MEDICAL SURGICAL NURSING RESEARCH PRACTICE QUESTIONS

1. A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? A. 14 units B. 28 units C. 32 units D. 42 units 2. A patient has Lactated Ringers IV infusing at 100 mL/hr. How many hours will it take to complete a 0.5 L bag of fluid? 0.5 L = 500 mL100 mL/hr x 5 hours = 500 mL 3. A nurse is reinforcing discharge teaching with a client who has a new permanent pacemaker. Which of the following information should the nurse include in the teaching? A. "Use your cell phone on the same ear as the pacemaker site is located." B. Limited arm and shoulder movement reduces the risk of lead dislodgement Rationale: Limited arm and shoulder movement reduces the risk of lead dislodgementThe nurse should also reinforce that the client should avoid lifting her arm or shoulder on the side of the pacemaker because dislodgement of the pacer leads can occur. C. "Hiccups are an expected outcome of having a pacemaker." D. "Avoid travel by airplane." 4. A nurse is monitoring a post surgical client who is receiving Blood transfusion- a unit of packed red blood cells Should in the die (PRBC). The client reports hives and itching 30 min after the start of the infusion. Which of the following actions A. Send the blood container and tubing to the blood bank. B. Maintain the IV access with 0.9% sodium chloride. C. Stop the infusion of blood. D. Obtain a urine sample. 5. A nurse is collecting data from a client who sustained superficial partial thickness burns 48 hours ago. Which of the finding is an indication of infection and the nurse should report this finding to the provider? A. Severe pain at the burn sites B. Edema in the affected extremities C. Temperature of 39.1° C (102.4° F) Rationale: An elevated temperature is an indication of infection and the nurse should report this finding to the provider. Sepsis is a critical finding following a major burn injury. Initially, burn wounds are relatively pathogen-free. On approximately the third day following the injury, early colonization of the wound surface by gram-negative organisms changes to predominantly gram-positive opportunistic organisms. D. Urine output of 30 mL/hr 6. A nurse in a provider's office is caring for a client who has a new diagnosis of herpes zoster. Which medication should the nurse anticipate to be prescribed? A. Shingles vaccine B. Acyclovir Rationale: The nurse should anticipate a prescription for acyclovir, an antiviral medication, because it inhibits replication of the virus that causes herpes zoster. C. Infliximab D. Amoxicillin 7. A nurse on the med/surg unit is caring for a post op patient after a total hip replacement. Which finding is an indication of Compartment syndrome A. 5 P's ( pain, palor, paresthesia, pulselessness, paralysis) B. Tracheal deviation MEDICAL SURGICAL NURSING RESEARCH PRACTICE QUESTIONS C. loss of weight D. Bradycardia 8. A nurse is collecting data from a patient in the urgent care clinic who was recently exposed to tuberculosis. Which of the following findings is a clinical manifestation of TB? A. Weight gain B. Night sweats Rationale: Night sweats and fevers are clinical manifestations of tuberculosis. C. Pericardial friction rub D. Cyanosis of the fingertips 9. A nurse is preparing to assist the provider with a thoracentesis. The nurse should assist the patient into which position for the procedure? A. Prone with the arms raised over the head B. Lying flat on the affected side C. Sitting while leaning forward over the bedside table Rationale: When preparing a client for a thoracentesis, the nurse should have the client sit on the edge of the bed and lean forward over the bedside table. This position maximizes the space between the client's ribs and allows for aspiration of accumulated fluid and air. D. Supine with the head of the bed elevated 10. The nurse is performing an assessment and implementation on a patient after total hip replacement. In order to prevent dislocation of the prosthesis what intervention should the nurse take? A. Should limit administering pain medication for not more than once daily to prevent dislocation of prosthesis. B. Excess protein intake can interfere with bone healing and result in dislocation of prosthesis C. The affected hip must not be adducted or flexed more than 90 degrees to prevent dislocation of prosthesis Rationale: the affected hip must not be abducted or flexed more than 90 degrees because excessive flexion/adduction can dislocate the prosthesis D. Blanching of the toenail beds with pressure will prevent dislocation of prosthesis 11. A nurse is preparing to administer eardrops to a 2-year-old child. The nurse should pull the auricle in which of the following directions when instilling the medication? A. Down and backward Rationale: The nurse should pull the auricle down and backward in order to straighten the ear canal to facilitate the flow of the medication. B. Down and outward C. Upward and backward D. Upward and outward 12. A nurse in the outpatient clinic is collecting data from a client who has psoriasis. Which of the following findings should the nurse expect? A. Lesions along the pathways of nerve endings Rationale: Common sites of psoriasis lesions are the scalp, elbows, knees, sacrum, genitalia, and nails. Lesions along the pathways of nerve endings are associated with herpes zoster. B. Serous drainage Rationale: Psoriasis is characterized by dry lesions. C. Intense pain Rationale: Psoriasis is characterized by pruritus rather than intense pain. D. Silvery scales Rationale: The characteristic lesions of psoriasis are thick, erythematous plaques covered by silvery scales. 13. Which action will the nurse take when a patient receiving morphine sulfate has a shallow, irregular respiratory rate of 6 breaths/min? A. Elevate the patient's head of bed to facilitate lung expansion B. Increase the patient's primary intravenous (IV) flow rate C. Complete the MOPS scale D. Notify the health care provider and prepare to administer naloxone (Narcan) Rationale: The patient is exhibiting signs of respiratory depression. Administration of the antidote naloxone would be the most appropriate nursing intervention. Lung expansion or increasing the is for children ages 1-4. 14. The registered nurse reviews the results of the arterial blood gases with the licensed practical nurse (LPN) and tells the LPN that the client is experiencing respiratory acidosis. The LPN should expect to note which on the laboratory result report? A. pH 7.50, PCO2 52 mm Hg B. pH 7.35, PCO2 40 mm Hg C. pH 7.25, PCO2 50 mm Hg D. pH 7.50, PCO2 30 mm Hg 15. A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABGs are: pH: 7.6, PaCO2: 40 mm Hg, HCO3: 32 mEq/L. Which of the following acid base conditions should the nurse identify the client is experiencing? A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis 16. What should a nurse expect of a patient's respirations caused by the falling blood pressure and impaired blood circulation during the end-organ dysfunction stage of shock? A. Rapid and deep B. Rapid and shallow C. Slow and deep D. Slow and shallow 17. The nurse administers atropine ordered pre-op for surgery. Thirty minutes after administration, the client complains of a very dry and has flushed, dry skin with an temperature of 101.5° F and an apical heart rate of 113. A. document the client's complaints. B. notify the physician. C. take the client's temperature in 1 hour. D. recognize that these are normal side effects of the drug. 18. A nurse is assessing and intervening the patient suffering from He