NUR 201/NUR201 Exam 4 V1 | Medical-
Surgical Nursing I Q&A with Rationale |
Fortis College
1. A patient with chronic kidney disease (CKD) is prescribed calcium acetate (PhosLo). The
nurse understands that the primary purpose of this medication is to:
A. Increase serum calcium levels by enhancing intestinal absorption.
B. Lower serum phosphorus levels by binding with dietary phosphate.
C. Prevent the development of renal osteodystrophy and bone pain.
D. Act as a calcium supplement to treat chronic hypocalcemia.
Correct Answer: B
Expert Explanation: Calcium acetate acts as a phosphate binder which is essential for
patients with CKD who cannot excrete phosphorus efficiently. It must be taken with meals
to bind with the phosphorus found in food before it can be absorbed. Effective management
helps prevent the secondary hyperparathyroidism often seen in renal failure patients.
2. Which clinical manifestation should the nurse prioritize when assessing a patient in the
oliguric phase of acute kidney injury (AKI)?
A. Hypokalemia and hypotension.
B. Metabolic alkalosis and hypovolemia.
C. Fluid volume excess and hyperkalemia.
,D. Hypernatremia and increased urine output.
Correct Answer: C
Expert Explanation: During the oliguric phase, the kidneys fail to excrete metabolic
wastes and excess fluid, leading to volume overload. Potassium is not excreted effectively,
which can lead to life-threatening cardiac arrhythmias. Monitoring daily weights and
cardiac rhythm is a critical nursing intervention during this phase.
3. A patient is admitted with partial-thickness burns over 30% of their body. Which
assessment finding indicates the patient is entering the emergent phase of burn
management?
A. Hypovolemia and increased hematocrit due to hemoconcentration.
B. Increased urinary output and decreased heart rate.
C. Hypervolemia and decreased serum potassium levels.
D. Generalized edema and hypertension.
Correct Answer: A
Expert Explanation: In the emergent phase of a burn injury, massive fluid shifts occur
from the intravascular to the interstitial space. This results in hypovolemia and
hemoconcentration, which is reflected by an elevated hematocrit level. Immediate fluid
resuscitation is required to maintain organ perfusion and prevent hypovolemic shock.
, 4. The nurse is caring for a patient post-transurethral resection of the prostate (TURP) with
continuous bladder irrigation (CBI). The nurse notes the drainage has turned bright red with
numerous clots. Which action is most appropriate?
A. Decrease the rate of the irrigation to prevent bladder spasms.
B. Stop the irrigation and notify the healthcare provider immediately.
C. Increase the irrigation rate to maintain a pink-tinged output.
D. Administer an ordered analgesic for report of bladder pain.
Correct Answer: C
Expert Explanation: Continuous bladder irrigation is used to prevent the formation of
clots that could obstruct the urinary catheter. If the drainage becomes bright red or
contains clots, the nurse must increase the rate of the inflow to flush the bladder
effectively. Keeping the output light pink ensures that the surgical site is not bleeding
excessively and the catheter remains patent.
5. A patient with a history of urolithiasis is being discharged. Which dietary instruction should
the nurse include for a patient with calcium oxalate stones?
A. Increase intake of spinach, rhubarb, and black tea.
B. Limit fluid intake to 1000 mL per day to rest the kidneys.
C. Avoid all dairy products to reduce calcium levels.
D. Reduce intake of high-oxalate foods and increase water intake.
Surgical Nursing I Q&A with Rationale |
Fortis College
1. A patient with chronic kidney disease (CKD) is prescribed calcium acetate (PhosLo). The
nurse understands that the primary purpose of this medication is to:
A. Increase serum calcium levels by enhancing intestinal absorption.
B. Lower serum phosphorus levels by binding with dietary phosphate.
C. Prevent the development of renal osteodystrophy and bone pain.
D. Act as a calcium supplement to treat chronic hypocalcemia.
Correct Answer: B
Expert Explanation: Calcium acetate acts as a phosphate binder which is essential for
patients with CKD who cannot excrete phosphorus efficiently. It must be taken with meals
to bind with the phosphorus found in food before it can be absorbed. Effective management
helps prevent the secondary hyperparathyroidism often seen in renal failure patients.
2. Which clinical manifestation should the nurse prioritize when assessing a patient in the
oliguric phase of acute kidney injury (AKI)?
A. Hypokalemia and hypotension.
B. Metabolic alkalosis and hypovolemia.
C. Fluid volume excess and hyperkalemia.
,D. Hypernatremia and increased urine output.
Correct Answer: C
Expert Explanation: During the oliguric phase, the kidneys fail to excrete metabolic
wastes and excess fluid, leading to volume overload. Potassium is not excreted effectively,
which can lead to life-threatening cardiac arrhythmias. Monitoring daily weights and
cardiac rhythm is a critical nursing intervention during this phase.
3. A patient is admitted with partial-thickness burns over 30% of their body. Which
assessment finding indicates the patient is entering the emergent phase of burn
management?
A. Hypovolemia and increased hematocrit due to hemoconcentration.
B. Increased urinary output and decreased heart rate.
C. Hypervolemia and decreased serum potassium levels.
D. Generalized edema and hypertension.
Correct Answer: A
Expert Explanation: In the emergent phase of a burn injury, massive fluid shifts occur
from the intravascular to the interstitial space. This results in hypovolemia and
hemoconcentration, which is reflected by an elevated hematocrit level. Immediate fluid
resuscitation is required to maintain organ perfusion and prevent hypovolemic shock.
, 4. The nurse is caring for a patient post-transurethral resection of the prostate (TURP) with
continuous bladder irrigation (CBI). The nurse notes the drainage has turned bright red with
numerous clots. Which action is most appropriate?
A. Decrease the rate of the irrigation to prevent bladder spasms.
B. Stop the irrigation and notify the healthcare provider immediately.
C. Increase the irrigation rate to maintain a pink-tinged output.
D. Administer an ordered analgesic for report of bladder pain.
Correct Answer: C
Expert Explanation: Continuous bladder irrigation is used to prevent the formation of
clots that could obstruct the urinary catheter. If the drainage becomes bright red or
contains clots, the nurse must increase the rate of the inflow to flush the bladder
effectively. Keeping the output light pink ensures that the surgical site is not bleeding
excessively and the catheter remains patent.
5. A patient with a history of urolithiasis is being discharged. Which dietary instruction should
the nurse include for a patient with calcium oxalate stones?
A. Increase intake of spinach, rhubarb, and black tea.
B. Limit fluid intake to 1000 mL per day to rest the kidneys.
C. Avoid all dairy products to reduce calcium levels.
D. Reduce intake of high-oxalate foods and increase water intake.
