Assessment 2: Adult Med Surg
Question: 1 of 50
A nurse is caring for a client who is hyperventilating and has the
following results: pH 7.50, PaCo2 29mm Hg, and HCO2 25mEq/L. The
nurse shouldrecognize that the client has which of the follow- ing acid-
base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolicalkal
osisAnswer: b
Question 2 of 50
A nurse is providing discharge teaching for a client who has COPD about
nutrition. Which of the following instructions should the nurse include?
a. Eat three large meals daily.
b. Consume high calorie foods.
c. Limit caffeinated drinks to two per day.
d. Drink fluids during
mealtimeAnswer: b
Question 3 of 50
A nurse is caring for a client who has a right sided pneumothorax.
Followingchest tube insertion, which of the following findings indicates
that the chest drainage system is functioning correctly?
a. Circle bubbling in the suction chamber
b. Crepitus around the insertion site
c. Constant bubbling in the water seal chamber
,d. Absence of breath sounds on
,the right sideAnswer: a
Question 4 of 50
A nurse is caring for a client who has a traumatic brain injury. Which of
the following findings should indicate to the nurse the need for
immediateintervention?
a. Auxiliary temperature 37.3 degrees Celsius (99 f)
b. Apical pulse 100mm
c. Respiratory rate 30/min
d. Blood pressure 140/34
mm HgAnswer: c
Question 5 of 50
A nurse is developing a plan of care for a client who will be placed in halo
traction following surgical repair of the cervical spine. Which of the
followingintervention should he nurse include in the plan?
a. Inspect the pin site every 48 hr
b. Monitor the client’s skin under the halo vest
c. Ensure two personnel hold the halo device when repositioning the chest
d. Apply powder frequently to the cline’s skin under the vest to decrease
aching.Answer: b
Question 6 of
50
A nurse is providing discharge teaching to a client who has heart failure and
aprescription for furosemide 20 mg PO two times daily. Which of the
following instructions should the nurse include in the teaching?
a. Monitor for increased blood pressure.
, b. Increase intake of high potassium foods.
Question: 1 of 50
A nurse is caring for a client who is hyperventilating and has the
following results: pH 7.50, PaCo2 29mm Hg, and HCO2 25mEq/L. The
nurse shouldrecognize that the client has which of the follow- ing acid-
base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolicalkal
osisAnswer: b
Question 2 of 50
A nurse is providing discharge teaching for a client who has COPD about
nutrition. Which of the following instructions should the nurse include?
a. Eat three large meals daily.
b. Consume high calorie foods.
c. Limit caffeinated drinks to two per day.
d. Drink fluids during
mealtimeAnswer: b
Question 3 of 50
A nurse is caring for a client who has a right sided pneumothorax.
Followingchest tube insertion, which of the following findings indicates
that the chest drainage system is functioning correctly?
a. Circle bubbling in the suction chamber
b. Crepitus around the insertion site
c. Constant bubbling in the water seal chamber
,d. Absence of breath sounds on
,the right sideAnswer: a
Question 4 of 50
A nurse is caring for a client who has a traumatic brain injury. Which of
the following findings should indicate to the nurse the need for
immediateintervention?
a. Auxiliary temperature 37.3 degrees Celsius (99 f)
b. Apical pulse 100mm
c. Respiratory rate 30/min
d. Blood pressure 140/34
mm HgAnswer: c
Question 5 of 50
A nurse is developing a plan of care for a client who will be placed in halo
traction following surgical repair of the cervical spine. Which of the
followingintervention should he nurse include in the plan?
a. Inspect the pin site every 48 hr
b. Monitor the client’s skin under the halo vest
c. Ensure two personnel hold the halo device when repositioning the chest
d. Apply powder frequently to the cline’s skin under the vest to decrease
aching.Answer: b
Question 6 of
50
A nurse is providing discharge teaching to a client who has heart failure and
aprescription for furosemide 20 mg PO two times daily. Which of the
following instructions should the nurse include in the teaching?
a. Monitor for increased blood pressure.
, b. Increase intake of high potassium foods.
