Certified Medical Surgical Practice Exam
Questions With New Update Solutions
/.The nurse recognizes the patient most likely to experience hypercarbic
respiratory failure is the one with a diagnosis of
a. acute respiratory distress syndrome
b. pulmonary embolus
c. bronchitis
d. pulmonary edema
Hypercarbic respiratory failure occurs when conditions cause a reduction in minute
volume or an increase in physiologic dead space (for example, COPD [including
bronchitis], asthma, exacerbation of underlying neuromuscular disease). Hypoxic
respiratory failure results from an insult to the pulmonary tissues (such as pneumonia,
ARDS, pulmonary contusion)
/.A patient with Stage II adenocarcinoma of the lung is being treated with the anti-
tumor antibiotic doxorubicin (Adriamycin). The nurse knows that alteration in
dose scheduling of doxorubicin is needed to decrease the risk of toxicity to
which of the following organs:
a. liver
b. heart
c. pancreas
d. kidney
Cardiotoxicity can develop from a cumulative drug effect. Altering the dose scheduling
of doxorubicin to include frequent lower doses has resulted in reduction of cardiotoxicity
without compromise of anti tumor effects.
/.A 57 Year old patient is admitted to the medical unit for progressive symptoms
of dyspnea on exertion and decreased appetite, and is scheduled for pulmonary
function testing. when the patient asks what the test will measure, the nurse's
response is based on the knowledge that the tests are used to identify which
three general patterns of pulmonary abnormality?
a. obstructive, restrictive, and mixed
b. obstructive, constrictive, and mixed
c. restrictive, functional, and mixed
d. constrictive, functional and mixed
, Pulmonary function tests are used to identify and quantify abnormalities in respiratory
function, including three general patterns of abnormality: obstructive, restrictive, and
mixed.
/.The preferred Mantoux test for screening and diagnosis of tuberculosis should
be read by the trained nurse in:
a. 18 to 24 hours
b. 24 to 36 hours
c. 48 to 72 hours.
d. 72 to 96 hours
the skin test should be read 48 to 72 hours after it has been administered.
/.Arterial blood gas results, including a pH less than 7.35 and a pCO2 greater than
45, would reflect:
a. metabolic acidosis
b. respiratory acidosis
c. metabolic alkalosis
d. respiratory alkalosis
Assess pH; less than 7.35 = acidosis.
Assess pCO2; greater than 45 = respiratory acidosis
/.For the patient with a new tracheostomy, the nurse must be alert to which early
complication?
a. decannulation
b. infection
c. bleeding
d. tracheomalacia
Common acute risks of tracheostomy include bleeding structures, and failure of the
chosen technique to achieve successful airway placement
.
/.A 32 year old patient on the medical unit experiences an acute asthma episode.
All of the following are ordered to treat the patient. What will the nurse administer
FIRST?
a. intravenous corticosteroids
b. oxygen by nasal cannula
c. bronchodilator by meter dose inhaler
d. intravenous fluids
Questions With New Update Solutions
/.The nurse recognizes the patient most likely to experience hypercarbic
respiratory failure is the one with a diagnosis of
a. acute respiratory distress syndrome
b. pulmonary embolus
c. bronchitis
d. pulmonary edema
Hypercarbic respiratory failure occurs when conditions cause a reduction in minute
volume or an increase in physiologic dead space (for example, COPD [including
bronchitis], asthma, exacerbation of underlying neuromuscular disease). Hypoxic
respiratory failure results from an insult to the pulmonary tissues (such as pneumonia,
ARDS, pulmonary contusion)
/.A patient with Stage II adenocarcinoma of the lung is being treated with the anti-
tumor antibiotic doxorubicin (Adriamycin). The nurse knows that alteration in
dose scheduling of doxorubicin is needed to decrease the risk of toxicity to
which of the following organs:
a. liver
b. heart
c. pancreas
d. kidney
Cardiotoxicity can develop from a cumulative drug effect. Altering the dose scheduling
of doxorubicin to include frequent lower doses has resulted in reduction of cardiotoxicity
without compromise of anti tumor effects.
/.A 57 Year old patient is admitted to the medical unit for progressive symptoms
of dyspnea on exertion and decreased appetite, and is scheduled for pulmonary
function testing. when the patient asks what the test will measure, the nurse's
response is based on the knowledge that the tests are used to identify which
three general patterns of pulmonary abnormality?
a. obstructive, restrictive, and mixed
b. obstructive, constrictive, and mixed
c. restrictive, functional, and mixed
d. constrictive, functional and mixed
, Pulmonary function tests are used to identify and quantify abnormalities in respiratory
function, including three general patterns of abnormality: obstructive, restrictive, and
mixed.
/.The preferred Mantoux test for screening and diagnosis of tuberculosis should
be read by the trained nurse in:
a. 18 to 24 hours
b. 24 to 36 hours
c. 48 to 72 hours.
d. 72 to 96 hours
the skin test should be read 48 to 72 hours after it has been administered.
/.Arterial blood gas results, including a pH less than 7.35 and a pCO2 greater than
45, would reflect:
a. metabolic acidosis
b. respiratory acidosis
c. metabolic alkalosis
d. respiratory alkalosis
Assess pH; less than 7.35 = acidosis.
Assess pCO2; greater than 45 = respiratory acidosis
/.For the patient with a new tracheostomy, the nurse must be alert to which early
complication?
a. decannulation
b. infection
c. bleeding
d. tracheomalacia
Common acute risks of tracheostomy include bleeding structures, and failure of the
chosen technique to achieve successful airway placement
.
/.A 32 year old patient on the medical unit experiences an acute asthma episode.
All of the following are ordered to treat the patient. What will the nurse administer
FIRST?
a. intravenous corticosteroids
b. oxygen by nasal cannula
c. bronchodilator by meter dose inhaler
d. intravenous fluids
