NSG 117 Exam 1 Review – Medical-Surgical Nursing Fundamentals Study Guide and Practice
Questions
A nurse explains the function of the alveoli to a patient with respiratory problems. Which
information about the alveoli's function will the nurse share with the patient? - ANS ✔✔Carries
out gas exchange
The nurse is teaching about the process of exchanging gases through the alveolar capillary
membrane. Which term will the nurse use to describe this process? - ANS ✔✔Diffusion
A nurse is caring for a patient who was in a motor vehicle accident that resulted in cervical
trauma to C4. Which assessment is the priority? - ANS ✔✔Respirations
The patient is breathing normally. Which process does the nurse consider is working properly
when the patient inspires? - ANS ✔✔Stimulation of chemical receptors in the aorta
The home health nurse recommends that a patient with respiratory problems install a carbon
monoxide detector in the home. What is the rationale for the nurse's action? - ANS ✔✔Carbon
monoxide tightly binds to hemoglobin, causing hypoxia.
While performing an assessment, the nurse hears crackles in the patient's lung fields. The nurse
also learns that the patient is sleeping on three pillows to help with the difficulty breathing
during the night. Which condition will the nurse most likely observe written in the patient's
medical record? - ANS ✔✔Left-sided heart failure
The nurse suspects the patient has increased afterload. Which piece of equipment should the
nurse obtain to determine the presence of this condition? - ANS ✔✔Blood pressure cuff
A patient's heart rate increased from 94 to 164 beats/min. What will the nurse expect? - ANS
✔✔Decrease in cardiac output
,The nurse is careful to monitor a patient's cardiac output. Which goal is the nurse trying to
achieve? - ANS ✔✔To determine peripheral extremity circulation
A nurse is caring for a group of patients. Which patient should the nurse see first?
a. A patient with hypercapnia wearing an oxygen mask
b. A patient with a chest tube ambulating with the chest tube unclamped - ANS ✔✔A patient
with hypercapnia wearing an oxygen mask
A patient has inadequate stroke volume related to decreased preload. Which treatment does
the nurse prepare to administer? - ANS ✔✔Intravenous (IV) fluids
The patient has right-sided heart failure. Which finding will the nurse expect when performing
an assessment? - ANS ✔✔Peripheral edema
A nurse teaches a patient about atelectasis. Which statement by the patient indicates an
understanding of atelectasis?
a. "Atelectasis affects only those with chronic conditions such as emphysema."
b. "It is important to do breathing exercises every hour to prevent atelectasis."
c. "If I develop atelectasis, I will need a chest tube to drain excess fluid."
d. "Hyperventilation will open up my alveoli, preventing atelectasis." - ANS ✔✔b. "It is
important to do breathing exercises every hour to prevent atelectasis."
The nurse is caring for a patient with respiratory problems. Which assessment finding indicates
a late sign of hypoxia? - ANS ✔✔Cyanosis
A nurse is caring for a 5-year-old patient whose temperature is 101.2° F. The nurse expects this
patient to hyperventilate. Which factor does the nurse remember when planning care for this
type of hyperventilation? - ANS ✔✔Increased metabolic demands
,A nurse is preparing a patient for nasotracheal suctioning. In which order will the nurse perform
the steps, beginning with the first step?
1. Insert catheter.
2. Apply suction and remove.
3. Have patient deep breathe.
4. Encourage patient to cough.
5. Attach catheter to suction system.
6. Rinse catheter and connecting tubing. - ANS ✔✔5, 3, 1, 2, 4, 6
5. Attach catheter to suction system
3. Have patient deep breathe.
1. Insert catheter.
2. Apply suction and remove.
4. Encourage patient to cough.
6. Rinse catheter and connecting tubing
A patient has carbon dioxide retention from lung problems. Which type of diet will the nurse
most likely suggest for this patient? - ANS ✔✔Low-carbohydrate
Upon auscultation of the patient's chest, the nurse hears a whooshing sound at the fifth
intercostal space. What does this finding indicate to the nurse? - ANS ✔✔Regurgitation of the
mitral valve
A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving 2 L/min of oxygen. Which oxygen delivery device is most appropriate for the nurse to
administer the oxygen? - ANS ✔✔Nasal cannula
, The nurse needs to closely monitor the oxygen status of an older-adult patient undergoing
anesthesia because of which age-related change?
a. Thinner heart valves cause lipid accumulation and fibrosis.
b. Diminished respiratory muscle strength may cause poor chest expansion. - ANS ✔✔b.
Diminished respiratory muscle strength may cause poor chest expansion.
The nurse determines that an older-adult patient is at risk for infection due to decreased
immunity. Which plan of care best addresses the prevention of infection for the patient? - ANS
✔✔Encourage the patient to stay up-to-date on all vaccinations
The nurse is caring for a patient with fluid volume overload. Which physiological effect does the
nurse most likely expect? - ANS ✔✔Increased preload
The nurse is creating a plan of care for an obese patient who is suffering from fatigue related to
ineffective breathing. Which intervention best addresses a short-term goal the patient could
achieve?
a. Sleeping on two to three pillows at night
b. Limiting the diet to 1500 calories a day - ANS ✔✔a. Sleeping on two to three pillows at night
Which nursing intervention is most effective in preventing hospital-acquired pneumonia in an
older-adult patient? - ANS ✔✔Assist the patient to cough, turn, and deep breathe every 2
hours.
The nurse is assessing a patient with emphysema. Which assessment finding requires further
follow-up with the health care provider? - ANS ✔✔Hemoptysis
The nurse is caring for a patient with a tracheostomy tube. Which nursing intervention is most
effective in promoting effective airway clearance? - ANS ✔✔Administering humidified oxygen
through a tracheostomy collar
Questions
A nurse explains the function of the alveoli to a patient with respiratory problems. Which
information about the alveoli's function will the nurse share with the patient? - ANS ✔✔Carries
out gas exchange
The nurse is teaching about the process of exchanging gases through the alveolar capillary
membrane. Which term will the nurse use to describe this process? - ANS ✔✔Diffusion
A nurse is caring for a patient who was in a motor vehicle accident that resulted in cervical
trauma to C4. Which assessment is the priority? - ANS ✔✔Respirations
The patient is breathing normally. Which process does the nurse consider is working properly
when the patient inspires? - ANS ✔✔Stimulation of chemical receptors in the aorta
The home health nurse recommends that a patient with respiratory problems install a carbon
monoxide detector in the home. What is the rationale for the nurse's action? - ANS ✔✔Carbon
monoxide tightly binds to hemoglobin, causing hypoxia.
While performing an assessment, the nurse hears crackles in the patient's lung fields. The nurse
also learns that the patient is sleeping on three pillows to help with the difficulty breathing
during the night. Which condition will the nurse most likely observe written in the patient's
medical record? - ANS ✔✔Left-sided heart failure
The nurse suspects the patient has increased afterload. Which piece of equipment should the
nurse obtain to determine the presence of this condition? - ANS ✔✔Blood pressure cuff
A patient's heart rate increased from 94 to 164 beats/min. What will the nurse expect? - ANS
✔✔Decrease in cardiac output
,The nurse is careful to monitor a patient's cardiac output. Which goal is the nurse trying to
achieve? - ANS ✔✔To determine peripheral extremity circulation
A nurse is caring for a group of patients. Which patient should the nurse see first?
a. A patient with hypercapnia wearing an oxygen mask
b. A patient with a chest tube ambulating with the chest tube unclamped - ANS ✔✔A patient
with hypercapnia wearing an oxygen mask
A patient has inadequate stroke volume related to decreased preload. Which treatment does
the nurse prepare to administer? - ANS ✔✔Intravenous (IV) fluids
The patient has right-sided heart failure. Which finding will the nurse expect when performing
an assessment? - ANS ✔✔Peripheral edema
A nurse teaches a patient about atelectasis. Which statement by the patient indicates an
understanding of atelectasis?
a. "Atelectasis affects only those with chronic conditions such as emphysema."
b. "It is important to do breathing exercises every hour to prevent atelectasis."
c. "If I develop atelectasis, I will need a chest tube to drain excess fluid."
d. "Hyperventilation will open up my alveoli, preventing atelectasis." - ANS ✔✔b. "It is
important to do breathing exercises every hour to prevent atelectasis."
The nurse is caring for a patient with respiratory problems. Which assessment finding indicates
a late sign of hypoxia? - ANS ✔✔Cyanosis
A nurse is caring for a 5-year-old patient whose temperature is 101.2° F. The nurse expects this
patient to hyperventilate. Which factor does the nurse remember when planning care for this
type of hyperventilation? - ANS ✔✔Increased metabolic demands
,A nurse is preparing a patient for nasotracheal suctioning. In which order will the nurse perform
the steps, beginning with the first step?
1. Insert catheter.
2. Apply suction and remove.
3. Have patient deep breathe.
4. Encourage patient to cough.
5. Attach catheter to suction system.
6. Rinse catheter and connecting tubing. - ANS ✔✔5, 3, 1, 2, 4, 6
5. Attach catheter to suction system
3. Have patient deep breathe.
1. Insert catheter.
2. Apply suction and remove.
4. Encourage patient to cough.
6. Rinse catheter and connecting tubing
A patient has carbon dioxide retention from lung problems. Which type of diet will the nurse
most likely suggest for this patient? - ANS ✔✔Low-carbohydrate
Upon auscultation of the patient's chest, the nurse hears a whooshing sound at the fifth
intercostal space. What does this finding indicate to the nurse? - ANS ✔✔Regurgitation of the
mitral valve
A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving 2 L/min of oxygen. Which oxygen delivery device is most appropriate for the nurse to
administer the oxygen? - ANS ✔✔Nasal cannula
, The nurse needs to closely monitor the oxygen status of an older-adult patient undergoing
anesthesia because of which age-related change?
a. Thinner heart valves cause lipid accumulation and fibrosis.
b. Diminished respiratory muscle strength may cause poor chest expansion. - ANS ✔✔b.
Diminished respiratory muscle strength may cause poor chest expansion.
The nurse determines that an older-adult patient is at risk for infection due to decreased
immunity. Which plan of care best addresses the prevention of infection for the patient? - ANS
✔✔Encourage the patient to stay up-to-date on all vaccinations
The nurse is caring for a patient with fluid volume overload. Which physiological effect does the
nurse most likely expect? - ANS ✔✔Increased preload
The nurse is creating a plan of care for an obese patient who is suffering from fatigue related to
ineffective breathing. Which intervention best addresses a short-term goal the patient could
achieve?
a. Sleeping on two to three pillows at night
b. Limiting the diet to 1500 calories a day - ANS ✔✔a. Sleeping on two to three pillows at night
Which nursing intervention is most effective in preventing hospital-acquired pneumonia in an
older-adult patient? - ANS ✔✔Assist the patient to cough, turn, and deep breathe every 2
hours.
The nurse is assessing a patient with emphysema. Which assessment finding requires further
follow-up with the health care provider? - ANS ✔✔Hemoptysis
The nurse is caring for a patient with a tracheostomy tube. Which nursing intervention is most
effective in promoting effective airway clearance? - ANS ✔✔Administering humidified oxygen
through a tracheostomy collar
