Test Bank for Introductory Medical-Surgical
Nursing 12th Edition by Timby Smith, All
Chapters 1-72 Covered, A+ guide.
Medical Surgical Nursing Exam Questions
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Here is a sample exam created in the style of a test bank for *Introductory Medical-Surgical
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Nursing, 12th Edition* by Timby & Smith. It includes multiple-choice questions with correct
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answers and rationales, covering key topics from several chapters.
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Exam: Introductory Medical-Surgical Nursing (Timby & Smith, 12th Ed.)
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Instructions: Choose the best answer for each question. hj hj hj hj hj hj hj
Chapter 1: The Nurse’s Role in Medical-Surgical Nursing
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1. A medical-surgical nurse is caring for a patient with diabetes who is also newly
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diagnosed with hypertension. Which action best demonstrates the role of a patient
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advocate?
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A. Administering antihypertensive medication as ordered
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B. Teaching the patient how to monitor blood pressure at home
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C. Informing the physician about the patient’s difficulty affording medications
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D. Documenting the patient’s blood pressure readings every shift
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Correct Answer: C hj hj
Rationale: Advocacy involves speaking up for the patient’s needs and preferences. Informing the
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, physician about financial barriers to medication adherence addresses a key social determinant
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of health.
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Chapter 3: Fluid, Electrolytes, and Acid-Base Balance
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2. A patient has a serum potassium level of 2.9 mEq/L (normal 3.5–5.0). Which
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assessment finding is most concerning?
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A. Dry mucous membranes
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B. Muscle weakness and ECG changes
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C. Blood pressure 140/90 mmHg
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D. Urine output of 60 mL/hr
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Correct Answer: B hj hj
Rationale: Hypokalemia (K+ <3.5) can cause muscle weakness, cardiac dysrhythmias (flat T
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waves, U waves), and respiratory failure. This finding requires immediate intervention.
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Chapter 10: Caring for Patients with Cancer
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3. A patient receiving chemotherapy reports severe nausea 24 hours after treatment.
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Which intervention should the nurse implement first?
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A. Offer dry crackers and ginger ale
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B. Administer prescribed antiemetic (ondansetron)
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C. Encourage the patient to eat a large meal
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D. Withhold fluids until nausea subsides
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Correct Answer: B hj hj
Rationale: Pharmacologic management is the first line for chemotherapy-induced nausea.
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Ondansetron (a 5-HT3 antagonist) is highly effective for delayed nausea.
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Chapter 20: Caring for Patients with Respiratory Disorders
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4. A patient with chronic obstructive pulmonary disease (COPD) has an SpO₂ of 88% on 2
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L/min oxygen via nasal cannula. Which action should the nurse take?
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A. Increase oxygen to 4 L/min immediately
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B. Remove oxygen and reassess in 15 minutes
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C. Continue current oxygen and notify the provider
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D. Place the patient in Trendelenburg position
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Correct Answer: C hj hj
Rationale: Patients with COPD rely on hypoxic drive. Increasing O₂ too much can cause CO₂
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, retention. The goal SpO₂ is usually 88–92% for COPD. The current level is acceptable but
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warrants provider notification for possible titration.
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Chapter 27: Caring for Patients with Cardiovascular Disorders
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5. A patient with heart failure has crackles in both lung bases, jugular vein distension,
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and 3+ pitting edema in the lower legs. Which medication order should the nurse
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question?
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A. Furosemide (Lasix) 40 mg IV
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B. Lisinopril 10 mg orally
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C. Metoprolol 25 mg orally
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D. Normal saline IV at 150 mL/hr
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Correct Answer: D hj hj
Rationale: The patient shows signs of fluid volume overload (crackles, JVD, edema). IV normal
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saline at 150 mL/hr would worsen fluid overload. Diuretics and afterload reducers are
hj hj hj hj hj hj hj hj hj hj hj hj hj
appropriate.
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Chapter 35: Caring for Patients with Diabetes Mellitus
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6. A patient with type 1 diabetes has a blood glucose of 350 mg/dL, deep rapid
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respirations, and fruity breath odor. Which acid-base imbalance is expected?
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A. Metabolic acidosis
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B. Metabolic alkalosis
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C. Respiratory acidosis
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D. Respiratory alkalosis
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Correct Answer: A hj hj
Rationale: Diabetic ketoacidosis (DKA) leads to ketone accumulation, causing metabolic acidosis
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(low pH, low HCO₃⁻). Kussmaul respirations are compensatory.
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Chapter 44: Caring for Patients with Neurologic Disorders
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7. A patient who had a stroke has difficulty swallowing and coughs while eating. What is
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the priority nursing action?
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A. Suction the patient’s airway
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B. Place the patient on NPO status and notify speech therapy
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C. Thicken all liquids to honey consistency
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D. Feed the patient pureed foods only
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, Correct Answer: B hj hj
Rationale: Dysphagia with coughing indicates aspiration risk. NPO and referral to speech-
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language pathology for swallow evaluation are essential before any oral intake.
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Chapter 52: Caring for Patients with Musculoskeletal Disorders
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8. A patient had a total hip arthroplasty. Which position should the nurse avoid to
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prevent dislocation?
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A. Supine with pillow between legs
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B. Side-lying on the operative side
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C. Sitting with hips lower than knees
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D. Crossing legs at the ankles or knees
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Correct Answer: D hj hj
Rationale: Crossing legs (adduction past midline) is contraindicated after hip replacement. Other
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precautions include no hip flexion >90°, no internal rotation.
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Chapter 60: Caring for Patients with Renal Disorders
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9. A patient with chronic kidney disease (CKD) has a hemoglobin of 8.2 g/dL. Which
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medication does the nurse anticipate administering?
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A. Iron sulfate orally
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B. Epoetin alfa (Epogen) subcutaneously
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C. Furosemide IV push
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D. Sodium polystyrene sulfonate (Kayexalate) orally
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Correct Answer: B hj hj
Rationale: CKD causes decreased erythropoietin production → anemia. Epoetin alfa
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(erythropoiesis-stimulating agent) is the standard treatment.
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Chapter 72: Caring for Patients with Emergencies, Disasters, and Bioterrorism
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10. A patient arrives at the ER after a house fire with singed nasal hairs, hoarseness, and
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carbonaceous sputum. What is the priority intervention?
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A. Administer tetanus vaccine
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B. Apply silver sulfadiazine to burns
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C. Prepare for immediate intubation
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D. Start IV antibiotics
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Correct Answer: C hj hj
Rationale: Singed nasal hairs, hoarseness, and carbonaceous sputum indicate inhalation injury,
hj hj hj hj hj hj hj hj hj hj
Nursing 12th Edition by Timby Smith, All
Chapters 1-72 Covered, A+ guide.
Medical Surgical Nursing Exam Questions
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Here is a sample exam created in the style of a test bank for *Introductory Medical-Surgical
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
Nursing, 12th Edition* by Timby & Smith. It includes multiple-choice questions with correct
hj hj hj hj hj hj hj hj hj hj hj hj hj
answers and rationales, covering key topics from several chapters.
hj hj hj hj hj hj hj hj hj
Exam: Introductory Medical-Surgical Nursing (Timby & Smith, 12th Ed.)
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Instructions: Choose the best answer for each question. hj hj hj hj hj hj hj
Chapter 1: The Nurse’s Role in Medical-Surgical Nursing
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1. A medical-surgical nurse is caring for a patient with diabetes who is also newly
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
diagnosed with hypertension. Which action best demonstrates the role of a patient
hj hj hj hj hj hj hj hj hj hj hj hj
advocate?
hj
A. Administering antihypertensive medication as ordered
hj hj hj hj hj
B. Teaching the patient how to monitor blood pressure at home
hj hj hj hj hj hj hj hj hj hj
C. Informing the physician about the patient’s difficulty affording medications
hj hj hj hj hj hj hj hj hj
D. Documenting the patient’s blood pressure readings every shift
hj hj hj hj hj hj hj hj
Correct Answer: C hj hj
Rationale: Advocacy involves speaking up for the patient’s needs and preferences. Informing the
hj hj hj hj hj hj hj hj hj hj hj hj
, physician about financial barriers to medication adherence addresses a key social determinant
hj hj hj hj hj hj hj hj hj hj hj hj
of health.
hj hj
Chapter 3: Fluid, Electrolytes, and Acid-Base Balance
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2. A patient has a serum potassium level of 2.9 mEq/L (normal 3.5–5.0). Which
hj hj hj hj hj hj hj hj hj hj hj hj hj
assessment finding is most concerning?
hj hj hj hj hj
A. Dry mucous membranes
hj hj hj
B. Muscle weakness and ECG changes
hj hj hj hj hj
C. Blood pressure 140/90 mmHg
hj hj hj hj
D. Urine output of 60 mL/hr
hj hj hj hj hj
Correct Answer: B hj hj
Rationale: Hypokalemia (K+ <3.5) can cause muscle weakness, cardiac dysrhythmias (flat T
hj hj hj hj hj hj hj hj hj hj hj
waves, U waves), and respiratory failure. This finding requires immediate intervention.
hj hj hj hj hj hj hj hj hj hj hj
Chapter 10: Caring for Patients with Cancer
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3. A patient receiving chemotherapy reports severe nausea 24 hours after treatment.
hj hj hj hj hj hj hj hj hj hj hj
Which intervention should the nurse implement first?
hj hj hj hj hj hj hj
A. Offer dry crackers and ginger ale
hj hj hj hj hj hj
B. Administer prescribed antiemetic (ondansetron)
hj hj hj hj
C. Encourage the patient to eat a large meal
hj hj hj hj hj hj hj hj
D. Withhold fluids until nausea subsides
hj hj hj hj hj
Correct Answer: B hj hj
Rationale: Pharmacologic management is the first line for chemotherapy-induced nausea.
hj hj hj hj hj hj hj hj hj
Ondansetron (a 5-HT3 antagonist) is highly effective for delayed nausea.
hj hj hj hj hj hj hj hj hj hj
Chapter 20: Caring for Patients with Respiratory Disorders
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4. A patient with chronic obstructive pulmonary disease (COPD) has an SpO₂ of 88% on 2
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
L/min oxygen via nasal cannula. Which action should the nurse take?
hj hj hj hj hj hj hj hj hj hj hj
A. Increase oxygen to 4 L/min immediately
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B. Remove oxygen and reassess in 15 minutes
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C. Continue current oxygen and notify the provider
hj hj hj hj hj hj hj
D. Place the patient in Trendelenburg position
hj hj hj hj hj hj
Correct Answer: C hj hj
Rationale: Patients with COPD rely on hypoxic drive. Increasing O₂ too much can cause CO₂
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
, retention. The goal SpO₂ is usually 88–92% for COPD. The current level is acceptable but
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
warrants provider notification for possible titration.
hj hj hj hj hj hj
Chapter 27: Caring for Patients with Cardiovascular Disorders
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5. A patient with heart failure has crackles in both lung bases, jugular vein distension,
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
and 3+ pitting edema in the lower legs. Which medication order should the nurse
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
question?
hj
A. Furosemide (Lasix) 40 mg IV
hj hj hj hj hj
B. Lisinopril 10 mg orally
hj hj hj hj
C. Metoprolol 25 mg orally
hj hj hj hj
D. Normal saline IV at 150 mL/hr
hj hj hj hj hj hj
Correct Answer: D hj hj
Rationale: The patient shows signs of fluid volume overload (crackles, JVD, edema). IV normal
hj hj hj hj hj hj hj hj hj hj hj hj hj
saline at 150 mL/hr would worsen fluid overload. Diuretics and afterload reducers are
hj hj hj hj hj hj hj hj hj hj hj hj hj
appropriate.
hj
Chapter 35: Caring for Patients with Diabetes Mellitus
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6. A patient with type 1 diabetes has a blood glucose of 350 mg/dL, deep rapid
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
respirations, and fruity breath odor. Which acid-base imbalance is expected?
hj hj hj hj hj hj hj hj hj hj
A. Metabolic acidosis
hj hj
B. Metabolic alkalosis
hj hj
C. Respiratory acidosis
hj hj
D. Respiratory alkalosis
hj hj
Correct Answer: A hj hj
Rationale: Diabetic ketoacidosis (DKA) leads to ketone accumulation, causing metabolic acidosis
hj hj hj hj hj hj hj hj hj hj
(low pH, low HCO₃⁻). Kussmaul respirations are compensatory.
hj hj hj hj hj hj hj hj
Chapter 44: Caring for Patients with Neurologic Disorders
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7. A patient who had a stroke has difficulty swallowing and coughs while eating. What is
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
the priority nursing action?
hj hj hj hj
A. Suction the patient’s airway
hj hj hj hj
B. Place the patient on NPO status and notify speech therapy
hj hj hj hj hj hj hj hj hj hj
C. Thicken all liquids to honey consistency
hj hj hj hj hj hj
D. Feed the patient pureed foods only
hj hj hj hj hj hj
, Correct Answer: B hj hj
Rationale: Dysphagia with coughing indicates aspiration risk. NPO and referral to speech-
hj hj hj hj hj hj hj hj hj hj hj
language pathology for swallow evaluation are essential before any oral intake.
hj hj hj hj hj hj hj hj hj hj
Chapter 52: Caring for Patients with Musculoskeletal Disorders
hj hj hj hj hj hj hj
8. A patient had a total hip arthroplasty. Which position should the nurse avoid to
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
prevent dislocation?
hj hj
A. Supine with pillow between legs
hj hj hj hj hj
B. Side-lying on the operative side
hj hj hj hj hj
C. Sitting with hips lower than knees
hj hj hj hj hj hj
D. Crossing legs at the ankles or knees
hj hj hj hj hj hj hj
Correct Answer: D hj hj
Rationale: Crossing legs (adduction past midline) is contraindicated after hip replacement. Other
hj hj hj hj hj hj hj hj hj hj hj
precautions include no hip flexion >90°, no internal rotation.
hj hj hj hj hj hj hj hj hj
Chapter 60: Caring for Patients with Renal Disorders
hj hj hj hj hj hj hj
9. A patient with chronic kidney disease (CKD) has a hemoglobin of 8.2 g/dL. Which
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
medication does the nurse anticipate administering?
hj hj hj hj hj hj
A. Iron sulfate orally
hj hj hj
B. Epoetin alfa (Epogen) subcutaneously
hj hj hj hj
C. Furosemide IV push
hj hj hj
D. Sodium polystyrene sulfonate (Kayexalate) orally
hj hj hj hj hj
Correct Answer: B hj hj
Rationale: CKD causes decreased erythropoietin production → anemia. Epoetin alfa
hj hj hj hj hj hj hj hj hj
(erythropoiesis-stimulating agent) is the standard treatment.
hj hj hj hj hj hj
Chapter 72: Caring for Patients with Emergencies, Disasters, and Bioterrorism
hj hj hj hj hj hj hj hj hj
10. A patient arrives at the ER after a house fire with singed nasal hairs, hoarseness, and
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
carbonaceous sputum. What is the priority intervention?
hj hj hj hj hj hj hj
A. Administer tetanus vaccine
hj hj hj
B. Apply silver sulfadiazine to burns
hj hj hj hj hj
C. Prepare for immediate intubation
hj hj hj hj
D. Start IV antibiotics
hj hj hj
Correct Answer: C hj hj
Rationale: Singed nasal hairs, hoarseness, and carbonaceous sputum indicate inhalation injury,
hj hj hj hj hj hj hj hj hj hj
