Exam (elaborations) NUR 1211 Medical Surgical Final Exam- Questions and Answers; International College of Health Sciences NUR 1211 Medical Surgical Final Exam- Questions and Answers/NUR 1211 Medical Surgical Final Exam- Questions and Answers NUR1211 Medic

Exam (elaborations) NUR 1211 Medical Surgical Final Exam- Questions and Answers; International College of Health Sciences NUR 1211 Medical Surgical Final Exam- Questions and Answers/NUR 1211 Medical Surgical Final Exam- Questions and Answers NUR1211 Medical-Surgical Nursing FINAL EXAM- Questions and Answers Question 1 Question text A client has a white blood cell change in which the number of suppressor T-cells is way below normal and asks the nurse which type of health problem(s) could be expected as a result of this deficiency. What is the nurse's best response? Select one: a. “Try to avoid crowds and people who are ill because you are now more susceptible to bacterial and viral infections.” b. “You will be more prone to allergic reactions when exposed to allergens or drugs.” c. "You will need to receive booster vaccinations more often because your ability to make antibodies is reduced.” d. “Your risk for cancer development is increased.” Question 2 Question text The nurse is preparing a client for discharge who developed an acute kidney injury during coronary artery bypass graft surgery. The nurse notices that the client has a serum creatinine of 1.2 mg/dL (106 mcmol/L) and a glomerular filtration rate (GFR) of 75 mL/kg/1.73 m2. Which is the priority nursing action? Select one: a. Checking the remaining values on the metabolic panel and informing the primary care provider of all results before the client is discharged b. Encouraging the client to reduce protein intake to reduce creatinine production until the follow-up visit with the nephrologist occurs c. Reminding the client to remain hydrated by drinking 500 mL of an electrolyte-based solution daily d. Educating the client about the need for follow-up, including re-evaluation of serum creatinine with the primary care provider or nephrologist in 8-12 weeks Question 3 Correct 1.00 points out of 1.00 Question text The laboratory values of a client who has diabetes mellitus include a fasting blood glucose level of 82 mg/dL (mmol/L) and hemoglobin A1C of 5.9%. What is the nurse's interpretation of these findings? Select one: a. The client's glucose control for the past 24 hours has been good, but the overall control is poor. b. The values indicate that the client has poorly managed his or her disease. c. The client's glucose control for the past 24 hours has been poor, but the overall control is good. d. The values indicate that the client has managed his or her disease well. Question 4 Incorrect 0.00 points out of 1.00 Question text A client thought to be at risk for distributive shock is given a drug that constricts blood vessels. What effect does the nurse expect the drug to have on the client's mean arterial pressure (MAP)? Select one: a. Increased MAP by increasing vascular volume b. Decreased MAP from widespread capillary leak c. Decreased MAP by decreasing vascular volume d. Increased MAP without a change in vascular volume Question 5 Incorrect 0.00 points out of 1.00 Question text Which description of respiratory physiologic features is correct? Select one: a. The epiglottis closes during speech to divert air movement into and through the vocal cords to produce sound. b. Any problem with the right lung interferes with gas exchange and perfusion to a greater degree than a problem in the left lung. c. The elastic tissues of the tracheobronchial tree are the major structures responsible for gas exchange. d. The left lung is responsible for approximately 60% of gas exchange, and the right lung is responsible for 60% of pulmonary perfusion. Question 6 Correct 1.00 points out of 1.00 Question text The nurse notes that a client with a history of chronic obstructive pulmonary disease (COPD) who is receiving oxygen therapy at 2 L/min and had an oxygen saturation of 88% 1 hour ago now has dyspnea and an oxygen saturation of 80%. Should the nurse increase the FiO2? Select one: a. Yes; hypoxia must be treated despite the risk for oxygen-induced hypercapnia. b. No; increasing the FiO2 will severely depress the respiratory rate by blunting the hypoxic drive c. Yes; the expected outcome for any client with hypoxia is to achieve a saturation of at least 97%. d. No; an oxygen saturation of 80% is acceptable for a client with COPD. Question 7 Correct 1.00 points out of 1.00 Question text Which client being managed for dehydration does the nurse consider at greatest risk for possible reduced kidney function? Select one: a. An 80-year-old man who has benign prostatic hyperplasia b. A 48-year-old woman with established urinary incontinence c. A 45-year-old man receiving oral and IV fluid therapy d. A 62-year-old woman with a known allergy to contrast media Question 8 Correct 1.00 points out of 1.00 Question text When reviewing the laboratory values for a client admitted with pneumonia, which result will cause the nurse to collaborate quickly with the primary health care provider? Select one: a. White blood cell (WBC) count of 14,526 mm3 b. Blood glucose 146 mg/dL c. PaCO2 46 mm Hg d. PaO2 68 mm Hg Question 9 Correct 1.00 points out of 1.00 Question text The nurse is caring for these clients. Which client does the nurse recognize as having the highest risk for development of breast cancer? Select one: a. 75-year-old female who was treated for breast cancer 5 years ago b. 55-year-old male with gynecomastia and obesity c. 65-year-old male whose mother had ovarian cancer d. 60-year-old female whose father died from colon cancer Question 10 Correct 1.00 points out of 1.00 Question text How should the nurse communicate with a client who is deaf? Select one: a. By talking exclusively with the client's caregivers b. By using pictures and writing, if the client can see c. By talking more loudly to the client d. By having the client read the nurse's lips Question 11 Incorrect 0.00 points out of 1.00 Question text A 70-year-old client is seeing his primary care provider for an annual examination. Which assessment finding alerts the nurse to an increased risk for bladder cancer? Select one: a. A 30-year occupation as a long-distance truck driver b. A five-pack year history of smoking 45 years ago c. A recent colon cancer diagnosis in his 72-year-old brother d. Difficulty starting and stopping the urine stream Question 12 Incorrect 0.00 points out of 1.00 Question text The nurse is caring for a client who is jaundiced and reports pruritus. Which intervention will the nurse include in the plan of care? Select one: a. Assist the client with a hot bath and apply moisturizer b. Instruct the client to scratch with knuckles instead of nails c. Encourage the client to eat a high-protein, high-cholesterol diet d. Monitor the client's vital signs and intake and output Question 13 Incorrect 0.00 points out of 1.00 Question text Which action by a nurse is most likely to increase accurate communication with a client who has low vision? Select one: a. Enhancing the talk using hand gestures b. Marking the door of the client's room to indicate his or her vision status c. Marking the door of the client's room to indicate his or her vision status d. Speaking slowly and loudly Question 14 Incorrect 0.00 points out of 1.00 Question text The client is a 62-year-old admitted 2 days ago with traumatic injuries and hypovolemic shock from a car crash. The nurse reviewing the client's daily laboratory test results notices the following values. Which result is most important to report to the primary health care provider immediately? Select one: a. Serum sodium 132 mEq/L (mmol/L) b. Hematocrit 32% (0.32 volume fraction); hemoglobin 9.2 g/dL (92 g/L) c. Serum potassium 6.9 mEq/L (mmol/L) d. Blood urea nitrogen 24 mg/dL (mmol/L) Question 15 Incorrect 0.00 points out of 1.00 Question text With which client should the nurse remain alert for the possibility of sepsis and septic shock? Select one: a. 72-year-old man with severe allergies who is undergoing radiation therapy for early-stage prostate cancer. b. 53-year-old woman who had an open abdominal hysterectomy 3 days ago to remove several large fibroid tumors. c. 41-year-old man who sustained closed depression fractures of the face when hit with a baseball d. 67-year-old woman on chronic corticosteroid therapy who had several teeth extracted 2 days ago. Question 16 Correct 1.00 points out of 1.00 Question text A client returns to the postanesthesia care unit (PACU) after an arthroscopy to repair a knee injury. What is the nurse's priority when caring for this client? Select one: a. Perform passive range-of-motion exercises. b. Ensure that the patient uses the patient-controlled analgesia (PCA) pump. c. Keep the affected leg immobilized. d. Check the neurovascular status of the affected leg and foot. Question 17 Correct 1.00 points out of 1.00 Question text Which statement made by a client newly diagnosed with polycystic kidney disease (PKD) in the hyperfiltration stage indicates to the nurse that additional teaching for self-management is needed? Select one: a. “I'll need to decrease my daily water intake.” b. “Regular low-impact exercise may help me feel better and help prevent constipation.” c. “I need to make certain my brothers and sisters know about this disease.” d. Probably the best time of day to take my lisinopril each day is with breakfast.” Question 18 Correct 1.00 points out of 1.00 Question text A nursing assistant (NA) is assigned to care for a client who had a cemented total knee arthroplasty. Which statement by the NA indicates a need for further teaching and supervision by the nurse? Select one: a. “I'll tell the client not to place a pillow under the surgical knee.” b. “I'll apply ice packs to decrease swelling in the knee as ordered.” c. “I'll keep an abduction pillow in place at all times.” d. “I'll check to make sure the client's leg is not rotated.” Question 19 Correct 1.00 points out of 1.00 Question text Which statement made by the client on the way to the catheterization laboratory requires an immediate action by the nurse? Select one: a. “I don't know what I will do if they find a blockage in my heart.” b. “My allergies are bothering me, so I took some Benadryl last night before bed.” c. “I sure am hungry. I haven't had anything to eat since I went to bed last night.” d. “I was nervous last night, but I still remembered to take my warfarin.” Question 20 Correct 1.00 points out of 1.00 Question text Which information is most important for a nurse to include when teaching a client with tuberculosis about the prescribed first-line drug therapy? Select one: a. “Do not drink alcohol in any quantity while taking Isoniazid.” b. “Restrict fluid intake to 2 quarts of liquid a day on pyrazinamide.” c. “Report darkening or reddening of the urine while taking Rifampin.” d. “Temporary visual changes while taking ethambutol are not serious.” Question 21 Correct 1.00 points out of 1.00 Question text The nurse gives a client an IM dose of penicillin G for primary syphilis. Which client statement indicates a need for further teaching? Select one: a. “When I get home, I'll call my partner to tell them about my diagnosis.” b. “I'll wait in the clinic for 30 minutes to be sure I don't have a reaction.” c. “If I have sex with someone, I don't have to worry about spreading the disease.” d. “I plan to return to see my primary care provider for follow-up in 6, 12, and 24 months.” Question 22 Correct 1.00 points out of 1.00 Question text While performing skin assessment on an elderly client, the nurse observes an isolated brownish-purple lesion with irregular borders on the anterior chest wall. The lesion feels slightly raised on palpation, and crusted blood is visible at the lower edge. Which is the appropriate nursing intervention? Select one: a. Ask the patient about exposure to new lotions or perfumes that could cause an allergic reaction. b. Wash the lesion gently with warm water to remove the crusts and teach not to pick it. c. Reassure that the lesion is a common occurrence with aging, especially in sun-exposed areas. d. Document lesion's location, size, and characteristics and request a dermatology consult. Question 23 Correct 1.00 points out of 1.00 Question text The nurse reviewing the laboratory work of a client with hypoparathyroidism finds all the following blood values. For which value does the nurse immediately assess the client's reflexes? Select one: a. Potassium 5.1 mEq/L (mmol/L) b. Sodium 131 mEq/L (mmol/L) c. pH 7.33 d. Calcium 7.8 mg/dL (1.76 mmol/L) Question 24 Incorrect 0.00 points out of 1.00 Question text The nurse is teaching a client about taking sildenafil (Viagra) for erectile dysfunction. Which statement by the client indicates a need for further teaching? Select one: a. “I should have sex within an hour after taking the drug.” b. “I should avoid alcohol when on the drug or it might not work well.” c. “If I have chest pain during sex, I should take a nitroglycerin tablet.” d. “I can expect to maybe feel flushed or get a headache when I take the drug.” Question 25 Correct 1.00 points out of 1.00 Question text The nurse is caring for four clients. Which client is at the highest risk for hepatitis B infection? Select one: a. 81-year-old who donated own blood before a surgical procedure b. 40-year-old who is 2 days postpartum and is breastfeeding c. 65-year-old who reports using street drugs 10 years ago when homeless d. 24-year-old with abdominal pain who just returned from Central America Question 26 Incorrect 0.00 points out of 1.00 Question text Which hormone changes does the nurse expect when a client receives a continuous cortisol infusion for 24 hours when his or her endocrine feedback mechanisms are functioning normally? Select one: a. Higher than normal adrenocorticotropic hormone (ACTH) levels; higher than normal corticotropin-releasing hormone (CRH) levels b. Lower than normal adrenocorticotropic hormone (ACTH) levels; higher than normal corticotropin-releasing hormone (CRH) levels c. Higher than normal adrenocorticotropic hormone (ACTH) levels; lower than normal corticotropin-releasing hormone (CRH) levels d. Lower than normal adrenocorticotropic hormone (ACTH) levels; lower than normal corticotropin-releasing hormone (CRH) levels Question 27 Incorrect 0.00 points out of 1.00 Question text Which assessment finding does the nurse interpret as demonstrating a client's fluid resuscitation adequacy? Select one: a. Decreased skin turgor b. Decreased urine specific gravity c. Decreased pulse pressure d. Decreased core body temperature Question 28 Incorrect 0.00 points out of 1.00 Question text A client recently diagnosed with primary bone cancer states, “My life is over. I'll never get married now!” What is the nurse's best action at this time? Select one: a. Provide hope that marriage will happen. b. Ask the client what is meant by that statement. c. Listen while the client expresses feelings. d. Refer the client to a clergy member or spiritual leader. Question 29 Correct 1.00 points out of 1.00 Question text The nurse is caring for a client with tinnitus. Which client statement requires nursing teaching? Select one: a. “I enjoy eating bananas every day for breakfast.” b. “I'm seeing an audiologist who is fitting me for hearing aids.” c. “I've found several local support groups for people with tinnitus.” d. “I take aspirin every day to help reduce my risk for having a stroke.” Question 30 Correct 1.00 points out of 1.00 Question text A client returns from surgery after a laparoscopic total abdominal hysterectomy. On initial assessment, which finding by the nurse requires immediate intervention? Select one: a. Temperature of 99° F (37.2° C) b. Heavy vaginal bleeding with clots c. Client statement that pain is 4 on a scale of 0 to 10 d. Decreased bowel sounds in all quadrants Question 31 Incorrect 0.00 points out of 1.00 Question text A 44-year-old client with diabetes asks how often a visit to the eye-care practitioner is recommended. What is the appropriate nursing response? Select one: a. “Only if you have vision problems.” b. “Annually.” c. “No examinations are necessary until you are 50 years old.” d. “Every 6 months.” Question 32 Correct 1.00 points out of 1.00 Question text The nurse is teaching a client with a newly diagnosed cardiovascular disorder. Which statement made by the client demonstrates health promotion? Select one: a. “My heart disease will go away when I cut down to one cigarette a day.” b. “I'm glad I don't have to change my diet and can continue to eat whatever I want.” c. “I finally have my blood pressure to a normal level of 150/85.” d. “I need to get at least 150 minutes of moderate exercise a week.” Question 33 Correct 1.00 points out of 1.00 Question text Which statement, made by the student nurse, requires further teaching by the nurse preceptor? Select one: a. “I will avoid using adult briefs for my bedridden incontinent client who has a perineal yeast infection.” b. “If signs and symptoms of a systemic infection are present, I will contact the health care provider to discuss ordering blood cultures.” c. “I will tell my client that transmission-based precautions are not necessary after the first dose of oral antiviral therapy for herpes zoster is taken.” d. “I will always remove crusts from bacterial lesions before applying topical antimicrobials.” Question 34 Incorrect 0.00 points out of 1.00 Question text he nurse is preparing to give medications to a group of clients. Which drug is not appropriate to treat the disease with which it is matched? Select one: a. Acute gout—allopurinol b. Rheumatoid arthritis—leflunomide c. Systemic lupus erythematosus—prednisone d. Osteoarthritis—acetaminophen Question 35 Correct 1.00 points out of 1.00 Question text A 45-year-old client is receiving subcutaneous injections of a biologic therapy for plaque psoriasis. Which condition will the nurse immediately report to the health care provider? Select one: a. Increased pruritus b. Cough and fever c. Missed injection d. New plaques on leg Question 36 Correct 1.00 points out of 1.00 Question text A client receiving palliative care asks the nurse, “Why is this happening to me?” What is the nurse's best response? Select one: a. “It's going to be OK; at least you aren't leaving any family behind.” b. “I'm sorry. I know that this is a difficult time for you.” c. “I don't know. God only knows when your time is up on this earth.” d. “We'll make sure that all of your needs are met, so don't worry.” Question 37 Correct 1.00 points out of 1.00 Question text The nurse is caring for a client immediately after a bunionectomy. What is the nurse's priority action? Select one: a. Relieve or reduce the patient's pain. b. Check the surgical dressing for intactness. c. Apply a hot compress to the surgical area. d. Assess neurovascular status in the affected foot. Question 38 Incorrect 0.00 points out of 1.00 Question text Which statement by the client regarding lifestyle changes to prevent osteoporosis indicates a need for further teaching by the nurse? Select one: a. “I'm going to continue having my DXA scans as my doctor orders.” b. “I'm going to jog every day for at least 30 minutes.” c. “I plan to increase calcium and vitamin D foods in my diet.” C. “I plan to increase calcium and vitamin D foods in my diet.” C. “I plan to increase calcium and vitamin D foods in my diet.” d. “I'll drink only a half glass of wine occasionally to help me sleep.” Question 39 Correct 1.00 points out of 1.00 Question text With which client does the nurse anticipate complications from obstructive sleep apnea following abdominal surgery? Select one: a. 48-year-old who has type 1 diabetes and chronic sinusitis b. 78-year-old who wears upper and lower dentures and has asthma c. 58-year-old who has had gastroesophageal reflux disease for 10 years d. 28-year-old who is 80 lbs (36.4 kg) overweight and has a short neck Question 40 Incorrect 0.00 points out of 1.00 Question text When assessing a client with acute glomerulonephritis, which question about self-management will the nurse ask to determine whether the client is currently following best practices to slow progression of kidney damage? Select one: a. “Have you contacted anyone from our dialysis support services?” b. “Have you increased your protein intake to promote healing of the damaged nephrons?” c. “Do you avoid contact sports while you're taking cyclosporine?” d. “How are you evaluating the amount of daily fluid you drink?” Question 41 Incorrect 0.00 points out of 1.00 Question text The nurse is caring for four clients. Which is at the highest risk for development of oral cancer? Select one: a. 41-year-old with human papilloma virus (HPV) infection b. 32-year-old client with ankle fracture c. 83-year-old who lives in a warm climate during the winter d. 60-year-old who quit smoking 20 years ago Question 42 Correct 1.00 points out of 1.00 Question text The nurse is teaching a client who must instill multiple types of eye drops before cataract surgery. Which client statement requires further teaching? Select one: a. “If I can't remember when to take which drops, I'll just take them all at once.” b. “I will make a schedule for inserting the eyedrops.” c. “If I have trouble instilling the drops, I will have my spouse put them in for me.” d. “Touching the dropper to my eye could cause contamination and infection.” Question 43 Incorrect 0.00 points out of 1.00 Question text For which client will the nurse avoid performing an otoscopic examination? Select one: a. 59-year-old with confusion b. 37-year-old with vertigo c. 45-year-old with new diagnosis of diabetes d. 29-year-old with abdominal pain Question 44 Incorrect 0.00 points out of 1.00 Question text Which client does the nurse caution to avoid self-monitoring of blood glucose (SMBG) at alternate sites? Select one: a. 55-year-old client who has hypoglycemic unawareness b. 45-year-old client with type 1 diabetes mellitus c. 80-year-old client with type 2 diabetes mellitus d. 75-year-old client whose blood glucose levels show little variation Question 45 Correct 1.00 points out of 1.00 Question text A client with diabetes has all of the following changes after a percutaneous nephrolithotomy procedure. Which change is most important for the nurse need to immediately report to the health care provider? Select one: a. A decreased hematocrit by 1% (compared with preoperative values and hematuria b. Difficulty breathing and an oxygen saturation of 88% on 2 L of oxygen by nasal cannula c. An oral temperature of 38° C (101° F) and cloudiness of urine draining from the nephrostomy tube right after IV administration of a broad-spectrum antibiotic d. A point-of-care blood glucose of 150 mg/dL and client report of thirst Question 46 Incorrect 0.00 points out of 1.00 Question text A client with rectal bleeding who is preparing to undergo a colonoscopy tells the nurse, “I'm very afraid of having polyps and cancer.” What is the appropriate nursing response? Select one: a. “Polyps are never cancerous, so you don't need to worry.” b. “Let's worry about that after the procedure.” c. “Unfortunately all polyps are malignant, so you may already have cancer.” d. “Unfortunately all polyps are malignant, so you may already have cancer.” Question 47 Correct 1.00 points out of 1.00 Question text Which statement by a client undergoing radioactive iodine (RAI) therapy demonstrates to the nurse correct understanding of post-procedure precautions? Select one: a. “I'll avoid having a manicure or pedicure during the first month after treatment.” b. I'll be sure to use only one toilet and not let others use it for 2 weeks.” c. “I'll wear a wig until my hair grows back in.” d. “I'll avoid crowds and people who are ill to reduce the risk for an infection.” Question 48 Incorrect 0.00 points out of 1.00 Question text Which question does the nurse ask the client who has a urinary tract infection to assess the risk for possible pyelonephritis? Select one: a. How m