NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
M e d S urge Q u i z 1 - 36 37 38 39
1. A n u r s e is a d m i t t i n g a p a t i en t with a n i m m u n o d e f i c i e n c y to t h e m e d i c a l
u n i t . In p l a n n i n g t h e c a r e o f t h i s p a t i e n t , t h e n u r s e s h o u l d a s s e s s f o r w h a t
c o m m o n s i g n of i m m u n o d e f i c i e n c y?
a. C h r o n i c d i a r r h e a
2. A n u r s e is c a r i n g for a p a t i en t w h o h a s a n i m m u n o d e f i c i e n c y . W h a t
a s s e s s m e n t finding sh o u ld p r o m p t th e n u r s e to con side r t h e possibility
that the patient is de v el o pi n g a n infection?
a. P e r s i s t e n t d i a r r h e a
3. T h e n u r s e is a p p l y i n g s t a n d a r d p r e c a u t i o n s in t h e c a r e of a p a ti e nt w h o
h a s a n i mmu n od e fic ienc y. W h a t ar e k e y e l e m e n t s of st an d a r d
p re c au t i on s ? S e l e c t all t hat a p p l y .
a. U s i n g a p p r o p r i a t e p e r s o n a l p r o t e c t i v e e q u i p m e n t
b. U s i n g s a f e i n j e c t i o n p r a c t i c e s
c. P e r f o r m i n g h a n d h y g i e n e
4. A h o m e h e a l t h n u r s e i s r e i n f o r c i n g h e a l t h e d u c a t i o n w i t h a p a t i e n t w h o
is i mmun o sup pr ess ed an d his family. What statement best su g g e st s that
the patient h a s u n d e r s t o o d t h e n u r s e ' s t e a c h i n g ?
a. “ M y f a m i l y n e e d s t o u n d e r s t a n d t h a t I'll p r o b a b l y
n eed lifelong treatment.”
5. T h e n u r s e is p r e p a r i n g to ad m i n i s t e r IVIG t o a p a t i e nt w h o
h a s an immunodeficiency. What nursing guideline should
the nurse apply?
a. A d m i n i s t e r p r e t r e a t m e n t m e d i c a t i o n s a s o r d e r e d 3 0
minutes prior to infusion.
6. A n u r s e h a s c r e a t e d a p l a n of c a r e for a n i m m u n o d e f i c i e n t p at ien t ,
speci fyi n g that ca r e providers t a ke the patient's puls e a n d respiratory
r a t e f o r a f u ll m i n u t e . W h a t i s t h e r a t i o n a l e f o r t h i s a s p e c t o f c a r e ?
a. T h e s e p a t i e n t s ' b l u n t e d i n f l a m m a t o r y r e s p o n s e s c a n
cau se subtle ch an ge s in status.
7. A n u r s e is p r o v id i n g h e a l t h e d u c at i o n r e g a r d i n g s e lf - c a r e to a p a t ien t
with a n immun od efi c i enc y . W h at te a c h in g point sho u ld t he n u r s e
emphasize?
a. T h e n e e d f o r t h o r o u g h o r a l h y g i e n e
8. A p a t ien t ' s p r i m a r y i m m u n o d e f i c i e n c y d i s e a s e is c h a r a c t e r i z e d b y t h e
inab ility of w h i t e bl o o d c el l s to initiate a n i n f l a m m a t o r y r e s p o n s e to
infectious o r g a n i s m s . W h a t is this patien t's m o s t likely d i agn o si s ?
a. H y p e r i m m u n o g l o b u l i n e m i a E s y n d r o m e
9. A n u r s e is w o r k i n g wi t h a p a t i en t w h o w a s d i a g n o s e d wit h H I V s e v e r a l
m o n t h s earlier. T h e nur s e sho uld r e co g ni z e that a patient with HIV is
cons ide red to h a v e A I D S at the point w h e n th e C D 4 + T - l ym p h o cyt e cell
coun t dro ps below wh at threshold?
a. 2 0 0 c e l l s / m m 3 o f b l o o d
10. A patient h a s b e e n d i a gn o s ed with A I D S com plic at ed b y chronic
d i a r r h e a . W h a t n u r s i n g in t e r ve n t ion w o u l d b e ap p r o p r i a t e for th is
patient?
a. O b t a i n a s t o o l c u l t u r e t o i d e n t i f y p o s s i b l e p a t h o g e n s .
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
11. A n 1 8- y e a r - o l d p r e g n a n t f e m a l e h a s t e s t e d po si t ive for H I V a n d
a s k s t h e n u r s e if h e r b a b y i s g o i n g t o b e b o r n w i t h H I V . W h a t i s t h e
nurse's best response?
a. “ I t ' s p o s s i b l e t h a t y o u r b a b y c o u l d c o n t r a c t H I V ,
either before, during, or after delivery.”
12. S i n c e t h e e m e r g e n c e of H I V / A I D S , t h e r e h a v e b e e n s i g n i f i c a n t
c h a n g e s in e p i d e m i o l o g i c t r e n d s . M e m b e r s o f w h a t g r o u p c u r r e n t l y
h a v e the gr eat e st risk of contracting HIV?
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
a. G a y , b i s e x u a l , a n d o t h e r m e n w h o h a v e s e x w i t h m e n
13. A hospital patient is i m m u n o c o m p r o m i s e d b e c a u s e of s t a g e 3
HI V infection a n d the p hy sic i a n h a s o rd ered a ch e s t rad io grap h. H o w
should the n u r se m o s t sa fely facilitate th e test?
a. A r r a n g e f o r a p o r t a b l e x - r a y m a c h i n e t o b e u s e d
14. A patien t's cu rrent antiretroviral r e g i m e n in c lu d es n u cl eo si d e
r e v e r s e t r a n s c r i p t a s e i n h i b i t o r s ( N R T I s ) . W h a t d i e t a r y c o u n s e l i n g wi ll
the nurse provide b a s e d on the patient's medicatio n regimen?
a. T a k e t h i s m e d i c a t i o n w i t h o u t r e g a r d t o m e a l s .
15. A n u r s e is p e rf o rm i n g t h e a d m i s s i o n a s s e s s m e n t of a p atient w h o
h a s AID S. W h at co m p on e n t s should the nur se include in this
c o m p r e h e n s i v e a s s e s s m e n t ? S e l e c t all that a p p l y .
a. C u r r e n t m e d i c a t i o n r e g i m e n
b. I d e n t i f i c a t i o n o f p a t i e n t ' s s u p p o r t s y s t e m
c. I m m u n e s y s t e m f u n c t i o n
d. H i s t o r y o f s e x u a l p r a c t i c e s
16. A p at i en t is in t h e p r i m a r y in f ect ion s t a g e of H I V . W h a t is t ru e of th i s
patient's cur r en t h e a l t h s ta t u s ?
a. T h e p a t i e n t i s i n f e c t e d w i t h H I V b u t l a c k s H I V - s p e c i f i c
antibodies.
17. A n u r s e is a w a r e of t h e n e e d to a s s e s s patients' risks for
anaphylaxis. What health care procedure constitutes the highest risk
for a n a p h y l a x i s ?
a. C o m p u t e d t o m o g r a p h y w i t h c o n t r a s t s o l u t i o n
18. A patient with multiple food a n d envi r o n me n t al allergies tells the
n u r s e tha t h e is fru strated a n d a n g r y a b o u t h a v i n g to b e s o wa t ch f u l all
t h e t i m e a n d w o n d e r s if it i s r e a l l y w o r t h it. W h a t w o u l d b e t h e n u r s e ' s
best response?
a. “ I c a n o n l y i m a g i n e h o w y o u f e e l . W o u l d y o u l i k e t o t a l k
a b o u t it?
19. A n u r s e i s c a r i n g fo r a p a t i e n t w h o h a s a l l e r g i c r h i n i t i s . W h a t
intervention would b e m o s t likely to help the patient m e e t th e go a l of
improved breathing pattern?
a. M o d i f y t h e e n v i r o n m e n t t o r e d u c e t h e s e v e r i t y o f a l l e r g i c
symptoms.
20. T h e nu r s e in a n allergy clinic is ed u c a t i n g a n e w patient abo ut th e
path ology of t h e patient's he a lt h p ro b le m . W h a t r e s p o n s e sh ou l d t he
nu r se descr ib e a s a possible c o n s e q u e n c e of hist a mine release?
a. C o n t r a c t i o n o f b r o n c h i a l s m o o t h m u s c l e
21. A patient h a s pre sen ted with sig ns a n d s y m p t o m s that are
con s i st en t with c on t a ct d erm at itis. W h a t a s p e c t of c a r e s h o u l d th e nu r s e
prioritize w h e n w o r k i n g with this patien t ?
a. I d e n t i f y i n g t h e o f f e n d i n g a g e n t , i f p o s s i b l e
22. A pa ti en t' s r h e u m a t o i d arthritis ( R A ) h a s fail ed to r e s p o n d
a p p r e c i a b l y t o f i r st - l i n e t r e a t m e n t s a n d t h e p r i m a r y c a r e p r o v i d e r h a s
a d d e d p r e d n i s o n e t o t h e p a t i e n t ' s d r u g r e g i m e n . W h a t p r i n c i p l e wil l
gu id e this a s p e ct of the patient's treatment?
a. T h e d r u g s h o u l d b e u s e d f o r a s s h o r t a t i m e a s
possible.
23. A pa tient with S L E h a s c o m e to th e clinic for a routine ch e c k - u p .
W h e n auscultating the patient's apical heart rate, the nurs e notes the
p r e s e n c e of a distinct “ s cr a t ch i n g ” s o u n d . W h a t is th e n u r s e ' s m o s t
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
appropriate action?
a. I n f o r m t h e p r i m a r y c a r e p r o v i d e r t h a t a f r i c t i o n r u b m a y
be present.
24. A n u r s e is ed u c at i n g a patient with g o u t ab o u t lifestyle
modi ficat ions that c a n h e l p control th e s i g n s a n d s y m p t o m s of the
disease. What recommendation should the nurse ma ke ?
a. L i m i t i n g i n t a k e o f a l c o h o l
M e d S urge Q u i z 1 - 36 37 38 39
1. A n u r s e is a d m i t t i n g a p a t i en t with a n i m m u n o d e f i c i e n c y to t h e m e d i c a l
u n i t . In p l a n n i n g t h e c a r e o f t h i s p a t i e n t , t h e n u r s e s h o u l d a s s e s s f o r w h a t
c o m m o n s i g n of i m m u n o d e f i c i e n c y?
a. C h r o n i c d i a r r h e a
2. A n u r s e is c a r i n g for a p a t i en t w h o h a s a n i m m u n o d e f i c i e n c y . W h a t
a s s e s s m e n t finding sh o u ld p r o m p t th e n u r s e to con side r t h e possibility
that the patient is de v el o pi n g a n infection?
a. P e r s i s t e n t d i a r r h e a
3. T h e n u r s e is a p p l y i n g s t a n d a r d p r e c a u t i o n s in t h e c a r e of a p a ti e nt w h o
h a s a n i mmu n od e fic ienc y. W h a t ar e k e y e l e m e n t s of st an d a r d
p re c au t i on s ? S e l e c t all t hat a p p l y .
a. U s i n g a p p r o p r i a t e p e r s o n a l p r o t e c t i v e e q u i p m e n t
b. U s i n g s a f e i n j e c t i o n p r a c t i c e s
c. P e r f o r m i n g h a n d h y g i e n e
4. A h o m e h e a l t h n u r s e i s r e i n f o r c i n g h e a l t h e d u c a t i o n w i t h a p a t i e n t w h o
is i mmun o sup pr ess ed an d his family. What statement best su g g e st s that
the patient h a s u n d e r s t o o d t h e n u r s e ' s t e a c h i n g ?
a. “ M y f a m i l y n e e d s t o u n d e r s t a n d t h a t I'll p r o b a b l y
n eed lifelong treatment.”
5. T h e n u r s e is p r e p a r i n g to ad m i n i s t e r IVIG t o a p a t i e nt w h o
h a s an immunodeficiency. What nursing guideline should
the nurse apply?
a. A d m i n i s t e r p r e t r e a t m e n t m e d i c a t i o n s a s o r d e r e d 3 0
minutes prior to infusion.
6. A n u r s e h a s c r e a t e d a p l a n of c a r e for a n i m m u n o d e f i c i e n t p at ien t ,
speci fyi n g that ca r e providers t a ke the patient's puls e a n d respiratory
r a t e f o r a f u ll m i n u t e . W h a t i s t h e r a t i o n a l e f o r t h i s a s p e c t o f c a r e ?
a. T h e s e p a t i e n t s ' b l u n t e d i n f l a m m a t o r y r e s p o n s e s c a n
cau se subtle ch an ge s in status.
7. A n u r s e is p r o v id i n g h e a l t h e d u c at i o n r e g a r d i n g s e lf - c a r e to a p a t ien t
with a n immun od efi c i enc y . W h at te a c h in g point sho u ld t he n u r s e
emphasize?
a. T h e n e e d f o r t h o r o u g h o r a l h y g i e n e
8. A p a t ien t ' s p r i m a r y i m m u n o d e f i c i e n c y d i s e a s e is c h a r a c t e r i z e d b y t h e
inab ility of w h i t e bl o o d c el l s to initiate a n i n f l a m m a t o r y r e s p o n s e to
infectious o r g a n i s m s . W h a t is this patien t's m o s t likely d i agn o si s ?
a. H y p e r i m m u n o g l o b u l i n e m i a E s y n d r o m e
9. A n u r s e is w o r k i n g wi t h a p a t i en t w h o w a s d i a g n o s e d wit h H I V s e v e r a l
m o n t h s earlier. T h e nur s e sho uld r e co g ni z e that a patient with HIV is
cons ide red to h a v e A I D S at the point w h e n th e C D 4 + T - l ym p h o cyt e cell
coun t dro ps below wh at threshold?
a. 2 0 0 c e l l s / m m 3 o f b l o o d
10. A patient h a s b e e n d i a gn o s ed with A I D S com plic at ed b y chronic
d i a r r h e a . W h a t n u r s i n g in t e r ve n t ion w o u l d b e ap p r o p r i a t e for th is
patient?
a. O b t a i n a s t o o l c u l t u r e t o i d e n t i f y p o s s i b l e p a t h o g e n s .
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
11. A n 1 8- y e a r - o l d p r e g n a n t f e m a l e h a s t e s t e d po si t ive for H I V a n d
a s k s t h e n u r s e if h e r b a b y i s g o i n g t o b e b o r n w i t h H I V . W h a t i s t h e
nurse's best response?
a. “ I t ' s p o s s i b l e t h a t y o u r b a b y c o u l d c o n t r a c t H I V ,
either before, during, or after delivery.”
12. S i n c e t h e e m e r g e n c e of H I V / A I D S , t h e r e h a v e b e e n s i g n i f i c a n t
c h a n g e s in e p i d e m i o l o g i c t r e n d s . M e m b e r s o f w h a t g r o u p c u r r e n t l y
h a v e the gr eat e st risk of contracting HIV?
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
a. G a y , b i s e x u a l , a n d o t h e r m e n w h o h a v e s e x w i t h m e n
13. A hospital patient is i m m u n o c o m p r o m i s e d b e c a u s e of s t a g e 3
HI V infection a n d the p hy sic i a n h a s o rd ered a ch e s t rad io grap h. H o w
should the n u r se m o s t sa fely facilitate th e test?
a. A r r a n g e f o r a p o r t a b l e x - r a y m a c h i n e t o b e u s e d
14. A patien t's cu rrent antiretroviral r e g i m e n in c lu d es n u cl eo si d e
r e v e r s e t r a n s c r i p t a s e i n h i b i t o r s ( N R T I s ) . W h a t d i e t a r y c o u n s e l i n g wi ll
the nurse provide b a s e d on the patient's medicatio n regimen?
a. T a k e t h i s m e d i c a t i o n w i t h o u t r e g a r d t o m e a l s .
15. A n u r s e is p e rf o rm i n g t h e a d m i s s i o n a s s e s s m e n t of a p atient w h o
h a s AID S. W h at co m p on e n t s should the nur se include in this
c o m p r e h e n s i v e a s s e s s m e n t ? S e l e c t all that a p p l y .
a. C u r r e n t m e d i c a t i o n r e g i m e n
b. I d e n t i f i c a t i o n o f p a t i e n t ' s s u p p o r t s y s t e m
c. I m m u n e s y s t e m f u n c t i o n
d. H i s t o r y o f s e x u a l p r a c t i c e s
16. A p at i en t is in t h e p r i m a r y in f ect ion s t a g e of H I V . W h a t is t ru e of th i s
patient's cur r en t h e a l t h s ta t u s ?
a. T h e p a t i e n t i s i n f e c t e d w i t h H I V b u t l a c k s H I V - s p e c i f i c
antibodies.
17. A n u r s e is a w a r e of t h e n e e d to a s s e s s patients' risks for
anaphylaxis. What health care procedure constitutes the highest risk
for a n a p h y l a x i s ?
a. C o m p u t e d t o m o g r a p h y w i t h c o n t r a s t s o l u t i o n
18. A patient with multiple food a n d envi r o n me n t al allergies tells the
n u r s e tha t h e is fru strated a n d a n g r y a b o u t h a v i n g to b e s o wa t ch f u l all
t h e t i m e a n d w o n d e r s if it i s r e a l l y w o r t h it. W h a t w o u l d b e t h e n u r s e ' s
best response?
a. “ I c a n o n l y i m a g i n e h o w y o u f e e l . W o u l d y o u l i k e t o t a l k
a b o u t it?
19. A n u r s e i s c a r i n g fo r a p a t i e n t w h o h a s a l l e r g i c r h i n i t i s . W h a t
intervention would b e m o s t likely to help the patient m e e t th e go a l of
improved breathing pattern?
a. M o d i f y t h e e n v i r o n m e n t t o r e d u c e t h e s e v e r i t y o f a l l e r g i c
symptoms.
20. T h e nu r s e in a n allergy clinic is ed u c a t i n g a n e w patient abo ut th e
path ology of t h e patient's he a lt h p ro b le m . W h a t r e s p o n s e sh ou l d t he
nu r se descr ib e a s a possible c o n s e q u e n c e of hist a mine release?
a. C o n t r a c t i o n o f b r o n c h i a l s m o o t h m u s c l e
21. A patient h a s pre sen ted with sig ns a n d s y m p t o m s that are
con s i st en t with c on t a ct d erm at itis. W h a t a s p e c t of c a r e s h o u l d th e nu r s e
prioritize w h e n w o r k i n g with this patien t ?
a. I d e n t i f y i n g t h e o f f e n d i n g a g e n t , i f p o s s i b l e
22. A pa ti en t' s r h e u m a t o i d arthritis ( R A ) h a s fail ed to r e s p o n d
a p p r e c i a b l y t o f i r st - l i n e t r e a t m e n t s a n d t h e p r i m a r y c a r e p r o v i d e r h a s
a d d e d p r e d n i s o n e t o t h e p a t i e n t ' s d r u g r e g i m e n . W h a t p r i n c i p l e wil l
gu id e this a s p e ct of the patient's treatment?
a. T h e d r u g s h o u l d b e u s e d f o r a s s h o r t a t i m e a s
possible.
23. A pa tient with S L E h a s c o m e to th e clinic for a routine ch e c k - u p .
W h e n auscultating the patient's apical heart rate, the nurs e notes the
p r e s e n c e of a distinct “ s cr a t ch i n g ” s o u n d . W h a t is th e n u r s e ' s m o s t
, NUR 4500 All Med Surge Exams and Quizzes MedSurge Quiz 1 - 36 37 38 39
appropriate action?
a. I n f o r m t h e p r i m a r y c a r e p r o v i d e r t h a t a f r i c t i o n r u b m a y
be present.
24. A n u r s e is ed u c at i n g a patient with g o u t ab o u t lifestyle
modi ficat ions that c a n h e l p control th e s i g n s a n d s y m p t o m s of the
disease. What recommendation should the nurse ma ke ?
a. L i m i t i n g i n t a k e o f a l c o h o l
