MEDICAL-SURGICAL NURSING EXAM
PREP: DAVIS ADVANTAGE 3RD EDITION
TEST BANK BY HOFFMAN
Which action is most likely to reduce confusion in a dehydrated patient?
a. increasing the IV rate to 250 mL/hr
b. administering oxygen via mask or nasal cannula
c. positioning the patient in high Fowler’s
d. tracking intake and output every four hours
- ANSWER ✓A
Dehydration often results in poor brain perfusion and low oxygen levels,
leading to confusion. Increasing IV fluids enhances perfusion, helping relieve
confusion. However, overly rapid rehydration can cause cerebral edema, so the
process must be monitored carefully.
Which patient faces the highest risk of dehydration?
a. young adult on bed rest
b. elderly patient receiving hypotonic IV fluids
c. older adult with cognitive impairment
d. young adult on hypertonic IV fluids
- ANSWER ✓C
Older adults have reduced total body water compared to younger individuals.
Those with cognitive limitations who can’t communicate or obtain fluids
independently are especially vulnerable to dehydration.
The nurse is caring for multiple patients. Which one requires the closest
observation for hyperkalemia?
a. a diabetic patient taking oral medication
b. a heart failure patient using a salt substitute
c. a hypertensive patient on thiazide diuretics
,d. a patient using NSAIDs daily
- ANSWER ✓B
Many salt substitutes contain potassium chloride. Overuse can result in
hyperkalemia. Patients should be taught to check labels and select products free
of potassium. NSAIDs cause sodium retention, not potassium retention.
An elderly patient exhibits signs of digitalis toxicity. Which age-related
change most likely contributed to this?
a. decreased kidney blood flow
b. increased gastrointestinal activity
c. reduced fat-to-lean body mass ratio
d. increased body water content
- ANSWER ✓A
Reduced renal circulation and slower filtration in older adults lead to delayed
drug excretion and possible toxic buildup. Aging also causes reduced total body
water and slower gut motility, but these do not directly cause digoxin toxicity.
A client is receiving treatment for dehydration. Which statement by the
client shows understanding of this condition?
a. I’ll start using a salt substitute when cooking and eating.
b. I need to drink about a quart of water or other fluids daily.
c. I’ll avoid drinking fluids after 6 PM so I don’t wake up at night.
d. I’ll weigh myself every morning before I eat or drink anything.
• ANSWER ✓D
Since 1 liter of water equals 1 kilogram, changes in body weight are a reliable
measure of fluid loss or retention. A daily weight reduction exceeding 0.5 lb
suggests excessive fluid loss. The other responses do not reflect proper
dehydration prevention measures.
The nurse observes that the client with hypokalemia has a weaker
handgrip than during the previous assessment one hour ago. Which action
should the nurse take first?
,a. Assess the client’s breathing rate, rhythm, and depth.
b. Document the findings and continue to monitor.
c. Measure the client’s pulse and blood pressure.
d. Notify the health care provider.
• ANSWER ✓A
In hypokalemia, worsening muscle weakness can indicate increasing severity.
The greatest danger is respiratory failure, so the nurse must first assess the
client’s respiratory function to ensure safety before notifying the provider for
potassium replacement.
The provider prescribes Lasix (furosemide) 60 mg by mouth daily.
Available tablets are Lasix 40 mg. How many tablets should the nurse
administer?
a. 3
b. 1
c. 1 ½
d. 2 ⅕
• ANSWER ✓C
Use the formula: 60 ÷ 40 = 1.5 tablets.
A client has been instructed to limit dietary sodium. Which meal choice
indicates that teaching was successful?
a. A grilled cheese sandwich with tomato soup
b. Chinese takeout with steamed rice
c. A chicken leg, one slice of bread with butter, and steamed carrots
d. Ham and cheese slices on whole-grain crackers
• ANSWER ✓C
Clients on low-sodium diets should avoid foods that are processed, smoked, or
pickled, as well as those containing sauces or condiments. Fresh meats,
vegetables, and fruits are lowest in sodium. The other options are high in salt
content.
, When assessing a client, which behavior most clearly suggests the presence
of acute pain?
a. Difficulty concentrating
b. Expression of hopelessness
c. Social withdrawal
d. Anger and hostility
• ANSWER ✓A
Chronic pain often leads to withdrawal, anger, and depression. In contrast,
difficulty concentrating is more characteristic of acute pain, before adaptation
occurs.
A nurse is caring for several clients at risk for fluid overload. Which older
client should the nurse assess first?
a. Has had diabetes mellitus for 12 years
b. Recently had abdominal surgery with an NG tube
c. Just received 3 units of packed red blood cells
d. Frequently uses sodium-based antacids
• ANSWER ✓C
Transfusing packed red blood cells significantly raises the risk for fluid
overload because this increases the blood’s oncotic pressure, drawing fluid into
the plasma volume. Older adults may lack adequate cardiac or renal function to
handle the excess volume.
The client recovering from a stroke is admitted to a medical-surgical unit.
Which task can the nurse safely delegate to unlicensed assistive personnel
(UAP)?
a. Assess the client’s level of consciousness.
b. Evaluate the client’s oxygen saturation.
c. Assist the client during meals.
d. Complete the nursing care plan.
PREP: DAVIS ADVANTAGE 3RD EDITION
TEST BANK BY HOFFMAN
Which action is most likely to reduce confusion in a dehydrated patient?
a. increasing the IV rate to 250 mL/hr
b. administering oxygen via mask or nasal cannula
c. positioning the patient in high Fowler’s
d. tracking intake and output every four hours
- ANSWER ✓A
Dehydration often results in poor brain perfusion and low oxygen levels,
leading to confusion. Increasing IV fluids enhances perfusion, helping relieve
confusion. However, overly rapid rehydration can cause cerebral edema, so the
process must be monitored carefully.
Which patient faces the highest risk of dehydration?
a. young adult on bed rest
b. elderly patient receiving hypotonic IV fluids
c. older adult with cognitive impairment
d. young adult on hypertonic IV fluids
- ANSWER ✓C
Older adults have reduced total body water compared to younger individuals.
Those with cognitive limitations who can’t communicate or obtain fluids
independently are especially vulnerable to dehydration.
The nurse is caring for multiple patients. Which one requires the closest
observation for hyperkalemia?
a. a diabetic patient taking oral medication
b. a heart failure patient using a salt substitute
c. a hypertensive patient on thiazide diuretics
,d. a patient using NSAIDs daily
- ANSWER ✓B
Many salt substitutes contain potassium chloride. Overuse can result in
hyperkalemia. Patients should be taught to check labels and select products free
of potassium. NSAIDs cause sodium retention, not potassium retention.
An elderly patient exhibits signs of digitalis toxicity. Which age-related
change most likely contributed to this?
a. decreased kidney blood flow
b. increased gastrointestinal activity
c. reduced fat-to-lean body mass ratio
d. increased body water content
- ANSWER ✓A
Reduced renal circulation and slower filtration in older adults lead to delayed
drug excretion and possible toxic buildup. Aging also causes reduced total body
water and slower gut motility, but these do not directly cause digoxin toxicity.
A client is receiving treatment for dehydration. Which statement by the
client shows understanding of this condition?
a. I’ll start using a salt substitute when cooking and eating.
b. I need to drink about a quart of water or other fluids daily.
c. I’ll avoid drinking fluids after 6 PM so I don’t wake up at night.
d. I’ll weigh myself every morning before I eat or drink anything.
• ANSWER ✓D
Since 1 liter of water equals 1 kilogram, changes in body weight are a reliable
measure of fluid loss or retention. A daily weight reduction exceeding 0.5 lb
suggests excessive fluid loss. The other responses do not reflect proper
dehydration prevention measures.
The nurse observes that the client with hypokalemia has a weaker
handgrip than during the previous assessment one hour ago. Which action
should the nurse take first?
,a. Assess the client’s breathing rate, rhythm, and depth.
b. Document the findings and continue to monitor.
c. Measure the client’s pulse and blood pressure.
d. Notify the health care provider.
• ANSWER ✓A
In hypokalemia, worsening muscle weakness can indicate increasing severity.
The greatest danger is respiratory failure, so the nurse must first assess the
client’s respiratory function to ensure safety before notifying the provider for
potassium replacement.
The provider prescribes Lasix (furosemide) 60 mg by mouth daily.
Available tablets are Lasix 40 mg. How many tablets should the nurse
administer?
a. 3
b. 1
c. 1 ½
d. 2 ⅕
• ANSWER ✓C
Use the formula: 60 ÷ 40 = 1.5 tablets.
A client has been instructed to limit dietary sodium. Which meal choice
indicates that teaching was successful?
a. A grilled cheese sandwich with tomato soup
b. Chinese takeout with steamed rice
c. A chicken leg, one slice of bread with butter, and steamed carrots
d. Ham and cheese slices on whole-grain crackers
• ANSWER ✓C
Clients on low-sodium diets should avoid foods that are processed, smoked, or
pickled, as well as those containing sauces or condiments. Fresh meats,
vegetables, and fruits are lowest in sodium. The other options are high in salt
content.
, When assessing a client, which behavior most clearly suggests the presence
of acute pain?
a. Difficulty concentrating
b. Expression of hopelessness
c. Social withdrawal
d. Anger and hostility
• ANSWER ✓A
Chronic pain often leads to withdrawal, anger, and depression. In contrast,
difficulty concentrating is more characteristic of acute pain, before adaptation
occurs.
A nurse is caring for several clients at risk for fluid overload. Which older
client should the nurse assess first?
a. Has had diabetes mellitus for 12 years
b. Recently had abdominal surgery with an NG tube
c. Just received 3 units of packed red blood cells
d. Frequently uses sodium-based antacids
• ANSWER ✓C
Transfusing packed red blood cells significantly raises the risk for fluid
overload because this increases the blood’s oncotic pressure, drawing fluid into
the plasma volume. Older adults may lack adequate cardiac or renal function to
handle the excess volume.
The client recovering from a stroke is admitted to a medical-surgical unit.
Which task can the nurse safely delegate to unlicensed assistive personnel
(UAP)?
a. Assess the client’s level of consciousness.
b. Evaluate the client’s oxygen saturation.
c. Assist the client during meals.
d. Complete the nursing care plan.
