Nurs 120 med surg final exam questions with verified answers 2022 update
Pt. acute phase of burn injury requires frequent hydrotherapy sessions for wound debridement –
o closely monitor serum sodium level
Acute asthma attack, which info indicates pt. requires further teaching –
o pt. has been using Proventil more frequently over the last 4 days
Asthma pt. admitted for acute respiratory distress, notify HCP immediately if –
o decreased breath sounds and wheezing
Intubation with mechanical ventilation for pt. with status asthmaticus when –
o fatigue and oxygen saturation of 88% develops
Asthma pt. has new prescription for Advair and diskus, ask nurse for purpose of 2 drugs –
o one drug decreases inflammation, other is a bronchodilator
HCP prescribed MDI q8h Maxair and Symbicort –
o use spacer with MDI
Activity intolerance for pt. with asthma –
o work of breathing
Finding for acute asthma attack was responding to bronchodilator therapy –
o wheezes are more easily heard
Pt. has mild persistent asthma uses Proventil has new prescription for chromolyn –
o use chromolyn for inflammatory airway changes, take several weeks for max effect
During assessment of asthma, has wheezing and dyspnea –
o give meds to reduce airway narrowing
Pt. receiving chemo with acute dehydration (nausea and vomiting), what to do to prevent to Systemic
inflammatory response syndrome (SIRS) and Multiple organ dysfunction syndrome (MODS) –
o place patient in a private room (immunocompromised)
When assessing hemodynamic of patient with shock of unknown etiology, don’t give large volumes of
crystalloids when –a
o CO is high and CVP is low (septic shock)
Diabetic patient vomiting and diarrhea for past 3 days, glucose is 748, urine output 120, cyanotic hands
and feet–
o progressive stage of hypovolemic shock
,Nurs 120 med surg final exam questions with verified answers 2022 update
Industrial acids at work spilled on patient, what to do before transporting to hospital –
o flush burned area with large amounts of tap water
6 hours after thermal burn to arms and legs, important info to tell doctor
o urine output 20-30 ml per hour
During early emergent phase of burns –
o give opioid IV so that medications will be rapidly effective
Nurse caring for pt. admitted with burns, 30% of body surface recognized, emergent to acute phase –
pt. has large quantities of pale urine
Pt. with acute asthma attack comes to ER, ABG’s are drawn, pH 7.4, co2 32, paO2 70, teach pt use of
peak flow meter –
o take something before peak flow readings when asthma attack/symptoms
COPD pt. has dyspnea, cough, yellow sputum, upon palpation of thorax expected finding –
o chest expansion is diminished
COPD with barrel chest, why – overinflation of the alveoli
Pulmonary function test for COPD pt – increased residual volume
Chronic hypoxemia 89-90 % caused by COPD, compliance – arrange pt. spouse to be present during
teaching
68 YO with COPD, cor pulmonale manifestation – 3+ edema in lower extremities
COPD that smokes, tell them that smoking – decreases area available for oxygen absorption
Acute COPD exacerbation, ph 7.32 paO2 58, co2 55, pulse ox 86 indicates – respiratory acidosis
Imbalanced nutrition less than body requirement intervention –
o offer high calorie snacks between meals and at bedtime
COPD, info given by patient that confirms chronic bronchitis –
o productive cough every winter for 2 months
Pursed lip breathing purpose –
o preventing airway collapse and trapping air in lung during expiration
Impaired gas exchange in COPD with acute respiratory distress – pulse ox 86%
COPD with cor pulmonale, assess/monitor for – JVD
,Nurs 120 med surg final exam questions with verified answers 2022 update
COPD receiving oxygen – maintain oxygen at 90% or greater
COPD ask about home health oxygen use – it can improve pt. long term prognosis and quality of life
RN observes students suctioning, when to intervene – clean gloves when using a sterile catheter
Pt. coughs violently and dislodges trach tube – insert obturator
When inflating cough to appropriate level – use manometer
Info in pt with ARDS being treated with PEEP indicates complication – pt. has subcutaneous
emphysema
PEEP purpose, explains to family –
o PEEP prevents air sacs from collapsing during exhalation
Evaluate 02 ventilation for acute respiratory – use ABG
Findings for acute respiratory failure – partial pressure of Oxygen at 45 mmhg
Caring for patient developed ARDS as a result of a UTI, how it happened?
o – infection caused by generalized inflammation that damaged the lungs
When prone position Is used for ARDS, positioning is effective if – patients FIo2 is 90, and o2 stat is 92
Nurse obtains vital signs of temp 101, bp 90/56, pulse 92, resp 34, whats next ? – obtain pulse ox
Monitor for clinical manifestations of hypercapnia when pt. in ER has –
o chest trauma and multiple rib fractures
Pt. hypercapnia respiratory failure, resp. 8, pulse ox 89, extremely lethargic – ET with PEEP
Protect pt. from aspiration pneumonia – position pt. with altered level of consciousness in lateral position
Drug overdose in ER, barbiturates, potential complication–
o hypercapnic respiratory failure related to decreased ventilator effort
Pulmonary embolism, how to explain to patient –
o blood flow to some areas of your lungs is decreased even though you’re taking adequate
breaths
Upper Lobectomy patient complains of incisional pain 7/10, decreased left sided breath sounds, 100 ML of bloody
drainage with large air leak, intervention –
o medicate patient with ordered morphine
HCP 2 chest tubes with Y-connector in pneumothorax, nurse should be concerned about –
o 400 ml of blood in the collection chamber
Pt has right sided chest tube following thoracotomy has continuous bubbling in collection chamber –
, Nurs 120 med surg final exam questions with verified answers 2022 update
o take no action with collection device
Pre-op for left pneumonectomy for cancer of lungs – use incentive spirometer
Monitor strip for MI, no P wave, rate 162, R interval irregular, PR not measurable, QRS wide and
distorted
o Ventricular tachycardia
50 second episode of v. tach –
o administer IV antidysrhythmic drugs per protocol
MI develop symptomatic hypotension, hr 30, atropine is prescribed, effective when –
o increase in patient heart rate
Large MI has frequent PVC - monitor apical heart rate
Pt. complains of racing heart, BP 102/68, puts on cardiac monitor –
o obtain further info about possible cause for heart rate (STRIP)
Dizziness and SOB for several days
o 3rd degree av block (STRIP)
Nurse gets stuck by a needle –
o hep b vaccine and HBIG injection
Hepatitis from contaminated food, serologic testing result –
o anti-hepatitis virus immunoglobulin
Evaluation of patient at outpatient clinic, admin of hep B vaccine is effective when –
o anti Hep B are present in specimen
Positive for anti HCV –
o schedule patient for HCV genotype testing
Homeless patient, severe anorexia, jaundice, diagnosed with hepatitis –
o maintain adequate nutrition
Acute hep B asks if treatment is available –
o no meds are available to treat acute viral hepatitis, adequate nutrition and rest are the most
important treatments (HB=NO MED)
Pt. acute phase of burn injury requires frequent hydrotherapy sessions for wound debridement –
o closely monitor serum sodium level
Acute asthma attack, which info indicates pt. requires further teaching –
o pt. has been using Proventil more frequently over the last 4 days
Asthma pt. admitted for acute respiratory distress, notify HCP immediately if –
o decreased breath sounds and wheezing
Intubation with mechanical ventilation for pt. with status asthmaticus when –
o fatigue and oxygen saturation of 88% develops
Asthma pt. has new prescription for Advair and diskus, ask nurse for purpose of 2 drugs –
o one drug decreases inflammation, other is a bronchodilator
HCP prescribed MDI q8h Maxair and Symbicort –
o use spacer with MDI
Activity intolerance for pt. with asthma –
o work of breathing
Finding for acute asthma attack was responding to bronchodilator therapy –
o wheezes are more easily heard
Pt. has mild persistent asthma uses Proventil has new prescription for chromolyn –
o use chromolyn for inflammatory airway changes, take several weeks for max effect
During assessment of asthma, has wheezing and dyspnea –
o give meds to reduce airway narrowing
Pt. receiving chemo with acute dehydration (nausea and vomiting), what to do to prevent to Systemic
inflammatory response syndrome (SIRS) and Multiple organ dysfunction syndrome (MODS) –
o place patient in a private room (immunocompromised)
When assessing hemodynamic of patient with shock of unknown etiology, don’t give large volumes of
crystalloids when –a
o CO is high and CVP is low (septic shock)
Diabetic patient vomiting and diarrhea for past 3 days, glucose is 748, urine output 120, cyanotic hands
and feet–
o progressive stage of hypovolemic shock
,Nurs 120 med surg final exam questions with verified answers 2022 update
Industrial acids at work spilled on patient, what to do before transporting to hospital –
o flush burned area with large amounts of tap water
6 hours after thermal burn to arms and legs, important info to tell doctor
o urine output 20-30 ml per hour
During early emergent phase of burns –
o give opioid IV so that medications will be rapidly effective
Nurse caring for pt. admitted with burns, 30% of body surface recognized, emergent to acute phase –
pt. has large quantities of pale urine
Pt. with acute asthma attack comes to ER, ABG’s are drawn, pH 7.4, co2 32, paO2 70, teach pt use of
peak flow meter –
o take something before peak flow readings when asthma attack/symptoms
COPD pt. has dyspnea, cough, yellow sputum, upon palpation of thorax expected finding –
o chest expansion is diminished
COPD with barrel chest, why – overinflation of the alveoli
Pulmonary function test for COPD pt – increased residual volume
Chronic hypoxemia 89-90 % caused by COPD, compliance – arrange pt. spouse to be present during
teaching
68 YO with COPD, cor pulmonale manifestation – 3+ edema in lower extremities
COPD that smokes, tell them that smoking – decreases area available for oxygen absorption
Acute COPD exacerbation, ph 7.32 paO2 58, co2 55, pulse ox 86 indicates – respiratory acidosis
Imbalanced nutrition less than body requirement intervention –
o offer high calorie snacks between meals and at bedtime
COPD, info given by patient that confirms chronic bronchitis –
o productive cough every winter for 2 months
Pursed lip breathing purpose –
o preventing airway collapse and trapping air in lung during expiration
Impaired gas exchange in COPD with acute respiratory distress – pulse ox 86%
COPD with cor pulmonale, assess/monitor for – JVD
,Nurs 120 med surg final exam questions with verified answers 2022 update
COPD receiving oxygen – maintain oxygen at 90% or greater
COPD ask about home health oxygen use – it can improve pt. long term prognosis and quality of life
RN observes students suctioning, when to intervene – clean gloves when using a sterile catheter
Pt. coughs violently and dislodges trach tube – insert obturator
When inflating cough to appropriate level – use manometer
Info in pt with ARDS being treated with PEEP indicates complication – pt. has subcutaneous
emphysema
PEEP purpose, explains to family –
o PEEP prevents air sacs from collapsing during exhalation
Evaluate 02 ventilation for acute respiratory – use ABG
Findings for acute respiratory failure – partial pressure of Oxygen at 45 mmhg
Caring for patient developed ARDS as a result of a UTI, how it happened?
o – infection caused by generalized inflammation that damaged the lungs
When prone position Is used for ARDS, positioning is effective if – patients FIo2 is 90, and o2 stat is 92
Nurse obtains vital signs of temp 101, bp 90/56, pulse 92, resp 34, whats next ? – obtain pulse ox
Monitor for clinical manifestations of hypercapnia when pt. in ER has –
o chest trauma and multiple rib fractures
Pt. hypercapnia respiratory failure, resp. 8, pulse ox 89, extremely lethargic – ET with PEEP
Protect pt. from aspiration pneumonia – position pt. with altered level of consciousness in lateral position
Drug overdose in ER, barbiturates, potential complication–
o hypercapnic respiratory failure related to decreased ventilator effort
Pulmonary embolism, how to explain to patient –
o blood flow to some areas of your lungs is decreased even though you’re taking adequate
breaths
Upper Lobectomy patient complains of incisional pain 7/10, decreased left sided breath sounds, 100 ML of bloody
drainage with large air leak, intervention –
o medicate patient with ordered morphine
HCP 2 chest tubes with Y-connector in pneumothorax, nurse should be concerned about –
o 400 ml of blood in the collection chamber
Pt has right sided chest tube following thoracotomy has continuous bubbling in collection chamber –
, Nurs 120 med surg final exam questions with verified answers 2022 update
o take no action with collection device
Pre-op for left pneumonectomy for cancer of lungs – use incentive spirometer
Monitor strip for MI, no P wave, rate 162, R interval irregular, PR not measurable, QRS wide and
distorted
o Ventricular tachycardia
50 second episode of v. tach –
o administer IV antidysrhythmic drugs per protocol
MI develop symptomatic hypotension, hr 30, atropine is prescribed, effective when –
o increase in patient heart rate
Large MI has frequent PVC - monitor apical heart rate
Pt. complains of racing heart, BP 102/68, puts on cardiac monitor –
o obtain further info about possible cause for heart rate (STRIP)
Dizziness and SOB for several days
o 3rd degree av block (STRIP)
Nurse gets stuck by a needle –
o hep b vaccine and HBIG injection
Hepatitis from contaminated food, serologic testing result –
o anti-hepatitis virus immunoglobulin
Evaluation of patient at outpatient clinic, admin of hep B vaccine is effective when –
o anti Hep B are present in specimen
Positive for anti HCV –
o schedule patient for HCV genotype testing
Homeless patient, severe anorexia, jaundice, diagnosed with hepatitis –
o maintain adequate nutrition
Acute hep B asks if treatment is available –
o no meds are available to treat acute viral hepatitis, adequate nutrition and rest are the most
important treatments (HB=NO MED)
