RN VIRTUAL MED SURG 2019 EXAM – STUDY GUIDE
1. A nurse is caring for a client in Buck’s traction. What is the purpose of this type of traction?
Used preoperatively for hip fractures for immobilization in adult clients)
2. A client with osteoarthritis has been prescribed glucosamine. What are some potential
contraindications to this supplement?
Glucosamine sulfate is believed to aid in the synthesis of synovial fluid and rebuild
cartilage. Use with caution with shellfish allergy. Question clients about concurrent use of
chondroitin, NSAIDs, heparin, and warfarin
3. A nurse is caring for an adult male client following a lumbar spinal surgery. Which of the
following findings would indicate a fluid volume deficit?
Urine specific gravity 1.020
4. A nurse is caring for a client who is starting hemodialysis. What information regarding a
change in protein intake from the predialysis recommendation should the nurse provided?
Increase the client’s dietary intake of protein over predialysis restrictions
5. A nurse is caring for a client following gastrectomy surgery. What information regarding
prevention of dumping syndrome should the nurse provide to this client?
Assist/instruct the client to lie down when vasomotor manifestations occur
Lying down after a meal slows the movement of food within the
intestines. Limit the amount of fluid ingested at one time.
Eliminate liquids with meals, for 1 hr prior to, and following a meal.
Consume a high-protein, high-fat, low-fiber, and low- to moderate-carbohydrate diet.
Avoid milk and sugars (sweets, fruit juice, sweetened fruit, milk shakes, honey, syrup,
jelly). Consume small, frequent meals rather than large meals
6. While assessing a patient two hours after a transurethral prostatectomy (TURP), the nurse
notes the catheter drainage is bright red in color and contains many clots. Name the priority
nursing intervention.
The rate of the CBI is adjusted to keep the irrigation return pink or lighter. For example, if
bright-red or ketchup-appearing (arterial) bleeding with clots is observed, the nurse should
increase the CBI rate.
7. A nurse is caring for a client with a burn injury who has been prescribed hydrotherapy. How
is hydrotherapy instituted and what actions should the nurse take during this therapy?
Assist the client into a warm tub of water or use warm running water, as if to shower, to
cleanse the wound.
, Use mild soap or detergent to wash burns gently, and then rinse with room-temperature
water.
Encourage the client to exercise his joints during the hydrotherapy treatment
8. A nurse is caring for a client with a new ileostomy. What should the nurse instruct the client
to expect in the post-operative period?
A surgical opening into the ileum to drain stool, which is typically frequent and liquid since
large intestine is bypassed
9. A client is experiencing disequilibrium syndrome. What are the clinical manifestations of
disequilibrium syndrome?
Identify three (3) nursing measures associated with managing the findings of this syndrome.
10. The emergency room nurse is assisting the provider perform an emergency thoracentesis
to relieve a tension pneumothorax following a traumatic motor vehicle accident.
List three (3) steps that are imperative for the nurse to perform prior to the procedure.
11. Describe five (5) ongoing nursing interventions necessary for all clients receiving
mechanical ventilation.
Monitor ventilator alarms, which signal if the client is not receiving the correct ventilation.
Never turn off ventilator alarms.
There are three types of ventilator alarms.
Volume (low pressure) alarms indicate a low exhaled volume due to a disconnection, cuff
leak, and/or tube displacement.
Pressure (high pressure) alarms indicate excess secretions, client biting the tubing, kinks in
the tubing, client coughing, pulmonary edema, bronchospasm, or pneumothorax.
Apnea alarms indicate that the ventilator does not detect spontaneous respiration in a preset
time period
12. List three (3) client teaching points following permanent pacemaker insertion.
Carry a pacemaker identification card at all times.
Prevent wire dislodgement. (Wear sling when out of bed. Do not raise arm above shoulder
for 1 to 2 weeks.)
Take pulse daily at the same time. Notify the provider if heart rate is less than the pacemaker
rate.
13. The nurse is administering 6 AM medications to a client with Gastroesophageal Reflux
Disorder (GERD). The client states, “I don’t want to take that Protonix, it never helps
my heart burn. I like taking TUMS better!” How will the nurse educate this client on the
1. A nurse is caring for a client in Buck’s traction. What is the purpose of this type of traction?
Used preoperatively for hip fractures for immobilization in adult clients)
2. A client with osteoarthritis has been prescribed glucosamine. What are some potential
contraindications to this supplement?
Glucosamine sulfate is believed to aid in the synthesis of synovial fluid and rebuild
cartilage. Use with caution with shellfish allergy. Question clients about concurrent use of
chondroitin, NSAIDs, heparin, and warfarin
3. A nurse is caring for an adult male client following a lumbar spinal surgery. Which of the
following findings would indicate a fluid volume deficit?
Urine specific gravity 1.020
4. A nurse is caring for a client who is starting hemodialysis. What information regarding a
change in protein intake from the predialysis recommendation should the nurse provided?
Increase the client’s dietary intake of protein over predialysis restrictions
5. A nurse is caring for a client following gastrectomy surgery. What information regarding
prevention of dumping syndrome should the nurse provide to this client?
Assist/instruct the client to lie down when vasomotor manifestations occur
Lying down after a meal slows the movement of food within the
intestines. Limit the amount of fluid ingested at one time.
Eliminate liquids with meals, for 1 hr prior to, and following a meal.
Consume a high-protein, high-fat, low-fiber, and low- to moderate-carbohydrate diet.
Avoid milk and sugars (sweets, fruit juice, sweetened fruit, milk shakes, honey, syrup,
jelly). Consume small, frequent meals rather than large meals
6. While assessing a patient two hours after a transurethral prostatectomy (TURP), the nurse
notes the catheter drainage is bright red in color and contains many clots. Name the priority
nursing intervention.
The rate of the CBI is adjusted to keep the irrigation return pink or lighter. For example, if
bright-red or ketchup-appearing (arterial) bleeding with clots is observed, the nurse should
increase the CBI rate.
7. A nurse is caring for a client with a burn injury who has been prescribed hydrotherapy. How
is hydrotherapy instituted and what actions should the nurse take during this therapy?
Assist the client into a warm tub of water or use warm running water, as if to shower, to
cleanse the wound.
, Use mild soap or detergent to wash burns gently, and then rinse with room-temperature
water.
Encourage the client to exercise his joints during the hydrotherapy treatment
8. A nurse is caring for a client with a new ileostomy. What should the nurse instruct the client
to expect in the post-operative period?
A surgical opening into the ileum to drain stool, which is typically frequent and liquid since
large intestine is bypassed
9. A client is experiencing disequilibrium syndrome. What are the clinical manifestations of
disequilibrium syndrome?
Identify three (3) nursing measures associated with managing the findings of this syndrome.
10. The emergency room nurse is assisting the provider perform an emergency thoracentesis
to relieve a tension pneumothorax following a traumatic motor vehicle accident.
List three (3) steps that are imperative for the nurse to perform prior to the procedure.
11. Describe five (5) ongoing nursing interventions necessary for all clients receiving
mechanical ventilation.
Monitor ventilator alarms, which signal if the client is not receiving the correct ventilation.
Never turn off ventilator alarms.
There are three types of ventilator alarms.
Volume (low pressure) alarms indicate a low exhaled volume due to a disconnection, cuff
leak, and/or tube displacement.
Pressure (high pressure) alarms indicate excess secretions, client biting the tubing, kinks in
the tubing, client coughing, pulmonary edema, bronchospasm, or pneumothorax.
Apnea alarms indicate that the ventilator does not detect spontaneous respiration in a preset
time period
12. List three (3) client teaching points following permanent pacemaker insertion.
Carry a pacemaker identification card at all times.
Prevent wire dislodgement. (Wear sling when out of bed. Do not raise arm above shoulder
for 1 to 2 weeks.)
Take pulse daily at the same time. Notify the provider if heart rate is less than the pacemaker
rate.
13. The nurse is administering 6 AM medications to a client with Gastroesophageal Reflux
Disorder (GERD). The client states, “I don’t want to take that Protonix, it never helps
my heart burn. I like taking TUMS better!” How will the nurse educate this client on the
