PNR 206/PNR206 Final Exam V3 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing increased dyspnea. Which oxygen delivery method should the nurse prioritize to
provide a precise concentration of oxygen?
A. Simple face mask
B. Venturi mask
C. Nasal cannula
D. Non-rebreather mask
Correct Answer: B
Expert Explanation: The Venturi mask is the most accurate device for delivering a specific
oxygen concentration, which is critical for patients with COPD who rely on a hypoxic drive.
It uses different sized adaptors to mix room air with a fixed flow of oxygen to achieve a
precise FiO2. This prevents the risk of oxygen-induced hypoventilation that can occur with
high concentrations in chronic lung disease patients.
2. A patient diagnosed with Type 2 Diabetes is prescribed Metformin. Which teaching point is
most important for the nurse to include regarding this medication?
A. Take the medication on an empty stomach to increase absorption.
,B. Notify the provider if scheduled for a CT scan with intravenous contrast.
C. Monitor for weight gain as a common side effect of therapy.
D. This medication works by stimulating the pancreas to produce more insulin.
Correct Answer: B
Expert Explanation: Metformin must be discontinued 48 hours before and after
procedures involving intravenous contrast media to prevent the risk of lactic acidosis.
Contrast media can cause temporary renal impairment, which leads to the accumulation of
metformin in the body. The nurse must educate the patient on this safety precaution to
prevent potentially fatal complications.
3. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Crackles in the lungs
B. Paroxysmal nocturnal dyspnea
C. Peripheral edema
D. Orthopnea
Correct Answer: C
Expert Explanation: Right-sided heart failure results in systemic venous congestion
because the right ventricle cannot pump blood effectively to the lungs. This leads to
symptoms such as peripheral edema, jugular venous distention, and hepatomegaly. In
,contrast, crackles and orthopnea are hallmark signs of left-sided heart failure due to
pulmonary congestion.
4. A patient is 2 hours post-operative following a total hip arthroplasty. Which nursing
intervention is essential to prevent dislocation of the prosthesis?
A. Place an abduction pillow between the patient’s legs.
B. Ensure the hip is flexed more than 90 degrees when sitting.
C. Maintain the affected leg in an adducted position.
D. Encourage the patient to cross their legs while resting.
Correct Answer: A
Expert Explanation: An abduction pillow or wedge is used to keep the legs separated and
prevent adduction, which is a major risk factor for prosthesis dislocation. The nurse should
also ensure the patient avoids internal rotation and hip flexion beyond 90 degrees. These
precautions are vital during the early recovery phase to allow the surgical site to stabilize.
5. A nurse is reviewing laboratory results for a patient with Chronic Kidney Disease (CKD).
Which result requires immediate notification of the healthcare provider?
A. Creatinine of 2.5 mg/dL
B. Hemoglobin of 10 g/dL
C. Potassium of 6.2 mEq/L
D. Calcium of 8.8 mg/dL
, Correct Answer: C
Expert Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which is a
life-threatening electrolyte imbalance that can lead to cardiac arrhythmias or arrest. While
an elevated creatinine and low hemoglobin are expected in CKD, they are not as acutely
dangerous as high potassium. The nurse must act quickly to implement interventions such
as administering Kayexalate or insulin/glucose to lower the potassium level.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is
considered the ‘gold standard’ for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. CT Pulmonary Angiography (CTPA)
Correct Answer: D
Expert Explanation: CT Pulmonary Angiography is the preferred diagnostic tool for PE
because it provides high-quality visualization of the pulmonary vasculature. A D-dimer test
can suggest a clot is present but is not specific to PE, whereas a chest X-ray often appears
normal in these patients. Prompt diagnosis is essential for initiating anticoagulant therapy
and preventing right ventricular failure.
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing increased dyspnea. Which oxygen delivery method should the nurse prioritize to
provide a precise concentration of oxygen?
A. Simple face mask
B. Venturi mask
C. Nasal cannula
D. Non-rebreather mask
Correct Answer: B
Expert Explanation: The Venturi mask is the most accurate device for delivering a specific
oxygen concentration, which is critical for patients with COPD who rely on a hypoxic drive.
It uses different sized adaptors to mix room air with a fixed flow of oxygen to achieve a
precise FiO2. This prevents the risk of oxygen-induced hypoventilation that can occur with
high concentrations in chronic lung disease patients.
2. A patient diagnosed with Type 2 Diabetes is prescribed Metformin. Which teaching point is
most important for the nurse to include regarding this medication?
A. Take the medication on an empty stomach to increase absorption.
,B. Notify the provider if scheduled for a CT scan with intravenous contrast.
C. Monitor for weight gain as a common side effect of therapy.
D. This medication works by stimulating the pancreas to produce more insulin.
Correct Answer: B
Expert Explanation: Metformin must be discontinued 48 hours before and after
procedures involving intravenous contrast media to prevent the risk of lactic acidosis.
Contrast media can cause temporary renal impairment, which leads to the accumulation of
metformin in the body. The nurse must educate the patient on this safety precaution to
prevent potentially fatal complications.
3. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Crackles in the lungs
B. Paroxysmal nocturnal dyspnea
C. Peripheral edema
D. Orthopnea
Correct Answer: C
Expert Explanation: Right-sided heart failure results in systemic venous congestion
because the right ventricle cannot pump blood effectively to the lungs. This leads to
symptoms such as peripheral edema, jugular venous distention, and hepatomegaly. In
,contrast, crackles and orthopnea are hallmark signs of left-sided heart failure due to
pulmonary congestion.
4. A patient is 2 hours post-operative following a total hip arthroplasty. Which nursing
intervention is essential to prevent dislocation of the prosthesis?
A. Place an abduction pillow between the patient’s legs.
B. Ensure the hip is flexed more than 90 degrees when sitting.
C. Maintain the affected leg in an adducted position.
D. Encourage the patient to cross their legs while resting.
Correct Answer: A
Expert Explanation: An abduction pillow or wedge is used to keep the legs separated and
prevent adduction, which is a major risk factor for prosthesis dislocation. The nurse should
also ensure the patient avoids internal rotation and hip flexion beyond 90 degrees. These
precautions are vital during the early recovery phase to allow the surgical site to stabilize.
5. A nurse is reviewing laboratory results for a patient with Chronic Kidney Disease (CKD).
Which result requires immediate notification of the healthcare provider?
A. Creatinine of 2.5 mg/dL
B. Hemoglobin of 10 g/dL
C. Potassium of 6.2 mEq/L
D. Calcium of 8.8 mg/dL
, Correct Answer: C
Expert Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which is a
life-threatening electrolyte imbalance that can lead to cardiac arrhythmias or arrest. While
an elevated creatinine and low hemoglobin are expected in CKD, they are not as acutely
dangerous as high potassium. The nurse must act quickly to implement interventions such
as administering Kayexalate or insulin/glucose to lower the potassium level.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is
considered the ‘gold standard’ for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. CT Pulmonary Angiography (CTPA)
Correct Answer: D
Expert Explanation: CT Pulmonary Angiography is the preferred diagnostic tool for PE
because it provides high-quality visualization of the pulmonary vasculature. A D-dimer test
can suggest a clot is present but is not specific to PE, whereas a chest X-ray often appears
normal in these patients. Prompt diagnosis is essential for initiating anticoagulant therapy
and preventing right ventricular failure.
