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MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s)

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Exam (elaborations) MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s) QUESTION BANK (From Exams 1-3 & ATI’s) Exam 1 1. A patient has received atropine before surgery and complains of dry mouth. Which action by the nurse is best? Answer: Tell the patient dry mouth is an expected side effect. 2. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy procedure in outpatient surgery. Which information is of most concern to the nurse? Answer: The patient is planning to drive home after surgery. 3. As the nurse prepares a patient the morning of surgery, the patient refuses to remove a wedding ring, saying, "I have never taken it off since the day I was married." Which response by the nurse is best? Answer: Suggest that the patient give the ring to a family member to keep. 4. The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a patient who is scheduled for surgery in a few days. The results are white blood cell (WBC) count 10.2 × 103/μL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 × 103/μL. Which action should the nurse take? Answer: Continue to prepare the patient for the surgical procedure. 5. A 36-year-old female is admitted for an elective surgical procedure. Which information obtained by the nurse during the preoperative assessment is most important to report to the anesthesiologist before surgery? Answer: The patient's statement that her last menstrual period was 8 weeks ago 6. Which information in the preoperative patient's medication history is most important to communicate to the health care provider? Answer: The patient takes garlic capsules daily. 7. A patient who takes a diuretic and a β-blocker to control blood pressure is scheduled for breast reconstruction surgery. Which patient information is most important to communicate to the health care provider before surgery? Answer: Serum potassium 3.2 mEq/L 8. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a dislocated shoulder. What does the nurse anticipate? Answer: Starting an IV in the patient’s unaffected arm. 9. While in the holding area, a patient reveals to the nurse that his father had a high fever after surgery. What action by the nurse is a priority? Answer: Alert the anesthesia care provider of the family member’s reaction to surgery 10. The nurse facilitates student clinical experiences in the surgical suite. Which action, if performed by a student, would require the nurse to intervene? Answer: The student wears street clothed in the semi-restricted area. 11. The operating room nurse is providing orientation to a student nurse. Which action would the nurse list as a major responsibility of a scrub nurse? Answer: Keep both hands above the operating table level MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s) 12. A patient in surgery receives a neuromuscular blocking agent as an adjunct to general anesthesia. While in the PACU, what assessment finding is most important for the nurse to report? Answer: Weak chest movement 13. Which action in the perioperative patient plan of care can the charge nurse delegate to a surgical technologist? Answer: Pass sterile instruments and supplies to the surgeon and scrub technician 14. When caring for a patient who has received general anesthetic, the circulating nurse notes red, raised wheals on the patient’s arms. Which action should the nurse take? Answer: Notify the ACP 15. The NG tube is removed 2nd day postop, pt is placed on a clear, liquid diet. 4 hrs later the pt complains of sharp, cramping gas pains. What action by the RN is most appropriate? Answer: assist the patient to ambulate 16. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure (BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74 and warm, dry skin. Which action by the nurse is most appropriate? Answer: Continue to take vital signs every 15 minutes. 17. A postop patient has not voided for 8 hrs after surgery…. what action should the nurse take first? Answer: Bladder scan 18. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit. Which action by the nurse on the clinical unit should be performed first? Answer: Take the patient's vital signs. 19. A postop pt has a nursing dx of ineffective airway clearance. The nurse determines that interventions for this nursing diagnosis have been successful if which is observed? Answer: Patients breath sounds are clear to auscultation 20. In the postanesthesia care unit (PACU), a patient's vital signs are blood pressure 116/72, pulse 74, respirations 12, and SpO2 91%. The patient is sleepy but awakens easily. Which action should the nurse take first? Answer: Encourage the patient to take deep breaths. 21. Which action could the PACU nurse delegate to an UAP? Answer: Help with transfer onto a stretcher 22. An older pt is being dc from the ambulatory surgical unit following L eye surgery. The pt tells the nurse, “I don’t know if I can take care of myself once I’m home”. Which action by the nurse is most appropriate? Answer: discuss specific concerns regarding self-care 23. A patient is admitted with possible botulism poisoning after eating home-canned green beans. Which intervention ordered would the nurse question? Answer: Encourage oral fluids to 3L/day 24. A 22-year-old patient who sustained a T2 spinal cord injury 10 days ago tells the nurse "i want to be transferred to a hospital where the nurses know what they are doing"… Answer: Request patient to take part in their care 25. The nurse will explain to the patient who has a T2 spinal cord transection injury that… Answer: function of both arms should be retained 26. A 27-year-old patient is hospitalized with new onset of Guillain-Barré syndrome. The most essential assessment for the nurse to carry out is? Answer: observing respiratory rate and effort. 27. A construction worker arrives at an urgent care center with a deep puncture wound after an old nail penetrated his boot.. The patient reports having had a tetanus booster 6 years ago. The nurse will anticipate? Answer: administration of the tetanus-diphtheria (Td) booster. 28. Which assessment data for a patient who has GBS will require the nurses most immediate action? Answer: The patient is continuously drooling saliva 29. A 35 yr old pt who has had a spinal cord injury returned home following rehab. The home care RN notes the spouse is performing many of the activities the pt has been managing unassisted in rehab… Answer: develop a plan to increase pt independence in consult with pt and spouse 30. Which nursing action will the home health nurse include in the plan of care for a patient with paraplegia at the T4 level in order to prevent autonomic dysreflexia? Answer: Assist in planning a prescribed bowel program. 31. When giving home care instructions to a patient who has comminuted L forearm fractures ana long-arm cast, which info should the nurse include? Answer: Call the health care provider for numbness of the hand 32. Which statement by the pt indicates a good understanding of the nurse’s teaching about a new short-arm synthetic cast? Answer: “I will apply an ice pack to the cast over the fracture site off and on for 24 hrs” 33. Which dc instruction will the ED nurse include for a pt w/ a sprained ankle? Answer: use pillows to elevate the ankle above the heart 34. A pt w/ a complex pelvic fracture from a MVC is on bed rest. Which nursing assessment finding indicates a potential complication? Answer: Abdomen is distended and bowel sounds are absent 35. How often should pin site care be performed? Daily with sterile cotton tipped applicator. Books says to use chlorhexidine not hydrogen peroxide. 36. A pt who is to have NWB on the R leg is learning to walk w/ crutches. Which observation by the nurse indicates the pt can ambulate independently? Answer: The pt advances the right leg and both crutches together and then advances the left leg 37. A pt is being dc in 3 days after hip arthroplasty using the posterior approach. Which action requires intervention? Answer: The pt leans over to pull on shoes and socks 38. Which info will the nurse teach seniors at a community recreation center about ways to prevent fractures? Answer: Buy shoes that provide good support and are comfortable 39. When caring for a preoperative patient on the day of surgery, which actions included in the plan of care can the nurse delegate to unlicensed assistive personnel (UAP)? (Select all that apply.) Answers: Obtain and document baseline vital signs, remove nail polish and apply pulse oximeter, Transport the patient by stretcher to the operating room. 40. Which actions will the nurse include in the surgical time-out procedure before surgery? Answer: Verify pt ID band number, ask pt to state procedure, pt state name and DOB Exam 2 1. A pts cap BG level is 120 mg/dL 6 hrs after the nurse initiated a parenteral nutrition infusion. The appropriate action by the nurse is to a. Recheck BG 4-6 hrs later 2. After abdominal surgery, a pt w/ protein calorie malnutrition that is receiving PN; what is the best indicator of adequate nutrition? a. Surgical incision is healing normally 3. When caring for a pt with a soft, silicone NG tube in place for tube feeding the nurse will a. Flush the tubing after checking for residual volume 4. A 76 yr old woman w/ a BMI of 17 kg/m2 and a low serum albumin level is being admitted by the nurse. Which assessment finding will the nurse expect to find? a. Pitting edema 5. A healthy adult woman who weighs 145 lb asks the clinic nurse about the minimum daily requirement for protein. How many grams of protein will the nurse recommend? a. 53 6. Which menu choice best indicates that the pt is implementing the nurses suggestion to choose high-calorie, high-protein food? a. Fried chicken with potatoes and gravy 7. The nurse will be teaching self-management to pts after gastric bypass surgery. Which info will the nurse plan to include? a. Drink fluids between meals but not with meals 8. A pt is being admitted for bariatric surgery. Which nursing action can the nurse delegate to UAP? a. Assist with IV insertion by holding adipose tissue out of the way 9. After the nurse teaches a pt about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the initial instructions about diet have been understood? a. 3 oz of roasted pork, a cup of corn, and a cup of carrot sticks 10. Which item should the nurse offer to the pt who is to restart oral intake after being NPO due to nausea and vomiting? a. Dish of lemon gelatin 11. Which info will the nurse include when teaching adults to decrease the risk of cancers of the tongue and buccal mucosa? a. Avoid use of cigarettes and smokeless tobacco 12. Which info will the nurse include when teaching a pt with peptic ulcer disease about the effect of zantac? a. Ranitidine decreases gastric acid secretion 13. A pt vomiting blood-streaked fluid is admitted to the

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MED SURG FINAL EXAM QUESTION
BANK (From Exams 1-3 & ATI’s)
MED SURG FINAL EXAM QUESTION BANK (From Exams 1-3 & ATI’s)
Exam 1
1. A patient has received atropine before surgery and complains of dry mouth. Which
action by the nurse is best? Answer: Tell the patient dry mouth is an expected side effect.
2. A patient arrives at the ambulatory surgery center for a scheduled laparoscopy
procedure in outpatient surgery. Which information is of most concern to the nurse?
Answer: The patient is planning to drive home after surgery.
3. As the nurse prepares a patient the morning of surgery, the patient refuses to remove a
wedding ring, saying, "I have never taken it off since the day I was married." Which
response by the nurse is best? Answer: Suggest that the patient give the ring to a family
member to keep.
4. The outpatient surgery nurse reviews the complete blood cell (CBC) count results for a
patient who is scheduled for surgery in a few days. The results are white blood cell
(WBC) count 10.2 × 103/µL; hemoglobin 15 g/dL; hematocrit 45%; platelets 150 ×
103/µL. Which action should the nurse take? Answer: Continue to prepare the patient for
the surgical procedure.
5. A 36-year-old female is admitted for an elective surgical procedure. Which information
obtained by the nurse during the preoperative assessment is most important to report to
the anesthesiologist before surgery? Answer: The patient's statement that her last
menstrual period was 8 weeks ago
6. Which information in the preoperative patient's medication history is most important to
communicate to the health care provider? Answer: The patient takes garlic capsules
daily.
7. A patient who takes a diuretic and a β-blocker to control blood pressure is scheduled for
breast reconstruction surgery. Which patient information is most important to
communicate to the health care provider before surgery? Answer: Serum potassium 3.2
mEq/L
8. Monitored anesthesia care (MAC) is going to be used for a closed, manual reduction of a
dislocated shoulder. What does the nurse anticipate? Answer: Starting an IV in the
patient’s unaffected arm.
9. While in the holding area, a patient reveals to the nurse that his father had a high fever
after surgery. What action by the nurse is a priority? Answer: Alert the anesthesia care
provider of the family member’s reaction to surgery
10. The nurse facilitates student clinical experiences in the surgical suite. Which action, if
performed by a student, would require the nurse to intervene? Answer: The student
wears street clothed in the semi-restricted area.
11. The operating room nurse is providing orientation to a student nurse. Which action would
the nurse list as a major responsibility of a scrub nurse? Answer: Keep both hands
above the operating table level

,12. A patient in surgery receives a neuromuscular blocking agent as an adjunct to general
anesthesia. While in the PACU, what assessment finding is most important for the nurse
to report? Answer: Weak chest movement
13. Which action in the perioperative patient plan of care can the charge nurse delegate to a
surgical technologist? Answer: Pass sterile instruments and supplies to the surgeon and
scrub technician
14. When caring for a patient who has received general anesthetic, the circulating nurse
notes red, raised wheals on the patient’s arms. Which action should the nurse take?
Answer: Notify the ACP

15. The NG tube is removed 2nd day postop, pt is placed on a clear, liquid diet. 4 hrs later the
pt complains of sharp, cramping gas pains. What action by the RN is most appropriate?
Answer: assist the patient to ambulate

16. On admission of a patient to the postanesthesia care unit (PACU), the blood pressure
(BP) is 122/72. Thirty minutes after admission, the BP falls to 114/62, with a pulse of 74
and warm, dry skin. Which action by the nurse is most appropriate? Answer: Continue to
take vital signs every 15 minutes.
17. A postop patient has not voided for 8 hrs after surgery…. what action should the nurse
take first? Answer: Bladder scan
18. A patient is transferred from the postanesthesia care unit (PACU) to the clinical unit.
Which action by the nurse on the clinical unit should be performed first? Answer: Take
the patient's vital signs.
19. A postop pt has a nursing dx of ineffective airway clearance. The nurse determines that
interventions for this nursing diagnosis have been successful if which is observed?
Answer: Patients breath sounds are clear to auscultation
20. In the postanesthesia care unit (PACU), a patient's vital signs are blood pressure 116/72,
pulse 74, respirations 12, and SpO2 91%. The patient is sleepy but awakens easily.
Which action should the nurse take first? Answer: Encourage the patient to take deep
breaths.
21. Which action could the PACU nurse delegate to an UAP? Answer: Help with transfer
onto a stretcher
22. An older pt is being dc from the ambulatory surgical unit following L eye surgery. The pt
tells the nurse, “I don’t know if I can take care of myself once I’m home”. Which action by
the nurse is most appropriate? Answer: discuss specific concerns regarding self-care
23. A patient is admitted with possible botulism poisoning after eating home-canned green
beans. Which intervention ordered would the nurse question? Answer: Encourage oral
fluids to 3L/day
24. A 22-year-old patient who sustained a T2 spinal cord injury 10 days ago tells the nurse "i
want to be transferred to a hospital where the nurses know what they are doing"…
Answer: Request patient to take part in their care

, 25. The nurse will explain to the patient who has a T2 spinal cord transection injury that…
Answer: function of both arms should be retained

26. A 27-year-old patient is hospitalized with new onset of Guillain-Barré syndrome. The
most essential assessment for the nurse to carry out is? Answer: observing respiratory
rate and effort.

27. A construction worker arrives at an urgent care center with a deep puncture wound after
an old nail penetrated his boot.. The patient reports having had a tetanus booster 6
years ago. The nurse will anticipate? Answer: administration of the tetanus-diphtheria
(Td) booster.

28. Which assessment data for a patient who has GBS will require the nurses most
immediate action? Answer: The patient is continuously drooling saliva

29. A 35 yr old pt who has had a spinal cord injury returned home following rehab. The home
care RN notes the spouse is performing many of the activities the pt has been managing
unassisted in rehab… Answer: develop a plan to increase pt independence in consult
with pt and spouse

30. Which nursing action will the home health nurse include in the plan of care for a patient
with paraplegia at the T4 level in order to prevent autonomic dysreflexia? Answer: Assist
in planning a prescribed bowel program.

31. When giving home care instructions to a patient who has comminuted L forearm
fractures ana long-arm cast, which info should the nurse include? Answer: Call the
health care provider for numbness of the hand

32. Which statement by the pt indicates a good understanding of the nurse’s teaching about
a new short-arm synthetic cast? Answer: “I will apply an ice pack to the cast over the
fracture site off and on for 24 hrs”

33. Which dc instruction will the ED nurse include for a pt w/ a sprained ankle? Answer: use
pillows to elevate the ankle above the heart

34. A pt w/ a complex pelvic fracture from a MVC is on bed rest. Which nursing assessment
finding indicates a potential complication? Answer: Abdomen is distended and bowel
sounds are absent

35. How often should pin site care be performed? Daily with sterile cotton tipped applicator.
Books says to use chlorhexidine not hydrogen peroxide.

36. A pt who is to have NWB on the R leg is learning to walk w/ crutches. Which observation
by the nurse indicates the pt can ambulate independently? Answer: The pt advances the
right leg and both crutches together and then advances the left leg

37. A pt is being dc in 3 days after hip arthroplasty using the posterior approach. Which
action requires intervention? Answer: The pt leans over to pull on shoes and socks

38. Which info will the nurse teach seniors at a community recreation center about ways to
prevent fractures? Answer: Buy shoes that provide good support and are comfortable

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