MED-SURG/ADULT HEALTH QS EXAM QUESTIONS AND
ANSWERS WITH COMPLETE VERIFIED SOLUTIONS
2024/2025
An older client is apprehensive about being hospitalized. The nurse realizes that
one of the stresses of hospitalization is the unfamiliarity of the environment and
activity. How can the nurse best limit the client's stress?
1. Use the client's first name.
2. Visit with the client frequently.
3. Explain what the client can expect.
4. Listen to what the client has to say.
3
Explaining procedures and routines should decrease the client's anxiety about the
unknown. The nurse should not confuse roles of professional and friend; the client
should be called by an appropriate title (Mr., Miss, Ms., Mrs., etc.) unless the client
requests otherwise. The nurse should not confuse the role of professional with that of
being a friend; "visiting" has a social connotation. Although listening to the client is
therapeutic, this does not change the fact that the hospital environment is strange to the
client and the client needs information.
,The nurse recognizes that a common conflict experienced by the older adult is
the conflict between:
1. Youth and old age
2. Retirement and work
3. Independence and dependence
4. Wishing to die and wishing to live
3
A common conflict confronting the older adult is between the desire to be taken care of
by others and the desire to be in charge of one's own destiny. The conflict between the
young and old age may occur but is not common. The conflict between the retired and
working may occur but is not common. The conflict between those wishing to die and
those wishing to live may occur but is not common.
A primary nurse receives prescriptions for a newly admitted client and has
difficulty reading the health care provider's writing. Who should the nurse ask for
clarification of this prescription?
1. Nurse practitioner
2. House health care provider that is on-call
3. Health care provider who wrote the prescription
4. Nurse manager familiar with the health care provider's writing
3
The health care provider who wrote the prescription should be called for clarification.
,The nurse is liable and responsible if the prescription is misinterpreted. Only the health
care provider who wrote an undecipherable prescription can correctly clarify the
prescription.
A client is admitted with metabolic acidosis. The nurse considers that two body
systems interact with the bicarbonate buffer system to preserve healthy body
fluid pH. What two body systems should the nurse assess for compensatory
changes?
1. Skeletal and nervous
2. Circulatory and urinary
3. Respiratory and urinary
4. Muscular and endocrine
3
Increased respirations blow off carbon dioxide (CO2), which decreases the hydrogen
ion concentration and the pH increases (less acidity). Decreased respirations result in
CO2 buildup, which increases hydrogen ion concentration and the pH falls (more
acidity). The kidneys either conserve or excrete bicarbonate and hydrogen ions, which
helps to adjust the body's pH. The buffering capacity of the renal system is greater than
that of the pulmonary system, but the pulmonary system is quicker to respond. Skeletal
and nervous systems do not maintain the pH, nor do muscular and endocrine systems.
Although the circulatory system carries fluids and electrolytes to the kidneys, it does not
interact with the urinary system to regulate plasma pH.
A 2 g sodium diet is prescribed for a client with stage 2 hypertension, and the
nurse teaches the client the rationale for this diet. The client reports distaste for
the food. The primary nurse hears the client request that the family "bring in a
ham and cheese sandwich and fries." What is the most effective nursing
intervention?
, 1. Discuss the diet with the client and family.
2. Tell the client why salty foods should not be eaten.
3. Explain the dietary restriction to the client's visitors.
4. Ask the dietitian to teach the client and family about sodium restrictions.
1
The client and significant family members should be included in dietary teaching;
families provide support that promotes adherence. The client already has received
information about why salty foods should not be eaten. Explaining the dietary restriction
to the client's visitors could violate confidentiality. The client should be involved in his or
her own care; the client ultimately will assume the responsibility. The dietitian is a
resource person who can give specific, practical information about diet and food
preparation once there is a basic understanding of the reasons for the diet.
The nurse should place the client in which position to obtain the most accurate
reading of jugular vein distention?
1. Upright at 90 degrees
2. Supine position
3. Raised to 30 degrees
4. Raised to 10 degrees
3
Jugular vein pressure is measured with a centimeter ruler to obtain the vertical distance
between the sternal angle and the point of highest pulsation. This procedure is most
ANSWERS WITH COMPLETE VERIFIED SOLUTIONS
2024/2025
An older client is apprehensive about being hospitalized. The nurse realizes that
one of the stresses of hospitalization is the unfamiliarity of the environment and
activity. How can the nurse best limit the client's stress?
1. Use the client's first name.
2. Visit with the client frequently.
3. Explain what the client can expect.
4. Listen to what the client has to say.
3
Explaining procedures and routines should decrease the client's anxiety about the
unknown. The nurse should not confuse roles of professional and friend; the client
should be called by an appropriate title (Mr., Miss, Ms., Mrs., etc.) unless the client
requests otherwise. The nurse should not confuse the role of professional with that of
being a friend; "visiting" has a social connotation. Although listening to the client is
therapeutic, this does not change the fact that the hospital environment is strange to the
client and the client needs information.
,The nurse recognizes that a common conflict experienced by the older adult is
the conflict between:
1. Youth and old age
2. Retirement and work
3. Independence and dependence
4. Wishing to die and wishing to live
3
A common conflict confronting the older adult is between the desire to be taken care of
by others and the desire to be in charge of one's own destiny. The conflict between the
young and old age may occur but is not common. The conflict between the retired and
working may occur but is not common. The conflict between those wishing to die and
those wishing to live may occur but is not common.
A primary nurse receives prescriptions for a newly admitted client and has
difficulty reading the health care provider's writing. Who should the nurse ask for
clarification of this prescription?
1. Nurse practitioner
2. House health care provider that is on-call
3. Health care provider who wrote the prescription
4. Nurse manager familiar with the health care provider's writing
3
The health care provider who wrote the prescription should be called for clarification.
,The nurse is liable and responsible if the prescription is misinterpreted. Only the health
care provider who wrote an undecipherable prescription can correctly clarify the
prescription.
A client is admitted with metabolic acidosis. The nurse considers that two body
systems interact with the bicarbonate buffer system to preserve healthy body
fluid pH. What two body systems should the nurse assess for compensatory
changes?
1. Skeletal and nervous
2. Circulatory and urinary
3. Respiratory and urinary
4. Muscular and endocrine
3
Increased respirations blow off carbon dioxide (CO2), which decreases the hydrogen
ion concentration and the pH increases (less acidity). Decreased respirations result in
CO2 buildup, which increases hydrogen ion concentration and the pH falls (more
acidity). The kidneys either conserve or excrete bicarbonate and hydrogen ions, which
helps to adjust the body's pH. The buffering capacity of the renal system is greater than
that of the pulmonary system, but the pulmonary system is quicker to respond. Skeletal
and nervous systems do not maintain the pH, nor do muscular and endocrine systems.
Although the circulatory system carries fluids and electrolytes to the kidneys, it does not
interact with the urinary system to regulate plasma pH.
A 2 g sodium diet is prescribed for a client with stage 2 hypertension, and the
nurse teaches the client the rationale for this diet. The client reports distaste for
the food. The primary nurse hears the client request that the family "bring in a
ham and cheese sandwich and fries." What is the most effective nursing
intervention?
, 1. Discuss the diet with the client and family.
2. Tell the client why salty foods should not be eaten.
3. Explain the dietary restriction to the client's visitors.
4. Ask the dietitian to teach the client and family about sodium restrictions.
1
The client and significant family members should be included in dietary teaching;
families provide support that promotes adherence. The client already has received
information about why salty foods should not be eaten. Explaining the dietary restriction
to the client's visitors could violate confidentiality. The client should be involved in his or
her own care; the client ultimately will assume the responsibility. The dietitian is a
resource person who can give specific, practical information about diet and food
preparation once there is a basic understanding of the reasons for the diet.
The nurse should place the client in which position to obtain the most accurate
reading of jugular vein distention?
1. Upright at 90 degrees
2. Supine position
3. Raised to 30 degrees
4. Raised to 10 degrees
3
Jugular vein pressure is measured with a centimeter ruler to obtain the vertical distance
between the sternal angle and the point of highest pulsation. This procedure is most
