NUR 309 Final Exam Study Guide Med-Surg
Exam (elaborations)
,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
Exam (elaborations)
,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
