1|Page
END OF COURSE MEDSURG ENDTERM
LATEST ASSESSMENT WITH NEWEST
370 STRUCTURED
QUESTIONS WITH VERIFIED DETAILED
ANSWERS (370/370 CORRECT
ANSWERS)DISTINCTION GUARANTEED
A critically ill patient has a living will in the chart. The patient's condition has
deteriorated, but the spouse wants "everything done," regardless of the
patient's wishes. Which ethical principle is the spouse violating?
A) Nonmaleficence
B) Justice
C) Autonomy
D) Beneficence -- ANSWER>>Autonomy
The nurse is caring for a patient
admitted with a traumatic brain injury following a motor vehicle crash.
Several weeks later, the patient is still ventilator dependent and
unresponsive to stimulation but occasionally takes a spontaneous breath.
The physician explains to the family that the patient has severe
neurological impairment and is not expected to recover consciousness.
The nurse recognized that this patient is:
A) brain dead
B) in a persistent vegetative state
C) terminally ill
D) an organ donor -- ANSWER>>in a persistent vegetative state
A nurse caring for a patient with neurological impairment often must use
painful stimuli to elicit the patient's response. The nurse uses subtle
,2|Page
measures of painful stimuli, such as nail bed pressure. She neither slaps
the patient nor pinches the nipple to elicit a response to pain. In this
scenario, the nurse is exemplifying the ethical principle of:
A) veracity- obligation to tell the truth
B) fidelity- moral duty to be faithful
C) nonmaleficence- to not intentionally harm others
D) beneficence- demonstrates actions intended to benefit others --
ANSWER>>nonmaleficence
The critical care nurse wants a better understanding of when to initiate an
ethics consult. After attending an educational program, the nurse
understands that the following situation would require an ethics
consultation:
A) Patient with multiple trauma & is not responding to treatment. No family
members are known, and the health care team is debating if care is futile.
B) Family members disagree as to a patient's course of treatment. The pt
has designated health care proxy & has written advance directive. C)
Conflict has occurred between physician & family regarding txt decisions.
Family conference is held. Family & physician agree to txt plan that
includes aggressive treatment for 24 hrs. followed by reevaluations.
D) Patient postop coronary artery bypass who sustained cardiopulm arrest
in operating room. He was resuscitated, but now is not responding to txt.
He has written advance directive & wife is present. -- ANSWER>>Patient
with multiple trauma and is not responding to treatment. No family
members are known, and the health care team is debating if care is futile.
A postsurgical patient is on a ventilator in the critical care unit. The patient
has been tolerating the ventilator well and has not required any sedation.
On assessment, the nurse notes the patient is tachycardic and
hypertensive with an increased respiratory rate of 28 breaths/min. The
patient has been suctioned recently via the endotracheal tube, and the
airway is clear. The patient responds appropriately to the nurse's
commands. The nurse should:
,3|Page
A) provide sedation as ordered
B) suction the patient again
C) assess the patient's level of pain
D) decrease the ventilator rate -- ANSWER>>Assess the patient's level of
pain
In the trauma patient, symptoms of decreased cardiac output are most
commonly caused by:
A) hypovolemia
B) cardiogenic shock
C) pericardial tamponade
D) cardiac contusion -- ANSWER>>hypolvemia
A community-based
external disaster is initiated after a tornado moved through the city. A
nurse from the medical records review department arrives at the
emergency department asking how to assist. The best response by a
nurse working for the trauma center would be to:
A) have the nurse assist with transport of patients to procedural areas
B) thank the nurse but inform her to return to her department as her skill
set is not a good match for patients' needs
C) assign the nurse administrative duties, such as obtaining patient
demographic information.
D) assign the nurse to a triage room with another nurse form the
emergency department -- ANSWER>>assign the nurse administrative
duties, such as obtaining patient demographic information
A patient has been admitted to the emergency department with a massive
hemothorax. What action by the nurse takes priority?
A) prepare for rapid intubatio n
B) seal the wound with occlusive dressings
The nurse is
C) place the patient on a cardiac monitor
, 4|Page
caring for a
D) start 2 large bore IV's -- ANSWER>>Start 2 large bore IV's
patient who
sustained rib fractures after hitting the steering wheel of the car during a
motor vehicle crash. The patient is spontaneously breathing and receiving
oxygen via a face mask; the oxygen saturation is 95%. During the nurse's
assessment, the oxygen saturation drops to 80%. The patient's blood
pressure has dropped from 128/76 mmHg to 84/60. The nurse assesses
the breath sounds are absent throughout the left lung fields. The nurse
notifies the provider and anticipates:
A) needle thoracostomy and chest tube insertion
B) administration of lactated Ringer's solution (1L) wide open
C) endotracheal intubation and mechanical ventilation
D) chest x-ray study to determine the etiology of the symptoms --
ANSWER>>needle thoracostomy and chest tube insertion
Treatment and/or prevention of rhabdomyolysis in at-risk patients includes
aggressive fluid resuscitation to achieve urine output of:
a. 30 mL/hr.
b. 50 mL/hr.
c. 100 mL/hr.
d. 300 mL/hr. -- ANSWER>>100 mL/hr
A 36-year-old driver was pulled from a car after it collided with a tree and a
gas tank exploded. What assessment data suggest the patient suffered
tissue damage consistent with a blast injury?
A) responsive only to painful stimuli
B) irregular heart rate and rhythm
C) blood pressure 82/60 mmHg, heart rate 122 beats/min, respiratory rate
28 breaths/min.
END OF COURSE MEDSURG ENDTERM
LATEST ASSESSMENT WITH NEWEST
370 STRUCTURED
QUESTIONS WITH VERIFIED DETAILED
ANSWERS (370/370 CORRECT
ANSWERS)DISTINCTION GUARANTEED
A critically ill patient has a living will in the chart. The patient's condition has
deteriorated, but the spouse wants "everything done," regardless of the
patient's wishes. Which ethical principle is the spouse violating?
A) Nonmaleficence
B) Justice
C) Autonomy
D) Beneficence -- ANSWER>>Autonomy
The nurse is caring for a patient
admitted with a traumatic brain injury following a motor vehicle crash.
Several weeks later, the patient is still ventilator dependent and
unresponsive to stimulation but occasionally takes a spontaneous breath.
The physician explains to the family that the patient has severe
neurological impairment and is not expected to recover consciousness.
The nurse recognized that this patient is:
A) brain dead
B) in a persistent vegetative state
C) terminally ill
D) an organ donor -- ANSWER>>in a persistent vegetative state
A nurse caring for a patient with neurological impairment often must use
painful stimuli to elicit the patient's response. The nurse uses subtle
,2|Page
measures of painful stimuli, such as nail bed pressure. She neither slaps
the patient nor pinches the nipple to elicit a response to pain. In this
scenario, the nurse is exemplifying the ethical principle of:
A) veracity- obligation to tell the truth
B) fidelity- moral duty to be faithful
C) nonmaleficence- to not intentionally harm others
D) beneficence- demonstrates actions intended to benefit others --
ANSWER>>nonmaleficence
The critical care nurse wants a better understanding of when to initiate an
ethics consult. After attending an educational program, the nurse
understands that the following situation would require an ethics
consultation:
A) Patient with multiple trauma & is not responding to treatment. No family
members are known, and the health care team is debating if care is futile.
B) Family members disagree as to a patient's course of treatment. The pt
has designated health care proxy & has written advance directive. C)
Conflict has occurred between physician & family regarding txt decisions.
Family conference is held. Family & physician agree to txt plan that
includes aggressive treatment for 24 hrs. followed by reevaluations.
D) Patient postop coronary artery bypass who sustained cardiopulm arrest
in operating room. He was resuscitated, but now is not responding to txt.
He has written advance directive & wife is present. -- ANSWER>>Patient
with multiple trauma and is not responding to treatment. No family
members are known, and the health care team is debating if care is futile.
A postsurgical patient is on a ventilator in the critical care unit. The patient
has been tolerating the ventilator well and has not required any sedation.
On assessment, the nurse notes the patient is tachycardic and
hypertensive with an increased respiratory rate of 28 breaths/min. The
patient has been suctioned recently via the endotracheal tube, and the
airway is clear. The patient responds appropriately to the nurse's
commands. The nurse should:
,3|Page
A) provide sedation as ordered
B) suction the patient again
C) assess the patient's level of pain
D) decrease the ventilator rate -- ANSWER>>Assess the patient's level of
pain
In the trauma patient, symptoms of decreased cardiac output are most
commonly caused by:
A) hypovolemia
B) cardiogenic shock
C) pericardial tamponade
D) cardiac contusion -- ANSWER>>hypolvemia
A community-based
external disaster is initiated after a tornado moved through the city. A
nurse from the medical records review department arrives at the
emergency department asking how to assist. The best response by a
nurse working for the trauma center would be to:
A) have the nurse assist with transport of patients to procedural areas
B) thank the nurse but inform her to return to her department as her skill
set is not a good match for patients' needs
C) assign the nurse administrative duties, such as obtaining patient
demographic information.
D) assign the nurse to a triage room with another nurse form the
emergency department -- ANSWER>>assign the nurse administrative
duties, such as obtaining patient demographic information
A patient has been admitted to the emergency department with a massive
hemothorax. What action by the nurse takes priority?
A) prepare for rapid intubatio n
B) seal the wound with occlusive dressings
The nurse is
C) place the patient on a cardiac monitor
, 4|Page
caring for a
D) start 2 large bore IV's -- ANSWER>>Start 2 large bore IV's
patient who
sustained rib fractures after hitting the steering wheel of the car during a
motor vehicle crash. The patient is spontaneously breathing and receiving
oxygen via a face mask; the oxygen saturation is 95%. During the nurse's
assessment, the oxygen saturation drops to 80%. The patient's blood
pressure has dropped from 128/76 mmHg to 84/60. The nurse assesses
the breath sounds are absent throughout the left lung fields. The nurse
notifies the provider and anticipates:
A) needle thoracostomy and chest tube insertion
B) administration of lactated Ringer's solution (1L) wide open
C) endotracheal intubation and mechanical ventilation
D) chest x-ray study to determine the etiology of the symptoms --
ANSWER>>needle thoracostomy and chest tube insertion
Treatment and/or prevention of rhabdomyolysis in at-risk patients includes
aggressive fluid resuscitation to achieve urine output of:
a. 30 mL/hr.
b. 50 mL/hr.
c. 100 mL/hr.
d. 300 mL/hr. -- ANSWER>>100 mL/hr
A 36-year-old driver was pulled from a car after it collided with a tree and a
gas tank exploded. What assessment data suggest the patient suffered
tissue damage consistent with a blast injury?
A) responsive only to painful stimuli
B) irregular heart rate and rhythm
C) blood pressure 82/60 mmHg, heart rate 122 beats/min, respiratory rate
28 breaths/min.
