ESTUDYR
MED SURG III FINAL EXAM STUDY EXAM MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
⃣ A 79-year-old patient with BPH is admitted. What’s most appropriate to include in the nursing
plan?
A) Limit fluid intake to ≤ 1000 mL/day
B) ✅Leave a light on in the bathroom at night
C) Ask the patient to use a urinal for measuring output
D) Pad the bed for overflow incontinence
Rationale: Nocturia is common in BPH; a light reduces fall risk. Fluids shouldn’t be restricted, and there’s
no indication for measuring output or pad use yet.
⃣ To obtain a clean-catch urine specimen for C&S in a female with suspected UTI, the nurse should:
A) Have her empty bladder completely, then collect next void
B) ✅Instruct: clean urethral area → void a small amount → collect midstream
C) Insert a “mini” sterile catheter without an order
D) Clean with Betadine, then collect first stream
Rationale: Midstream “clean-catch” minimizes contamination without requiring catheterization or
Betadine.
⃣ A post-cystoscopy patient reports:
“My urine looks pink,”
“My IV site is bruised,”
“My sleep was restless,”
“My temperature is 101 °F.”
Which warrants immediate HCP notification?
A) Pink urine
B) Bruised IV site
C) Restless sleep
D) ✅Fever of 0 °F
Rationale: Post-cystoscopy fever can indicate infection; pink urine and bruising are expected; insomnia
is nonurgent.
,ESTUDYR
⃣ A patient admitted with acute glomerulonephritis. The nurse should ask about:
A) Recent bladder infection
B) Kidney stones
C) ✅Recent sore throat/fever
D) History of hypertension
Rationale: Post-strep GN often follows streptococcal throat infection.
⃣ A nephrotic syndrome patient develops flank pain. Treatment teaching will include:
A) Antibiotics
B) Antifungals
C) ✅Anticoagulants
D) Antihypertensives
Rationale: Flank pain suggests renal vein thrombosis; anticoagulation is indicated.
⃣ A 27-year-old woman who smokes ppd is at increased risk for:
A) Kidney stones
B) ✅Bladder cancer
C) Bladder infection
D) Interstitial cystitis
Rationale: Smoking is the leading risk factor for urothelial carcinoma.
⃣ Post-rectal surgery, a patient voids ~ 0 mL every 30– 0 min × hr. The best intervention is:
A) Monitor I&O overnight
B) Encourage small sips frequently
C) ✅Use a bladder scanner to check PVR
D) Reassure it’s normal post-anesthesia
Rationale: Low output suggests urinary retention; a PVR check guides further action.
⃣ Teaching intermittent self-catheterization at home, an effective statement is:
,ESTUDYR
A) “Use seven new catheters weekly.”
B) “Use sterile catheters & gloves every time.”
C) ✅“Clean the catheter before and after each use.”
D) “Take antibiotics prophylactically.”
Rationale: Clean technique is acceptable at home; daily new catheters and routine antibiotics are
unnecessary.
⃣ A 68-year-old male with an Indiana pouch needs teaching on:
A) Ostomy appliances
B) Skin barriers
C) ✅Catheterization technique & schedule
D) Analgesics before emptying
Rationale: The Indiana pouch requires regular self-catheterization every 4–6 hr.
✅Three days post-TURBT, the most important finding to report is:
A) Voiding every 4 hr
B) Using opioids for pain
C) ✅Clots in urine
D) Anxiety about cancer
Rationale: Urinary clots can indicate bleeding or obstruction requiring immediate attention.
⃣ ⃣ To reduce catheter-associated UTIs on a med-surg unit, the most helpful action is:
A) Daily dipsticks for nitrates
B) ✅Avoid unnecessary catheterization
C) Encourage fluids & nutrition
D) Provide perineal hygiene
Rationale: The single best way to prevent CA-UTI is minimizing catheter use.
⃣ ⃣ A CKD patient on hemodialysis should be taught:
A) Unlimited fluids
B) Glucose lost during HD
, ESTUDYR
C) ✅More protein allowed—urea is removed by dialysis
D) No potassium restriction
Rationale: Dialysis clears urea, allowing increased protein intake; fluids, K⁺ remain restricted.
⃣ ⃣ A CKD patient taking magnesium hydroxide needs teaching because:
A) Acetaminophen is contraindicated
B) Calcium phosphate is wrong
C) Magnesium products accumulate and cause toxicity
D) Multivitamins with iron are harmful
Rationale: Magnesium is renally excreted; CKD patients should avoid magnesium-containing
antacids/laxatives.
⃣ ⃣ A crush injury patient’s labs:
Creatinine 2.1
Potassium 6.5
WBC 11,500
BUN 56
Which is most important to report?
A) Creatinine 2.1
B) Potassium 6.5
C) WBC 11,500
D) BUN 56
Rationale: Hyperkalemia > 6 mEq/L can cause life-threatening arrhythmias.
⃣ ⃣ In helping a newly diagnosed type II diabetic adapt, the nurse should first assess the patient’s:
A) Ideal weight
B) Value system
C) Activity level
D) Visual changes
Rationale: Understanding values guides personalized strategies for adaptation and adherence.
MED SURG III FINAL EXAM STUDY EXAM MOST TESTED QUESTIONS
AND ANSWERS GRADED A+ WITH RATIONALES
⃣ A 79-year-old patient with BPH is admitted. What’s most appropriate to include in the nursing
plan?
A) Limit fluid intake to ≤ 1000 mL/day
B) ✅Leave a light on in the bathroom at night
C) Ask the patient to use a urinal for measuring output
D) Pad the bed for overflow incontinence
Rationale: Nocturia is common in BPH; a light reduces fall risk. Fluids shouldn’t be restricted, and there’s
no indication for measuring output or pad use yet.
⃣ To obtain a clean-catch urine specimen for C&S in a female with suspected UTI, the nurse should:
A) Have her empty bladder completely, then collect next void
B) ✅Instruct: clean urethral area → void a small amount → collect midstream
C) Insert a “mini” sterile catheter without an order
D) Clean with Betadine, then collect first stream
Rationale: Midstream “clean-catch” minimizes contamination without requiring catheterization or
Betadine.
⃣ A post-cystoscopy patient reports:
“My urine looks pink,”
“My IV site is bruised,”
“My sleep was restless,”
“My temperature is 101 °F.”
Which warrants immediate HCP notification?
A) Pink urine
B) Bruised IV site
C) Restless sleep
D) ✅Fever of 0 °F
Rationale: Post-cystoscopy fever can indicate infection; pink urine and bruising are expected; insomnia
is nonurgent.
,ESTUDYR
⃣ A patient admitted with acute glomerulonephritis. The nurse should ask about:
A) Recent bladder infection
B) Kidney stones
C) ✅Recent sore throat/fever
D) History of hypertension
Rationale: Post-strep GN often follows streptococcal throat infection.
⃣ A nephrotic syndrome patient develops flank pain. Treatment teaching will include:
A) Antibiotics
B) Antifungals
C) ✅Anticoagulants
D) Antihypertensives
Rationale: Flank pain suggests renal vein thrombosis; anticoagulation is indicated.
⃣ A 27-year-old woman who smokes ppd is at increased risk for:
A) Kidney stones
B) ✅Bladder cancer
C) Bladder infection
D) Interstitial cystitis
Rationale: Smoking is the leading risk factor for urothelial carcinoma.
⃣ Post-rectal surgery, a patient voids ~ 0 mL every 30– 0 min × hr. The best intervention is:
A) Monitor I&O overnight
B) Encourage small sips frequently
C) ✅Use a bladder scanner to check PVR
D) Reassure it’s normal post-anesthesia
Rationale: Low output suggests urinary retention; a PVR check guides further action.
⃣ Teaching intermittent self-catheterization at home, an effective statement is:
,ESTUDYR
A) “Use seven new catheters weekly.”
B) “Use sterile catheters & gloves every time.”
C) ✅“Clean the catheter before and after each use.”
D) “Take antibiotics prophylactically.”
Rationale: Clean technique is acceptable at home; daily new catheters and routine antibiotics are
unnecessary.
⃣ A 68-year-old male with an Indiana pouch needs teaching on:
A) Ostomy appliances
B) Skin barriers
C) ✅Catheterization technique & schedule
D) Analgesics before emptying
Rationale: The Indiana pouch requires regular self-catheterization every 4–6 hr.
✅Three days post-TURBT, the most important finding to report is:
A) Voiding every 4 hr
B) Using opioids for pain
C) ✅Clots in urine
D) Anxiety about cancer
Rationale: Urinary clots can indicate bleeding or obstruction requiring immediate attention.
⃣ ⃣ To reduce catheter-associated UTIs on a med-surg unit, the most helpful action is:
A) Daily dipsticks for nitrates
B) ✅Avoid unnecessary catheterization
C) Encourage fluids & nutrition
D) Provide perineal hygiene
Rationale: The single best way to prevent CA-UTI is minimizing catheter use.
⃣ ⃣ A CKD patient on hemodialysis should be taught:
A) Unlimited fluids
B) Glucose lost during HD
, ESTUDYR
C) ✅More protein allowed—urea is removed by dialysis
D) No potassium restriction
Rationale: Dialysis clears urea, allowing increased protein intake; fluids, K⁺ remain restricted.
⃣ ⃣ A CKD patient taking magnesium hydroxide needs teaching because:
A) Acetaminophen is contraindicated
B) Calcium phosphate is wrong
C) Magnesium products accumulate and cause toxicity
D) Multivitamins with iron are harmful
Rationale: Magnesium is renally excreted; CKD patients should avoid magnesium-containing
antacids/laxatives.
⃣ ⃣ A crush injury patient’s labs:
Creatinine 2.1
Potassium 6.5
WBC 11,500
BUN 56
Which is most important to report?
A) Creatinine 2.1
B) Potassium 6.5
C) WBC 11,500
D) BUN 56
Rationale: Hyperkalemia > 6 mEq/L can cause life-threatening arrhythmias.
⃣ ⃣ In helping a newly diagnosed type II diabetic adapt, the nurse should first assess the patient’s:
A) Ideal weight
B) Value system
C) Activity level
D) Visual changes
Rationale: Understanding values guides personalized strategies for adaptation and adherence.
