Med Surge Final Exam l l l
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatitis.The n
l l l l l l l l l l l l l l l l
urse should expect to find an elevation of which of following values?
l l l l l l l l l l l
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can beused
l l l l l l l l l l l l l l l
by the body. It is produced by the pancreas and salivary glands and releasedinto the m
l l l l l l l l l l l l l l l l
outh, stomach, and intestines to aid in digestion. The amylase level of aclient who has
l l l l l l l l l l l l l l l l
acute pancreatitis usually increases within 12 to 24 hr and can remain elevated for 2 to
l l l l l l l l l l l l l l l
3 days.
l l
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of endometrio
l l l l l l l l l l l l l l l l
sis. Which of the following findings in the client's history should thenurse recognize as c
l l l l l l l l l l l l l l l
onsistent with a diagnosis of endometriosis? l l l l l
Dysmenorrhea that is unresponsive to NSAIDs. l l l l l
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus implants i l l l l l l l l l l l l l l l
n locations outside the uterus. This typically causes pelvic pain aroundthe time of the
l l l l l l l l l l l l l l l
menstrual period but can cause pain at other times in the cycle.The discomfort is ofte
l l l l l l l l l l l l l l l
n unrelieved by the use of NSAIDs.
l l l l l l
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury that res
l l l l l l l l l l l l l l l l l
ulted in paraplegia. After a week on the unit, the nurse notes that the client is withdra
l l l l l l l l l l l l l l l l
wn and increasinglyresistant to rehabilitative efforts bythe staff.Which of the followin
l l l l l l l l l l l l l
g actions should the nurse take?
l l l l l
Establish a plan of care with the client that sets attainable goals.
l l l l l l l l l l l
Rational
The nurse should develop a plan of care for this client with mutually set goals. Thisactio
l l l l l l l l l l l l l l l l
n invests the client in the rehabilitation process, which encourages feelings ofownershi
l l l l l l l l l l l l
p for it, and sees the goals as more attainable
l l l l l l l l l
,4….A nurse in a burn treatment center is caring for a client who is admitted withsever
l l l l l l l l l l l l l l l l
e burns to both lower extremities and is scheduled for an escharotomy. Theclient's sp
l l l l l l l l l l l l l l
ouse asks the nurse what the procedure entails. Which of the followingnursing state
l l l l l l l l l l l l l
ments is appropriate? l l
Large incisions will be made in the eschar to improve circulation.
l l l l l l l l l l
Rational
An escharotomy is a surgical incision made to release pressure and improve circulation
l l l l l l l l l l l l l
in a part of the body that has a deep burn and is experiencing excessiveswelling. Burn inj
l l l l l l l l l l l l l l l l l
uries that encircle a body part, such as an arm or the chest, can cause swelling and tightn
l l l l l l l l l l l l l l l l l
ess in the affected area, resulting in reduced circulation. Making surgical incisions into t
l l l l l l l l l l l l l
he burned tissue allows the skin to expand, reducestightness and pressure, and improv
l l l l l l l l l l l l l
es circulation.
l
5….A nurse is caring for a client who has suspected cholecystitis. The nurse shouldexpec
l l l l l l l l l l l l l l
t the client's urine to appear which of the following colors?
l l l l l l l l l l
Dark and foamy l l
Rational
The nurse should expect the client to have dark and foamy urine, which indicatesthe kid
l l l l l l l l l l l l l l l
neys are filtering excess bilirubin from the blood.
l l l l l l l
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is ta
l l l l l l l l l l l l l l l l
king aspirin 650 mg every 4 hours. Which of the following diagnostic testsshould the nu
l l l l l l l l l l l l l l l
rse monitor to evaluate the effectiveness of this medication?
l l l l l l l l
Erythrocyte sedimentation rate (ESR) l l l
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detectingand l l l l l l l l l l l l l
monitoring tissue inflammation in clients with RA. As the disease improves the ESR d l l l l l l l l l l l l l
ecreases.
7….A nurse is providing dietary teaching to a client who has a history of recurringcalciu
l l l l l l l l l l l l l l l
m oxalate kidney stones. Which of the following instructions should the nurse include
l l l l l l l l l l l l l
in the teaching?
l l
Drink 3 L of fluid every day. l l l l l l
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day todilute the
l l l l l l l l l l l l l l l l l l l l l
urine and reduce the risk for stone formation.
l l l l l l l
8….A nurse is assessing a client who has disseminated intravascular coagulation(DIC).
l l l l l l l l l l l l
Which of the following findings should the nurse expect?
l l l l l l l l
Excessive thrombosis and bleeding l l l
Rational
The nurse should expect excessive thrombosis and bleeding of mucous membranes b
l l l l l l l l l l l
ecause both DIC impairs both coagulation and anticoagulationpathways.
l l l l l l l l
9….A nurse is caring for a middle adult client who has just received the diagnosisof end
l l l l l l l l l l l l l l l l
ometrial cancer. In taking a nursing history, which of the following manifestations is li
l l l l l l l l l l l l l
kely to be reported by this client?
l l l l l l
Postmenopausal bleeding l
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of theuter
l l l l l l l l l l l
us). The most common manifestation of endometrial cancer is abnormal uterine blee
l l l l l l l l l l l
ding, including postmenopausal bleeding and bleeding between normal periods in pr
l l l l l l l l l l
emenopausal women. l
10…A nurse is giving a presentation to a community group about preventing atherosc
l l l l l l l l l l l l
lerosis. Which of the following should the nurse include as a modifiablerisk factor for t
l l l l l l l l l l l l l l l
his disorder? (Select all that apply.)
l l l l l
Hypercholesterolemia l
Hypertension
Obesity l
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a medical-
l l l l l l l l l l l l l l l
surgical unit. Which of the following room assignments should the nursemake for the
l l l l l l l l l l l l l l
client?
A room with air exhaust directly to the outdoor environment
l l l l l l l l l
, Rational
A room with air exhaust directly to the outside environment eliminates contaminati
l l l l l l l l l l l
on of other client-
l l l
care areas. This type of ventilation system isreferred to as an airborne infection isolati
l l l l l l l l l l l l l l
on room. l
12…A nurse is caring for a client who has Cushing's syndrome. Which of the following int
l l l l l l l l l l l l l l l
erventions should the nurse expect to perform? (Select all that apply.)Assess blood gluc
l l l l l l l l l l l l l
ose level l
Assess for neck vein distention l l l l
Incorrect. Monitor for an irregular heart rateIncorre l l l l l l l
ct. Monitor for postural hypotension Weigh the clie
l l l l l l l
nt daily l
13…A nurse is teaching a client about risk factors for osteoporosis. Which of thefollowi
l l l l l l l l l l l l l l
ng factors should the nurse include in the teaching? (Select all that apply.)
l l l l l l l l l l l l
Sedentary lifestyle l l
Incorrect. Obesity l l
Aging
Caffeine intake Sec l l
ondhand smoke l
Sedentary lifestyle is correct. Immobility depletes bone. l l l l l l
Obesity is incorrect. Women who are obese have a greater capacity for storingestrogen
l l l l l l l l l l l l l l
to help maintain acceptable levels of calcium.
l l l l l l
Aging is correct. Women lose bone due to estrogen depletion after menopause.Caffe
l l l l l l l l l l l l
ine intake is correct. Excessive caffeine intake causes calcium loss in the urine.
l l l l l l l l l l l l
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, bothactive an l l l l l l l l l l l l l
d passive (secondhand) smoking.
l l l
14…A nurse is caring for a client who has a history of exposure to TB and symptoms of n
l l l l l l l l l l l l l l l l l l
ight sweats and hemoptysis. Which of the following tests should the nurse realize is th
l l l l l l l l l l l l l l
e most reliable to confirm the diagnosis of active pulmonaryTB?
l l l l l l l l l l
Sputum culture for acid- l l l
fast bacillusRational l l
1…. A nurse is reviewing the laboratory data of a client who has acute pancreatitis.The n
l l l l l l l l l l l l l l l l
urse should expect to find an elevation of which of following values?
l l l l l l l l l l l
Amylase
Rational
Amylase is an enzyme that changes complex sugars into simple sugars that can beused
l l l l l l l l l l l l l l l
by the body. It is produced by the pancreas and salivary glands and releasedinto the m
l l l l l l l l l l l l l l l l
outh, stomach, and intestines to aid in digestion. The amylase level of aclient who has
l l l l l l l l l l l l l l l l
acute pancreatitis usually increases within 12 to 24 hr and can remain elevated for 2 to
l l l l l l l l l l l l l l l
3 days.
l l
2…. A nurse in a clinic is interviewing a client who has a possible diagnosis of endometrio
l l l l l l l l l l l l l l l l
sis. Which of the following findings in the client's history should thenurse recognize as c
l l l l l l l l l l l l l l l
onsistent with a diagnosis of endometriosis? l l l l l
Dysmenorrhea that is unresponsive to NSAIDs. l l l l l
Rational
Endometriosis is a condition in which the type of tissue that lines the uterus implants i l l l l l l l l l l l l l l l
n locations outside the uterus. This typically causes pelvic pain aroundthe time of the
l l l l l l l l l l l l l l l
menstrual period but can cause pain at other times in the cycle.The discomfort is ofte
l l l l l l l l l l l l l l l
n unrelieved by the use of NSAIDs.
l l l l l l
3…. A rehabilitation nurse is caring for a client who has had a spinal cord injury that res
l l l l l l l l l l l l l l l l l
ulted in paraplegia. After a week on the unit, the nurse notes that the client is withdra
l l l l l l l l l l l l l l l l
wn and increasinglyresistant to rehabilitative efforts bythe staff.Which of the followin
l l l l l l l l l l l l l
g actions should the nurse take?
l l l l l
Establish a plan of care with the client that sets attainable goals.
l l l l l l l l l l l
Rational
The nurse should develop a plan of care for this client with mutually set goals. Thisactio
l l l l l l l l l l l l l l l l
n invests the client in the rehabilitation process, which encourages feelings ofownershi
l l l l l l l l l l l l
p for it, and sees the goals as more attainable
l l l l l l l l l
,4….A nurse in a burn treatment center is caring for a client who is admitted withsever
l l l l l l l l l l l l l l l l
e burns to both lower extremities and is scheduled for an escharotomy. Theclient's sp
l l l l l l l l l l l l l l
ouse asks the nurse what the procedure entails. Which of the followingnursing state
l l l l l l l l l l l l l
ments is appropriate? l l
Large incisions will be made in the eschar to improve circulation.
l l l l l l l l l l
Rational
An escharotomy is a surgical incision made to release pressure and improve circulation
l l l l l l l l l l l l l
in a part of the body that has a deep burn and is experiencing excessiveswelling. Burn inj
l l l l l l l l l l l l l l l l l
uries that encircle a body part, such as an arm or the chest, can cause swelling and tightn
l l l l l l l l l l l l l l l l l
ess in the affected area, resulting in reduced circulation. Making surgical incisions into t
l l l l l l l l l l l l l
he burned tissue allows the skin to expand, reducestightness and pressure, and improv
l l l l l l l l l l l l l
es circulation.
l
5….A nurse is caring for a client who has suspected cholecystitis. The nurse shouldexpec
l l l l l l l l l l l l l l
t the client's urine to appear which of the following colors?
l l l l l l l l l l
Dark and foamy l l
Rational
The nurse should expect the client to have dark and foamy urine, which indicatesthe kid
l l l l l l l l l l l l l l l
neys are filtering excess bilirubin from the blood.
l l l l l l l
6….A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is ta
l l l l l l l l l l l l l l l l
king aspirin 650 mg every 4 hours. Which of the following diagnostic testsshould the nu
l l l l l l l l l l l l l l l
rse monitor to evaluate the effectiveness of this medication?
l l l l l l l l
Erythrocyte sedimentation rate (ESR) l l l
Rational
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detectingand l l l l l l l l l l l l l
monitoring tissue inflammation in clients with RA. As the disease improves the ESR d l l l l l l l l l l l l l
ecreases.
7….A nurse is providing dietary teaching to a client who has a history of recurringcalciu
l l l l l l l l l l l l l l l
m oxalate kidney stones. Which of the following instructions should the nurse include
l l l l l l l l l l l l l
in the teaching?
l l
Drink 3 L of fluid every day. l l l l l l
,Rational
The nurse should instruct the client to drink at least 3 to 4 L of fluid every day todilute the
l l l l l l l l l l l l l l l l l l l l l
urine and reduce the risk for stone formation.
l l l l l l l
8….A nurse is assessing a client who has disseminated intravascular coagulation(DIC).
l l l l l l l l l l l l
Which of the following findings should the nurse expect?
l l l l l l l l
Excessive thrombosis and bleeding l l l
Rational
The nurse should expect excessive thrombosis and bleeding of mucous membranes b
l l l l l l l l l l l
ecause both DIC impairs both coagulation and anticoagulationpathways.
l l l l l l l l
9….A nurse is caring for a middle adult client who has just received the diagnosisof end
l l l l l l l l l l l l l l l l
ometrial cancer. In taking a nursing history, which of the following manifestations is li
l l l l l l l l l l l l l
kely to be reported by this client?
l l l l l l
Postmenopausal bleeding l
Rational
Endometrial cancer involves cancerous growth of the endometrium (lining of theuter
l l l l l l l l l l l
us). The most common manifestation of endometrial cancer is abnormal uterine blee
l l l l l l l l l l l
ding, including postmenopausal bleeding and bleeding between normal periods in pr
l l l l l l l l l l
emenopausal women. l
10…A nurse is giving a presentation to a community group about preventing atherosc
l l l l l l l l l l l l
lerosis. Which of the following should the nurse include as a modifiablerisk factor for t
l l l l l l l l l l l l l l l
his disorder? (Select all that apply.)
l l l l l
Hypercholesterolemia l
Hypertension
Obesity l
Smoking
11…A nurse is admitting a client who has active tuberculosis to a room on a medical-
l l l l l l l l l l l l l l l
surgical unit. Which of the following room assignments should the nursemake for the
l l l l l l l l l l l l l l
client?
A room with air exhaust directly to the outdoor environment
l l l l l l l l l
, Rational
A room with air exhaust directly to the outside environment eliminates contaminati
l l l l l l l l l l l
on of other client-
l l l
care areas. This type of ventilation system isreferred to as an airborne infection isolati
l l l l l l l l l l l l l l
on room. l
12…A nurse is caring for a client who has Cushing's syndrome. Which of the following int
l l l l l l l l l l l l l l l
erventions should the nurse expect to perform? (Select all that apply.)Assess blood gluc
l l l l l l l l l l l l l
ose level l
Assess for neck vein distention l l l l
Incorrect. Monitor for an irregular heart rateIncorre l l l l l l l
ct. Monitor for postural hypotension Weigh the clie
l l l l l l l
nt daily l
13…A nurse is teaching a client about risk factors for osteoporosis. Which of thefollowi
l l l l l l l l l l l l l l
ng factors should the nurse include in the teaching? (Select all that apply.)
l l l l l l l l l l l l
Sedentary lifestyle l l
Incorrect. Obesity l l
Aging
Caffeine intake Sec l l
ondhand smoke l
Sedentary lifestyle is correct. Immobility depletes bone. l l l l l l
Obesity is incorrect. Women who are obese have a greater capacity for storingestrogen
l l l l l l l l l l l l l l
to help maintain acceptable levels of calcium.
l l l l l l
Aging is correct. Women lose bone due to estrogen depletion after menopause.Caffe
l l l l l l l l l l l l
ine intake is correct. Excessive caffeine intake causes calcium loss in the urine.
l l l l l l l l l l l l
Secondhand smoke is correct. Smoking is a risk factor for osteoporosis, bothactive an l l l l l l l l l l l l l
d passive (secondhand) smoking.
l l l
14…A nurse is caring for a client who has a history of exposure to TB and symptoms of n
l l l l l l l l l l l l l l l l l l
ight sweats and hemoptysis. Which of the following tests should the nurse realize is th
l l l l l l l l l l l l l l
e most reliable to confirm the diagnosis of active pulmonaryTB?
l l l l l l l l l l
Sputum culture for acid- l l l
fast bacillusRational l l
