Nur 372 Advantage for Understanding Medical-
Surgical Nursing 2 Questions and Answers with
Detailed Rationales Already Graded A+
Guaranteed Pass
1. A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the priority
for this client?
a. Fluid and electrolyte balance.
b. Prevention of water toxicity.
c. Reduced glucose in the urine.
d. Adequate cellular nourishment.
D
Rationale
Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and polyuria
(frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Polyphagia is a
consequence of cellular malnourishment when insulin deficiency prevents utilization of glucose into
the cell for energy, so the outcome statement should include stabilization of adequate cellular
nutrition which is done by providing the insulin supplement the client needs.
2. A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this client?
Assess the client's
a. pulse rate, both apically and radially.
b. blood pressure, both standing and sitting.
c. temperature.
d. skin color and turgor.
C
Rationale
A+ TEST BANK 2
,It is very important to check the client's temperature. Long term use of steroids use COPD clients is
effective in suppressing inflammation in their airways making it easier for them to breath, but at the
same time suppresses the immune system, placing the client at risk for infection.
3. Which intervention should the nurse plan to implement when caring for a client who has just
undergone a right above-the-knee amputation?
a. Maintain the residual limb on three pillows at all times.
b. Place a large tourniquet at the client's bedside.
c. Apply constant, direct pressure to the residual limb.
d. Do not allow the client to lie in the prone position.
B
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe bleeding
occurs. The purpose is to have the tourniquet available to applied to the residual limb to control
bleeding if hemorrhaging was to occur. The residual limb should not be placed on a pillow because a
flexion contracture of the hip may result and the client should be encouraged to lie in the prone
position to prevent flexion contracture of the hip.
4. The nurse knows that lab values sometimes vary for the older client. Which data would the nurse
expect to find when reviewing laboratory values of an 80-year-old male?
a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity.
C
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the
serum glucose increases slightly, also due to changes in the kidney. The specific gravity declines by age
80 from 1.032 to 1.024.
A+ TEST BANK 3
,5. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO PRN,
for a client with chronic kidney disease (CKD) who is complaining of indigestion. What intervention
should the nurse implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription.
D
Rationale
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so
this prescription should be questioned by the nurse.
6. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping.
A
Rationale
Among the findings characteristic of a small bowel obstruction is the presence of severe fluid and
electrolyte imbalances.
7. The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment.
Which subjective information is most important for the nurse to note?
a. A history of obesity.
b. An allergy to sulfa drugs.
c. Cessation of smoking three years ago.
d. Numbness in the soles of the feet.
B
A+ TEST BANK 4
, Rationale
An allergy to sulfa drugs may make the client unable to use some of the most common
antihyperglycemic agents (sulfonylureas). The nurse needs to highlight this allergy for the healthcare
provider.
8. The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure
without specific instruction from the healthcare provider if the client's
a. serum digoxin level is 1.5.
b. blood pressure is 104/68.
c. serum potassium level is 3.
d. apical pulse is 68/min.
C
Rationale
Hypokalemia can precipitate digitalis toxicity in persons receiving digoxin which will increase the
chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
9. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours
is dated two years ago. The client reports that he has a history of "heart trouble," but has no problems
at present. Hospital protocol requires that those over 50 years of age have a recent ECG prior to
surgery. What nursing action is best for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately.
B
Rationale
According to the hospital policy, clients over the age of 50 and/or with a history of cardiovascular
disease, should receive ECG evaluation prior to surgery, generally 24 hours to two weeks before. The
nurse needs to first arrange for an ECG to be performed immediately prior to surgery.
10. The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin.
Which assessment should the nurse identify before beginning the teaching session?
a. Present knowledge related to the skill of injection.
A+ TEST BANK 5
Surgical Nursing 2 Questions and Answers with
Detailed Rationales Already Graded A+
Guaranteed Pass
1. A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the priority
for this client?
a. Fluid and electrolyte balance.
b. Prevention of water toxicity.
c. Reduced glucose in the urine.
d. Adequate cellular nourishment.
D
Rationale
Diabetes mellitus Type 1 is characterized by hyperglycemia that precipitates glucosuria and polyuria
(frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Polyphagia is a
consequence of cellular malnourishment when insulin deficiency prevents utilization of glucose into
the cell for energy, so the outcome statement should include stabilization of adequate cellular
nutrition which is done by providing the insulin supplement the client needs.
2. A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this client?
Assess the client's
a. pulse rate, both apically and radially.
b. blood pressure, both standing and sitting.
c. temperature.
d. skin color and turgor.
C
Rationale
A+ TEST BANK 2
,It is very important to check the client's temperature. Long term use of steroids use COPD clients is
effective in suppressing inflammation in their airways making it easier for them to breath, but at the
same time suppresses the immune system, placing the client at risk for infection.
3. Which intervention should the nurse plan to implement when caring for a client who has just
undergone a right above-the-knee amputation?
a. Maintain the residual limb on three pillows at all times.
b. Place a large tourniquet at the client's bedside.
c. Apply constant, direct pressure to the residual limb.
d. Do not allow the client to lie in the prone position.
B
Rationale
A large tourniquet should be placed in plain sight at the client's bedside, in the event severe bleeding
occurs. The purpose is to have the tourniquet available to applied to the residual limb to control
bleeding if hemorrhaging was to occur. The residual limb should not be placed on a pillow because a
flexion contracture of the hip may result and the client should be encouraged to lie in the prone
position to prevent flexion contracture of the hip.
4. The nurse knows that lab values sometimes vary for the older client. Which data would the nurse
expect to find when reviewing laboratory values of an 80-year-old male?
a. Increased WBC, decreased RBC.
b. Increased serum bilirubin, slightly increased liver enzymes.
c. Increased protein in the urine, slightly increased serum glucose levels.
d. Decreased serum sodium, an increased urine specific gravity.
C
Rationale
As older adults aged, the protein found in urine slightly rises as a result of kidney changes and the
serum glucose increases slightly, also due to changes in the kidney. The specific gravity declines by age
80 from 1.032 to 1.024.
A+ TEST BANK 3
,5. The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO PRN,
for a client with chronic kidney disease (CKD) who is complaining of indigestion. What intervention
should the nurse implement?
a. Administer 30 minutes before eating.
b. Evaluate the effectiveness 1 hour after administration.
c. Instruct the client to swallow the tablet whole.
d. Question the healthcare provider's prescription.
D
Rationale
Magnesium agents are not usually used for clients with CKD due to the risk of hypermagnesemia, so
this prescription should be questioned by the nurse.
6. Small bowel obstruction is a condition characterized by which finding?
a. Severe fluid and electrolyte imbalances.
b. Metabolic acidosis.
c. Ribbon-like stools.
d. Intermittent lower abdominal cramping.
A
Rationale
Among the findings characteristic of a small bowel obstruction is the presence of severe fluid and
electrolyte imbalances.
7. The nurse is taking a history of a newly diagnosed Type 2 diabetic who is beginning treatment.
Which subjective information is most important for the nurse to note?
a. A history of obesity.
b. An allergy to sulfa drugs.
c. Cessation of smoking three years ago.
d. Numbness in the soles of the feet.
B
A+ TEST BANK 4
, Rationale
An allergy to sulfa drugs may make the client unable to use some of the most common
antihyperglycemic agents (sulfonylureas). The nurse needs to highlight this allergy for the healthcare
provider.
8. The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure
without specific instruction from the healthcare provider if the client's
a. serum digoxin level is 1.5.
b. blood pressure is 104/68.
c. serum potassium level is 3.
d. apical pulse is 68/min.
C
Rationale
Hypokalemia can precipitate digitalis toxicity in persons receiving digoxin which will increase the
chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
9. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours
is dated two years ago. The client reports that he has a history of "heart trouble," but has no problems
at present. Hospital protocol requires that those over 50 years of age have a recent ECG prior to
surgery. What nursing action is best for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately.
B
Rationale
According to the hospital policy, clients over the age of 50 and/or with a history of cardiovascular
disease, should receive ECG evaluation prior to surgery, generally 24 hours to two weeks before. The
nurse needs to first arrange for an ECG to be performed immediately prior to surgery.
10. The nurse is planning care for a client with newly diagnosed diabetes mellitus that requires insulin.
Which assessment should the nurse identify before beginning the teaching session?
a. Present knowledge related to the skill of injection.
A+ TEST BANK 5
