PN Medical-Surgical Nursing Final Exam
deWit 3rd edition
A 65-year-old patient complains of leg pain that disappears at rest after having
walked a short distance. The nurse recognizes the patient's symptoms are
consistent with which problem?
A. Muscle spasm
B. Deep venous thrombosis
C. Claudication
D. Angiospasm - ANS - Answer:
C. Claudication
\A 75-year-old patient asks the nurse if the Pneumovax immunization he took
when he was 65 is still protecting him. Which reply is most accurate?
A. "Pneumovax protects you for your lifetime."
B. "Immunity afforded you by Pneumovax lasts only 2 years."
C. "Pneumovax protection varies according to your risk factors and living
situation."
D. "After 6 years, you need a repeat dose of Pneumovax for full immunity." - ANS
- Answer:
D. "After 6 years, you need a repeat does of Pneumovax for full immunity."
\A 75-year-old patient presents to the emergency department with shortness of
breath, fatigue, and a dry cough. What information leads the nurse to suspect this
patient should undergo a workup for histoplasmosis?
A. The patient reports drinking pond water.
B. The patient lives on a farm and raises chickens.
C. The patient recently went hunting in a wooded area.
D. The patient owns a landscaping company. - ANS - Answer:
B. The patient lives on a farm and raises chickens.
\A 75-year-old patient questions the nurse about vaccination to prevent shingles.
What response is most appropriate?
,A. "The incidence of shingles in people your age is not overly common, so
vaccination is unnecessary."
B. "The vaccination has not yet been approved for use in the older adult."
C. "Because of the incidence of shingles in your age group, you should consider
taking the vaccination."
D. "The vaccination is expensive but will provide lifelong immunity." - ANS -
Answer:
C. "Because of the incidence of shingles in your age group, you should consider
taking the vaccination."
\A 79-year-old patient with bacterial pneumonia becomes increasingly restless,
confused, and agitated. The patient's temperature is 100 F, and his pulse, blood
pressure, and respirations are elevated since the last assessment 6 hours ago.
What action should the nurse take first?
A. Auscultate the patient's lungs
B. Assess the patient's oxygen saturation
C. Administer the mild sedative as ordered
D. Administer an ordered analgesic for discomfort - ANS - Answer:
B. Assess the patient's oxygen saturation
\A patient who presented to the emergency room with a myocardial infarction (MI)
becomes pale, diaphoretic, and hypotensive. What action should the nurse take
first?
A. Notify the physician immediately.
B. Ensure the patient has patent IV access.
C. Request assistance from respiratory therapy.
D. Inform the patient's family of the change in status. - ANS - Answer:
A. Notify the physician immediately
\According to most state NPAs, the vocational nurse acting as charge nurse in a
long-term care facility acts in which capacity?
A. Working under direct supervision of an RN on the unit.
B. Working with the RN in the building.
C. Working under general supervision by the RN available on site or by phone.
D. Working as an independent vocational nurse. - ANS - Answer:
, C. Working under general supervision by the RN available on site or by the
phone.
\An 85-year-old patient with a newly diagnosed heart murmur expresses concern
that he has never been notified of this finding before. What is the most likely
cause of this patient's heart murmur?
A. Hypertension
B. Atherosclerosis
C. Insufficient heart valve
D. Weakened pacemaker - ANS - Answer:
C. Insufficient heart valve
\An 86-year-old patient asks why her ankles have a brownish discoloration and
the skin looks thick. Which response best addresses the patient's concern?
A. "The valves in the vessels in your legs aren't working as well as they used to,
which causes the discoloration and thickening of your skin."
B. "You probably aren't getting enough iron in your diet. We should talk to your
doctor about adding an iron supplement."
C. "How many years have you smoked? Nicotine will cause these changes in your
skin."
D. "These are just normal changes seen in most older people." - ANS - Answer:
A. "The valves in the vessels in your legs aren't working as well as they used to,
which causes the discoloration and thickening of your skin."
\For which patient would the nurse question an order for isotretinoin (Accutane)?
A. A 20-year-old epileptic man with nodular acne and epilepsy.
B. A 22-year-old pregnant woman with severe acne.
C. A 46-year-old woman on oral contraceptive pills with cystic acne.
D. A 50-year-old hypertensive man with cystic acne. - ANS - Answer:
B. A 22-year-old pregnant woman with severe acne.
\The clinic nurse offers suggestions to a patient who is planning a trip to Mexico
that will help prevent a protozoan infection. Which suggestion is most helpful?
A. "Ask the doctor for a prophylactic prescription for an antiviral drug."
B. "Broad-spectrum antibiotics will be most helpful if you contract a protozoan
infection."
C. "Be sure to practice good hand hygiene while on your trip."
deWit 3rd edition
A 65-year-old patient complains of leg pain that disappears at rest after having
walked a short distance. The nurse recognizes the patient's symptoms are
consistent with which problem?
A. Muscle spasm
B. Deep venous thrombosis
C. Claudication
D. Angiospasm - ANS - Answer:
C. Claudication
\A 75-year-old patient asks the nurse if the Pneumovax immunization he took
when he was 65 is still protecting him. Which reply is most accurate?
A. "Pneumovax protects you for your lifetime."
B. "Immunity afforded you by Pneumovax lasts only 2 years."
C. "Pneumovax protection varies according to your risk factors and living
situation."
D. "After 6 years, you need a repeat dose of Pneumovax for full immunity." - ANS
- Answer:
D. "After 6 years, you need a repeat does of Pneumovax for full immunity."
\A 75-year-old patient presents to the emergency department with shortness of
breath, fatigue, and a dry cough. What information leads the nurse to suspect this
patient should undergo a workup for histoplasmosis?
A. The patient reports drinking pond water.
B. The patient lives on a farm and raises chickens.
C. The patient recently went hunting in a wooded area.
D. The patient owns a landscaping company. - ANS - Answer:
B. The patient lives on a farm and raises chickens.
\A 75-year-old patient questions the nurse about vaccination to prevent shingles.
What response is most appropriate?
,A. "The incidence of shingles in people your age is not overly common, so
vaccination is unnecessary."
B. "The vaccination has not yet been approved for use in the older adult."
C. "Because of the incidence of shingles in your age group, you should consider
taking the vaccination."
D. "The vaccination is expensive but will provide lifelong immunity." - ANS -
Answer:
C. "Because of the incidence of shingles in your age group, you should consider
taking the vaccination."
\A 79-year-old patient with bacterial pneumonia becomes increasingly restless,
confused, and agitated. The patient's temperature is 100 F, and his pulse, blood
pressure, and respirations are elevated since the last assessment 6 hours ago.
What action should the nurse take first?
A. Auscultate the patient's lungs
B. Assess the patient's oxygen saturation
C. Administer the mild sedative as ordered
D. Administer an ordered analgesic for discomfort - ANS - Answer:
B. Assess the patient's oxygen saturation
\A patient who presented to the emergency room with a myocardial infarction (MI)
becomes pale, diaphoretic, and hypotensive. What action should the nurse take
first?
A. Notify the physician immediately.
B. Ensure the patient has patent IV access.
C. Request assistance from respiratory therapy.
D. Inform the patient's family of the change in status. - ANS - Answer:
A. Notify the physician immediately
\According to most state NPAs, the vocational nurse acting as charge nurse in a
long-term care facility acts in which capacity?
A. Working under direct supervision of an RN on the unit.
B. Working with the RN in the building.
C. Working under general supervision by the RN available on site or by phone.
D. Working as an independent vocational nurse. - ANS - Answer:
, C. Working under general supervision by the RN available on site or by the
phone.
\An 85-year-old patient with a newly diagnosed heart murmur expresses concern
that he has never been notified of this finding before. What is the most likely
cause of this patient's heart murmur?
A. Hypertension
B. Atherosclerosis
C. Insufficient heart valve
D. Weakened pacemaker - ANS - Answer:
C. Insufficient heart valve
\An 86-year-old patient asks why her ankles have a brownish discoloration and
the skin looks thick. Which response best addresses the patient's concern?
A. "The valves in the vessels in your legs aren't working as well as they used to,
which causes the discoloration and thickening of your skin."
B. "You probably aren't getting enough iron in your diet. We should talk to your
doctor about adding an iron supplement."
C. "How many years have you smoked? Nicotine will cause these changes in your
skin."
D. "These are just normal changes seen in most older people." - ANS - Answer:
A. "The valves in the vessels in your legs aren't working as well as they used to,
which causes the discoloration and thickening of your skin."
\For which patient would the nurse question an order for isotretinoin (Accutane)?
A. A 20-year-old epileptic man with nodular acne and epilepsy.
B. A 22-year-old pregnant woman with severe acne.
C. A 46-year-old woman on oral contraceptive pills with cystic acne.
D. A 50-year-old hypertensive man with cystic acne. - ANS - Answer:
B. A 22-year-old pregnant woman with severe acne.
\The clinic nurse offers suggestions to a patient who is planning a trip to Mexico
that will help prevent a protozoan infection. Which suggestion is most helpful?
A. "Ask the doctor for a prophylactic prescription for an antiviral drug."
B. "Broad-spectrum antibiotics will be most helpful if you contract a protozoan
infection."
C. "Be sure to practice good hand hygiene while on your trip."
