive in all 4 quadrants. Client reports passing
flatus, no Abdomen firm and slightly distended bowel movement. Lungs clear to
auscultation bilaterally. Client reports incisional pain level of 3/10 red blood cell count
4.2 million/mcl, thirty (30) minutes following oxycodone 5 mg orally. Reports an
increased, but tolerabl - ANSWER--has separated and has yellow drainage on dressing
-clumps of yellow pus
-102 beats/min; respiratory rate, 22 breaths/min; temperature, 101.2°F
(38.4°C) orally
-White blood count 12.9 x 103 cells/mm3 (12.9 x 109 /l)
-blood glucose level 130 mg/dl (7.21 mmol/l).
The nurse monitors a client for side effects associated with furosemide, which is newly
prescribed for the treatment of heart failure.
Due to the client's high risk for developing _________ as a result of the prescribed
medication, the nurse focuses on monitoring the client for __________. - ANSWER-Due
to the client's high risk for developing hypokalemia as a result of the prescribed
medication, the nurse focuses on monitoring the client for ventricular arrhythmia.
A client has been admitted to the hospital with a large sacral pressure ulcer. The
physician prescribes the wound care protocol to be performed twice a day. What would
be a statement on the plan of care that would address the implementation phase of the
nursing process for this client? - ANSWER-Turn the client every 2 hours.
The basic difference between nursing diagnoses and collaborative problems -
ANSWER-Nurses manage collaborative problems using physician-prescribed
interventions.
Nursing diagnoses can be managed by independent nursing interventions.
A nurse saw a coworker steal drugs from a locked cabinet. The supervisor notices the
missing drugs and has a good idea who is responsible for the theft. The supervisor asks
if the nurse saw anything out of the ordinary. Which professional value reflects a nurse's
duty to tell the truth? - ANSWER-Veracity
,Veracity is the nurse's duty to tell the truth in all professional situations.
A nurse is working in a rural nurse-managed agency that provides immunizations,
health assessments, and screening services. The nurse is most likely working in which
of the following? - ANSWER-Community nursing center
Which is a primary task of nursing research? - ANSWER-Contributing to the scientific
base of nursing practice
A student nurse has been assigned to provide basic care for a 58-year-old man with a
diagnosis of AIDS-related pneumonia. The student tells the instructor that she is
unwilling to care for this client. What key component of critical thinking is most likely
missing from this student's practice? - ANSWER-Withholding judgment
A nurse in a hospice facility cares for clients with terminal illnesses and witnesses a
great deal of pain and emotional distress. Which factor that affects healthcare ethics
determines how the nurse must respond when a client asks for help in ending his or her
suffering? - ANSWER-Legislative and judicial decisions
The nurse is caring for a client who is withdrawing from heavy alcohol use and who is
consequently combative and confused, despite the administration of benzodiazepines.
The client has a fractured hip that he suffered in a traumatic accident and is trying to get
out of bed. What is the most appropriate action for the nurse to take? - ANSWER-
Obtain a physician's order to restrain the client.
Who should be involved in establishing specific and realistic outcomes, so the client
does not become frustrated in trying to achieve them? - ANSWER-The client and family
Which of the following patient age groups is currently one of the fastest growing age
groups in the population? - ANSWER-Adults 65 years of age and over
The nurse monitors a male client for symptoms of urethral strictures following a
transurethral resection of the prostate (TURP) for the treatment of prostate cancer.
Client symptoms indicative of this complication that the nurse monitors for following a
TURP include _________, __________, and _______________. - ANSWER-Client
symptoms indicative of this complication that the nurse monitors for following a TURP
include straining, dysuria, and a weak urinary stream.
The nurse on a telemetry unit is caring for a 54-year-old male client, admitted with chest
pain, who has an arteriovenous (AV) fistula in the left arm for hemodialysis secondary to
chronic kidney disease.
Specify if the intervention is indicated or contraindicated for this client.
-Take blood pressure readings in the left arm.
, -Auscultate for a bruit over AV fistula every 8 hours.
-Assess for redness, swelling, and drainage at AV fistula site.
-Use AV fistula site to draw blood.
-Palpate for a thrill over the AV fistula every 8 hours.
-Wrap the AV fistula site in the left arm with a compression dressing. - ANSWER-
Indicated
-Auscultate for a bruit over AV fistula every 8 hours.
-Assess for redness, swelling, and drainage at AV fistula site.
-Palpate for a thrill over the AV fistula every 8 hours.
Contraindicated
-Take blood pressure readings in the left arm.
-Use AV fistula site to draw blood.
-Wrap the AV fistula site in the left arm with a compression dressing.
The nurse is providing education to a 65-year-old female client with pneumococcal
pneumonia being discharged from the health clinic on oral antibiotics. The client is a
nonsmoker, takes levothyroxine for Hashimoto disease, and is otherwise in good health.
The nurse in the oncology clinic is caring for a 42-year-old female client receiving
chemotherapy with fludarabine for acute myeloid leukemia who has developed
petechiae, epistaxis, and ecchymosis.
client has developed ______________ that the laboratory results will reveal
__________ - ANSWER-client has developed hemorrhage that the laboratory results
will reveal thrombocytopenia.
The nurse provides care for a client, with a history of atherosclerosis, who is
hospitalized for the initiation of pharmacotherapy for the treatment of hypothyroidism.
The client is at highest risk for developing _______________ as evidenced by
_______________. - ANSWER-The client is at highest risk for developing cardiac
dysfunction as evidenced by angina.
The nurse is caring for a 24-year-old female client with a right tibial fracture treated with
a cast 2 hours ago. The client now reports unrelenting pain, rated as 7/10, despite
taking oxycodone, and decreased sensation in the right foot. A nursing assessment
reveals the right foot is cooler and paler than the left foot, with delayed capillary refill
and a weak pulse.
Based on the nursing assessment, the priority action the nurse should take is to
_________________________ and prepare the client for _________________. -
ANSWER-Based on the nursing assessment, the priority action the nurse should take is
to notify the orthopedic health care provider immediately and prepare the client for
bivalving of the cast.
