MEDICAL SURGICAL NURSING CONCEPTS

MULTIPLE CHOICE 1. A nurse contacts the primary health care provider after reviewing a client’s laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL (12.5 mmol/L) and a serum creatinine of 1.0 mg/dL (88.4 mcmol/L). What collaborative care measure would the nurse recommend? a. Intravenous fluids b. Hemodialysis c. Fluid restriction d. Urine culture and sensitivity ANS: A Normal BUN is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). Normal creatinine is 0.6 to 1.2 mg/dL (53...

MULTIPLE CHOICE 1. After teaching a client with nephrotic syndrome and a normal glomerular filtration, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the diet therapy for this condition? a. “I must decrease my intake of fat.” b. “I will increase my intake of protein.” c. “A decreased intake of carbohydrates will be required.” d. “An increased intake of vitamin C is necessary.” ANS: B In nep...

MULTIPLE CHOICE 1. A client with pneumonia and dementia is admitted with an indwelling urinary catheter in place. During interprofessional rounds the following day, which question would the nurse ask the primary health care provider? a. “Do you want daily weights on this client?” b. “Will the client be able to return home?” c. “May we discontinue the indwelling catheter?” d. “Should we get another chest x-ray today?” ANS: C An indwelling urinary catheter dramati...

MULTIPLE CHOICE 1. A nurse teaches a client who is at risk for colorectal cancer. Which dietary recommendation would the nurse teach the client? a. “Eat low-fiber and low-residual foods.” b. “White rice and bread are easier to digest.” c. “Add vegetables such as broccoli and cauliflower to your diet.” d. “Foods high in animal fat help to protect the intestinal mucosa.” ANS: C The client would be taught to modify his or her diet to decrease animal fat and refined ...

MULTIPLE CHOICE 1. The nurse is managing care for a client receiving feeding through a gastrostomy tube (G-tube). What assessment would the nurse perform? a. Check the skin around the tube insertion site. b. Weigh the client every shift with the same scale. c. Draw blood to assess albumin every shift. d. Irrigate the tube at least once a day. ANS: A The most important assessment would be to observe the skin around the tube for irritation, redness, and skin breakdown. The skin sh...

MULTIPLE CHOICE 1. A nurse assesses a female client who presents with hirsutism. Which question would the nurse ask when assessing this client? a. “How do you plan to pay for your treatments?” b. “How do you feel about yourself?” c. “What medications are you prescribed?” d. “What are you doing to prevent this from happening?” ANS: B Hirsutism, or excessive hair growth on the face and body, can result from endocrine disorders. This may cause a disruption in body i...

MULTIPLE CHOICE 1. A nurse cares for a client with end-stage pancreatic cancer. The client asks, “Why is this happening to me?” How would the nurse respond? a. “I don’t know. I wish I had an answer for you, but I don’t.” b. “It’s important to keep a positive attitude for your family right now.” c. “Scientists have not determined why cancer develops in certain people.” d. “I think that this is a trial so you can become a better person because of it.” ANS: ...

MULTIPLE CHOICE 1. A nurse plans care for a client with hypothyroidism. Which priority problem does the nurse address first for this client? a. Heat intolerance b. Body image problems c. Depression and withdrawal d. Obesity and water retention ANS: C Hypothyroidism causes many problems in psychosocial functioning. Depression is the most common reason for seeking medical attention. Memory and attention span may be impaired. The client’s family may have great difficulty acceptin...

MULTIPLE CHOICE 1. A nurse develops a dietary plan for a client with diabetes mellitus and new-onset microalbuminuria. Which component of the client’s diet would the nurse decrease? a. Carbohydrates b. Proteins c. Fats d. Total calories ANS: B Restriction of dietary protein is recommended for clients with microalbuminuria to delay progression to renal failure. The client’s diet does not need to be decreased in carbohydrates, fats, or total calories. DIF: Remembering TOP: ...

MULTIPLE CHOICE 1. The nurse is caring for a client who is diagnosed with diabetes insipidus (DI). For what common complication will the nurse monitor? a. Hypertension b. Bradycardia c. Dehydration d. Pulmonary embolus ANS: C The client who has DI has fluid loss through excessive urination. Decreased fluid volume, or dehydration, is manifested by tachycardia, hypotension, and possibly elevated temperature. Pulmonary embolism (PE) could possible as a clot in the lower extremity (...