MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
· The nurse is caring for a patient in the clinic setting who complains of vaginal discharge that is
thick with a white, cottage cheese-like appearance. The patient states that she has pruritus and
irritation. The symptoms seem to be more severe just before menstruation. What should the
nurse expect to be included in the plan of care for this patient?
o Clindamycin (Cleocin)
o Fluconazole (Diflucan)
o Metronidazole (Flagyl)
o Tinidazole (Tindamax) - ✔✔✔-Fluconazole (Diflucan). This patient presents with symptoms of
a candidiasis infection which should be treated with an antifungal agent such as Diflucan. The
other three medications are anti-infectives used to treat bacterial vaginosis and trichomoniasis
· When educating the public about eye safety, the nurse would instruct that if chemical
exposure or irritant to the eye occurs the eye should be flushed with water for how long?
o 5 minutes
o 10 minutes
o 15 minutes
o 20 minutes - ✔✔✔-Answer: 20 minutes. § When an exposure occurs, the eye should be
continuously flushed with tap water for 20 minutes. It is important to begin the flushing process
within 5 minutes for the best outcome. Additional education should include saving the bottle or
container, if a chemical exposure, for the emergency response providers so the chemical
involved is known to provide further emergent care
· Which instruction would be appropriate to include in discharge instructions after cataract
surgery with a lens implant?
o Sleep on the side of the affected eye the night after surgery
o Resume normal activities on postoperative day 2
o Avoid bending or stooping for an extended period
o Attempt to hold in sneeze if it occurs - ✔✔✔-Answer: Avoid bending or stooping for an
extended period
,MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
· Which patient is at highest risk for venous thromboembolism?
o A. a 50 y/o post op patient
o B. 25 y/o patient with central venous catheter in place to treat septicemia
o C. 71 y/o otherwise healthy older adult
o D. pregnant 30 y/o woman due in two weeks - ✔✔✔-B
· Which woman is at highest risk for cervical cancer?
o A 25-year-old woman who smokes and has multiple sexual partners
o A 40-year-old woman who had her first child at age 19 years and has been exposed to HPV
o An 18-year-old woman who has just had her first sexual encounter
o An obese 30-year-old woman who has nutritional deficiencies and a family history of cervical
cancer - ✔✔✔-Answer: An obese 30-year-old woman who has nutritional deficiencies and a
family history of cervical cancer
· Rationale: Risk factors for cervical cancer include but are not limited to smoking, multiple
sexual partners, first child at an early age, exposure to HPV, first sexual encounter at an early
age, obesity, nutritional deficiencies, and a family history of cervical cancer. All patients have risk
factors, but the 40-year-old woman has the most (three: obesity, nutritional deficiencies, and
family history)
A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot.
A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess
the client for:
1.Familial tendency toward peripheral vascular disease
2.Smoking history
3.Recent exposures to allergens
4.History of insect bite - ✔✔✔-2. The mixture of arterial and venous manifestations
(claudication and phlebitis, respectively) in the young male client suggests Buerger's disease.
This is an uncommon disorder characterized by inflammation and thrombosis of smaller arteries
,MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
and veins. This disorder typically is found in young adult males who smoke. The cause is not
known precisely but is suspected to have an autoimmune component.
a family member of the client undergoing cataract surgery asks the nurse if there are ways to
prevent cataracts. Which recommendations should the nurse suggest? Select all that apply.
1. wear sunglasses that limit UV light penetration
2. wear sunscreen with a high protection factor number
3. wear eye protection if there is any risk for eye injury
4. avoid activities and reading in dimly lit environments
5. eat foods that are high in Vitamin C, such as oranges - ✔✔✔-1, 3
Limiting eye exposure to UV light has been found to decrease the risk for cataracts
Avoiding trauma to the eye has been found to decrease the risk for cataracts
A nurse in a clinic receives a phone call from a client seeking information about his new
prescription for
erythropoietin (Epogen). Which of the following information should be reviewed with the
client?
A. The client needs an erythrocyte sedimentation rate (ESR) test weekly.
B. The client should have his hemoglobin checked twice a week.
C. Oxygen saturation levels should be monitored.
D. Folic acid production will increase. - ✔✔✔-B
A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. He
states he had a cough along with nausea and diarrhea. His temperature is 38.1 C orally. The
client is afraid he has HIV. Which action should the nurse take? Select all that apply.
a. perform a physical assessment
b. determine when s/s began
c. teach the client about HIV transmission
, MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
d. draw blood for HIV testing
e. obtain a sexual history - ✔✔✔-a, b, e
A nurse is assessing a client for HIV. Which are risk factors? Select all that apply.
a. perinatal exposure
b. pregnancy
c. monogamous sex partner
d. older woman adult
e. occupational exposure - ✔✔✔-A, D, E
A nurse is assessing a client who has PAD. Which of the following should the nurse expect?
a. edema around ankles and feet
b. ulceration around the medial malleoli
c. scaling edema of the lower legs with stasis dermatitis
d. pallor on elevation of the limbs, and rubber when the limbs are dependent - ✔✔✔-D. In a
client who has PAD, pallor is seen in the extremities when the limbs are elevated, and rubor
occurs when they are lowered
A nurse is caring for a client who has a DVT and has been taking heparin for a week. Two days
ago, the provider also prescribed warfarin. The client asks the nurse about receiving both at the
same time. What should the nurse say?
a. I will remind your provider that you are already receiving heparin
b. your lab findings indicate that 2 anticoagulants are needed
c. it takes 3-4 days for the therapeutic effects of warfarin, and then heparin can be discontinued
d. only one of these medications are being given to treat your DVT - ✔✔✔-C. warfarin
depresses synthesis of clotting factors but does not have an effect on clotting factors that are
present. It takes 3-4 days for the clotting factors that are present to decay and for the
therapeutic effects of warfarin to occur.
· The nurse is caring for a patient in the clinic setting who complains of vaginal discharge that is
thick with a white, cottage cheese-like appearance. The patient states that she has pruritus and
irritation. The symptoms seem to be more severe just before menstruation. What should the
nurse expect to be included in the plan of care for this patient?
o Clindamycin (Cleocin)
o Fluconazole (Diflucan)
o Metronidazole (Flagyl)
o Tinidazole (Tindamax) - ✔✔✔-Fluconazole (Diflucan). This patient presents with symptoms of
a candidiasis infection which should be treated with an antifungal agent such as Diflucan. The
other three medications are anti-infectives used to treat bacterial vaginosis and trichomoniasis
· When educating the public about eye safety, the nurse would instruct that if chemical
exposure or irritant to the eye occurs the eye should be flushed with water for how long?
o 5 minutes
o 10 minutes
o 15 minutes
o 20 minutes - ✔✔✔-Answer: 20 minutes. § When an exposure occurs, the eye should be
continuously flushed with tap water for 20 minutes. It is important to begin the flushing process
within 5 minutes for the best outcome. Additional education should include saving the bottle or
container, if a chemical exposure, for the emergency response providers so the chemical
involved is known to provide further emergent care
· Which instruction would be appropriate to include in discharge instructions after cataract
surgery with a lens implant?
o Sleep on the side of the affected eye the night after surgery
o Resume normal activities on postoperative day 2
o Avoid bending or stooping for an extended period
o Attempt to hold in sneeze if it occurs - ✔✔✔-Answer: Avoid bending or stooping for an
extended period
,MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
· Which patient is at highest risk for venous thromboembolism?
o A. a 50 y/o post op patient
o B. 25 y/o patient with central venous catheter in place to treat septicemia
o C. 71 y/o otherwise healthy older adult
o D. pregnant 30 y/o woman due in two weeks - ✔✔✔-B
· Which woman is at highest risk for cervical cancer?
o A 25-year-old woman who smokes and has multiple sexual partners
o A 40-year-old woman who had her first child at age 19 years and has been exposed to HPV
o An 18-year-old woman who has just had her first sexual encounter
o An obese 30-year-old woman who has nutritional deficiencies and a family history of cervical
cancer - ✔✔✔-Answer: An obese 30-year-old woman who has nutritional deficiencies and a
family history of cervical cancer
· Rationale: Risk factors for cervical cancer include but are not limited to smoking, multiple
sexual partners, first child at an early age, exposure to HPV, first sexual encounter at an early
age, obesity, nutritional deficiencies, and a family history of cervical cancer. All patients have risk
factors, but the 40-year-old woman has the most (three: obesity, nutritional deficiencies, and
family history)
A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot.
A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess
the client for:
1.Familial tendency toward peripheral vascular disease
2.Smoking history
3.Recent exposures to allergens
4.History of insect bite - ✔✔✔-2. The mixture of arterial and venous manifestations
(claudication and phlebitis, respectively) in the young male client suggests Buerger's disease.
This is an uncommon disorder characterized by inflammation and thrombosis of smaller arteries
,MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
and veins. This disorder typically is found in young adult males who smoke. The cause is not
known precisely but is suspected to have an autoimmune component.
a family member of the client undergoing cataract surgery asks the nurse if there are ways to
prevent cataracts. Which recommendations should the nurse suggest? Select all that apply.
1. wear sunglasses that limit UV light penetration
2. wear sunscreen with a high protection factor number
3. wear eye protection if there is any risk for eye injury
4. avoid activities and reading in dimly lit environments
5. eat foods that are high in Vitamin C, such as oranges - ✔✔✔-1, 3
Limiting eye exposure to UV light has been found to decrease the risk for cataracts
Avoiding trauma to the eye has been found to decrease the risk for cataracts
A nurse in a clinic receives a phone call from a client seeking information about his new
prescription for
erythropoietin (Epogen). Which of the following information should be reviewed with the
client?
A. The client needs an erythrocyte sedimentation rate (ESR) test weekly.
B. The client should have his hemoglobin checked twice a week.
C. Oxygen saturation levels should be monitored.
D. Folic acid production will increase. - ✔✔✔-B
A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. He
states he had a cough along with nausea and diarrhea. His temperature is 38.1 C orally. The
client is afraid he has HIV. Which action should the nurse take? Select all that apply.
a. perform a physical assessment
b. determine when s/s began
c. teach the client about HIV transmission
, MedSurg 2 Final Book Proctored Exam Revision Kit – High Score Materials
d. draw blood for HIV testing
e. obtain a sexual history - ✔✔✔-a, b, e
A nurse is assessing a client for HIV. Which are risk factors? Select all that apply.
a. perinatal exposure
b. pregnancy
c. monogamous sex partner
d. older woman adult
e. occupational exposure - ✔✔✔-A, D, E
A nurse is assessing a client who has PAD. Which of the following should the nurse expect?
a. edema around ankles and feet
b. ulceration around the medial malleoli
c. scaling edema of the lower legs with stasis dermatitis
d. pallor on elevation of the limbs, and rubber when the limbs are dependent - ✔✔✔-D. In a
client who has PAD, pallor is seen in the extremities when the limbs are elevated, and rubor
occurs when they are lowered
A nurse is caring for a client who has a DVT and has been taking heparin for a week. Two days
ago, the provider also prescribed warfarin. The client asks the nurse about receiving both at the
same time. What should the nurse say?
a. I will remind your provider that you are already receiving heparin
b. your lab findings indicate that 2 anticoagulants are needed
c. it takes 3-4 days for the therapeutic effects of warfarin, and then heparin can be discontinued
d. only one of these medications are being given to treat your DVT - ✔✔✔-C. warfarin
depresses synthesis of clotting factors but does not have an effect on clotting factors that are
present. It takes 3-4 days for the clotting factors that are present to decay and for the
therapeutic effects of warfarin to occur.
