3
MED SURGE FINAL EXAM
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatitis.
The nurse should expect to find an elevation of which of following values?
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can
be used by the body. It is produced by the pancreas and salivary glands and
released into the mouth, stomach, and intestines to aid in digestion. The amylase
level of a client who has acute pancreatitis usually increases within 12 to 24 hr
and can remain elevated for 2 to 3 days.
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of
endometriosis. Which of the following findings in the client's history should the
nurse recognize as consistent with a diagnosis of endometriosis?
Dysmenorrhea that is unresponsive to NSAIDs.
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus
implants in locations outside the uterus. This typically causes pelvic pain around
the time of the menstrual period but can cause pain at other times in the cycle.
The discomfort is often unrelieved by the use of NSAIDs.
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
that resulted in paraplegia. After a week on the unit, the nurse notes that the
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client is withdrawn and increasingly resistant to rehabilitative efforts by the staff.
Which of the following actions should the nurse take?
Establish a plan of care with the client that sets attainable goals.
Rational
The nurse should develop a plan of care for this client with mutually set goals.
This action invests the client in the rehabilitation process, which encourages
feelings of ownership for it, and sees the goals as more attainable
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4….A nurse in a burn treatment center is caring for a client who is admitted with
severe burns to both lower extremities and is scheduled for an escharotomy.
The client's spouse asks the nurse what the procedure entails. Which of the
following nursing statements is appropriate?
Large incisions will be made in the eschar to improve circulation.
Rational
An escharotomy is a surgical incision made to release pressure and improve
circulation in a part of the body that has a deep burn and is experiencing excessive
swelling. Burn injuries that encircle a body part, such as an arm or the chest, can
cause swelling and tightness in the affected area, resulting in reduced circulation.
Making surgical incisions into the burned tissue allows the skin to expand, reduces
tightness and pressure, and improves circulation.
5….A nurse is caring for a client who has suspected cholecystitis. The nurse should
expect the client's urine to appear which of the following colors?
Dark and foamy
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
the kidneys are filtering excess bilirubin from the blood.
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests
should the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
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Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in
detecting and monitoring tissue inflammation in clients with RA. As the disease
improves the ESR decreases.
7….A nurse is providing dietary teaching to a client who has a history of recurring
calcium oxalate kidney stones. Which of the following instructions should the
nurse include in the teaching?
Drink 3 L of fluid every day.
Page 4 of 116
MED SURGE FINAL EXAM
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatitis.
The nurse should expect to find an elevation of which of following values?
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can
be used by the body. It is produced by the pancreas and salivary glands and
released into the mouth, stomach, and intestines to aid in digestion. The amylase
level of a client who has acute pancreatitis usually increases within 12 to 24 hr
and can remain elevated for 2 to 3 days.
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of
endometriosis. Which of the following findings in the client's history should the
nurse recognize as consistent with a diagnosis of endometriosis?
Dysmenorrhea that is unresponsive to NSAIDs.
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus
implants in locations outside the uterus. This typically causes pelvic pain around
the time of the menstrual period but can cause pain at other times in the cycle.
The discomfort is often unrelieved by the use of NSAIDs.
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury
that resulted in paraplegia. After a week on the unit, the nurse notes that the
Page 1 of 116
, 3
client is withdrawn and increasingly resistant to rehabilitative efforts by the staff.
Which of the following actions should the nurse take?
Establish a plan of care with the client that sets attainable goals.
Rational
The nurse should develop a plan of care for this client with mutually set goals.
This action invests the client in the rehabilitation process, which encourages
feelings of ownership for it, and sees the goals as more attainable
Page 2 of 116
, 3
4….A nurse in a burn treatment center is caring for a client who is admitted with
severe burns to both lower extremities and is scheduled for an escharotomy.
The client's spouse asks the nurse what the procedure entails. Which of the
following nursing statements is appropriate?
Large incisions will be made in the eschar to improve circulation.
Rational
An escharotomy is a surgical incision made to release pressure and improve
circulation in a part of the body that has a deep burn and is experiencing excessive
swelling. Burn injuries that encircle a body part, such as an arm or the chest, can
cause swelling and tightness in the affected area, resulting in reduced circulation.
Making surgical incisions into the burned tissue allows the skin to expand, reduces
tightness and pressure, and improves circulation.
5….A nurse is caring for a client who has suspected cholecystitis. The nurse should
expect the client's urine to appear which of the following colors?
Dark and foamy
Rational
The nurse should expect the client to have dark and foamy urine, which indicates
the kidneys are filtering excess bilirubin from the blood.
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA)
and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests
should the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
Page 3 of 116
, 3
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in
detecting and monitoring tissue inflammation in clients with RA. As the disease
improves the ESR decreases.
7….A nurse is providing dietary teaching to a client who has a history of recurring
calcium oxalate kidney stones. Which of the following instructions should the
nurse include in the teaching?
Drink 3 L of fluid every day.
Page 4 of 116
