MEDSURGE 2 MIDTERM EXAM
REPORTED QUESTIONS AND
ANSWERS
What is the blood glucose level, serum pH level, serum HCO3, bun and creatinine
levels of DKA? -Answer-Glucose: greater than 300
PH: less than 7.35
HCO3: less than 15
Bun: greater than 30
Creatinine: greater than 1.5
What two symptoms would alert you to the patient needing a dose adjustment when
they are taking Synthroid? -Answer-When the patient requires more sleep and is
constipated
A client with atherosclerosis asks a nurse which factors are responsible for this
condition. What is the nurse's best response? -Answer-"A combination of platelets and
fats accumulates, narrowing the artery and reducing blood flow."
The nurse is working with clients at a health fair. Which teaching takes priority to reduce
the risk of atherosclerosis? -Answer-Instructing a diabetic client not to smoke or use any
tobacco
A client has been diagnosed with Cushing's syndrome. What assessment does the
nurse perform to detect vascular complications associated with this illness? -Answer-
Assessment of blood pressure
Should thyroid medications be taken with or without food? -Answer-without
Are TSH levels high or low in hypothyroidism? -Answer-High because the body is trying
to stimulate the thyroid gland to produce more hormones
What should you teach the patient who is taking lithium carbonate? -Answer-1. To take
the drug every eight hours
2. Drink at least 3 to 4 quarts of fluids daily
3. To check for weight gain, slow heart rate and cold tolerance (indicate hypothyroidism)
What does lithium carbonate do? -Answer-Reduces the manifestations of
hyperthyroidism by inhibiting the release of thyroid hormones (temporarily)
What does MSH do? -Answer-Stimulate the release of melanin (sleep)
, The nurse is caring for four clients who had arterial blood gases (ABGs). Which
laboratory value warrants immediate intervention by the nurse? -Answer-PaCO2 of 48
mm Hg
The nurse assesses a client with a new tracheotomy, and the tracheostomy tube is
pulsating in synchrony with the client's heartbeat. Which is the nurse's priority action? -
Answer-Notify the health care provider immediately.
Which statement by a client indicates an accurate understanding of home self-care of a
tracheostomy? -Answer-"While showering, I need to keep water out of my airway."
The nurse is preparing to receive a postoperative client who just had a tracheostomy.
Which action by the nurse takes priority? -Answer-Place a second tracheostomy tube
and obturator at the bedside.
A client is being weaned from a tracheostomy tube and has tolerated capping of the
tube for 24 hours. Which action by the nurse is most appropriate? -Answer-Place a dry
dressing over the stoma and tape it securely.
The nursing student is performing tracheostomy care on a client. Which action by the
student leads the supervising nurse to intervene? -Answer-Cutting a slit in a gauze 4 × 4
pad to fit around the stoma
A client is being discharged home with a tracheostomy. Which action does the nurse
teach the client to decrease the risk for aspiration while eating? -Answer-Thicken all
liquids.
A client has severe metabolic alkalosis. Which nursing diagnosis does the nurse choose
as the client's priority problem? -Answer-Risk for injury related to increased neuronal
sensitivity from hypocalcemia
A client is in the emergency department after an overdose of an unknown substance.
Which assessment findings does the nurse correlate with possible salicylate poisoning?
-Answer-increased rate and depth of respiration
A client has a prolonged fever. For which acid-base imbalance does the nurse assess
the client further? -Answer-Metabolic acidosis from increased production of hydrogen
ions
While suctioning a client who had a tracheostomy placed 4 days ago, the nurse notes
particles of food in the tracheal secretions. Which action by the nurse is most
appropriate? -Answer-Perform a more thorough assessment of the client.
REPORTED QUESTIONS AND
ANSWERS
What is the blood glucose level, serum pH level, serum HCO3, bun and creatinine
levels of DKA? -Answer-Glucose: greater than 300
PH: less than 7.35
HCO3: less than 15
Bun: greater than 30
Creatinine: greater than 1.5
What two symptoms would alert you to the patient needing a dose adjustment when
they are taking Synthroid? -Answer-When the patient requires more sleep and is
constipated
A client with atherosclerosis asks a nurse which factors are responsible for this
condition. What is the nurse's best response? -Answer-"A combination of platelets and
fats accumulates, narrowing the artery and reducing blood flow."
The nurse is working with clients at a health fair. Which teaching takes priority to reduce
the risk of atherosclerosis? -Answer-Instructing a diabetic client not to smoke or use any
tobacco
A client has been diagnosed with Cushing's syndrome. What assessment does the
nurse perform to detect vascular complications associated with this illness? -Answer-
Assessment of blood pressure
Should thyroid medications be taken with or without food? -Answer-without
Are TSH levels high or low in hypothyroidism? -Answer-High because the body is trying
to stimulate the thyroid gland to produce more hormones
What should you teach the patient who is taking lithium carbonate? -Answer-1. To take
the drug every eight hours
2. Drink at least 3 to 4 quarts of fluids daily
3. To check for weight gain, slow heart rate and cold tolerance (indicate hypothyroidism)
What does lithium carbonate do? -Answer-Reduces the manifestations of
hyperthyroidism by inhibiting the release of thyroid hormones (temporarily)
What does MSH do? -Answer-Stimulate the release of melanin (sleep)
, The nurse is caring for four clients who had arterial blood gases (ABGs). Which
laboratory value warrants immediate intervention by the nurse? -Answer-PaCO2 of 48
mm Hg
The nurse assesses a client with a new tracheotomy, and the tracheostomy tube is
pulsating in synchrony with the client's heartbeat. Which is the nurse's priority action? -
Answer-Notify the health care provider immediately.
Which statement by a client indicates an accurate understanding of home self-care of a
tracheostomy? -Answer-"While showering, I need to keep water out of my airway."
The nurse is preparing to receive a postoperative client who just had a tracheostomy.
Which action by the nurse takes priority? -Answer-Place a second tracheostomy tube
and obturator at the bedside.
A client is being weaned from a tracheostomy tube and has tolerated capping of the
tube for 24 hours. Which action by the nurse is most appropriate? -Answer-Place a dry
dressing over the stoma and tape it securely.
The nursing student is performing tracheostomy care on a client. Which action by the
student leads the supervising nurse to intervene? -Answer-Cutting a slit in a gauze 4 × 4
pad to fit around the stoma
A client is being discharged home with a tracheostomy. Which action does the nurse
teach the client to decrease the risk for aspiration while eating? -Answer-Thicken all
liquids.
A client has severe metabolic alkalosis. Which nursing diagnosis does the nurse choose
as the client's priority problem? -Answer-Risk for injury related to increased neuronal
sensitivity from hypocalcemia
A client is in the emergency department after an overdose of an unknown substance.
Which assessment findings does the nurse correlate with possible salicylate poisoning?
-Answer-increased rate and depth of respiration
A client has a prolonged fever. For which acid-base imbalance does the nurse assess
the client further? -Answer-Metabolic acidosis from increased production of hydrogen
ions
While suctioning a client who had a tracheostomy placed 4 days ago, the nurse notes
particles of food in the tracheal secretions. Which action by the nurse is most
appropriate? -Answer-Perform a more thorough assessment of the client.
