Medsurg Iggy Final Exam 2025
Prior to the administration of Mannitol the nurse should:
a. insert an indwelling urinary catheter
b. administer a barbituate
c. check an apical pulse
d. check BUN and creatine levels - ANSWER- A. insert an indwelling catheter
A nurse is assessing a patient diagnosed with a brain tumor. Which S/S would the nurse
expect:
a. dysphagia
b. positive Homan's sign
c. vertigo
d. increased blood pressure
e. positive Babinski sign - ANSWER- a. dysphagia
c. vertigo
e. positive babinksi sign
The nurse is monitoring a patient with increased intracranial pressure (ICP). What
assessment change is the highest priority?
a. complains of headache
b. aphasia
c. slurring speech
d. constricted and nonreactive pupils - ANSWER- d. constricted and nonreactive pupils
A patient is having a blood transfusion reaction. What must the nurse do in order in
priority first to last?
1. notify the healthcare provider and blood bank
2. complete an appropriate documention
3. stop the transfusion
4.keep the IV open with normal saline infusion - ANSWER- 3, 4, 1, 2
Which respiratory pattern indicated intracranial pressure in the brain?
a. rapid, shallow respirations
b. nasal flaring
c. asymmetric chest excursion
d. slow, irregular respirations - ANSWER- d. slow irregular respirations
The nurse is caring for four patients. Which patient should the nurse assess first?
a. a 34 year old with non productive cough and oxygen saturation of 93%
,b. a 42 year patient with the tibial cast and complains of itching
c. a 20 year old patient with complaints of severe headache and photophobia
d. a post surgical 55year old patient with complaints of 7/10 pain - ANSWER- c. a 20
year old patient with complaints of severe headache and photophobia
When communicating with a patient who has aphasia, which approach is helpful?
a. present one idea at the time
b. avoid writing messages
c. speak loudly
d. only use "yes and "no" questions - ANSWER- a. present one idea at the time
A patient with iron deficiency anemia is having trouble selecting food from the hospital
menu. Which foods should the nurse suggest to meet the patients needs for iron? select
all that apply.
a. white rice
b. prunes
c. eggs
d. leafy green vegetables
e. red meat - ANSWER- c. eggs
d. leafy green vegetables
e. red meat
A nurse is assessing a patient and the following S/S are noted: pallor, jaundice,
glossitis, fatigue and weight loss. What should the nurse further assess?
a. adventitious breath sounds
b. temperature of 98.6 F
c. oxygen saturation level of 95%
d. any s/s of paresthesia - ANSWER- d. any s/s of paresthesia
What is the name and function of cranial nerve II?
a. optic and central and peripheral vision
b. trochlear and eye movement
c. vagus and pain and temperature from ear
d. hypoglossal and skeletal muscles of the tongue - ANSWER- a. optic and central and
peripheral vision
The nurse is assigned to care for a patient with complete right-sided hemiparesis from a
stroke. Which characteristics are associated with this condition? Select all that apply.
a. the patient is capable to ambulate independently
b. the patient has weakness on the right side of the face and tongue
,c. the patient has weakness on the right side of the body
d. the patient has complete bilateral paralysis of the arms and legs
e. the patient is aphasic - ANSWER- b. the patient has weakness on the right side of the
face and tongue
c. the patient has weakness on the right side of the body
e. the patient is aphasic
The patient with idiopathic thrombocytopenia purpura (ITP) asks the nurse why it is
necessary to take steroids. The nurse should base the response on which information?
a. steroids destroy the antibodies and prolong the life of platelets
b. steroids alter the spleens recognition of platelets and increase the life of platelets
c. steroids neutralize the antigens and prolong life of platelets
d. steroids increase phagocytosis and increase the life of platelets - ANSWER- b.
steroids alter the spleens recognition of platelets and increase the life of platelets
Which is a common sign of PV (polycythemia vera)?
a. stasis ulcers
b. jaundice
c. pruritus
d. impaired gait - ANSWER- c. pruritus
A patient is experiencing a sickle cell crisis and hypotonic solution is ordered to infuse at
250ml/hr for 4 hours. What is an expected outcome for hydration therapy?
a. to increase blood pressure and pulse
b. to reduce duration of the pain episode
c. to promote an adequate gas exchange
d. to increase circulation in the extremities - ANSWER- b. to reduce duration of the pain
episode
A nurse receives an order to administer IV alteplase to the patient experiencing stroke.
Vital signs for the patient as follows: 97.0-100-185/110-22
a. administer warfarin sodium instead
b. hold the medication and notify the provider
c. administer medication as ordered
d. administer propranolol because it is much safer - ANSWER- b. hold the medication
and notify the provider
The nurse is creating a plan of care for the patient with multiple myeloma and includes
which priority intervention in the plan?
a. encouraging fluids
, b. coughing and deep breathing
c. providing frequent oral care
d. monitoring the red blood cell count - ANSWER- a. encouraging fluids
A patient is experiencing increased intracranial pressure (ICP). which s/s would a
patient exhibit? Select all that apply.
a. tachycardia
b. dilated and nonreactive pupils
c. aphasia
d. decreased level of consciousness
e. hypotension - ANSWER- b. dilated and nonreactive pupils
c. aphasia
d. decreased level of conciousness
The nurse admits a patient who is in sickle cell crisis. The nurse should prepare for
which intervention as a priority in the management of the patient?
a. IV therapy
b. oxygen administration
c. blood transfusion
d. pain management with an opioid - ANSWER- b. oxygen administration
A nurse is educating a patient with carotid stent placement. Which statement by the
patient indicates understanding of the teaching?
a. "I won't be able to speak for a while"
b. "I will let my doctor know if cam weak and can't do my daily routine"
c. "A little headache is ok"
d. "My wife will be changing dressing weekly" - ANSWER- b. "I will let my doctor know if
cam weak and can't do my daily routine"
For which early post craniotomy complication should the nurse monitor the patient for?
a. hydrocephalus
b. seizures
c. dehydration
d. meningitis - ANSWER- a. hydrocephalus
An elderly patient diagnosed with Alzheimer's disease wanders the halls of the locked
nursing unit during the day. To ensure the patients safety while walking in the halls,
what should the nurse do?
a. administer PRN haloperidol to decrease the need to walk
b. restrain the patient in a geriatric chair
Prior to the administration of Mannitol the nurse should:
a. insert an indwelling urinary catheter
b. administer a barbituate
c. check an apical pulse
d. check BUN and creatine levels - ANSWER- A. insert an indwelling catheter
A nurse is assessing a patient diagnosed with a brain tumor. Which S/S would the nurse
expect:
a. dysphagia
b. positive Homan's sign
c. vertigo
d. increased blood pressure
e. positive Babinski sign - ANSWER- a. dysphagia
c. vertigo
e. positive babinksi sign
The nurse is monitoring a patient with increased intracranial pressure (ICP). What
assessment change is the highest priority?
a. complains of headache
b. aphasia
c. slurring speech
d. constricted and nonreactive pupils - ANSWER- d. constricted and nonreactive pupils
A patient is having a blood transfusion reaction. What must the nurse do in order in
priority first to last?
1. notify the healthcare provider and blood bank
2. complete an appropriate documention
3. stop the transfusion
4.keep the IV open with normal saline infusion - ANSWER- 3, 4, 1, 2
Which respiratory pattern indicated intracranial pressure in the brain?
a. rapid, shallow respirations
b. nasal flaring
c. asymmetric chest excursion
d. slow, irregular respirations - ANSWER- d. slow irregular respirations
The nurse is caring for four patients. Which patient should the nurse assess first?
a. a 34 year old with non productive cough and oxygen saturation of 93%
,b. a 42 year patient with the tibial cast and complains of itching
c. a 20 year old patient with complaints of severe headache and photophobia
d. a post surgical 55year old patient with complaints of 7/10 pain - ANSWER- c. a 20
year old patient with complaints of severe headache and photophobia
When communicating with a patient who has aphasia, which approach is helpful?
a. present one idea at the time
b. avoid writing messages
c. speak loudly
d. only use "yes and "no" questions - ANSWER- a. present one idea at the time
A patient with iron deficiency anemia is having trouble selecting food from the hospital
menu. Which foods should the nurse suggest to meet the patients needs for iron? select
all that apply.
a. white rice
b. prunes
c. eggs
d. leafy green vegetables
e. red meat - ANSWER- c. eggs
d. leafy green vegetables
e. red meat
A nurse is assessing a patient and the following S/S are noted: pallor, jaundice,
glossitis, fatigue and weight loss. What should the nurse further assess?
a. adventitious breath sounds
b. temperature of 98.6 F
c. oxygen saturation level of 95%
d. any s/s of paresthesia - ANSWER- d. any s/s of paresthesia
What is the name and function of cranial nerve II?
a. optic and central and peripheral vision
b. trochlear and eye movement
c. vagus and pain and temperature from ear
d. hypoglossal and skeletal muscles of the tongue - ANSWER- a. optic and central and
peripheral vision
The nurse is assigned to care for a patient with complete right-sided hemiparesis from a
stroke. Which characteristics are associated with this condition? Select all that apply.
a. the patient is capable to ambulate independently
b. the patient has weakness on the right side of the face and tongue
,c. the patient has weakness on the right side of the body
d. the patient has complete bilateral paralysis of the arms and legs
e. the patient is aphasic - ANSWER- b. the patient has weakness on the right side of the
face and tongue
c. the patient has weakness on the right side of the body
e. the patient is aphasic
The patient with idiopathic thrombocytopenia purpura (ITP) asks the nurse why it is
necessary to take steroids. The nurse should base the response on which information?
a. steroids destroy the antibodies and prolong the life of platelets
b. steroids alter the spleens recognition of platelets and increase the life of platelets
c. steroids neutralize the antigens and prolong life of platelets
d. steroids increase phagocytosis and increase the life of platelets - ANSWER- b.
steroids alter the spleens recognition of platelets and increase the life of platelets
Which is a common sign of PV (polycythemia vera)?
a. stasis ulcers
b. jaundice
c. pruritus
d. impaired gait - ANSWER- c. pruritus
A patient is experiencing a sickle cell crisis and hypotonic solution is ordered to infuse at
250ml/hr for 4 hours. What is an expected outcome for hydration therapy?
a. to increase blood pressure and pulse
b. to reduce duration of the pain episode
c. to promote an adequate gas exchange
d. to increase circulation in the extremities - ANSWER- b. to reduce duration of the pain
episode
A nurse receives an order to administer IV alteplase to the patient experiencing stroke.
Vital signs for the patient as follows: 97.0-100-185/110-22
a. administer warfarin sodium instead
b. hold the medication and notify the provider
c. administer medication as ordered
d. administer propranolol because it is much safer - ANSWER- b. hold the medication
and notify the provider
The nurse is creating a plan of care for the patient with multiple myeloma and includes
which priority intervention in the plan?
a. encouraging fluids
, b. coughing and deep breathing
c. providing frequent oral care
d. monitoring the red blood cell count - ANSWER- a. encouraging fluids
A patient is experiencing increased intracranial pressure (ICP). which s/s would a
patient exhibit? Select all that apply.
a. tachycardia
b. dilated and nonreactive pupils
c. aphasia
d. decreased level of consciousness
e. hypotension - ANSWER- b. dilated and nonreactive pupils
c. aphasia
d. decreased level of conciousness
The nurse admits a patient who is in sickle cell crisis. The nurse should prepare for
which intervention as a priority in the management of the patient?
a. IV therapy
b. oxygen administration
c. blood transfusion
d. pain management with an opioid - ANSWER- b. oxygen administration
A nurse is educating a patient with carotid stent placement. Which statement by the
patient indicates understanding of the teaching?
a. "I won't be able to speak for a while"
b. "I will let my doctor know if cam weak and can't do my daily routine"
c. "A little headache is ok"
d. "My wife will be changing dressing weekly" - ANSWER- b. "I will let my doctor know if
cam weak and can't do my daily routine"
For which early post craniotomy complication should the nurse monitor the patient for?
a. hydrocephalus
b. seizures
c. dehydration
d. meningitis - ANSWER- a. hydrocephalus
An elderly patient diagnosed with Alzheimer's disease wanders the halls of the locked
nursing unit during the day. To ensure the patients safety while walking in the halls,
what should the nurse do?
a. administer PRN haloperidol to decrease the need to walk
b. restrain the patient in a geriatric chair
