MED/SURG FINAL (Lewis Chapters 14-16, 23-24, 41-50,
63-65). 100% Complete Pack 2024-2025. Real
Questions & Correct Answers. Already Graded A+
*1. In teaching a patient with pyelonephritis about the disorder, the nurse informs the
paitent that the organisms that cause pyelonephritis most commonly reach the kidneys
through*
a. the bloodstream
b.the lymphatic system
c. a descending infection
d. an ascending infection - ANSd. an ascending infection
*10. A patient with ureterolithotomy returns from surgery with a nephrostomy tube in
place. Postoperative nursing care of the patient includes:*
a.encourage the patient to drink fruit juices and milk
b.encouraging fluids of at least 2-3 L/day after nausea has subsided
c. irrigating the nephrostomy tube with 10ml of NS solution as needed
d. notifying the physician if nephrostomy tube drainage is more than 30ml/hr -
ANSb.encouraging fluids of at least 2-3 L/day after nausea has subsided
*11. A patient has has a cystectomy and ileal conduit diversion performed. Four days
postoperatively, mucous shred are seen in the drainage bag. The nurse should.*
a. notify the physician
b.notify the charge nurse
c. irrigate the drainage tube
d. chart it as a normal observation - ANSd. chart it as a normal observation
*2. The nurse teaches the female paitent who has frequent UTIs that she should*
a. take tub baths with bubble bath
b.urinate before and after sexual intercourse
c.take prophylactic sufonamides for the rest of her life
d. restrict fluid intake to prevent the need for frequent voiding - ANSb.urinate before and
after sexual intercourse
*3. The immunologic mechanisms involved in acute poststreptococal glomerulonephritis
include:*
a. tubular blocking by precipitates of bacteria and antibody reactions
b. deposition of immune complexes and complement along the GBM
c. thickening of the GBM from autoimmune microangiopathic changes
d. destruction of glomeruli by proteolytic enzymes contained in the GBM - ANSb.
deposition of immune complexes and complement along the GBM
*4.One of the nruse's most important roles in relation to acute poststreptococcal
golmerulonephritis is to*
,a. promote early diagnosis and treatment of sore throats and skin lesions
b.encourage patients to obtain antibiotic therapy for upper respiratory tract infections
c.teach patients with APSGN that long term prophylactic antibiotic therapy is necessary
to prevent recurrence
d.monitor patients for respiratory symptoms that indicate the disease is affecting the
alveolar basement membrane - ANSa. promote early diagnosis and treatment of sore
throats and skin lesions
*5.The edema that occurs in nephrotic syndrome is due to*
a. increased hydrostatic pressure caused by sodium retention.
b. decreased aldosterone secretion from adrenal insufficiency.
c. increased fluid retention caused by decreased glomerular filtration
d.decreased colloidal osmotic pressure caused by loss of serum albumin -
ANSd.decreased colloidal osmotic pressure caused by loss of serum albumin
*6. A patient is admitted to the hospital with severe renal colic. The nurse's first priority
in management of the patient is to*
a. administer opioids as prescribed.
b. obtain supplies for straining all urine
c. encourage fluid intake of 3-4L/day
d. keep the patient NPO in preparation for surgery - ANSa. administer opioids as
prescribed.
*7. The nurse recommends genetic counseling for the children of a patient with*
a.nephrotic syndrome
b.chronic pyelonephritis
c. malignant nephrosclerosis
d.adult onset polycystic kidney disease - ANSd.adult onset polycystic kidney disease
*8. The nurse identifies a risk factor for kidney and bladder cancer in a patient who
relates a history of*
a.aspirin use
b.tobacco use
c.chronic alcohol abuse
d.use of artificial sweeteners - ANSb.tobacco use
*9. In planning nursing interventions to increase bladder control in the patient with
urinary incontinence, the nurse includes:*
a. teaching the patient to use Kegel exercises
b.clamping and releasing a catheter to increase bladder tone
c.teaching the patient biofeedback mechanisms to suppress the urge to void
d.counseling the patient concerning choices of incontinence containment devices -
ANSa. teaching the patient to use Kegel exercises
1. A 60-year-old patient has osteoarthritis (OA) of the left knee. A finding that the nurse
would expect to be present on examination of the patient's knee is
,a. Heberden's nodules.
b. redness and swelling of the knee joint.
c. pain upon joint movement.
d. stiffness that increases with movement. - ANSAnswer: C
Rationale: Initial symptoms of OA include pain with joint movement. Heberden's nodules
occur on the fingers. Redness of the joint is more strongly associated with rheumatoid
arthritis (RA), and stiffness in OA is worse right after the patient rests and decreases
with joint movement.
Cognitive Level: Comprehension Text Reference: p. 1694
Nursing Process: Assessment NCLEX: Physiological Integrity
1. A nurse is caring for a client who is to undergo a cystoscopy. When reinforcing
teaching to the client on post-procedure expectation, which of the following should the
nurse state?
-"It will be necessary to keep the sutures clean."
-"You will be placed in a dorsal recumbent position"
-"Expect to be on bed rest for 24 hours"
-"Pink-tinged urine and burning while urinating can be expected." - ANSPink tinged
urine and burning while urinating can be expected
1. A patient who has vague symptoms of fatigue and headaches is found to have a
positive enzyme immunoassay (EIA) for human immunodeficiency virus (HIV)
antibodies. In discussing the test results with the patient, the nurse informs the patient
that
a.
the EIA test will need to be repeated to verify the results.
b.
a viral culture will be done to determine the progress of the disease.
c.
it will probably be 10 or more years before the patient develops acquired
immunodeficiency syndrome (AIDS).
d.
the Western blot test will be done to determine whether AIDS has developed. - ANSA.
the EIA test will need to be repeated to verify the results
After an initial positive EIA test, the EIA is repeated before more specific testing such as
the Western blot is done. Viral cultures are not part of HIV testing. Because the nurse
does not know how recently the patient was infected, it is not appropriate to predict the
time frame for AIDS development. The Western blot tests for HIV antibodies, not for
AIDS.
, 1. A patient with deep partial-thickness burns experiences severe pain associated with
nausea during dressing changes. Which action will be most useful in decreasing the
patient's nausea?
a. The patient NPO for 2 hours before and after dressing changes.
b. Avoid performing dressing changes close to the patient's mealtimes.
c. Administer the prescribed morphine sulfate before dressing changes.
d. Give the ordered prochlorperazine (Compazine) before dressing changes. -
ANSANS: C
Because the patient's nausea is associated with severe pain, it is likely that it is
precipitated by stress and pain. The best treatment will be to provide adequate pain
medication before dressing changes. The nurse should avoid doing painful procedures
close to mealtimes, but nausea/vomiting that occur at other times also should be
addressed. Keeping the patient NPO does not address the reason for the nausea and
vomiting and will have an adverse effect on the patient's nutrition. Administration of
antiemetics is not the best choice for a patient with nausea caused by pain.
1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what "type 2"
means in relation to diabetes. The nurse explains to the patient that type 2 diabetes
differs from type 1 diabetes primarily in that with type 2 diabetes
a. the patient is totally dependent on an outside source of insulin.
b. there is decreased insulin secretion and cellular resistance to insulin that is produced.
c. the immune system destroys the pancreatic insulin-producing cells.
d. the insulin precursor that is secreted by the pancreas is not activated by the liver. -
ANSB. there is a decreased insulin secretion and cellular resistance to insulin that is
produced.
Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is
insufficient for the body's needs or the cells do not respond to the insulin appropriately.
1. When caring for a patient who has just been diagnosed with early chronic HIV
infection, which prophylactic measures will the nurse anticipate being included in the
plan of care (select all that apply)?
a.
Hepatitis B vaccine
b.
Pneumococcal vaccine
c.
Influenza virus vaccine
d.
Trimethoprim-sulfamethoxazole
e.
Varicella zoster immune globulin - ANSA. Hepatitis B vaccine
B. Pneumococcal vaccine
C. Influenza virus vaccine
63-65). 100% Complete Pack 2024-2025. Real
Questions & Correct Answers. Already Graded A+
*1. In teaching a patient with pyelonephritis about the disorder, the nurse informs the
paitent that the organisms that cause pyelonephritis most commonly reach the kidneys
through*
a. the bloodstream
b.the lymphatic system
c. a descending infection
d. an ascending infection - ANSd. an ascending infection
*10. A patient with ureterolithotomy returns from surgery with a nephrostomy tube in
place. Postoperative nursing care of the patient includes:*
a.encourage the patient to drink fruit juices and milk
b.encouraging fluids of at least 2-3 L/day after nausea has subsided
c. irrigating the nephrostomy tube with 10ml of NS solution as needed
d. notifying the physician if nephrostomy tube drainage is more than 30ml/hr -
ANSb.encouraging fluids of at least 2-3 L/day after nausea has subsided
*11. A patient has has a cystectomy and ileal conduit diversion performed. Four days
postoperatively, mucous shred are seen in the drainage bag. The nurse should.*
a. notify the physician
b.notify the charge nurse
c. irrigate the drainage tube
d. chart it as a normal observation - ANSd. chart it as a normal observation
*2. The nurse teaches the female paitent who has frequent UTIs that she should*
a. take tub baths with bubble bath
b.urinate before and after sexual intercourse
c.take prophylactic sufonamides for the rest of her life
d. restrict fluid intake to prevent the need for frequent voiding - ANSb.urinate before and
after sexual intercourse
*3. The immunologic mechanisms involved in acute poststreptococal glomerulonephritis
include:*
a. tubular blocking by precipitates of bacteria and antibody reactions
b. deposition of immune complexes and complement along the GBM
c. thickening of the GBM from autoimmune microangiopathic changes
d. destruction of glomeruli by proteolytic enzymes contained in the GBM - ANSb.
deposition of immune complexes and complement along the GBM
*4.One of the nruse's most important roles in relation to acute poststreptococcal
golmerulonephritis is to*
,a. promote early diagnosis and treatment of sore throats and skin lesions
b.encourage patients to obtain antibiotic therapy for upper respiratory tract infections
c.teach patients with APSGN that long term prophylactic antibiotic therapy is necessary
to prevent recurrence
d.monitor patients for respiratory symptoms that indicate the disease is affecting the
alveolar basement membrane - ANSa. promote early diagnosis and treatment of sore
throats and skin lesions
*5.The edema that occurs in nephrotic syndrome is due to*
a. increased hydrostatic pressure caused by sodium retention.
b. decreased aldosterone secretion from adrenal insufficiency.
c. increased fluid retention caused by decreased glomerular filtration
d.decreased colloidal osmotic pressure caused by loss of serum albumin -
ANSd.decreased colloidal osmotic pressure caused by loss of serum albumin
*6. A patient is admitted to the hospital with severe renal colic. The nurse's first priority
in management of the patient is to*
a. administer opioids as prescribed.
b. obtain supplies for straining all urine
c. encourage fluid intake of 3-4L/day
d. keep the patient NPO in preparation for surgery - ANSa. administer opioids as
prescribed.
*7. The nurse recommends genetic counseling for the children of a patient with*
a.nephrotic syndrome
b.chronic pyelonephritis
c. malignant nephrosclerosis
d.adult onset polycystic kidney disease - ANSd.adult onset polycystic kidney disease
*8. The nurse identifies a risk factor for kidney and bladder cancer in a patient who
relates a history of*
a.aspirin use
b.tobacco use
c.chronic alcohol abuse
d.use of artificial sweeteners - ANSb.tobacco use
*9. In planning nursing interventions to increase bladder control in the patient with
urinary incontinence, the nurse includes:*
a. teaching the patient to use Kegel exercises
b.clamping and releasing a catheter to increase bladder tone
c.teaching the patient biofeedback mechanisms to suppress the urge to void
d.counseling the patient concerning choices of incontinence containment devices -
ANSa. teaching the patient to use Kegel exercises
1. A 60-year-old patient has osteoarthritis (OA) of the left knee. A finding that the nurse
would expect to be present on examination of the patient's knee is
,a. Heberden's nodules.
b. redness and swelling of the knee joint.
c. pain upon joint movement.
d. stiffness that increases with movement. - ANSAnswer: C
Rationale: Initial symptoms of OA include pain with joint movement. Heberden's nodules
occur on the fingers. Redness of the joint is more strongly associated with rheumatoid
arthritis (RA), and stiffness in OA is worse right after the patient rests and decreases
with joint movement.
Cognitive Level: Comprehension Text Reference: p. 1694
Nursing Process: Assessment NCLEX: Physiological Integrity
1. A nurse is caring for a client who is to undergo a cystoscopy. When reinforcing
teaching to the client on post-procedure expectation, which of the following should the
nurse state?
-"It will be necessary to keep the sutures clean."
-"You will be placed in a dorsal recumbent position"
-"Expect to be on bed rest for 24 hours"
-"Pink-tinged urine and burning while urinating can be expected." - ANSPink tinged
urine and burning while urinating can be expected
1. A patient who has vague symptoms of fatigue and headaches is found to have a
positive enzyme immunoassay (EIA) for human immunodeficiency virus (HIV)
antibodies. In discussing the test results with the patient, the nurse informs the patient
that
a.
the EIA test will need to be repeated to verify the results.
b.
a viral culture will be done to determine the progress of the disease.
c.
it will probably be 10 or more years before the patient develops acquired
immunodeficiency syndrome (AIDS).
d.
the Western blot test will be done to determine whether AIDS has developed. - ANSA.
the EIA test will need to be repeated to verify the results
After an initial positive EIA test, the EIA is repeated before more specific testing such as
the Western blot is done. Viral cultures are not part of HIV testing. Because the nurse
does not know how recently the patient was infected, it is not appropriate to predict the
time frame for AIDS development. The Western blot tests for HIV antibodies, not for
AIDS.
, 1. A patient with deep partial-thickness burns experiences severe pain associated with
nausea during dressing changes. Which action will be most useful in decreasing the
patient's nausea?
a. The patient NPO for 2 hours before and after dressing changes.
b. Avoid performing dressing changes close to the patient's mealtimes.
c. Administer the prescribed morphine sulfate before dressing changes.
d. Give the ordered prochlorperazine (Compazine) before dressing changes. -
ANSANS: C
Because the patient's nausea is associated with severe pain, it is likely that it is
precipitated by stress and pain. The best treatment will be to provide adequate pain
medication before dressing changes. The nurse should avoid doing painful procedures
close to mealtimes, but nausea/vomiting that occur at other times also should be
addressed. Keeping the patient NPO does not address the reason for the nausea and
vomiting and will have an adverse effect on the patient's nutrition. Administration of
antiemetics is not the best choice for a patient with nausea caused by pain.
1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what "type 2"
means in relation to diabetes. The nurse explains to the patient that type 2 diabetes
differs from type 1 diabetes primarily in that with type 2 diabetes
a. the patient is totally dependent on an outside source of insulin.
b. there is decreased insulin secretion and cellular resistance to insulin that is produced.
c. the immune system destroys the pancreatic insulin-producing cells.
d. the insulin precursor that is secreted by the pancreas is not activated by the liver. -
ANSB. there is a decreased insulin secretion and cellular resistance to insulin that is
produced.
Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is
insufficient for the body's needs or the cells do not respond to the insulin appropriately.
1. When caring for a patient who has just been diagnosed with early chronic HIV
infection, which prophylactic measures will the nurse anticipate being included in the
plan of care (select all that apply)?
a.
Hepatitis B vaccine
b.
Pneumococcal vaccine
c.
Influenza virus vaccine
d.
Trimethoprim-sulfamethoxazole
e.
Varicella zoster immune globulin - ANSA. Hepatitis B vaccine
B. Pneumococcal vaccine
C. Influenza virus vaccine
