NUR 309 Final Exam
Study Guide Med-Surg
,Test 1
A nursing manager is concerned about the number of
infections on the hospital unit. What action by the manager
would best help?
Assess staf f members' hand hygiene practices This is the best
possible answer- Power Point (PP) Slide 7 Igi-Pg 418.
The nursing instructor explaining infection tells students that
which factor is the best and most important barrier to infection?
Intact skin and mucous membrane Power Point Slide 5 Igi-p 415
Which type of transmission-based precautions must the nurse use
to prevent the transmission of tuberculosis?
Airborne Precautions pg 419
A nurse is assessing patients on a medical-surgical unit. Which
adult patient does the nurse identify as being at greatest risk for
insensible water loss?
A patient who is febrile with diaphoresis
A nurse is assessing a patient with hypokalemia and notes that
the patient’s hand-grip strength has diminished since the
previous assessment 1 hour ago. What action does the nurse take
FIRST?
Assess the patient's respiratory rate, rhythm, and depth Fluid
and Electrolyte table page 2
Which patient is at risk for hypokalemia?
Patient with pancreatitis who has continuous nasogastric suction
Fluid and Electrolyte Table pg 2
1. What is the minimum amount of urine per day needed to
excrete toxic products?
400 to 600 mL Slide 6 pg 165
A patient with heart failure asks, “Why do I need to weigh myself
every day?” How would the nurse respond?
“Weight is the best indication that you are gaining or losing fluid." pg. 168
,The patient who has undergone which surgical procedure is most at risk for
hypocalcemia?
Parathyroidectomy
A nurse is caring for a patient who is experiencing excessive
diarrhea. The patient’s arterial blood gas values are pH 7.18,
PaO2 98 mm Hg, PaCO2 45 mm Hg and
HCO3 16 mEq/L. Which provider order does the nurse expect to receive?
Sodium Bicarbonate 100 mEq diluted in 1 Liter of D5W Power
Point Slide 11 in notes Igi page 195
The nurse is caring for a patient who is hyperventilating. The
patient’s arterial blood gas values are pH 7.52, PaO2 94mmHg,
PaCO2 31 mmHg and HCO3 26mEq. Which question would the
nurse ask when developing this patient’s plan of care?
You appear anxious. What is causing your distress? Open end
question Asking for clarication
A patient who has Clostridioides difficile with severe diarrhea will
likely have related alteration in which acid base balance?
Metabolic Acidosis Slide 11 p 192
Which nursing assessment nding indicates a worsening of
respiratory acidosis?
Respiratory Depression pg. 192
A patient has taken antacids for the past 3 weeks to relieve heart
burn. What alteration in the acid base balance with the nurse likely
nd?
Metabolic Alkalosis pg. 196
The person is with respiratory acidosis is considered full
compensated with which ABG?
pH 7.35 PaCO2 is 75 and the HCO3 is 30 Slide 16 pg 190
, An emergency department nurse obtains the health history of a
patient. Which statement by the patient would alert the nurse to
the occurrence of heart failure?
I get short of breath when I climb stairs
The nurse evaluates prescriptions for a patient with chronic
heart failure. Which class of medications would the nurse
expect to nd on the patient’s medication administration record
to decrease cardiac workload?
Ace Inhibitors Slides 17 and 23. JCHAO Core Measure
A nurse prepares to discharge a patient with chronic heart failure
home who is prescribed home healthcare services. Which priority
information would be communicated to the home health nurse
upon discharge?
Medication reconciliation Slides 23 24 and Igi table 35-4
A nurse assesses a patient in an outpatient clinic. Which statement
alerts the nurse to the possibility of left- sided heart failure?
I wake up at night short of breath. Slide 12 and 14 Igi p. 695
A nurse assesses a patient admitted to the cardiac unit. Which
statement by the patient alerts the nurse to the possibility of right-
sided heart failure?
My shoes t tight lately Slide 15 and Igi p696
A nurse admits a patient who is experiencing an exacerbation
of heart failure. What action would the nurse take rst?
Assess the patient’s respiratory status Slides 13 and 14 Igi pg 695
The nurse performing a physical assessment on a patient with
known cardiovascular disease observes ascites and +3 pitting
edema to lower extremities. The patient reports loss of appetite
and nausea. How does the nurse interpret these ndings?
Right Side Heart Failure
A patient has been diagnosed with hypertension but does not
take the prescribed antihypertensive medication because of
the patient’s lack of symptoms. What is the best response by
the nurse?
Most people with hypertension do not have symptoms Slides 13
and 14 pg 722
Study Guide Med-Surg
,Test 1
A nursing manager is concerned about the number of
infections on the hospital unit. What action by the manager
would best help?
Assess staf f members' hand hygiene practices This is the best
possible answer- Power Point (PP) Slide 7 Igi-Pg 418.
The nursing instructor explaining infection tells students that
which factor is the best and most important barrier to infection?
Intact skin and mucous membrane Power Point Slide 5 Igi-p 415
Which type of transmission-based precautions must the nurse use
to prevent the transmission of tuberculosis?
Airborne Precautions pg 419
A nurse is assessing patients on a medical-surgical unit. Which
adult patient does the nurse identify as being at greatest risk for
insensible water loss?
A patient who is febrile with diaphoresis
A nurse is assessing a patient with hypokalemia and notes that
the patient’s hand-grip strength has diminished since the
previous assessment 1 hour ago. What action does the nurse take
FIRST?
Assess the patient's respiratory rate, rhythm, and depth Fluid
and Electrolyte table page 2
Which patient is at risk for hypokalemia?
Patient with pancreatitis who has continuous nasogastric suction
Fluid and Electrolyte Table pg 2
1. What is the minimum amount of urine per day needed to
excrete toxic products?
400 to 600 mL Slide 6 pg 165
A patient with heart failure asks, “Why do I need to weigh myself
every day?” How would the nurse respond?
“Weight is the best indication that you are gaining or losing fluid." pg. 168
,The patient who has undergone which surgical procedure is most at risk for
hypocalcemia?
Parathyroidectomy
A nurse is caring for a patient who is experiencing excessive
diarrhea. The patient’s arterial blood gas values are pH 7.18,
PaO2 98 mm Hg, PaCO2 45 mm Hg and
HCO3 16 mEq/L. Which provider order does the nurse expect to receive?
Sodium Bicarbonate 100 mEq diluted in 1 Liter of D5W Power
Point Slide 11 in notes Igi page 195
The nurse is caring for a patient who is hyperventilating. The
patient’s arterial blood gas values are pH 7.52, PaO2 94mmHg,
PaCO2 31 mmHg and HCO3 26mEq. Which question would the
nurse ask when developing this patient’s plan of care?
You appear anxious. What is causing your distress? Open end
question Asking for clarication
A patient who has Clostridioides difficile with severe diarrhea will
likely have related alteration in which acid base balance?
Metabolic Acidosis Slide 11 p 192
Which nursing assessment nding indicates a worsening of
respiratory acidosis?
Respiratory Depression pg. 192
A patient has taken antacids for the past 3 weeks to relieve heart
burn. What alteration in the acid base balance with the nurse likely
nd?
Metabolic Alkalosis pg. 196
The person is with respiratory acidosis is considered full
compensated with which ABG?
pH 7.35 PaCO2 is 75 and the HCO3 is 30 Slide 16 pg 190
, An emergency department nurse obtains the health history of a
patient. Which statement by the patient would alert the nurse to
the occurrence of heart failure?
I get short of breath when I climb stairs
The nurse evaluates prescriptions for a patient with chronic
heart failure. Which class of medications would the nurse
expect to nd on the patient’s medication administration record
to decrease cardiac workload?
Ace Inhibitors Slides 17 and 23. JCHAO Core Measure
A nurse prepares to discharge a patient with chronic heart failure
home who is prescribed home healthcare services. Which priority
information would be communicated to the home health nurse
upon discharge?
Medication reconciliation Slides 23 24 and Igi table 35-4
A nurse assesses a patient in an outpatient clinic. Which statement
alerts the nurse to the possibility of left- sided heart failure?
I wake up at night short of breath. Slide 12 and 14 Igi p. 695
A nurse assesses a patient admitted to the cardiac unit. Which
statement by the patient alerts the nurse to the possibility of right-
sided heart failure?
My shoes t tight lately Slide 15 and Igi p696
A nurse admits a patient who is experiencing an exacerbation
of heart failure. What action would the nurse take rst?
Assess the patient’s respiratory status Slides 13 and 14 Igi pg 695
The nurse performing a physical assessment on a patient with
known cardiovascular disease observes ascites and +3 pitting
edema to lower extremities. The patient reports loss of appetite
and nausea. How does the nurse interpret these ndings?
Right Side Heart Failure
A patient has been diagnosed with hypertension but does not
take the prescribed antihypertensive medication because of
the patient’s lack of symptoms. What is the best response by
the nurse?
Most people with hypertension do not have symptoms Slides 13
and 14 pg 722
